MU 2 Presentation 2014v2 final - TSI Healthcaretsihealthcare.com/.../05/MU-2-Presentation-2015v1.pdf ·

7/17/2015

1

“helping physicians and computers work better together”™

800.354.4205 | [email protected] | www.tsihealthcare.com

Meaningful Use Stage 2



Control PanelAudio Options:

This is a listen-only presentation

Audio by Phone

o Select “Use Telephone”

o Dial the provided number

o Follow voice prompts

o You will need to use the Access Code and Audio Pin

o The Code and Pin are unique to each attendee

Minimizing your Meeting Controls:o Meeting controls will minimize automatically

o To open & close controls, use the Orange arrow button

Raising your Hand:oIf you have been muted and would like to get the presenter’s attention, use the “Raise Hand” icon.

Asking Questions:o Questions can be asked using the Questions Panel on the

Meeting Controls

o We will attempt to answer all questions at the end of the session.

7/17/2015

2



Agenda

o Introduction to Meaningful Use (approx 30min) o Incentive Payments

o Requirements

o Changes from Stage 1

o Registration, Reporting, & Payments

o Tips for Success

o Reporting Requirements (approx 2 hours; 5min break) o Core Measures

o Menu Measures

o Clinical Quality Measures

o Questions (approx 10 min)



Goals

o General Understanding of the Stage 2

Meaningful Use program

o Understand the changes from Stage 1 to

Stage 2

o Understand Meaningful Use workflow

changes in NextGen 5.8 & KBM 8.3

7/17/2015

3



INTRODUCTION

The Long Road to Incentives



Introduction

o What is the EHR Incentive Program?

o Medicare or Medicaid bonuses for certain providers using

EHR technology

o Signed into law as part of the American Recovery and

Reinvestment Act of 2009

o Rules established by the Centers for Medicare and

Medicaid Services (CMS)

o Payment adjustments on Medicare Part B FFS will begin in

2015 for providers that have not successfully participated

in the program

7/17/2015

4



Introduction

o Is this the only CMS Quality Improvement Program?o There are other programs:

o Physician Quality Reporting System (PQRS)

o E-Prescribing (eRX) Incentive Program

o Each program has it’s own requirements, timelines, bonuses, and payment

adjustments

o Questions regarding PQRS and eRx incentives/penalties will not be answered

today. Feel free to contact [email protected] for additional

assistance.

**TODAY’S PRESENTATION: EHR Incentives Program**



Introduction

STAGE 1:

Data Capturing & Sharing

2 Years*

STAGE 2:

Patient Engagement and

Electronic Exchange of Info

2 years

STAGE 3:

Improved Outcomes

*Due to the postponement of Stage 2 MU, providers

that began MU in 2011 may have been in stage 1 for 3

years compared to 2 years

o How does the program work?o Consists of 3 stages w/ increased requirements

o 5 reporting periods, spread over 5 years (depending on initial reporting year)

o 1st reporting period: any 90 days in your first calendar year

o Providers attempting Meaningful Use for the first time in 2015 should attest by October 1st, 2015

o 2nd-5th reporting periods: Full Calendar Yearo Exception: in 2014 all providers reported on a 90 day quarter regardless of stage

7/17/2015

5



What’s My Status?o Remember: MU is a provider program. Some practices may have

providers in multiple stages. It’s important to determine each providers

status prior to beginning the reporting quarter.

My First MU Year: 2012

During 2015:

•You are on Stage 2

•You must report data

for the full year

•You may qualify for $4k

incentive

•You must attest this

year to avoid

2017penalties


During 2015:


•There are NEW Stage 2

measures that you

didn’t have to do in

Stage 1.


for the full year

•You may qualify for $8k

incentive


year to avoid 2017

penalties


During 2015:

•You are on Stage 1, year

2


for a full calendar year

•You must attest by the

beginning of 2016

•You may qualify for the

$8k incentive


year to avoid 2017

penalties


During 2015:



for any 90 day period

(does not have to be on

calendar quarter)

•You must ATTEST no

later than Oct 1st of this

year to avoid payment

adjustments in 2016.

