PowerPoint Presentation

Series 1: Meaningful Use for Behavioral Health Providers

1/2014Changes to Stage 1: Core Objective #10Clinical Quality Measures(required for Stage 1 reporting by 1/1/2014)

From the CIHS Video Series Ten Minutes at a Time

The Center for Medicaid/Medicare Services continues to refine the requirements for Meaningful Use, which includes some adjustments to the Core and Menu Objectives and Measures for Reporting in Stage 1. Most of the changes were optional in 2013 and then required in 2014. Some of the smaller changes were effective for the 2013 reporting period. 1Core Objective #10: Clinical Quality Measures (CQMs) Review, ended 12/31/2013Objective 10Report ambulatory clinical quality measures to CMS

Measure For 2011, provide aggregate numerator, denominator, and exclusions through attestation. For 2012, electronically submit the clinical quality measures

https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/stage1changestipsheet.pdf

The 2011-2013 requirements and specifications around Clinical Quality Measures in Meaningful Use Stage 1 are identified in Core Objective #10. Included here is a link to a CMS Stage 1 Changes Tipsheet that discusses this and other revisions to Stage 1 reporting requirements. https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/stage1changestipsheet.pdf

2Three Core CQMsNQF 0013 Hypertension Blood Pressure MeasurementNQF 0028 Preventative Care and Screening Measure PairNQF 0421 Adult Weight Screening and Follow Up Three Alternate Core CQMsMeasures for Core Objective #10Review, ended 12/31/2013NQF 0024 Weight Assessment and Counseling for Children and AdolescentsNQF 0038 Childhood Immunization StatusNQF 0041 Preventive Care and Screening: Influenza Immunization for Patients > 50 Years Old Three Additional CQMs Must Be SelectedSelect 3 from a list of 44

The EP was required to report on three Core CQMs. If one or more of these did not apply to their practice, they could select from any one of the three Alternate Core CQMs to fill the gap. They were also required to select and report on 3 Additional CQMs from a Menu set of CQMs. It is important to note that during Stage 1 the focus is on demonstrating the ABILITY to report on CQMs. If none of the Core and Additional CQMs were populated with data, it was acceptable to report 0 in the denominator. This continues to be the case.3Use Stage 2 schema for reporting on Clinical Quality Measures in Stage 1

Select 9 CQMs from a list of 64Core Objective #10 eliminatedCQM reporting now considered part of definition of Meaningful UseIf data is available, must report it. If not available, can still report 0 in denominator

Sources: http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/CQM_Through_2013.html Stage 1 Core Objective #10 Changes begin 1/1/2014

But beginning January 2014, the EP selects a total of 9 CQMs from a list of 64. This is a vastly simplified schema for reporting CQMs developed for Stage 2 and applied to Stage 1. Also, reporting on clinical quality measures is no longer considered a Core Objective. It has actually always been one of the practice standards that defines Meaningful Use and EPs already attest to their implementation of Meaningful Use. So, attesting to this activity a second time according to Core Objective #10 is redundant. Core Objective #10 was therefore removed from the list. But the reporting activity continues as a critical component of Meaningful Use.4Two levels of certification of the EHR itself Stage 1, and Stage 2Providers allowed to implement 2014 certified EHR edition for use in Stage 1, for the 2013 reporting year. There are 44 CQMs for Stage 1 but only 32 of these were carried into Stage 2.The 2014 certified EHR edition cant report on the 12 dropped CQMsOne of those CQMs is one of the three Core CQMs from Stage 1, so they cannot report on one of the three Core CQMs. They have to report on an Alternate Core CQM. Since they can report 0in the denominator, this was an acceptable solution. http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/2014_ClinicalQualityMeasures.html

Stage 1 Core Objective #10 Implications re: EHR Certification Level

There is a slight complication to this change that is related to the EHR certification level. The EHR can be certified to Stage 1 only, to both Stage 1 and Stage 2, and to Stage 2 only. Providers were allowed to adopt the Stage 2 edition in 2013, but this edition is not able to report on the Stage 1 CQM schema used until the end of 2013. This presented some challenges in terms of meeting the 2013 reporting requirements. This slide summarizes he workaround to this particular issue. If your situation happens to fall into this category, you should follow the link for more detail. But the information is presented here because without appropriate context, this guidance may confuse providers who are trying to determine what they need to do for Stage 1 in 2013, and Stage 1 in 2014.5We Have Solutions for Integrating Primary and Behavioral Healthcare

Contact CIHS for all types of primary and behavioral health care integration technical assistance and training needs

1701 K Street NW, Ste 400 Washington DC 20006

Web: www.integration.samhsa.govEmail:integration@thenationalcouncil.orgPhone:202-684-7457

Prepared and presented by Colleen ODonnell, MSW, PMP, CHTS-IM for the Center for Integrated Health Solutions

Our thanks go to SAMHSA and to HRSA for providing support to the Center for Integrated Health Solutions (CIHS) for this and many other forms of training and technical assistance related to the integration of primary and behavioral health care. Please visit our web site at www.integration.samhsa.gov, email us at integration@thenationalcouncil.org, or just pick up the phone and give us a call at 202-684-7547.

6