Medicare & Medicaid EHR Incentive Programs

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

Medicare & Medicaid EHR Incentive Programs

HIT Policy CommitteeOctober 2012

Elizabeth S HollandDirector, HIT Initiatives Group, OESS,

CMS

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

Registration and Payment Data

2

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

Active Registrations – September 2012

Active Registrations – September 2012

  Sep-12 Program-to-Date

Medicare Eligible Professionals 16,315  208,331

Doctors of Medicine or Osteopathy 13,535 185,244

Dentists 13 261

Optometrists 1,034 9,775

Podiatrists 497 6,919

Chiropractors 1,236 6,132

Medicaid Eligible Professionals 3,611  94,741 

Physicians 2,383 67,027

Certified Nurse-Midwives 83 2,045

Dentists 454 7,129

Nurse Practitioners 633 16,978

Physicians Assistants 58 1,562

Hospitals 84  4,057 

Medicare Only 0 213

Medicaid Only 6 102

Medicare/Medicaid 78 3,742

Total 20,010  307,129 

3

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

Active Registrations – 2012

States open for registration in September 2012 = Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Maine, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming

4

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

Active Registrations - 2012

Active Registrations – 2012

  Medicare Eligible Professionals Medicaid Eligible Professional Eligible Hospitals 

Total 2011 123,921 49,051 3,077

January-12 8,524 6,861 170

February-12 9,204 10,751 108

March-12 6,827 7,143 128

April-12 7,696 4,592 86

May-12 7,576 2,631 93

June-12 8,438 3,057 117

July-12 8,327 2,622 105

August-12 11,503 4,422 89

September-12 16,315 3,611 84

TOTAL                            208,331                                94,741                          4,057 

5

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

Medicare Incentive Payments – Sept. 2012 Meaningful Use (MU)-estimates!!

PAYMENT PERIOD    SEPTEMBER 2012 TOTALS  PROGRAM-TO-

DATE

PROVIDER TYPE PROGRAM TYPE PROVIDER COUNT

PAYMENT AMT

PROVIDER COUNT

PAYMENTS-TO-DATE

EP

Medicare 8,313 $149,447,251 82,535 $1,414,799,430

Medicare $7,840,436

Medicare 11,117 $189,436,486

TOTAL W/HPSA and MAO 8,313 $149,447,251 93,652 $1,612,076,352

HOSPITALS

Medicare 5 $6,714,346 134 $201,475,648

Medicare/ Medicaid 132 $223,186,666 1,340 $2,364,416,749

HOSPITAL TOTAL (INITIAL ONLY) 137 $229,901,012 1,474 $2,565,892,397

GRAND TOTAL W/HPSA and MAO (EP + HOSPITALS) 8,450 $379,348,263 95,126 $4,177,968,749

Note:* 4,362 HPSA payments have been paid. The count is not included to avoid double

counting of providers.    

6

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

EHR Incentive Programs Attestation Data

7

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• 94,782 EPs had attested

• 94,538 Successfully• 244 Unsuccessfully (200 EPs have resubmitted

successfully)

• 1,895 Hospital had attested• All successfully

8

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, Drug Formulary, and Clinical Lab Test

Results 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

9

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

EP Quality, Safety, Efficiency, and Reduce Health Disparities

10

Objective Performance Exclusion DeferralProblem List 97% N/A N/AMedication List 97% N/A N/AMedication Allergy List 97% N/A N/A

Demographics 91% N/A N/AVital Signs 91% 8% N/ASmoking Status 90% 0.4% N/A

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

EP Quality, Safety, Efficiency, and Reduce Health Disparities

11

Objective Performance Exclusion DeferralCPOE 83% 17% N/AElectronic prescribing 80% 21% N/AIncorporate lab results 92% 4% 36%Drug-formulary checks N/A 14% 15%Patient lists N/A N/A 25%Send reminders to patients 61% 0.5% 80%

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

EP Engage Patients and Their Families

12

Objective Performance Exclusion DeferralE – Copy of Health Information 97% 70% N/AOffice visit summaries 79% 2% N/APatient Education Resources 49% N/A 50%Timely electronic access 72% 1% 67%

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

EP Improve Care Coordination

13

Objective Performance Exclusion DeferralMedication reconciliation 90% 3% 54%Summary of care at transitions 90% 3% 84%

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

EP Improve Population and Public Health

14

*Performance is percentage of attesting providers who conducted test

Objective Performance* Exclusion Deferral

Immunizations 36% 44% 20%Syndromic Surveillance 6% 26% 69%

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

EH Quality, Safety, Efficiency, and Reduce Health Disparities

15

Objective Performance Exclusion DeferralProblem 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% 0.4% N/A

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

EH Quality, Safety, Efficiency, and Reduce Health Disparities

16

Objective Performance Exclusion DeferralCPOE 85% N/A N/AAdvance directives 95% 0.1% 10%Incorporate lab results 95% N/A 18%Drug-formulary checks N/A N/A 15%Patient lists N/A N/A 39%

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

EH Engage Patients and Their Families

17

Objective Performance Exclusion DeferralE – copy of health information 96% 67% N/AE – copy of discharge Instructions 95% 63% N/A

Patient education resources 70% N/A 60%

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

EH Improve Care Coordination

18

Objective Performance Deferral

Medication reconciliation 83% 74%Summary of care at transitions 83% 92%

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

EH Improve Population and Public Health

Objective Performance* Exclusion Deferral

Immunizations 49% 14% 37%Reportable Lab Results 17% 6% 78%Syndromic Surveillance 20% 4% 77%

19

*Performance is percentage of attesting providers who conducted test

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

Things to Remember

Everyone starts in Stage 1 (although Medicaid has AIU)

Hospitals have until November 30, 2012 to attest to receive first or second year payments)

EPs in their second year can begin to attest January 1, 2013

EPs in their first year must start their reporting period by Oct 3, 2012 to receive a 2012 payment

20

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

Coming to our website soon

Specification sheets for the Stage 2 measures

Technical specification sheets for vendors

More frequently asked questions

Guidance on how to apply for payment adjustment hardship exceptions

21