Presentation to Chinese American Association of Southern California Health Information Technology Extension Center for Los Angeles 1/31/11 This presentation is incomplete without supporting oral commentary A project of L.A. Care Health Plan A project of L.A. Care Health Plan
Federal HITECH Act “To improve the quality of our health care while lowering its costs, we will make immediate investments necessary to ensure that, within five years, all of America’s medical records are computerized. This will cut waste, eliminate red tape and reduce the need to repeat expensive tests … But it just won’t save billions of dollars and thousands of jobs; it will save lives by reducing the deadly but preventable medical errors that pervade our health care system. ” President Obama January 2009 A project of L.A. Care Health Plan
HITECH Program $60B HITECH Program: How the Pieces Fit Together Improved Individual • Regional Extension Centers ADOPTION & Population Health • Workforce Training Outcomes Increased • Medicare and Medicaid Transparency & MEANINGFUL USE Incentives & Penalties Efficiency Improved Ability to • State Grants for HIE • Standards & Study & Improve Care EXCHANGE Certification Framework Delivery • Privacy & Security Framework Health IT Practice Research A project of L.A. Care Health Plan 3
Regional Extension Centers • Not-for-profit organizations established to provide training, support, and technical assistance to help primary care providers select, implement, and use EHRs in a meaningful way • Selection, purchase, and implementation of EHR • Workflow redesign • Connection to health information exchange • Attainment of meaningful use • Compliance with privacy and security • Goal is for 100,000 priority primary care providers to become meaningful users of EHRs within four years • Four years are 90% subsidized by the federal government A project of L.A. Care Health Plan
Why Did L.A. Care Pursue the REC Program? • Mission Alignment : Focus on small and solo practices, community clinics, and public hospitals aligns with core mission to support safety net providers. The REC program leverages past and future investments with additional federal dollars. • Quality Alignment: Meaningful use of HIT is an important component of quality healthcare. Providers using EHRs and exchanging health information will improve quality of care for members. • Business Alignment: Two-thirds of Los Angeles County primary care providers are in L.A. Care network. The REC is an opportunity to strengthen relationships with these providers, develop relationships with new providers, and increase exchange of clinical data. A project of L.A. Care Health Plan 5
Who We Are • April 2010 – L.A. Care awarded a federally funded grant to serve 3,000 providers in Los Angeles County • HITEC-LA formed as a separate division of L.A. Care • Experienced 12-person core team; over 100 with Service Partners/EHR vendors • We are not vendors; we are a neutral party advised by providers A project of L.A. Care Health Plan
Meet the Team We’re ready to help you from start to finish Our team plus: • A set of hand-selected Service Partners who will assess, project manage, help you achieve meaningful use, and train • Certified EHR vendors who will install, implement, train, and support • Hardware vendors who will install, implement, and support 150 of us working together with you! A project of L.A. Care Health Plan
Members • 1400 providers have enrolled to-date including: Aids HealthCare Foundation Santosh Garg MD Saban Free Clinic Denise A. Albury, MD Harbor Community Clinic South Central Family Health Center AltaMed Health Systems Mona Iskander MD St. John's Well Child & Family Center American Indian Healing Center Wilbert Jordan MD Darren Takeuchi MD Ali Awada MD Vigen Khojayan MD Terence TZ Tan MD Asian Pacific Health Care Venture Gia D. Le T.H.E. Clinic Inc. Lily Balette, MD Los Angeles Christian Centers UMMA Community Clinic Clinica Msr Oscar Romero Manuel F. Mendoza, MD URDC Human Services Compton Central Health Willy Murtidjaja, MD Venice Family Clinic Lina C. Dela Cruz, MD Narinder Nat, MD Z. Joseph Wanski, MD Eisner Pediatric and Family Medical Oscar Perez, MD Center Watts Healthcare Corporation QueensCare Family Clinics El Proyecto del Barrio Kong-Tay Wu, MD Alagia Rangarajan, MD Family Health Care Center of L.A. Raquel M. Ynchausti, MD Ruben M Ruiz, III MD A project of L.A. Care Health Plan
Available Monies L.A. Care HITEC-LA CMS • Contracted, • Utilize REC’s • Medicare/ eligible Service Partners Medicaid providers can incentive • On-site receive $5,000 program technical from HIT • Medicare: assistance from incentive readiness up to $44,000 programs through MU • Medicaid: • Additional grant Stage I, paid for up to $63,750 money is by HITEC-LA available program A project of L.A. Care Health Plan
