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Meaningful Use
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Meaningful use is using certified electronic health record technology to improve quality, safety, efficiency, and reduce health disparities; engage patients and family; improve care coordination, and population and public health; and maintain privacy and security of patient health information. – HealthIT.gov

 

To participate in the Medicaid EHR incentive program, an EP would need to have submitted a registration for program year 2016 or earlier. 2016 was the last year a provider could start their participation in the Medicaid EHR Incentive program.

Medicaid EHR Incentive Program participants are encouraged to continue to participate in this program to earn all available incentive payments. Up to six incentive payments are available with participation through program year 2021.

The Medicaid EHR incentive Program is not the same as the MACRA/MIPS program. These are two separate programs and EPs will need to participate and attest to BOTH programs to meet the individual requirements of each program. Currently, there is no cross over of information from one program to the other.  
https://michiganhealthit.org/healthcare-professionals/mu/

 

Meaningful Use News

UPDATE: From CMS on November 1, 2016

CMS is making changes under the Medicare EHR Incentive Program for eligible hospitals and critical access hospitals attesting to CMS, including hospitals that are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs (dual-eligible hospitals), by eliminating the Clinical Decision Support (CDS) and Computerized Order Entry (CPOE) objectives and measures beginning in 2017. CMS is reducing a subset of thresholds for the remaining objectives and measures for Modified Stage 2 and Stage 3. Additional changes include allowing all returning participants in the EHR Incentive Programs to report on a 90-day EHR reporting period in 2016 and 2017. CMS is also finalizing an application process for a one-time significant hardship exception to the Medicare EHR Incentive Program for certain eligible professionals in 2017 who are also transitioning to MIPS. These additions both increase flexibility,  lower the reporting burden for providers, and focus on the exchange of health information and using technology to support patient care.

Programs' Overview

Michigan Medicaid EHR Incentive Program

To receive Michigan Medicaid EHR Incentive Program payments, EPs must show that they are “meaningfully using” certified EHR technology.  For more detailed information, and to see how MU applies specifically to the Michigan Medicaid EHR Incentive Program, download the EP Guide below:

EP Guide to the Medicaid EHR Incentive Program

  • Voluntarily offered by 43 individual states and territories, including Michigan, and administered by the State Medicaid agency
  • Michigan launched its program in January 2011 and distributed first payments in June 2011
  • Provides financial incentives to eligible Medicaid providers (eligible professionals and eligible hospitals) to adopt and meaningfully use a certified EHR technology
  • Eligible professionals can receive up to $63,750 over the six years that they choose to participate in the program (does not have to be consecutive
  • In the first 16 months of the Medicaid EHR Incentive Program, a total of 1,566 eligible professionals and 86 eligible hospitals have been paid more than $100 million in financial incentives through the program

Registration & Attestation: https://michiganhealthit.org/hospitals/eh-registration

 

Providers seeking to register or attest for Modified Meaningful Use Stage 2 in the 2016 program year may sign up starting June 1, 2016. Attestations and registrations for the 2016 program year will be accepted from June 1, 2016 through March 1, 2017 at 11:59PM ET.

 

eMIPP Program Availability

Start

End

AIU registrations and attestations

1/1/2015

4/30/2016 at 11:59PM

Program Year 2015:Modified Stage 2 registrations and attestations

2/14/2016

4/30/2016 at 11:59PM

Program Year 2016:Modified Stage 2 registrations and attestations

6/1/2016

3/1/2017 at 11:59PM

Registering for the Medicaid EHR Incentive Program is a two-step process: Click on Registration & Attestation link above for more details.

Step 1: Federal-level Registration

Step 2: State-level Registration

For more information, contact Michigan’s Medicaid EHR Incentive Program Outreach Coordinator, Robin Hepfinger, during regular business hours. Robin can be contacted at info@MichiganHealthIT.org  or (517) 324-8366.

Please review the 2015 Tipsheet and the table below to understand how to meet the the EHR Incentive Program requirements. 

