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Medicare & MedicaidEHR Incentive ProgramsRobert Anthony and Jessica KahnHIT Standards CommitteeJanuary 25, 2012http://www.cms.gov/EHRIncentivePrograms/
Active Registrations –December 2011December-11YTDEligible 089Eligible 2002,83418,819176,049Hospital (registered forboth Medicare & Medicaid )TOTALhttp://www.cms.gov/EHRIncentivePrograms/For final CMS reports, please visit:http://www.cms.gov/EHRIncentivePrograms/56 DataAndReports.asp
Medicare Incentive Payments –December 2011Meaningful Use (MU)December 2011 December 2011Providers PaidPaymentsEligible ProfessionalMedicare Only HospitalMedicare & MedicaidHospital(Medicare ms/YTDProvidersPaidYTDPayments 295,760,9104,997 86,946,00015,2554 5,600,87038 56,782,557189 369,136,265566 1,052,839,9555,190 464,683,13615,859 1,384,212,512For final CMS reports, please visit:http://www.cms.gov/EHRIncentivePrograms/56 DataAndReports.asp3
Medicaid Incentive Payments –December 2011(Both MU and AIU)December 2011 December 2011Providers PaidPaymentsEligible ProfessionalMedicare & MedicaidHospital(Medicaid Payment) Medicaid Only ms/2,7942303,024 YTDProvidersPaidYTDPayments58,373,53514,089 295,760,910171,007,2121,043 853,715,723 229,380,74715,132 1,149,476,633For final CMS reports, please visit:http://www.cms.gov/EHRIncentivePrograms/56 DataAndReports.asp4
EHR Incentive Programs –December 2011 TotalsRegistrationsDecember-11YTDMedicare EPs8,996123,921Medicaid edicare EPs 95,546,870 331,372,557Medicaid EPs 64,239,678 362,010,379Medicaid/Medicare Hospitals(Medicare Payment) 369,136,265 1,052,839,955Medicaid/Medicare Hospitals(Medicaid Payment) 165,141,069 787,466,254 694,063,883 2,533,689,145Medicaid/Medicare ncentivePrograms/For final CMS reports, please visit:http://www.cms.gov/EHRIncentivePrograms/56 DataAndReports.asp5
EHR Incentive Programs –December 2011Providers Paid by Month9,000Providers bhttp://www.cms.gov/EHRIncentivePrograms/MarAprMay June JulyAug SeptOctNovDec6
EHR Incentive Programs –December 2011Incentive Payments by Month 800,000,000Incentive Payments 700,000,000 600,000,000 500,000,000 400,000,000 300,000,000 200,000,000 100,000,000 Apr May June JulyAug Sept OctNovDec7
MedicaidImplementation Report (1/12)States launched as of January 2012: 42# of States that disbursed incentives: 33National HMAMNORIDMEINWV VAKYMONCCTNJMDDEDCTNAZOKNMSCARMSTXNote: ME,MA, DE, VTand NYhave alsodisbursedincentivesas of 12/31ALGALAFLAKPlanningHISMHPs SubmittedSMHPs Final ApprovalASCNMIIAPDs PendingGUIAPDs rograms/TerritoriesIncentives DisbursedUSVI8
CMS EHR Incentive ProgramsAttestation Datahttp://www.cms.gov/EHRIncentivePrograms/9
Data CaveatsAs of December 2011: Only Medicare EPs are attesting to meaningful use. Medicaid EPs are attesting to AIU Acute care/critical access hospitals could be receivinga meaningful use incentive payment from bothMedicare and Medicaid Medicaid-only hospitals are only attesting to AIU Reports from January onward will include bothMedicare and Medicaid MU data, as well as MedicaidAIU data as ttp://www.cms.gov/EHRIncentivePrograms/56 DataAndReports.asp10
Highlights MU data is only for Medicare physicians and for acutecare and critical access hospitals. It is not arepresentative sample of EPs, nor of all eligiblehospitals. Do we have the n? What we know about early adopters: On average all thresholds were greatly exceeded, but everythreshold had some providers on the borderline Little difference between EP and hospitals Little difference among specialties in performance, butdifferences in 11
Providers Included in MUAnalysisAt the time of the analysis: 33,595 Medicare EPs had attested 33,240 Successfully 355 Unsuccessfully (89 previously unsuccessful resubmitted) 842 Acute Care and Critical Access Hospitals hadattested All s/12
EP Quality, Safety, Efficiency, andReduce Health DisparitiesObjectiveRecording objectives*CPOEElectronic prescribingIncorporate lab resultsDrug-formulary checksPatient listsSend reminders to patientsPerformance Exclusion Deferral90% %17%27%77%*Refers to problem, med, allergy lists, vital signs, demographics and smokingstatus. Exclusion is for vital signs and smoking status.http://www.cms.gov/EHRIncentivePrograms/13
EP Engage Patients and TheirFamiliesObjectiveE – Copy of Health InformationOffice visit summariesPatient Education ResourcesTimely electronic ormance Exclusion Deferral96%78%50%75%75%2%N/A1%N/AN/A49%62%14
EP Improve Care CoordinationObjectiveMedication reconciliationSummary of care at /Performance Exclusion Deferral89%88%3%3%56%85%15
EP Improve Population andPublic HealthObjectiveImmunizationsSyndromic 7%20%70%*Performance is percentage of attesting providers who conducted testhttp://www.cms.gov/EHRIncentivePrograms/16
EH Quality, Safety, Efficiency,and Reduce Health DisparitiesObjectiveRecording objectives*CPOEAdvance directivesIncorporate lab resultsDrug-formulary checksPatient listsPerformance Exclusion Deferral 3%34%*Refers to problem, med, allergy lists, vital signs, demographics and smokingstatus. Exclusion is for vital signs and smoking status.http://www.cms.gov/EHRIncentivePrograms/17
EH Engage Patients and TheirFamiliesObjectiveE – copy of health informationE – copy of dischargeInstructionsPatient education erformance Exclusion Deferral96%68%N/A96%59%N/A71%N/A62%18
EH Improve CareCoordinationObjectiveMedication reconciliationSummary of care at /PerformanceDeferral84%81%75%93%19
EH Improve Populationand Public HealthObjectiveImmunizationsReportable Lab ResultsSyndromic 15%7%3%37%77%79%*Performance is percentage of attesting providers who conducted testhttp://www.cms.gov/EHRIncentivePrograms/20
Specialty Performance Family practice, internal medicine, and optometry highestfor CPOE Optometry and podiatry had lowest rates of recordingvitals Gastroenterology lowest rate for patient electronic accessby almost 10% For providing patient education resources, optometry wasnearly 10% higher than others, podiatry was nearly 20%lower. All others measures were consistent across s/21
Concluding Points Preliminary monthly data is provided to theHITPC for consideration Official data should be sourced and cited fromthe CMS website, updated DataAndReports.asp) Some States began accepting meaningful useattestations for Medicaid-only EHs in January Some States will begin accepting meaningfuluse attestations from Medicaid EPs in Aprilhttp://www.cms.gov/EHRIncentivePrograms/For final CMS reports, please visit:http://www.cms.gov/EHRIncentivePrograms/56 DataAndReports.asp22
HITSC Medicare and Medicade EHR Incentive Programs, January 25, 2012 Author: Department of Health and Human Services, Office of National Coordinator for Health Information Technology Subject: HITSC Medicare and Medicade EHR Incentive Programs Keywords: HIT, ONC Created Date: 1/24/2012 2:01:09 PM
