The Future is Upon Us

The Future is Upon Us

TFQ Stakeholders

Meeting

April 8, 2009

Discussion Topics

• Where We Are– Overview of TFQ Activities– ARRA Funds for HIT in Medicaid

• Where We Want to Be– Environmental Scan– Who Are the Players?

• How Do We Get There (HIT Strategic Plan)– Medicaid Plan– Alabama Plan

Funding Opportunities for Medicaid

• Office of National Coordinator will be distributing state grants for planning and implementing health information exchange that facilitate the movement of health information.

• ONC competitive grant program that would be awarded on a matching basis.

• ONC loan program (optional) for the purpose of enhancing the adoption of electronic health records and funding HIE.

• Grants to demonstrate integration of information technologies (acute care, public health, or behavioral health)

• Grants for EHR for GME and clinical education programs• Grants to support clinical informatics education programs

Medicaid Funding Opportunities (Continued)

• Medicaid Provider Incentive Program with 30% Medicaid patient volume, provider cannot participate in both Medicaid and Medicare incentive programs (max incentive $63,750 over five years).– Physicians– Nurse mid-wives– Nurse practitioners– Physician Assistance– Dentist– Federally Qualified Health Centers or Rural Clinics

• Medicaid Hospital Incentive Program (to be computed by Secretary of HHS based split be Medicare and Medicaid)– Children’s hospital– Acute care hospitals with at least 10% volume

• Before 2011: 100% federal (if approved by Secretary); after 2010 a state must participate to draw down federal dollars (2011:90/10, 2012: 85/15; 2013: 66.7/33.3)

Other Medicaid Funding

• 90/10 funding for administration of incentive program, technical assistance, and planning

• Grant funding for interfaces with HIE

• MITA funding is also available

• S-CHIP Funding Opps

• Broadband Monies

ARRA: HIT in Medicaid• Areas of Federal Stimulus Funds for HIT and HIT related technologies

– Health Information Exchange – Electronic Health Records– Clinical Decision Support– Clinical and Administrative Date Repositories– Continuity Care Record or Continuity Care Document– Disease Registries– Broadband Technologies– Telemedicine and Telehealth Technologies – Technical and Training Centers

• Funding Opportunities– Grants– Provider Incentive Payments– Medicaid 90/10 Support– Medicaid 75/25 operations – Loans

• Roles and Responsibilities– Medicaid– Public/Private Partnership– FQHCs

• Strategic Planning– Environmental Assessment of Readiness for Adoption of EHR and exchange of Health

Information– Strategic IT Vision and Plan for Medicaid health information technology

So Who is in Charge

– Who is going to take the lead for the state– Who will be designated as the authorize entity

for the purpose of receiving and coordinating grants for HIE

• Medicaid has Been Designated as HIT Lead, but . . .

Roles and Responsibilities

• Medicaid

• Medicare

• State Government

• Private Sector

• ONC, HHS, AHRQ, CMS, CDC, HRSA, NIH, DHS, IHS, NTIA, USDA, SSA, and VA.

Medicaid Leadership

• Engage with stakeholders in planning and implementing of HIT

• Assure public and private sector coordination.• Stimulate and facilitate the adoption of electronic

health records• Assure interoperability• Align electronic health records with clinical decision

support tools to improve quality and cost efficiency • Collaborate with other states Medicaid

programs

Environmental Scan

• It is Not All About Us– “though we have the beginnings”

• Who Are The Players– FQHCs– Hospitals– Broadband Initiatives– Private Initiatives– Physicians– Other State Agencies

Components of a Strategic HIT Plan

• Strategic Vision• Business and Organizational Goals and Performance

Improvement Requirements• Description of HIT scope and objectives, stakeholders, and

use cases• ‘As Is” and To Be descriptions• IT Strategies to meet the goals and performance

requirements• IT Architecture (Data, Systems, Processes)• Operations and organization• High-level budget/expenditure requirements• Return of Investment analysis and financing strategy• Project phasing and timeline

Start Thinking . . .

• Recommendations on requirements for:– Leadership support– Performance requirements– Process requirements– Technical support requirements– Staff development requirements– Funding phasing and

methodologies– Coordination with other

stakeholders

You Create Your Own Destiny

And to Get There: