EHR incentive program update

Modifications to Meaningful Use for 2015 through 2017: Realigning the EHR Incentive Programs to support health information exchange and quality improvement 

On April 10, 2015, the Centers for Medicare & Medicaid Services issued a new proposed rule for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs to align Stage 1 and Stage 2 objectives and measures with the long-term proposals for Stage 3, to build progress toward program milestones, to reduce complexity, and to simplify providers’ reporting. These modifications would allow providers to focus more closely on the advanced use of certified EHR technology to support health information exchange and quality improvement.

Better Care, Smarter Spending and Healthier People

The proposed rule is just one part of a larger effort across HHS to deliver better care, spend health dollars more wisely, and have healthier people and communities by working in three core areas: improving the way providers are paid, improving the way care is delivered, and improving the way information is shared to support transparency for consumers, health care providers, and researchers and to strengthen decision-making.

Vision for the Future

The proposed rule issued today is a critical step forward in helping to support the long-term goals of delivery system reform; especially those goals of a nationwide interoperable learning health system and patient-centered care. CMS is also simplifying the structure and reducing the reporting requirements for providers participating in the program by removing measures which have become duplicative, redundant, and reached wide-spread adoption (i.e., are “topped out”). This will allow providers to refocus on the advanced use objectives and measures. These advanced measures are at the core of health IT supported health care which drives toward improving the way electronic health information is shared among providers and with their patients, enhancing the ability to measure quality and set improvement goals, and ultimately improving the way health care is delivered and experienced.

What is Quality improvement program

Overview

SHP maintains an active Quality Improvement Program (QIP) that provides structure and processes for our ongoing commitment to proved and continually improve upon the care and services that are offered to our members. The QIP goals are based upon our ongoing evaluation of programs and services offered; regulatory, contractual and accreditation requirements; and strategic planning initiatives.

Program Goals

The goals of the QIP include but are not limited to:

*  Develop, implement and maintain systems and programs that monitor, measure and improve the health care outcomes and service levels within identified member populations

*  Ensure access to qualified, competent providers

*  Engage member/legal guardians in the education, managing and improving their current health state

*  Promote a safe, culturally-sensitive delivery of health care that promotes appropriate, efficient and effective use of resources and supports the physician-patient relationship

*  Ensure the coordination of and transition of care needs are identified and provided to our

members

*  Ensure compliance with standards as required by contract, regulatory statutes and accreditation agencies

*  Encourage and use feedback from stakeholders to improve reporting methods and information availability in relevant, timely manner

*  Utilize a multidisciplinary committee approach to facilitate the success of the QIP goals, improve organizational communication and ensure the participation of contracted community providers in the development/review of the clinical aspects of programs and services

The QIP works to achieve these goals through an evaluation process of clinical and service outcomes by measuring the effectiveness of internal processes and ongoing, active improvement interventions. Functional aspects of the QIP that contributes to a high level of clinical and service outcomes include, but are not limited to:

o Care Management Programs: