FAQ

1. What is HealthPOINT, South Dakota’s Regional Extension Center?
2. What does HealthPOINT do?
   • Member Services
   • Consulting Services
   • Managed Services
3. Who will be served by the efforts and activities of HealthPOINT?
4. How many priority Primary Care Providers and critical access hospitals will HealthPOINT serve?
5. How will support be prioritized across providers?
6. Will the Regional Extension Centers provide any sort of assistance to other types of providers in their service areas, or only to priority Primary Care Providers?
7. How will the Regional Extension Centers specifically help providers implement health information exchange (HIE)?
8. What are the benefits of being a member of HealthPOINT?
   • EDUCATION & OUTREACH
   • VENDOR CONSULTATION
   • FINANCIAL COORDINATION & GROUP PURCHASING
   • STAKEHOLDER COORDINATION
   • READINESS ASSESSMENT AND PLANNING
9. How will Regional Extension Centers maintain vendor independence and avoid furnishing biased advice when helping providers select an HIT vendor?
10. If a provider does not have an electronic health record system, how will HealthPOINT help providers select a health information technology (HIT) vendor?
11. What is this federal incentive program for the implementation of electronic health records?
12. What is “Meaningful Use?”
13. What providers are eligible for the CMS health information technology meaningful use incentive payments?
    • Medicare
    • Medicaid
14. What types of activities are included in the detailed requirements for Meaningful Use?
    • Stage 1 Criteria for Meaningful Use
    • Stage 2 Criteria for Meaningful Use
    • Stage 3 Criteria for Meaningful Use
15. Will the Medicare/Medicaid incentives be provided to providers or to the health care entity?
16. Who decides whether a provider meets the meaningful use criteria and can receive an incentive payment?
17. What will be the first steps of HealthPOINT?
18. How is HealthPOINT being provided with its funding?
19. What should I do if I am a “Primary Care Provider” and want to be helped as part of HealthPOINT’s activities?

1. What is HealthPOINT, South Dakota’s Regional Extension Center?

HealthPOINT is a new federally funded project under the Center for Advancement of Health IT (CAHIT) at Dakota State University.

HealthPOINT is one of 60 non-profit organizations across the nation that has been awarded federal American Recovery and Reinvestment Act (ARRA) dollars to support the development of Regional Extension Centers (RECs). These centers are being set up to aid health centers and medical professionals as they work to implement and use certified health information technology and achieve health improvement outcomes through “Meaningful Use” (see FAQ 12).

Regional health information technology extension centers (RECs) were created out of the ARRA HITECH Act – Section 3012, and are under the direction of the U.S. DHHS Office of the National Coordinator for Health Information Technology (ONC).

Back to top of page.

2. What does HealthPOINT do?

As a designated federal Regional Extension Center, HealthPOINT offers outreach, education, guidance, information on best practices, and direct assistance to support and accelerate health care centers’ and providers’ efforts to become Meaningful Users of certified Electronic Health Record (EHR) systems. Some of these services are provided on a subsidized basis to eligible entities, with priority to be given to Primary Care Providers and certain Critical Access Hospitals (see FAQ #8). Services also are available on a fee basis to all health care providers in the state.

In particular, HealthPOINT uses its HIT/EHR knowledge and experience to work one-on-one with small practices and offer technical expertise in managing relationships with vendors, share knowledge of software implementation, and provide an understanding of work-flow change and quality improvement methods.

The Regional Extension Centers focus their most intensive technical assistance on clinicians (physicians, physician assistants, and nurse practitioners) furnishing primary-care services, with a particular emphasis on individual and small group practices (fewer than 10 clinicians with prescriptive privileges). Clinicians in such practices deliver the majority of primary care services, but have the lowest rates of adoption of EHR systems, and the least access to resources to help them implement, use and maintain such systems.

The consistent, nationwide adoption and use of secure EHRs will ultimately enhance the quality and value of health care. By assisting health care providers, these outreach, education, and technical assistance services will help to accelerate these outcomes.

