ehr incentive program update to hit policy committee

http://www.cms.gov/EHRIncentivePrograms/

Medicare & Medicaid EHR Incentive Programs

HIT Policy CommitteeDecember 5, 2012

http://www.cms.gov/EHRIncentivePrograms/

Registration and Payment Data

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Active Registrations

Active Registrations – October 2012

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Active Registrations

Active Registrations – October 2012

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Medicare Incentive Payments

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Medicare Incentive Payments – October 2012 Meaningful Use (MU)

http://www.cms.gov/EHRIncentivePrograms/

Medicare Incentive Payments

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Medicare Incentive Payments – October 2012 Meaningful Use

For final CMS reports, please visit: http://www.cms.gov/EHRIncentivePrograms/56_DataAndReports.asp

http://www.cms.gov/EHRIncentivePrograms/

Medicare Incentive Payments

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Medicare Incentive Payments – October 2012 Meaningful Use

http://www.cms.gov/EHRIncentivePrograms/

Medicare Incentive Payments

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Medicaid Incentive Payments – October 2012 (Both MU and AIU)

For final CMS reports, please visit: http://www.cms.gov/EHRIncentivePrograms/56_DataAndReports.asp

http://www.cms.gov/EHRIncentivePrograms/

Medicare Incentive Payments

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Medicaid Incentive Payments – October 2012

http://www.cms.gov/EHRIncentivePrograms/

EHR Incentive Programs

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EHR Incentive Programs – October 2012 Totals

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EHR Incentive Programs

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EHR Incentive Programs – October 2012 Totals

http://www.cms.gov/EHRIncentivePrograms/

October – by the numbers October – By the Numbers

0.179

0.1790.6462

Eligible Hospitals

5,011 Total

4,114 Total Registered

3,238 Paid

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http://www.cms.gov/EHRIncentivePrograms/

October – by the numbers October – By the Numbers

38.10%

42.62%

19.28%

Registered Eligible Professionals

521,600 Total EPsRegistered Medicare EPs (222,307)Registered Medicaid EPs (100,558)

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http://www.cms.gov/EHRIncentivePrograms/

October – by the numbers October – By the Numbers

69.07%

16.90%

11.91% 2.13%

Paid Eligible Professionals

521,600 Total EPsMedicare EPs (88,138)Medicaid EPs (62,100)MAO EPs (11,117)

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http://www.cms.gov/EHRIncentivePrograms/

October – by the numbers October – By the Numbers

• Nearly 65% of all eligible hospitals have received an EHR incentive payment for either MU or AIU • Nearly 65% have made a financial commitment to put an EHR

in place

• Approximately 26% or 1 out of every 4 Medicare EPs are meaningful users of EHRs

• Approximately 31% -- nearly 1 out of every 3 -- Medicare and Medicaid EPs have made a financial commitment to an EHR

• 58% of Medicare EPs receiving incentives specialists (non primary care)

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http://www.cms.gov/EHRIncentivePrograms/

Medicare & Medicaid Payments

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Medicare & Medicaid Payments for November 2012

DRAFT ESTIMATES ONLY

Providers Paid Oct-12 LTD

Medicare EPs – [ESTIMATED] 8,250 107,250

Medicaid EPs (AIU + MU) [ESTIMATED] 4,000 66,100Medicaid/Medicare Hospitals** [ESTIMATED] 525 3,750Total Number of UNIQUE Providers Paid 12,775 177,100

http://www.cms.gov/EHRIncentivePrograms/

Medicare & Medicaid Payments

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Medicare & Medicaid Payments for November 2012

DRAFT ESTIMATES ONLYPayments Oct-12 LTD

Medicare EPs [ESTIMATED] $150,000,000 $1,850,000,000Medicaid EPs [ESTIMATED] $73,000,000 $1,395,000,000

Medicaid/Medicare Hospitals [ESTIMATED] $645,000,000 $6,000,000,000Total $868,000,000 $9,245,000,000

http://www.cms.gov/EHRIncentivePrograms/

EHR Incentive Programs Attestation Data

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http://www.cms.gov/EHRIncentivePrograms/

Highlights• On average all thresholds were greatly exceeded, but

every threshold had some providers on the borderline• Drug formulary, immunization registries and patient list

are the most popular menu objectives for EPs• Advance Directives, Clinical Lab Test Results, and Drug

Formulary for hospitals

• Transition of care summary and patient reminders were the least popular menu objectives for EPs• Transition of Care and Reportable Lab Results for hospitals

• Little difference between EP and hospitals• Little difference among specialties in performance, but

differences in exclusions and deferrals

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http://www.cms.gov/EHRIncentivePrograms/

Providers Included

This data-only analysis shows our earliest adopters who have attested, but does not inform us on barriers to attestation.