 

EP Modified Stage 2 Meaningful Use Objectives for 2015 Through 2017

  • PROTECT PATIENT HEALTH INFORMATION
    Protect electronic health information created or maintained by the CEHRT through the implementation of appropriate technical capabilities.
  • CLINICAL DECISION SUPPORT 
    Use clinical decision support to improve performance on high priority health conditions.
  • COMPUTERIZED PROVIDER ORDER ENTRY 
    Use computerized provider order entry for medication, laboratory, and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local, and professional guidelines.
  • ELECTRONIC PRESCRIBING
    Generate and transmit permissible prescriptions electronically (eRx); (Eligible hospitals/CAHs) Generate and transmit permissible discharge prescriptions electronically (eRx).
  • HEALTH INFORMATION EXCHANGE 
    The EP, eligible hospital or CAH who transitions their patient to another provider or setting of care or refers their patient to another provider provides a summary care record for each transition of care or referral.
  • PATIENT-SPECIFIC EDUCATION
    Use clinically relevant information from CEHRT to identify patient specific education resources and provide those resources to the patient.
  • MEDICATION RECONCILIATION 
    The EP, eligible hospital, or CAH who receives a patient from another setting of care or provider of care or believes an encounter is relevant performs medication reconciliation.
  • PATIENT ELECTRONIC ACCESS (VDT) 
    Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP. (Eligible hospitals/CAHs) Provide patients the ability To view online, download, and transmit their health information within 36 hours of hospital discharge.
  • SECURE MESSAGING 
    Use secure electronic messaging to communicate with patients on relevant health information.
  • PUBLIC HEALTH REPORTING 
    The EP, eligible hospital or CAH is in active engagement with a public health agency to submit electronic public health data from CEHRT, except where prohibited and in accordance with applicable law and practice.

 

Stage 3 Meaningful Use (MU)

Please review the 2017 Stage 3 Spec sheet and the table below to understand how to meet the EHR Incentive Program requirements.

EP Stage 3 for 2017

  • PROTECT ELECTRONIC PROTECTED HEALTH INFORMATION (ePHI) 
    Protect electronic protected health information (ePHI) created or maintained by the CEHRT through the implementation of appropriate technical, administrative, and physical safeguards.
  • ELECTRONIC PRESCRIBING 
    Generate and transmit permissible prescriptions electronically (eRx).
  • CLINICAL DECISION SUPPORT (CDS) 
    Implement clinical decision support (CDS) interventions focused on improving performance on high-priority health conditions.
  • COMPUTERIZED PROVIDER ORDER ENTRY 
    Use computerized provider order entry (CPOE) for medication, laboratory, and diagnostic imaging orders directly entered by any licensed healthcare professional, credentialed medical assistant, or a medical staff member credentialed to and performing the equivalent duties of a credentialed medical assistant, who can enter orders into the medical record per state, local, and professional guidelines.
  • PATIENT ELECTRONIC ACCESS 
    The EP provides patients (or patient-authorized representative) with timely electronic access to their health information and patient-specific education.
  • COORDINATION OF CARE 
    Use CEHRT to engage with patients or their authorized representative about the patient’s care.
  • HEALTH INFORMATION EXCHANGE 
    The EP provides a summary of care record when transitioning or referring their patient to another setting of care, receives or retrieves a summary of care record upon the receipt of a transition or referral or upon the first patient encounter with a new patient, and incorporates summary of care information from other providers into their EHR using the functions of CERHT.
  • PUBLIC HEALTH REPORTING 
    The EP is in active engagement with a public health agency or clinical data registry to submit electronic public health data in a meaningful way using certified EHR technology, except where prohibited, and in accordance with applicable law and practice.

As noted above, beginning in program year 2017, providers will have the ability to use a second (different) certified EHR technology for their Clinical Quality Measures (CQMs). The use of a second certified EHR technology is optional.