Among the services and benefits that are provided by HealthPOINT are:

Member Services – HealthPOINT Member Services include Education and Outreach, Professional Collaboration, HIT Best Practices, and the Assessment of a practice’s current state of EHR and/or Meaningful Use readiness with a detailed Roadmap to plan efforts for achieving Meaningful Use. HealthPOINT Member Services are available to all South Dakota healthcare professionals in all settings for annual fixed fees that are determined by the size of the practice.

Consulting Services – HealthPOINT Direct Assistance Consulting Services provide expert direct assistance for successful EHR implementations including Change Management, Workflow Optimization, Privacy and Security practices, and limited assistance of vendor deployment services. HealthPOINT’s Direct Assistance Consulting Services are available to all South Dakota healthcare professionals in all settings at per hour rates determined by unique practice needs and the Meaningful Use Roadmap. Eligible Member Priority Primary Care Providers in priority settings will receive additionally discounted rates through funding provided by the Office of National Coordinator for Health IT, U.S. Department of Health and Human Services, ARRA Grant # 90RC0062/01.

Managed Services – HealthPOINT Managed Services provide long-term support including Meaningful Use Reporting and Analysis, Workflow Enhancements, and EHR Maintenance and Disaster Mitigation. HealthPOINT Managed Services are available to all South Dakota healthcare professionals at fixed fee and hourly rates that are determined by the size of the practice.

One-on-one assistance through Member Services Readiness Assessment and Direct Assistance Consulting are a key services HealthPOINT makes available to Priority Primary Care Providers, and will represent a significant portion of the Regional Extension Center’s activities. As a Regional Extension Center, HealthPOINT is expected to work with both priority Primary Care Providers and Critical Access Hospitals who have not yet adopted EHR systems, and with Priority Primary Care Providers and Critical Access Hospitals that have existing EHR systems, to assist them in achieving Meaningful Use of certified EHR technology.

Regional Extension Centers also help providers achieve, through appropriate available infrastructures, exchange of health information in compliance with applicable statutory and regulatory requirements, and patient preferences. HealthPOINT will be working with the State designated Health Information Exchange and the National Health Information Network (NHIN) on these activities.

Back to top of page.

3. Who will be served by the efforts and activities of HealthPOINT?

HealthPOINT membership is open to any health care center and provider in South Dakota including Dentists, Chiropractors, Optometrists, and Mid-level Professionals, but the Regional Extension Center focuses and prioritizes its efforts on “Primary Care Providers” and primary care physicians working with critical access and rural hospitals. A “Primary Care Provider” is defined as any doctor of medicine or osteopathy, any nurse practitioner, nurse midwife, or physician assistant with prescriptive privileges in the locality where s/he practices, who is actively practicing one of the following specialties: family, internal, pediatric, or obstetrics and gynecology.

Back to top of page.

4. How many priority Primary Care Providers and critical access hospitals will HealthPOINT serve?

During its first two years of operation, HealthPOINT expects to provide individualized technical assistance to a minimum of 1,070 Priority Primary Care Providers in South Dakota.

Nationally, the Regional Extension Centers are expected in their first two years of operation to help over 100,000 Priority Primary Care Providers become Meaningful Users of certified EHR technology.

Back to top of page.

5. How will support be prioritized across providers?

Following the completion of assessments as part of Member Services, HealthPOINT will give priority for intensive, individualized assistance to Primary Care Providers in individual and small-group practices (ten or fewer professionals with prescriptive privileges), Community and Rural Health Centers, rural and Critical Access Hospitals, and other settings predominately serving uninsured, underinsured, or medically underserved patients. These providers deliver the majority of primary care services in our state, but have lower rates of adoption of EHR systems, and the least access to quality improvement resources.