•You do not qualify for

any incentive payment


year to avoid 2017

penalties



INCENTIVE PAYMENTS

Options To Earn Your Share

7/17/2015

6



Incentive AmountsMedicare Payment Breakdown

o Eligibilityo Non-hospital based providers, and must see 50% of patients at a practice or

practice(s) with an EHR systemo MD, DO, DDS, DPM, OD, DC

o Amount Stipulationso Bonus amount is based on year Meaningful Use is achieved using certified EHR

o Incentive payment is 75% of your Medicare allowed charges, up to a maximum capo For example, providers that started MU in 2012 must have billed more than $10,666 to

earn the full $8,000K in 2014



Incentive AmountsSequestration and the EHR Incentive Programs

o Incentive payments made through the Medicare Electronic Health Records (EHR) Incentive Program are subject to the mandatory reductions in federal spending known as sequestration, required by the Budget Control Act of 2011. Under these mandatory reductions, Medicare EHR incentive payments made to eligible professionals and eligible hospitals will be reduced by 2%. This 2% reduction will be applied to any Medicare EHR incentive payment for a reporting period that ends on or after April 1, 2013. If the final day of the reporting period occurs before April 1, 2013, those incentive payments will not be subject to the reduction.

o This reduction does not apply to Medicaid EHR incentive payments

7/17/2015

7



Incentive AmountsMedicaid Payment Breakdown

o Eligibility

o Minimum 30% Medicaid Patient Population (defined by each state)

o Physicians, Certified Nurse Midwives, Nurse Practitioners, and Physician Assistants

o PAs must be employed by a FQHC or RHC run by a PA

o Amount Stipulations

o Year 1- Must show providers have “Adopted, Implemented, or Updated” (AIU) a certified EHR

o Year 2 & Up- Must meet Meaningful Use Objectives



Incentive AmountsMedicare Penalties

o Failure to Participate

o If you don’t meet MU for the first time by October 1st, 2015, your Medicare reimbursements will be penalized in 2016

o If you don’t meet MU in consecutive years you will also be penalized.

o Penalties will increase 1% until schedule is reduced by 5%

o 2015: 1% reduction in Medicare fee schedule



o And so forth…

7/17/2015

8



INCENTIVE REQUIREMENTS

Certified EHR, Meaningful Use Objectives & Clinical Quality Measures



Incentives RequirementsCertified EHR

o EHRs must be certified to earn incentives

o NextGen™ EHR v5.8 KBM 8.3

Ambulatory EHRNextGen EHR v5.8+Behavioral Health

+Cardiovascular with Advanced Reporting

+Child Health

+Dermatology

7/17/2015

9



Incentives RequirementsCertified EHR

o What does this mean for your practice?

o Must upgrade to version 5.8 and KBM 8.3 prior to

beginning your Meaningful use reporting period

o Two Separate Upgrades:

o NextGen 5.8 – Application Version (EHR & EPM)

o KBM 8.3 – Clinical Templates (EHR Only)



Incentives RequirementsMeaningful Use

o What is Meaningful Use?

o Comprised of three measures groups:

o Core & Menu Objectives/Measures

o Focus on utilization of EHR, patient engagement, and

electronic exchange of health info

o Clinical Quality Measures

o Focus on Provider’s Clinical Performance

Meaningful Use

17 + 3 + 9 = MUCore

Measures

Menu

MeasuresCQMs

Meaningful

Use

7/17/2015

10



Incentives RequirementsCore & Menu Objectives

o Objective Setso 17 Core Objectives

o Required for all providerso Some core objectives have

exclusions

o 6 Menu Objectiveso Must choose 3 out of 6o Providers can choose objectives

based on existing workflowo Exclusions no longer count as

satisfying the measure unlessthere are no other measures that would apply

3 Core CQMs & 3 Menu

CQMs

Total 6 of 44 CQMs

3 Core CQMs & 3 Menu

CQMs

Total 6 of 44 CQMs

9CQMs

Covering 3 Strategy

Domains

Total 9 of 64 CQMs

9CQMs

Covering 3 Strategy

Domains

Total 9 of 64 CQMs



Incentives RequirementsMeaningful Use

o In addition to the Core & Menu Objectives, professionals must report on Clinical Quality Measures.o Clinical Quality Measures are different from the Core and

Menu Objectives

o There are no thresholds to meet, simply report data exactly as reported by your EHR

Meaningful Use

17 + 3 + 9 = MUCore

Measures

Menu

Measures

CQMs Meaningful

Use

7/17/2015

11



Incentives RequirementsClinical Quality Measures

o Things to remember:

o Must report on 9 out of the 64 possible CQMS

o 3 different National Quality Strategy Domain

o Our team will assist you in selecting measures & running

reports.

o There are no minimum values to achieve- You only have to

report on them.

o IMPORTANT NOTE: CQM’s will eventually become public data. This

means that patients will have the ability to view how the EPs are

providing additional clinical quality care to their patients.



