10-2015 ARRA EHR Medicaid Incentive Program Changes

In October of 2015, CMS released the final ruling for requirements for the ARRA EHR Medicaid Incentive Program.

Read below to learn about the changes to the required measures and how they may affect PCC clients who are applying for the program.

Introduction: All Applications Now Use a Single Set of Requirements

The new set of standards are called “Modified Stage 2”, and they significantly change what Meaningful Use objectives your practice needs to meet to qualify for the ARRA program.

The new standard combines the earlier “Stage 1” and “Stage 2” standards into a single set of rules, with various alternates and exclusions for those who were previously seeking to apply for Stage 1.

Other Notes:

  • The standard reporting period for the EHR Medicaid Incentive program is now 1 full calendar year, but for 2015 you may still use any 90 days period within the calendar year.
  • All providers have until 02/29/2016 to attest for 2015.

What Meaningful Use Objectives Are Now Required for the ARRA EHR Medicaid Incentive Program?

The ten objectives in the new Modified Stage 2 standard are:

  • Objective 1: Protect Patient Health Information
  • Objective 2: Clinical Decision Support (CDS)
    • Measure 1: Implement Clinical Decisions
    • Measure 2: Enable Drug-Drug and Drug Allergy Interaction Checks
  • Objective 3: Computerized Provider Order Entry (CPOE)
    • Measure 1: CPOE for Medications
    • Measure 2: CPOE for Lab Orders
    • Measure 3: CPOE for Radiology
  • Objective 4: Electronic Prescribing
  • Objective 5: Health Information Exchange
  • Objective 6: Patient Specific Education
  • Objective 7: Medication Reconciliation
  • Objective 8: Patient Electronic Access
    • Measure 1: Timely Online Access
    • Measure 2: View, download, or transmit health information
  • Objective 9: Secure Electronic Messaging
  • Objective 10: Public Health Reporting
    • Measure 1: Immunization Registry Reporting
    • Measure 2: Syndromic Surveillance Reporting
    • Measure 3: Specialized Registry Reporting

Additional documentation on what each measure requires, how each measure is calculated, and how your practice can adjust PCC EHR configuration and workflow to meet each measure, is coming soon.

In the meantime, PCC’s Tim Proctor has updated his handy Meaningful Use Measures table.

You can also read about each measure in the EHR Incentive Programs 2015 through 2017 (Modified Stage 2) Overview.

If I Was Planning to Apply For Stage 1, How Are My Required Measures Different?

For an EHR reporting period in 2015, an eligible professional who was scheduled to participate in Stage 1 in 2015, may satisfy the 10 measures in different ways.

Additional documentation is coming soon. In the meantime, you can read EHR Incentive Programs 2015 through 2017 (Modified Stage 2) Overview to check up on each measure’s list Alternate Exclusions and/or Specifications.

What Measures Were “Cut” From the Program Requirements?

If you were applying for Meaningful Use Stage 1 for 2015, you no longer need to report on these previously-required measures:

  • Maintain an up-to-date problem list of current and active diagnoses
  • Maintain an active medication list
  • Maintain an active medication allergy list
  • Record all of the following demographics: preferred language, gender, race, ethnicity, and date of birth
  • Record and chart changes in the following vital signs: height, weight, blood pressure, BMI, and plot and display growth charts for these vitals
  • Provide clinical summaries for patients for each office visit
  • Incorporate clinical lab-test results into EHR as structured data
  • Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach
  • Send patient reminders per patient preference for preventative/follow-up care

These additional measures were cut from the list of previously required Meaningful Use Stage 2 list:

  • Record smoking status for patients 13 years or older
  • Use clinically relevant information to identify patients who should receive reminders for preventative/follow-up care and send those patients the reminders, per patient preference
  • Record electronic notes in patient records
  • Imaging results consisting of the image itself and any explanation or other accompanying information are accessible through CEHRT.
  • Record patient family health history as structured data

Do I Need to Follow the Guidelines For the Removed Measures?: While you no longer need to report on smoking status, followup-care reminders, and the other measures that were removed from the list of required Meaningful Use measures, your practice should still continue to perform the procedures defined in these “best practice” measures. For example, if your practice attests for the ARRA EHR Medicaid Incentive program, and you are audited, you will need to show that you collect smoking status for patients 13 years or older.

What Notable Threshold Percentages for Measures Have Changed?

The percentages required to meet each measure has changed for a number of measures.

The most notable changes include:

  • The “View, Download, or Transmit” measure threshold in the Patient Electronic Access objective is lower. For 2015 and 2016, the requirement is 1 or more patients. For 2017, the requirement is 5% of patients or more.
  • The Secure Messaging objective threshold now requires attestation of functionality for 2015, at least 1 patient for 2016, and at least 5% of patients for 2017.

Are There Any Changes to the Required Clinical Quality Measures?

The ARRA EHR Medicaid Incentive Program requirements for CQM reporting have not changed.

As with Meaningful Use measures, for 2015, providers may attest for any continuous 90-day period of CQM data during the calendar year.

How Does This Announcement Change How I Use PCC to Meet Meaningful Use?

PCC EHR is designed to help your practice meet all 20 of the Meaningful Use objectives as laid out in the previous set of requirements. After PCC practices made certain configuration and charting workflow changes, all 20 measures could easily be met by your practice using PCC EHR.

Since the 10/2015 CMS announcement significantly reduces the number of measures and the percentile threshold for some measures, some of PCC’s earlier recommended changes are no longer necessary.

Tim Proctor, PCC’s Meaningful Use expert, is offering a series of Web labs and a handy spreadsheet for practices seeking to meet Meaningful Use for the ARRA EHR Medicaid Incentive Program or a PCMH program.

Additional documentation is coming soon.

How Does This Announcement Change How I Use PCC to Report on Meaningful Use?

PCC EHR’s Meaningful Use Measures Report collects and calculates your percentages based on the set of requirements in place prior to October of 2015. Because of the CMS’s October 2015 changes, you can ignore many of the measures listed in the report.

If you were planning to apply for Stage 1 Meaningful Use using a 90 day reporting period in 2015, the current report in PCC EHR will show you many more measures than are required.

If you are applying for Stage 2, the new “Modified Stage Two” requirements are also significantly simpler than shown in PCC’s Meaningful Use Measures report for Stage 2.

  • Last modified: August 22, 2016