Some health care centers and Primary Care Providers (as described above) may have already acquired and/or implemented EHR technology. Such providers remain priority providers, though the technical assistance required is anticipated to be focused on movement from having an EHR to achieving all aspects of Meaningful Use of certified EHR technology, including but not necessarily limited to electronic exchange of health information and reporting of quality measures using the EHR.

Back to top of page.

6. Will the Regional Extension Centers provide any sort of assistance to other types of providers in their service areas, or only to priority Primary Care Providers?

HealthPOINT is available to offer assistance through Member, Consulting, and Managed Services, defined as education, outreach, and technical and process assistance, to all health care providers in South Dakota, particularly to those who select, successfully implement, and meaningfully use certified EHR technology to improve the quality and value of health care. This includes Dentists, Chiropractors, Optometrists, and Mid-level Professionals in certain settings. Pursuant to the federal statute, however, direct assistance is prioritized, and the federal subsidy limited to, Primary Care Providers as described in FAQ #5. All providers across the state are welcome and encouraged to become members of the HealthPOINT Provider Community. This membership will provide access to outreach and educational opportunities made available through the center as well as to the resources available in the private section of the HealthPOINT website.

Back to top of page.

7. How will the Regional Extension Centers specifically help providers implement health information exchange (HIE)?

This program will offer member health centers and providers access to information and technical expertise and will assist them with selecting and implementing certified electronic health records (EHRs), integrating health information exchange (HIE), using those EHRs into provider care delivery and administrative workflows to enhance the quality and safety of care while protecting patients’ privacy.

The South Dakota Department of Health has been designated by the federal government as the health information exchange provider in South Dakota. HealthPOINT will be coordinating its efforts with the South Dakota Department of Health to facilitate health information exchange.

Back to top of page.

8. What are the benefits of being a member of HealthPOINT?

Membership in HealthPOINT provides access to a basic set of educational and web-based resources as well as access to the direct assistance and customized services that HealthPOINT is offering. This membership is available for an annual fee of $300-$600 per EHR User (capped at 10-25 EHR Users per location).

HealthPOINT will offer members a number of key services and benefits including:

EDUCATION & OUTREACH

Education – HealthPOINT will disseminate appropriate information to the Practice concerning the effective strategies of meaningful use and will provide materials and hold general educational events and programs for Providers and their support staff through various one to many mechanisms including:

HealthPOINT Webinars: HealthPOINT will hold webinars and other remote one-to-many educational sessions with Member Practice providers, practice administrators, and IT professionals to learn more about HealthPOINT’s Direct Assistance Consulting and Managed Service offerings and EHR/HIT Best Practice topics including: Change Management, Workflow Optimization, EHR selection, Implementation and Project Management, Privacy and Security, and federal requirements related to HIE and Meaningful Use. The protection of PHI shall be and remain the responsibility of the Practice. The number of logins per practice may not exceed the registered number of designated EHR Users per practice.

HealthPOINT Workshops: HealthPOINT will make available to Member Practices regional small one-to-many educational workshops to provide an interactive forum for providers, practice administrators, and IT professionals to learn more about HealthPOINT Direct Consulting and Managed Service offerings and EHR/HIT Best Practice topics including: Change Management, Workflow Optimization, EHR selection, Implementation and Project Management, Privacy and Security, and federal requirements related to HIE and Meaningful Use. The number of attendees per practice may not exceed the registered number of designated EHR Users per practice.

HealthPOINT Online: HealthPOINT Member Practices will have access to the HealthPOINT web portal of resources, information, and materials as they are developed. This includes access for providers, practice administrators, and IT professionals to HealthPOINT’s exclusive online member portal of best practice information, links to web based education, and other helpful resources. Practices may also connect with other HealthPOINT community providers to share information and implementation resources through community forums. The number of logins per practice may not exceed the registered number of designated EHR Users per practice.