At the time of the analysis• 117,514 EPs had attested

• 117,284 Successfully• 230 Unsuccessfully (214 EPs have resubmitted

successfully)

• 2,558 Hospital had attested• All successfully

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http://www.cms.gov/EHRIncentivePrograms/

EP Quality, Safety, Efficiency, and Reduce Health Disparities

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Objective Performance Exclusion Deferral

Problem List 97% N/A N/AMedication List 97% N/A N/AMedication Allergy List 97% N/A N/ADemographics 91% N/A N/AVital Signs 91% 9% N/ASmoking Status 91% 0.4% N/A

http://www.cms.gov/EHRIncentivePrograms/

EP Quality, Safety, Efficiency, and Reduce Health Disparities

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Objective Performance Exclusion Deferral

CPOE 83% 17% N/AElectronic prescribing 81% 20% N/AIncorporate lab results 92% 4% 36%Drug-formulary checks N/A 14% 15%Patient lists N/A N/A 26%Send reminders to patients 61% 0.5% 81%

http://www.cms.gov/EHRIncentivePrograms/

EP Engage Patients and Their Families

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Objective Performance Exclusion Deferral

E – Copy of Health Information 97% 70% N/AOffice visit summaries 79% 2% N/APatient Education Resources 49% N/A 49%Timely electronic access 73% 1% 67%

http://www.cms.gov/EHRIncentivePrograms/

EP Improve Care Coordination

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Objective Performance Exclusion Deferral

Medication reconciliation 90% 3% 54%Summary of care at transitions 90% 3% 84%

http://www.cms.gov/EHRIncentivePrograms/

EP Improve Population and Public Health

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Objective Performance* Exclusion Deferral

Immunizations 35% 45% 20%Syndromic Surveillance 6% 25% 69%

*Performance is percentage of attesting providers who conducted test

http://www.cms.gov/EHRIncentivePrograms/

EH Quality, Safety, Efficiency, and Reduce Health Disparities

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Objective Performance Exclusion Deferral

Problem List 95% N/A N/AMedication List 98% N/A N/AMedication Allergy List 98% N/A N/ADemographics 96% N/A N/AVital Signs 92% N/A N/ASmoking Status 93% 0.6% N/A

http://www.cms.gov/EHRIncentivePrograms/

EH Quality, Safety, Efficiency, and Reduce Health Disparities

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Objective Performance Exclusion Deferral

CPOE 85% N/A N/AAdvance directives 96% 0.5% 8%Incorporate lab results 95% N/A 14%Drug-formulary checks N/A N/A 15%Patient lists N/A N/A 40%

http://www.cms.gov/EHRIncentivePrograms/

EH Engage Patients and Their Families

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Objective Performance Exclusion Deferral

E – copy of health information 96% 69% N/AE – copy of discharge Instructions 95% 66% N/A

Patient education resources 73% N/A 58%

http://www.cms.gov/EHRIncentivePrograms/

EH Improve Care Coordination

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Objective Performance Deferral

Medication reconciliation 85% 70%Summary of care at transitions 82% 91%

http://www.cms.gov/EHRIncentivePrograms/

EH Improve Population and Public Health

Objective Performance* Exclusion Deferral

Immunizations 50% 15% 35%Reportable Lab Results 16% 6% 77%Syndromic Surveillance 21% 3% 75%

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*Performance is percentage of attesting providers who conducted test

http://www.cms.gov/EHRIncentivePrograms/

REC Reported Challenges

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Full report: http://dashboard.healthit.gov/data/

http://www.cms.gov/EHRIncentivePrograms/

Overall Top Ten MU Measures

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http://www.cms.gov/EHRIncentivePrograms/

Practice Issue Challenges

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http://www.cms.gov/EHRIncentivePrograms/

Vendor Issue Challenges

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Top Five Challenges by Practice Type

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Top Five MU Measures

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http://www.cms.gov/EHRIncentivePrograms/

For questions, please contact:

Robert AnthonyOffice of E-Health Standards and ServicesCenters for Medicare & Medicaid Servicesrobert.anthony@cms.hhs.gov

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