I created and presented this as an overview for the Southern Illinois chapter of the HFMA.

1. Navigating the Path toward Meaningful Use Southern Illinois HFMA February 18, 2010

11. Source: CCHIT - Based on Interim Final Rule and NPRM; Maximum Incentive for EP Medicare (not Medicaid or underserved geographies 2010 2011 2012 2013 2014 2015 2016+ Maximum Incentive Stage 1 $18K Stage 1 $12K Stage 2 $8K Stage 2 $4K Stage 3 $2K Stage 3 $0K $44K Stage 1 $18K Stage 1 $12K Stage 2 $8K Stage 3 $4K Stage 3 $4K $44K Stage 1 $15K Stage 2 $12K Stage 3 $8K Stage 3 $4K $39K Stage 1 $12K Stage 3 $8K Stage 3 $4K $24K Less than Stage 3 PENALTY Less than Stage 3 PENALTY PENALTY

15. Medicare-FFS Program Fiscal Year Fiscal Year Eligible Hospital First Receives the Incentive Payment 2011 2012 2013 2014 2015 2011 1.00 --- --- --- --- 2012 0.75 1.00 --- --- --- 2013 0.50 0.75 1.00 --- --- 2014 .025 0.50 0.75 0.75 --- 2015 --- .025 0.50 0.50 0.50 2016 --- --- .025 .025 .025

19. Medicaid EHR Incentive Qualifying Patient Volume Threshold Entity Minimum 90-day Medicaid Patient Volume Threshold Or the Medicaid EP practices predominately in an FQHC or RHC – 30% “needy individual” patient volume threshold Physicians 30% Pediatricians 20% Dentists 30% Certified Nurse midwives 30% Physician Assistants when practicing at an FQHC or RHC led by a physician assistant 30% Nurse Practioner 30% Acute care hospital 30% Children’s hospitals

21. Medicaid EHR Incentive Maximum Incentive Payment for Medicaid Professionals Cap on Net Average Allowable Costs, per the HITECH Act 85 percent Allowed for Eligible Professionals Maximum Cumulative Incentive over 6-year period $25,000 in Year 1 for most professionals $21,250 $63,750 $10,000 in Years 2 – 6 for most professionals $8,500 $16,667 in Year 1 for pediatricians with a minimum 20% volume, but less than 30% volume, Medicaid patients $14,167 $42,500 $6,667 in Years 2 – 6 for pediatricians with a minimum 20% volume, but less than 30% volume, Medicaid patients $5,667

22. Medicaid EHR Incentive Payment Scenarios for EPs beginning adoption in the First Year Calendar Year Medicaid EPs who being adoption in 2011 2012 2013 2014 2015 2016 2011 $21,250 2012 $8,500 $21,250 2013 $8,500 $8,500 $21,250 2014 $8,500 $8,500 $8,500 $21,250 2015 $8,500 $8,500 $8,500 $8,500 $21,250 2016 $8,500 $8,500 $8,500 $8,500 $8,500 $21,250 2017 $8,500 $8,500 $8,500 $8,500 $8,500 2018 $8,500 $8,500 $8,500 $8,500 2019 $8,500 $8,500 $8,500 2020 $8,500 $8,500 2021 $8,500 TOTAL $63,750 $63,750 $63,750 $63,750 $63,750 $63,750

23. Medicaid EHR Incentive Payment Scenarios for EPs adopted EHR before First Year Calendar Year Medicaid EPs who begin Meaningful Use in 2011 2012 2013 2014 2015 2016 2011 $8,500 2012 $8,500 $8,500 2013 $8,500 $8,500 $8,500 2014 $8,500 $8,500 $8,500 $8,500 2015 $8,500 $8,500 $8,500 $8,500 $8,500 2016 $8,500 $8,500 $8,500 $8,500 $8,500 2017 $8,500 $8,500 $8,500 $8,500 2018 $8,500 $8,500 $8,500 2019 $8,500 $8,500 2020 $8,500 2021 TOTAL $42,500 $42,500 $42,500 $42,500 $42,500 $42,500

32. Medicaid EHR Incentives Hospital Incentives

70. Deviate from the Path The chart above indicates how market basket payment reduction would work if a hospital is not a meaningful user and/or does not report quality data by FY 2015 and beyond. 2015 2015 2015 2015 2016 2016 2016 2016 2017 2017 2017 2017 Report Data X X X X X X MU EHR X X X X X X Update 2% 1.5% 1.5% 1% 2% 1.5% 1% .5% 2% 1.5% .5% 0