HealthPOINT Events: HealthPOINT Member Practices will have priority access to HealthPOINT hosted statewide and local events for providers, practice administrators, and IT professionals to collaborate, learn, and network. Events to include summits, conferences, and seminars with regional and national industry expertise on Change Management, Workflow Optimization, EHR selection, Implementation and Project Management, Privacy and Security, and federal requirements related to HIE and Meaningful Use. The number of attendees per practice may not exceed the registered number of designated EHR Users per practice.

HealthPOINT Workforce Training Vouchers & Discounts: HealthPOINT Member Practice will have access to discounts and/or vouchers for HIT Workforce Training provided by Dakota State University. The number and type of discounts and/or vouchers vary per practice and may not exceed the registered number of designated EHR Users per practice.

Outreach – HealthPOINT will provide resources to build consumer engagement on the impact and benefits of electronic health records in Practice Member communities. Patient education materials, consumer website resource links, and content expert presentations for community groups, association meetings, and ancillary provider groups will be available to increase the public utilization and acceptance of electronic health records.

HealthPOINT Consulting Services – HealthPOINT Member Practices will have access to HealthPOINT Direct Assistance Consulting Services for custom training solutions including curriculum development, and instructional design at discounted hourly rates. Eligible Member Priority Primary Care Providers in priority settings will receive additionally discounted rates through funding provided by the Office of National Coordinator for Health IT, U.S. Department of Health and Human Services, ARRA Grant # 90RC0062/01.

VENDOR CONSULTATION

HealthPOINT Vendor Consultation – HealthPOINT will assist the Practice in assessing their HIT needs to provide best practices to select appropriate vendors for EHR software, hardware, network infrastructure and IT services and will incorporate Meaningful Use requirements into the vendor selection criteria. HealthPOINT will facilitate vendor demonstrations for certified EHR products. HealthPOINT does not represent or warrant (expressed or implied) the performance of the products or services of said third party approved vendors. Direct Assistance Consulting Services for detailed assessment or remedy of readiness barriers are available to Member Practices at discounted hourly rates under separate Statements of Work and are not within the scope of this Agreement.

HealthPOINT Consulting Services – HealthPOINT Member Practices will have access to HealthPOINT Direct Assistance Consulting Services including contract negotiations, vendor relationship management, and project/program management at discounted hourly rates under separate Statements of Work. Eligible Member Priority Primary Care Providers in priority settings will receive additionally discounted rates through funding provided by the Office of National Coordinator for Health IT, U.S. Department of Health and Human Services, ARRA Grant # 90RC0062/01.

FINANCIAL COORDINATION & GROUP PURCHASING

HealthPOINT Financial Coordination – HealthPOINT may provide information on various commercial banking programs that offer bridge funding and other forms of technology acquisition funding program as they become available. Through South Dakota regional stakeholders, HealthPOINT can help practices identify resources that can provide information on various federal, state, and rural programs that could provide financial and other assistance.

Group Purchasing – As a member of HealthPOINT, practices will have access to the informal negotiating and buying power of cooperating member practices. This may include group purchasing options offering volume discounts.

STAKEHOLDER COORDINATION

HealthPOINT will work collaboratively with all relevant stakeholders to build comprehensive and efficient health information technology linkages for all South Dakota healthcare providers and facilities. By working in partnership with the South Dakota Health Information Exchange (SD HIE), South Dakota Medicaid, the Centers for Medicare and Medicaid Services (CMS), the U.S. Department of Health and Human Services/Office of the National Coordinator of Health Information Technology (ONC) as well as connections with other federal programs, regional initiatives, and statewide coalitions, HealthPOINT will provide constantly updated resources on opportunities, best practices, and trends in health information technology. HealthPOINT will assist the practice in the coordination of efforts between providers, vendors, and other entities in connecting to available health information exchange infrastructures, including any applicable Regional Health Information Organizations and the State of South Dakota’s Health Information Exchange. HealthPOINT will provide communication of the most recent guidance, information and developments from the HHS Office of the National Coordinator for Health Information Technology.

