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Dentists &
Meaningful
Use: Stage 1
Adele Allison,
National Director of Government Affairs,
SuccessEHS
The
Opportunity
•Dentists are eligible
under both Medicare
and Medicaid Incentive
Programs
However…
•Medicare does not
cover General Dentistry;
No Medicare, No
Incentive
And…
• No oral health measures in
Meaningful Use Stage 1
 –No Standards for EDR
  Certification
 –All applicable measures must
  be performed using EHR
  Functionality
•253 dentists were paid
during Year One of the
Incentive Program

YTD earnings =
$5,376,250
•Same Stage 1 Criteria
applies

•Consider 13 exclusion
clauses
Medicaid EHR
Incentives:
Highlights
• Types of (Medicaid)
Providers – §495.100
–Physicians, Dentists, Certified
 Nurse Midwives, Nurse
 Practitioners, Physician
 Assistants (In FQHC/RHC led
 by PA)
• Year 1: Adopt, Implement,
Upgrade – §495.100
 –Acquire, purchase or secure
  access to certified EHR
  technology
 –Install/use certified EHR
  technology capable of MU
 Or…
−Expand functionality of
 certified EHR solution at the
 practice with:
 −Staffing
 −Maintenance
 −Training
 −Upgrading from existing EHR to
  certified EHR technology.
• Year 2: Meaningful Use for
90 continuous days.

• Years 3 – 6: Meaningful
Use for a full year.
• Must meet the individual
state requirements for
volume threshold
–20% for Pediatricians
–30% for FQHCs and RHCs
–30% for all others
• Defined in the State’s
SMHP – Method’s available
–By Encounter
–By Panel
–By Group
–Other
• “Needy Individual” is a
  patient who… §495.302
  (FQHC/RHC)
 −Receives Medicaid or CHIP
  assistance
 −Receives uncompensated
  care by the provider
• “Needy Individual” is a
  patient who… §495.302
  (FQHC/RHC)
 −Services provided at no cost
  or reduced cost based on
  sliding scale and ability to pay
Dentists &
MU: Metrics
• 67% of U.S. dentists are in a
  solo practice
• 65% of U.S. dentists are
  “General”
• 70% of Americans see the
  dentist one time a year
• 2% of dentists work full-time
  in safety net
• 4.6 million children receive
  no dental care due to cost
• 33.3 million live in Dental
  Health Professional Shortage
  Areas
• 6.7% of general dentists’
  patients are publicly insured
• 18.9% of pediatric dentists’
  patients are publicly insured
Dentists &
MU: Barriers
• Few dentists meet the 30%
  volume threshold
  requirement for MU
• 20% volume threshold does
  not apply to pediatric
  dentists
• Dentists are not on REC “hit
  list,” including safety net
  dentists
• Dentistry uses “procedure
  codes.” This does not include
  Diagnostic Codes (ICD-9)
• Dentists must continue CMS
  communication
• Most patients see the
  dentist when “Well.” This is
  a missed opportunity for
  point-of-care alerting
• The IT infrastructure that is
  common to physicians and
  hospitals is virtually non-
  existent in dentistry
• U.S. dentists use the current
  dental terminology
• There is a lack of EHR and
  EDR standards-based
  interoperability in
  marketplace
For more information about
industry trends, visit
www.successehs.com for
white papers, articles, blog
posts and more!

  Click here for our industry blog

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Dentists and Meaningful Use: Stage 1

  • 1. Dentists & Meaningful Use: Stage 1 Adele Allison, National Director of Government Affairs, SuccessEHS
  • 3. •Dentists are eligible under both Medicare and Medicaid Incentive Programs However…
  • 4. •Medicare does not cover General Dentistry; No Medicare, No Incentive And…
  • 5. • No oral health measures in Meaningful Use Stage 1 –No Standards for EDR Certification –All applicable measures must be performed using EHR Functionality
  • 6. •253 dentists were paid during Year One of the Incentive Program YTD earnings = $5,376,250
  • 7. •Same Stage 1 Criteria applies •Consider 13 exclusion clauses
  • 9. • Types of (Medicaid) Providers – §495.100 –Physicians, Dentists, Certified Nurse Midwives, Nurse Practitioners, Physician Assistants (In FQHC/RHC led by PA)
  • 10. • Year 1: Adopt, Implement, Upgrade – §495.100 –Acquire, purchase or secure access to certified EHR technology –Install/use certified EHR technology capable of MU Or…
  • 11. −Expand functionality of certified EHR solution at the practice with: −Staffing −Maintenance −Training −Upgrading from existing EHR to certified EHR technology.
  • 12. • Year 2: Meaningful Use for 90 continuous days. • Years 3 – 6: Meaningful Use for a full year.
  • 13. • Must meet the individual state requirements for volume threshold –20% for Pediatricians –30% for FQHCs and RHCs –30% for all others
  • 14. • Defined in the State’s SMHP – Method’s available –By Encounter –By Panel –By Group –Other
  • 15. • “Needy Individual” is a patient who… §495.302 (FQHC/RHC) −Receives Medicaid or CHIP assistance −Receives uncompensated care by the provider
  • 16. • “Needy Individual” is a patient who… §495.302 (FQHC/RHC) −Services provided at no cost or reduced cost based on sliding scale and ability to pay
  • 18. • 67% of U.S. dentists are in a solo practice • 65% of U.S. dentists are “General” • 70% of Americans see the dentist one time a year
  • 19. • 2% of dentists work full-time in safety net • 4.6 million children receive no dental care due to cost • 33.3 million live in Dental Health Professional Shortage Areas
  • 20. • 6.7% of general dentists’ patients are publicly insured • 18.9% of pediatric dentists’ patients are publicly insured
  • 22. • Few dentists meet the 30% volume threshold requirement for MU • 20% volume threshold does not apply to pediatric dentists
  • 23. • Dentists are not on REC “hit list,” including safety net dentists • Dentistry uses “procedure codes.” This does not include Diagnostic Codes (ICD-9)
  • 24. • Dentists must continue CMS communication • Most patients see the dentist when “Well.” This is a missed opportunity for point-of-care alerting
  • 25. • The IT infrastructure that is common to physicians and hospitals is virtually non- existent in dentistry • U.S. dentists use the current dental terminology
  • 26. • There is a lack of EHR and EDR standards-based interoperability in marketplace
  • 27. For more information about industry trends, visit www.successehs.com for white papers, articles, blog posts and more! Click here for our industry blog