Incentives RequirementsRecap of MU Stage 2 Changes

o Must be on 2014 Certified EHR Versiono Requires system upgrades

o New Objectives/Measures

o Exclusions for Menu Objectiveso No longer count towards your 3 items

o Updated clinical quality measures

o No Longer Utilize MU Crystal Reporto The summary report will be located in the HQM Module

o MU Check and CQM Check Templates

7/17/2015

12



REGISTRATION, ATTESTATION, &

PAYMENT

How Will CMS Know I’ve Achieved the Measures?



Registrationo Each provider must be registered. If you have any new providers you

must re-register the provider with your practice.o https://ehrincentives.cms.gov

o If you have not registered:o Email [email protected] and request to schedule a shadow session

o Items neededo National Provider Identifier (NPI)

o National Plan & Provider Enumeration System (NPPES) User ID and Password.o (Some practices call this the NPI log-in and password)

o Payee Tax Identification Numbero Last 4 SS #

o Group Tax ID

o Group NPI

7/17/2015

13



Attestation (Reporting) Process

o Each provider’s data must be submitted individually.

o To avoid Medicare Part B payment reductions in 2015 providers must have

reported by Oct 1st 2014 if it is their 1st year reporting, and meet Meaningful Use

for each consecutive year

o Providers that are not in their first reporting year have until the end of February

of the following year to submit data

o TSI Healthcare is happy to shadow your attestation. TSI Healthcare will not

shadow an attestation without first completing the pre-attestation call.



Payment Timing

o Incentives for each provider will be paid in a single,

consolidated, annual incentive payment.

o Payments will be made on a rolling basis, typically 4 to 12

weeks after attestation.

o ***Must meet Medicare Allowable minimums prior to receiving check

o Payments ARE taxable income.

7/17/2015

14



TIPS FOR SUCCESS

What We’ve Learned



Tips for SuccessEstablish a MU Team & Delegate Responsibilities

o Create a Team & Meet Often

o Create a Meaningful Use team comprised of a practice administrator and a clinical manager at a minimum.

o Meet weekly to review HQM Module reports and identify areas of improvement.

o Share with Your Entire Team

o Keep EVERYONE in the loop. Many of the objectives are workflow items for administrative staff, nurses, and medical assistants. Sharing everyone’s progress with the entire group encourages individual improvement.

o Save your documentation

o CMS can audit your practice up to 6 years after participation.

o It’s important for practices to retain supporting documentation that all measure requirements were satisfied. The practice is responsible for this not TSI Healthcare.

7/17/2015

15



Tips for SuccessPlan Aheado Establish a Time Line

o Setting an end-goal will help define how your team progresses through the process.

o Communicate with TSI Healthcare often and with advanced notice. We’re here to help.



Tips for Success

o Plan Ahead - Don’t Procrastinate

o There WILL be changes to your workflow with the new Stage 2

measures. Account for these changes when you plan your timeline.

o Contact TSI Healthcare as often as necessary

o Our Meaningful Use team is here to help with questions on reports,

reviewing progress, registration, and attestation.

o To ensure your team moves forward successfully, feel free to reach

out regularly. The resources are available… requesting assistance

ensures our team is aware of your plans and progress.

7/17/2015

16



What the lawyers make us say…o Eligibility for incentives is tied to adoption and “meaningful” use of certified EHR technology, which is

defined by the various agencies and offices of the US Federal Government. Incentive programs are part

of the American Recovery Act of 2009 and the HITECH Act of 2009 and are administered by such agencies

outlined therein and are subject to change. All questions as to the interpretation of ARRA, The HITECH

Act, other relevant rules, regulation, incentives programs, and/or their application to a specific practice,

provider or organization should be directed at the appropriate government agency. TSI Healthcare (TSI)

will attempt but does not guarantee to provide the necessary tools to achieve these requirements;

furthermore, the responsibility remains on the provider to successfully achieve and report on each

incentive payment. TSI does not administer incentive payments, guarantee eligibility, or guarantee the

accuracy or analysis of any statements of or about the program. TSI and its representatives have

provided guidance on current policy and does not present these findings as expert advice regarding

federal policies or their requirements. The opinions of this presenter are not necessarily the opinions of

TSI Healthcare.



MU Central & Route ICD -10

http://tsihealthcare.com/clientarea/

Password: success

http://www.tsihealthcare.com/mucentral

Password: success

Documents

MU 2 Presentation 2014v2 final - TSI Healthcaretsihealthcare.com/.../05/MU-2-Presentation-2015v1.pdf ·