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Speranza Avram the California State Rural Health Association

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									Electronic Health Records –
     The Future is Now

  Speranza Avram, M.P.A.
    Executive Director

        June 2010
ARRA and HITECH: An Unprecedented Opportunity
                           Medicare and
                           Medicaid MU
                            Incentives


                                                  Cal
           Regional       Transformed        eConnect for
           Extension                             Health
            Centers       Health Care         Information
                                               Exchange


                            Workforce
                           Development


Through the Health Information Technology for Economic and Clinical
    Health (HITECH) Act of 2009, the Federal government has aligned
   incentives and support for health IT adoption and meaningful use.
What Are the Medicare and MediCal Incentives?
                     •   The HITECH Act authorizes
                         incentive payments for eligible
                         Medicare and Medicaid providers to
                         achieve “meaningful use” of certified
                         EHR technology.

                     •   By 2015, providers are expected to
                         have adopted and to be actively
                         using EHR systems in compliance
                         with the “meaningful use” definitions
                         recently released by the Centers for
                         Medicare & Medicaid Services.

                     •   Medicare-participating physicians
                         and hospitals that do not reach this
                         goal by 2015 will be subject to
                         penalties under the Medicare
                         program.
               Medi-care Incentives
 Medicare Provider physicians are eligible to
  receive up to $44,000 in incentive payments for
  demonstrating “meaningful use” of EHR
  systems.
 Incentives are paid out over five years,
  beginning in 2011.
 Physicians who adopt EHR after 2014 will not
  receive Medicare payments.
 Physicians with an existing EHR system are also
  eligible.
 Physicians practicing in a Health Professions
  Shortage Area are eligible for 10% bonus
  payments.
          Medicaid (Medi-Cal) Incentives
Medi-Cal Providers are eligible to receive up to
$63,750 in incentive payments, paid out over 6
years.

Medi-Cal providers can receive upfront funding for
“adopting, implementing, or upgrading” their EHR
systems.

State Medi-cal agency implements Medi-cal
incentive program ($1.4 billion for California)
    Three Stages of MU Implementation

  First
Payment    2011    2012      2013      2014    2015
  Year
  2011    Stage 1 Stage 1   Stage 2   Stage 2 Stage 3
  2012            Stage 1   Stage 1   Stage 2 Stage 3
  2013                      Stage 1   Stage 2 Stage 3
  2014                                Stage 1 Stage 3
 2015+                                        Stage 3
       About CalHIPSO
• Formed by three key partners
  representing target “priority primary
  care providers”:
      California Medical Association (CMA)
      California Association of Public
       Hospitals & Health Systems (CAPH)
      California Primary Care Association
       (CPCA)
• CalHIPSO is tasked with supporting
  targeted providers throughout CA
  successfully adopt electronic health
  records
• One of three Regional Extension
  Centers serving California
Historical Precedent for Market Transformation
Agricultural Industry 1914   Banking Industry 1980’s
CalHIPSO’s Target Providers – Priority Primary
Care Providers (MD, DO, PA, NP) working in the
            following care settings:

                             • Small private physician
                               practices of 10 providers or less

                             • Community health centers and
                               other non-profit primary care
                               clinics

                             • Ambulatory care clinics
                               operated by public hospitals

                             • Outpatient clinics operated by
                               Critical Access and Rural
                               Hospitals
 CalHIPSO is a partnership organization whose
mission is to support the adoption of health IT and
         achievement of meaningful use.

                        • Goal is to assist 6,100 PPCPs achieve
                          meaningful use over the next two years

                        • Payment made by ONC to CalHIPSO based
                          on completion of three milestones:

                            • Enrollment in REC program
                            • Installation and basic use of EHR
                            • Ability to meet Stage 1 MU criteria

                        • Key to success will be partnerships between
                          broad array of stakeholders within public
                          and private sectors
  Education &         Standards &       Group           Provider          Standard
   Training              Best         Purchasing       Registry &        Deployment
  Curriculum           Practices      Contracts        Enrollment         of EHRs

• Outreach, Enrollment                                              • EHR Products (SaaS
  and Education                                                       Offerings)

• Readiness                                                         • Product Specific
  Assessments and                                                     Templates and
  Capacity Building                                                   Configuration

• Vendor Selection                                                  • Interfaces

• Workflow                                                          • Implementation
  Assessment &                                                        Project Management
  Redesign
                                                                    • Ongoing
• Project Mgmt.                                                       Maintenance
                                    Service Partners
• Meaningful Use                                                    • Meaningful Use
  Reporting                                                           Reporting


  Financial Operations – ARRA/ONC Reporting – Quality Assurance
    Why Would Providers Join CalHIPSO?

•   They are ready to adopt EHR, and they want some
    help doing it

•   They want their EHR installation to be as simple
    and easy as possible

•   They want to save some money and access the
    federal incentives payments as soon as possible

•   If they are CalHIPSO target providers, joining in
    2010 is free!
                    What’s Next?

• Local Extension Centers being organized and will
be in place June 2010

• Provider enrollment will begin June 2010 either
through LECs or through CalHIPSO

• Value-added services being organized in
collaboration with stakeholders: group purchasing,
education and training, best practices

								
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