READINESS ASSESSMENT AND PLANNING

Readiness Assessment & Planning – HealthPOINT will assess and identify gaps and barriers to the Practice’s EHR adoption and will provide a customized plan to identify those steps critical for the Practice to prepare for, select, implement, and Meaningful Use an EHR.

HealthPOINT Practice Readiness Assessment (Practice with no EHR): HealthPOINT will assess the readiness of the Practice to implement electronic health record (EHR) technology and achieve Meaningful Use. The readiness assessment will include identification of PPCPs, payer mix, current workforce readiness, current technology infrastructure, level of technology adoption, and high level workflow analysis. Direct Assistance Consulting Services for detailed assessment or remedy of readiness barriers are available to Member Practices at discounted hourly rates under separate Statements of Work and are not within the scope of this Agreement.

HealthPOINT Meaningful Use Gap Analysis (Practice with EHR): HealthPOINT will perform an independent Meaningful Use gap analysis and provide an independent assessment of the Practice’s readiness to meet Meaningful Use requirements using the EHR already in use at the Practice. Direct Assistance Consulting Services for detailed analysis or remedy of Meaningful Use gaps are available to Member Practices at discounted hourly rates under separate Statements of Work and are not within the scope of this Agreement.

HealthPOINT Incentive Program(s) Target: HealthPOINT will provide Practices with the rules and guidelines around eligibility for current and upcoming Stages of Meaningful Use. Stage 1 targets are – Clinical Quality Measure attestation, Data Collection, and initial exchange of information through e-prescribing (for Eligible Professionals only) and exchange of key clinical information.

HealthPOINT Meaningful Use Roadmap: HealthPOINT will provide a customized plan to identify those steps critical to prepare for, select, implement, and/or Meaningfully Use an EHR. The HealthPOINT Meaningful Use Roadmap will be based on the findings of the Practice Readiness Assessment, Incentive Programs Target, and/or Meaningful Use Gap Analysis and will identify the basic personnel, technology and process infrastructure changes that the Practice should make prior to Implementation to best position the Practice for a successful demonstration of Meaningful Use. The HealthPOINT Meaningful Use Roadmap will provide recommended timeframes for the Practice to address the barriers and provide orientation to additional HealthPOINT Direct Assistance Consulting and Managed services to execute the plan. Direct Assistance Consulting Services for detailed Project Planning and Project Management including remedy of readiness barriers indicated in the Meaningful Use Roadmap are available to Member Practices at discounted hourly rates under separate Statements of Work and are not within the scope of this Agreement.

HealthPOINT Roadmap Checkpoints: HealthPOINT will provide Practices with scheduled quarterly Meaningful Use Checkpoints to assess progress on the Practice’s Meaningful Use Roadmap including an issues/barriers list communicating current or future HealthPOINT Direct Assistance Consulting needs. HealthPOINT will review Practice’s utilization of EHR and provide appropriate feedback and support through Direct Assistance Consulting and Managed Services to improve low utilization of features essential for Meaningful Use. Direct Assistance Consulting Services for progress reports of higher frequency and/or intensity or remedy of readiness barriers indicated in the Roadmap Checkpoints are available to Member Practices at discounted hourly rates under separate Statements of Work and are not within the scope of this Agreement.

HealthPOINT Consulting Services – HealthPOINT Member Practices will have access to HealthPOINT Direct Assistance Consulting Services for Practice Workflow Assessment, Project Planning, and Project Management at discounted hourly rates under separate Statements of Work. Eligible Member Priority Primary Care Providers in priority settings will receive additionally discounted rates through funding provided by the Office of National Coordinator for Health IT, U.S. Department of Health and Human Services, ARRA Grant # 90RC0062/01.

Consulting Services will include:

• Training
• Vendor selection & group purchasing
• Implementation & project management
• Practice & workflow redesign
• Functional interoperability & health information exchange (“HIE”)
• Privacy & security best practices
• Progress toward meaningful use

Service offerings may be modified at the sole discretion of HealthPOINT or as required by HHS. Discounted fees may apply to some service offerings that are not covered in base funding provided by the ONC Cooperative Agreement.