EPs will continue to have an additional reporting period specific to Clinical Quality Measures. The CQM reporting period is dependent on previous year’s MU participation.


Please see “Reporting Periods” below for additional details on the requirements for MU and CQM reporting periods.

 

Clinical Quality Measure Domains (9 Measures From 3 Domains)

  • Patient and family engagement
  • Patient safety
  • Care Coordination
  • Population/public health
  • Efficient use of healthcare resources
  • Clinical process/effectiveness

Click here for additional information on the 2017 Program Requirements. For additional information on the 2017 Stage 3 Program Requirements,click here.

 

Reporting Table

Medicare EHR Incentive Program

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

On November 4, 2016, CMS published the Medicare Program; Merit-based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models final rule with comment period (CMS-5517-FC) which establishes the MIPS, a new program for certain Medicare-enrolled practitioners. MIPS consolidates components of three existing programs, the Physician Quality Reporting System (PQRS), the Physician Value-based Payment Modifier (VM), and the Medicare EHR Incentive Program for EPs, and focuses on quality--both a set of evidence-based, specialty-specific standards as well as practice based improvement activities; cost; and use of CEHRT to support interoperability and advanced quality objectives in a single, cohesive program that avoids redundancies.

 

Medicare Attestation Worksheets for 2017
The Medicare Attestation Worksheets allow providers to log their meaningful use measures on a document to use as a reference when attesting for the Medicare EHR Incentive Program in CMS’ Registration and Attestation system. Access the 2017 Eligible Hospital, CAH and Dual-Eligible Modified Stage 2 Attestation Worksheet here and Eligible Hospital, CAH and Dual-Eligible Stage 3 Attestation Worksheet here.

 

NOTE: Medicare EP’s will attest to the Advancing Care Information performance category under MIPs.

To access the Quality Payment Program and requirements for Medicare eligible clinicians visit the official website.

 

New Participation Requirements Beginning in 2015

Through the EHR Incentive Programs’ requirements for 2015 through 2017 (Modified Stage 2) and Stage 3, CMS will focus on advanced use of certified EHR technology to support health information exchange and interoperability, advanced quality measurement, and maximizing clinical effectiveness and efficiencies.

 

Changes to Meaningful Use Requirements:

  • All providers are required to attest to a single set of objectives and measures, beginning in 2015.
  • For all eligible professionals in 2015 through 2017 (Modified Stage 2), there are 10 objectives. For all eligible hospitals and CAHs, there are 9 objectives.
  • Beginning on a voluntary basis in 2017 and required beginning in 2018, all providers will attest to Stage 3 objectives and measures. More information about reporting in 2017 and beyond will be available in 2016.
  • Additional information related to EHR Incentive Programs’ requirements for 2015 through 2017 (Modified Stage 2) and Stage 3 can be found in the final rule.

Medicare: 2011

  • Administered by the Centers for Medicare & Medicaid Services (CMS)
  • Provides incentive payments to eligible professionals, eligible hospitals, and critical access hospitals that demonstrate meaningful use of certified EHR technology.
  •  Eligible professionals can receive up to $44,000 over five years.
  • There's an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area (HPSA).
  • To get the maximum incentive payment, Medicare eligible professionals must begin participation by 2012.
  • Payment adjustments will begin in 2015 for providers who are eligible but decide not to participate.
  • Providers must demonstrate meaningful use every year to receive incentive payments.
 

Meaningful Use Resources

Housed within the MPCA website is a wealth of educational and resource materials on a variety of topics relevant to Michigan Health Centers and the delivery of primary and preventive care to medically underserved areas and populations. To access Meaningful Use Resources you may search the website by keyword using the search field at the top of this page, or you may search the Meaningful Use Resources webpage.
 

More Information

More Information
Faiyaz Syed, MD, MPH
Associate Director, Clinical Services
fsyed@mpca.net
517.827.0887
 
Debbie Kristy
Health Information Technology Specialist
dkristy@mpca.net
517.827.0476

 
 
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