Provider Eligibility Crosswalk Provider Type/License Eligible for subsidized REC Eligible for Medi-Cal Incentives 1 Eligible for Medicare Incentives Services YES 2 YES 3 YES 3 Medical Doctor (MD) Doctor of Osteopathy (DO) YES 2 YES 3 YES 3 NO 4 YES 3 YES 3 Psychiatrists (MD) Dentist (DDS, DMD) NO 4 YES YES YES 2 YES 3 Nurse Practitioner (NP) NO YES 2 YES 3 Certified Nurse Midwife (CNM) NO Chiropractor (DC) NO 4 NO YES YES 2 YES 5 Physician Assistant (PA) NO Psychologists NO 4 NO NO NO 4 Optometrists (OD) YES YES NO 4 Podiatrists (DPM) NO YES Residents NO YES 3 YES 3 1 Must meet Medi-Cal Patient volume criteria • Minimum 30% Medicaid patient volume • Minimum 20% Medicaid patient volume and is a pediatrician • Practice predominantly in a Federally Qualified Health Center or Rural Health Clinic and have a minimum 30% patient volume of needy individuals 2 Non-Hospital based, certified in Internal Medicine, Family Practice, Pediatrics, Adolescent Medicine, OB/GYN, or Family Practice practicing in one of the following settings: • Physician Practices of 10 providers or less • Community health centers, primary care clinics and rural health clinics • Ambulatory care clinics associated with public hospitals, critical access hospitals, or rural hospitals • Other medically underserved settings 3 Non- Hospital based: if more than 90% or the provider’s services are performed in a hospital in -patient or emergency room setting, that provider is Hospital-Based and not eligible for the EHR incentive program 4 May be eligible for REC services on a Fee for Service basis 5 Physician Assistants are only eligible if practicing in FQHC or RCH that is “Physician Assistant - led” A project of L.A. Care Health Plan 10
Medicaid Incentives • Eligible Providers are those that see 30% Medicaid, Medicaid HMO or uninsured patients over any 90- day period during the year • Pediatricians must see 20% Medicaid, Medicaid HMO or uninsured patients • To qualify for the first payment, an EP must implement, upgrade or acquire an EHR • Payout occurs over 6 years with the last payment year being 2021 • EPs must show $25,000 in expenses in Year 1 and $10,000 in subsequent years for maximum incentive First Calendar Year in Which Eligible Provider Receives a Medicaid Incentive Payment Calendar Year 2011 2012 2013 2014 2015 2016 2011 $21,250 2012 $8,500 $21,250 2013 $8,500 $8,500 $21,250 2014 $8,500 $8,500 $8,500 $21,250 2015 $8,500 $8,500 $8,500 $8,500 $21,250 2016 $8,500 $8,500 $8,500 $8,500 $8,500 $21,250 2017 $8,500 $8,500 $8,500 $8,500 $8,500 2018 $8,500 $8,500 $8,500 $8,500 2019 $8,500 $8,500 $8,500 2020 $8,500 $8,500 2021 $8,500 Total $63,750 $63,750 $63,750 $63,750 $63,750 $63,750 A project of L.A. Care Health Plan 11
Medicare Incentives • Incentive payments are equal to 75% of Medicare Allowable amount up to the maximum listed in the table below. • During 2011, EPs only have to demonstrate meaningful use for 90 days. • During 2012+, EPs must demonstrate meaningful use for entire year. First Calendar Year in Which Eligible Provider Receives a Medicare Incentive Payment Calendar Year 2011 2012 2013 2014 2015 + 2011 $18,000 2012 $12,000 $18,000 2013 $8,000 $12,000 $15,000 2014 $4,000 $8,000 $12,000 $12,000 2015 $2,000 $4,000 $8,000 $8,000 $0 2016 $2,000 $4,000 $4,000 $0 Total $44,000 $44,000 $39,000 $24,000 $0 A project of L.A. Care Health Plan 12
Why Enroll Now? • The program serves the first 3,000 provider members • We can help make it easier to pick your EHR • We can get you money and free service • Enrolling helps other Los Angeles County providers get free assistance • The program ends in 2014 A project of L.A. Care Health Plan
Serving Our Members • Every practice receives a telephone practice assessment to determine readiness: – 741 assessments completed so far; 84% of our providers are ready • Next, a Service Partner is assigned, meets with practice, and scopes out the work to help onsite from start to finish: – Currently helping 100 providers with vendor selection, infrastructure selection, upgrades to certified EHRs, workflow redesign, and meaningful use achievement • We are also providing legal advice, answering MU questions, and processing incentives A project of L.A. Care Health Plan 14
Phases of EHR Implementation Planning Post- Implementation EHR Selection Meaningful Use Integration Implementation A project of L.A. Care Health Plan 15
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