Back to top of page.

9. How will Regional Extension Centers maintain vendor independence and avoid furnishing biased advice when helping providers select an HIT vendor?

HealthPOINT is required to avoid entering into business arrangements creating an actual or apparent conflict of interest with the center’s obligation to act solely on the best interest of advancing meaningful use of certified EHRs by the providers it serves. Any Regional Extension Center that chooses to offer group purchasing of EHR software, IT support services, and/or hardware must offer a choice of software, service, and/or hardware vendors and products.

HealthPOINT offers participating providers vendor evaluation. Evaluations are based upon comprehensive assessments to identify provider needs and the provider will identify their goals for EHR implementation.

Vendors will be recommended based on how closely the vendor’s services and products match the provider’s needs and goals.

Back to top of page.

10. If a provider does not have an electronic health record system, how will HealthPOINT help providers select a health information technology (HIT) vendor?

As a Regional Extension Center, HealthPOINT is required to offer health centers and providers in South Dakota with unbiased advice about EHR systems and other HIT products that will enable achievement of the “Meaningful Use” requirements, as defined by the U.S. Secretary of Health and Human Services. HealthPOINT is available to assist priority Primary Care Providers to assess their practice patterns and needs in the context of applicable laws, regulations, and available HIE infrastructures, and help each provider to select and obtain the highest-value option for its circumstances.

HealthPOINT offers participating providers vendor evaluation. Evaluations are based upon comprehensive assessments to identify provider needs and the provider will identify their goals for EHR implementation.

Vendors will be recommended based on how closely the vendor’s services and products match the provider’s needs and goals.

Back to top of page.

11. What is this federal incentive program for the implementation of electronic health records?

As part of the American Recovery and Reinvestment Act, the Centers for Medicare & Medicaid Services (CMS) is authorized to provide a reimbursement incentive for eligible Medicare and Medicaid providers (physician and hospital providers) who are successful in implementing electronic health records and achieving “meaningful use,” as defined by the U.S. DHHS. These incentive payments will begin in 2011 and gradually phase down. NOTE: Starting in 2015, providers are expected to have adopted and be actively utilizing an EHR in compliance with the “meaningful use” definition or they will be subject to financial penalties under Medicare.

Stimulus funding for participating practices who implement EHRs will range from a maximum of $44,000 per eligible provider over five years under Medicare or $63,750 per provider maximum under Medicaid. Again, these funds will be available to eligible providers who acquire a certified EHR and demonstrate they are using the technology to improve the health of patients through meaningful use of the EHR and its data. HealthPOINT will be available to assist eligible providers in meeting these goals.

Information on the Medicare and Medicaid EHR Incentive Programs, including a link to the text of the final rule, can be found at http://www.cms.gov/EHRIncentivePrograms.

Back to top of page.

12. What is “Meaningful Use?”

This is the term being used by the Office of the National Coordinator (ONC) and the Centers for Medicare and Medicaid (CMS) to describe the criteria eligible providers must meet to qualify to receive future financial incentives (see FAQ #13 and #14) for using electronic health records (EHRs) in a meaningful manner.

Back to top of page.

13. What providers are eligible for the CMS health information technology meaningful use incentive payments?

The Centers for Medicare & Medicaid Services (CMS) announced July 13, 2010 the final rule to implement the provisions of the American Recovery and Reinvestment Act of 2009 (Recovery Act) that provide incentive payments to providers for the Meaningful Use of certified EHR technology. The Medicare EHR incentive program will provide incentive payments to eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) that are meaningful users of certified EHRs. The Medicaid EHR incentive program will similarly provide incentive payments to eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) that are meaningful users of certified EHRs. However, in the initial year, Medicaid may provide incentive payments to eligible professionals and hospitals for efforts to adopt, implement, upgrade or successfully demonstrate Meaningful Use of certified EHR technology.

