Meaningful Use – Stage 2 Physician Office April, 2012
Credit Where Credit is Due
Terms
Contacts and Rules • Randi Terry, rterry@mhc.net • Joseph Cook, DO, jcook1@mhc.net • Avoid side conversations • Information available on http://www.munsonhealthcare.org/meaningful use
Our Observations Observations: 1. Opportunity for comment before final rules 2. Increased complexity a. Increased percentages b. Increased difficulty 3. Changed denominators 4. Impossible to meet without a patient portal 5. Increased focus on quality measurements 6. Increased integration Recommendations: 1. Submit comments and suggestions 2. Optimize current EHR functionality 3. Evaluate/implement a patient portal 4. Enhance skills with quality measurements/pay for performance 5. Carefully review "Final" rule when available
The Advisory Group – 10 Takeaways • Centers for Medicare & Medicaid Services (CMS) affirms a delay for 2011 attesters • Stage 1 requirements will be updated come 2013 (KMH and POMH) • Medicaid definitions are loosened; more providers are eligible • While the total number of objectives does not grow, Stage 2 measure complexity increases significantly • Information exchange will be key, but a health information exchange (HIE) will not be necessary. • Patients will need to act for providers to succeed • Sharing of health data will force real-time, high-quality data capture • More quality measures; CMS’ long term goals— electronic reporting and alignment with other reporting programs — remain intact. • The Office of the National Coordinator’s (ONC) sister rule proposes a more flexible certification process and greater utilization of standards • Payment adjustments begin in 2015
Public Comment
Great Resources
Years in Stage 1 and Stage 2
Penalty
EP – Who Qualifies
Who Receives the Money
Eligible - Medicaid Munson did get audited and if interested stay at the end to learn more
Stage 1 to Stage 2 Changes
Next Set of Slides
CPOE
e-RX
Demographics
Vital Signs
Smoking Status (The Advisory Group)
Clinical Decision Support
Lab Tests
Patient Lists
Patient Reminders
View, Download and Transmit
Clinical Summaries
Patient-Specific Education Resources
Secure Messaging
Medication Reconciliation
Summary of Care (AKA Transition of Care)
10% Problem
Transition of Care
Immunization
Privacy and Security Risk Analysis
Accessible Images
Family Health History
Syndromic Surveillance
Cancer Registries
Specialized Registries
Combined in Stage 2
Excluded from Stage 2
Group Reporting
Radiologist, Pathologist, etc.
Nice Summary
CQM - From Stage 1 to Stage 2
Quality Measures List of all Quality Measures available on website (too many to hand out)
Priorities
Priorities
CQM
Quality Measures Options
Medicare EP’s Before you Register
Medicaid EP’s Before You Register
Stage 2 - Items Excluded • Structured Physician Notes • Patient Communication Preference • Record Care Plans • HIE (Integration is extensive, but requirement for HIE is gone)
Munson Audit • Looking to see if you are an eligible provider • Individual numbers (not proxy). • Everything if you do work at hospital, but not Urgent Care • Inpatient is really encounters, not discharges • Must include all ED work (many providers work at several ED’s)
Munson Audit • Include ED, Inpatient and Long Term Care work. • Include encounters (every time you see a patient and a bill is generated). • Will only audit if your number is more than 10% different than there numbers • Residents handling • Proxy verses individual (they want you to proxy)
Munson Audit • Exclude ABW patients (for the state of Michigan) • Define encounter • Discharge Date (ED and Inpatient) and checkin date (basically they want date of service). • Exclude test patients • Exclude zero charge patients. • Maintain detail. • EKG’s (if there is a bill) have to be counted
Munson Audit – RHC/FQHC • Include MiChild (BCBS, Prefix ZYP, Group 31295) • Charity care includes write off of any portion of bill • Sliding scale can be used.
Munson Audit – RHC/FQHC • Any suggestions on how to find the data on the second item.
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