An EP may receive incentives from either Medicare or Medicaid, but not both. Each provider must make her or her selection to CMS, and then is permitted to change that selection once during the life of the incentive program.

Eligible Hospitals, including Critical Access Hospitals, may receive incentive payments from both Medicare and Medicaid.

Medicare: A Medicare EP is a doctor of medicine or osteopathy, a doctor of dental surgery or dental medicine, a doctor of podiatric medicine, a doctor of optometry, or a chiropractor, who is legally authorized to practice under state law. A qualifying EP is one who successfully demonstrates Meaningful Use for the EHR reporting period.

Hospital-based EPs who furnish substantially all their services in a “hospital setting” are not eligible for incentive payments. Hospital-based EPs are defined as EPs who furnish 90 percent or more of their allowed services in a hospital inpatient setting, or hospital emergency department.

A qualifying EP can receive EHR incentive payments for up to five years with payments beginning as early as 2011. In general, the maximum amount of total incentive payments that an EP can receive under the Medicare program is $44,000.

MEDICARE ELIGIBLE HOSPITALS An eligible hospital for Medicare incentive payments is a “subsection (d) hospital” that is paid under the hospital inpatient prospective payment system (IPPS).

Hospitals must be located in one of the 50 states or the District of Columbia.

Medicaid: Medicaid EPs are physicians (primarily doctors of medicine and doctors of osteopathy), dentists, nurse practitioners, certified nurse midwives, and physician assistants practicing in a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) led by a physician assistant. To be eligible for the incentive, 30% of the EP’s patient volume must be Medicaid or “needy individuals” in the case of an EP practicing in an FQHC or RHC. For pediatricians, the Medicaid volume threshold is 20%.

Eligible hospitals that can participate are acute care hospitals (which include cancer and critical access hospitals) and children’s hospitals. Hospitals must have 10% Medicaid volume to qualify for Medicaid incentives with the exception of children’s hospitals where there is no minimum volume requirement.

As with Medicare, hospital-based EPs who provide “substantially all of his or her professional services in a hospital setting” are not eligible for Medicaid incentives.

Medicaid EPs can receive up to $63,750; hospital payments are based on a formula outlined in the statute.

MEDICAID ELIGIBLE HOSPTIALS — Specifies that an acute care hospital is a primary health care facility where the average length of patient stay is 25 days or fewer. Hospitals with an average length of stay of 25 days or fewer and with a CMS Certification Number (CCN) that has the last four digits in the series 0001 – 0879 or 1300-1399 are eligible. This specification will include short term general hospitals, the 11 cancer hospitals, and critical access hospitals in the United States, District of Columbia, and U.S. territories. Acute care hospitals also must have 10 percent Medicaid patient volume in order to participate.

For children’s hospitals, specifies that only those hospitals that have CCNs in the 3300-3399 series will be considered children’s hospitals.

Back to top of page.

14. What types of activities are included in the detailed requirements for Meaningful Use?

The meaningful use criteria will involve three stages that are being rolled out over time. Only the Stage 1 criteria have been finalized at this point.

Stage 1 Criteria for Meaningful Use: The Stage 1 criteria for meaningful use focus on electronically capturing health information in a coded format, using that information to track key clinical conditions, communicating that information for care coordination purposes, and initiating the reporting of clinical quality measures and public health information.

The criteria for Meaningful Use are based on a series of specific objectives, each of which is tied to a measure that allows EPs and hospitals to demonstrate that they are meaningful users of certified EHR technology.

For Stage 1, which begins in 2011, there will be 25 objectives/measures for EPs and 24 objectives/measures for eligible hospitals. The objectives/measures have been divided into a core set and menu set. EPs and eligible hospitals must meet all objectives/measures in the core set (15 for EPs and 14 for eligible hospitals). They can choose to defer up to five remaining objectives/measures.

In 2011, EPs, eligible hospitals and CAHs seeking to demonstrate Meaningful Use are required to submit aggregate clinical quality measure numerator, denominator, and exclusion data to CMS or the States by attestation. In 2012, EPs, eligible hospitals and CAHs seeking to demonstrate Meaningful Use must electronically submit clinical quality measures selected by CMS directly to CMS (or the States) through certified EHR technology. CMS recognizes that for clinical quality reporting to become routine, the administrative burden of reporting must be reduced. By using certified EHR technology to report information on clinical quality measures electronically to a health information network, a State, CMS, or a registry, the burden on providers that are gathering the data and transmitting them will be greatly reduced.

Beyond the Stage 1 Criteria for Meaningful Use: The policy goals of meaningful use will be most fully realized by building on findings from Stage 1 and by making full use of the greater proliferation of certified EHR technology and supporting HIT/E infrastructure that will take place under Stage 1. CMS intends to propose, through future rulemaking, two additional stages of the criteria for Meaningful Use.

Stage 2 Criteria for Meaningful Use would expand upon the Stage 1 criteria in the areas of disease management, clinical decision support, medication management support for patient access to their health information, transitions in care, quality measurement and research, and bi-directional communication with public health agencies. These changes will be reflected by a larger number of core objective requirements for Stage 2. CMS may also consider applying the criteria more broadly to the outpatient hospital settings (and not just the emergency department). Information exchange is a critical part of care coordination and we expect that the infrastructure will support greater requirements for using health information exchanges for Stage 2.

Stage 3 Criteria for Meaningful Use would focus on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self-management tools, access to comprehensive patient data, and improving population health outcomes.

Back to top of page.

15. Will the Medicare/Medicaid incentives be provided to providers or to the health care entity?

This will be dependent upon the relationship that each provider has with his or her employer. In circumstances where a provider is in private practice, the ARRA incentives will come back to him or her.

In other instances, the provider may be required to assign the payment to his or employer so that the ARRA incentives go to the rural health center or to the hospital, which funded the EHR system.

Back to top of page.

16. Who decides whether a provider meets the meaningful use criteria and can receive an incentive payment?

The Medicare incentive program is being administered by CMS through its local fiscal agents. Systems for collecting Meaningful Use measures and for applying for incentives are still being developed.

The Medicaid incentive program is being administered by each state’s respective Medicaid agency. HealthPOINT is working closely with South Dakota’s Medicaid Program.

Back to top of page.

17. What will be the first steps of HealthPOINT?

Starting in the fall of 2010, HealthPOINT began working with eligible providers and critical access hospitals to assess their readiness for EHRs assisting them in implementing health information technology in their practices and moving toward Meaningful Use.

Back to top of page.

18. How is HealthPOINT being provided with its funding?

HealthPOINT is being funded as providers reach three (3) defined milestones that include the following:

Milestone One is considered met when ONC receives a signed Provider Agreement between a healthcare practice and a Regional Extension Center. Please see below for Provider Agreement parameters.

Milestone Two will be achieved when a practice and the associated providers have gone live on a certified EHR. “Go Live” is considered achieved when e-Prescribing and quality reporting measures are actively being utilized.

Milestone Three will be met when a practice and its associated providers have met the Meaningful Use criteria.
(NOTE: The Meaningful Use definition is currently being promulgated through the federal Notice of Proposed Rulemaking process. Please refer to the ONC website for updates and more information.)

Back to top of page.

19. What should I do if I am a “Primary Care Provider” and want to be helped as part of HealthPOINT’s activities?

Contact the HealthPOINT office or sign-up via the web site. Interested centers/providers will need to sign a HealthPOINT Member Services Agreement and agree to its terms and conditions, including the annual membership fee of $300-$600 (per EHR User) – see FAQ #8. Centers/providers also will be required to pay for the direct assistance through Consulting Services it requires, but these services are offered at a substantially discounted rate (until an individual maximum is reached) for eligible Priority Primary Care Providers.

Back to top of page.