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States Lagging Behind in Medicaid Meaningful Use Payments

Posted on March 30, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

If I were part of CMS, I’d be pretty annoyed right now: Apparently, state Medicaid programs are beginning to be a wet blanket in the race to get providers up to Meaningful Use standards.  According to InformationWeek, a dozen states aren’t yet paying out Medicaid incentives, and some of those haven’t even launched incentive programs yet.  Not good news, to say the least.

According to a new post on CMS’s official blog, CMS has handed out Medicare and Medicaid incentives to more than 59,000 eligible professionals and 2,000 hospitals. It also noted that the Medicaid program alone had made more than $1.8 billion in MU incentive payments between January 2011 and the end of last month.

That’s not a bad start, but the slow pace of some Medicaid MU programs is a drag on meeting CMS’s overall goal, which is to have 100,000 providers get MU payments this year.

True, some states are clearly doing their level best: Ohio, which wants to reach 40 percent of eligible providers, Washington, whose goal is 7,000 EPs and hospitals, California, which is trying to get 10,000 providers set up for Medicaid incentives by June; and New York, which hopes to get 6,000 providers get incentive payments in 2012. And 43 states in total have launched a Medicaid incentive program and begun registering applicants, the article reports.

But then there’s the naughty states, which include Hawaii, Idaho, Minnesota, Nebraska, Nevada, New Hampshire, and Virginia — which haven’t launched their Medicaid incentive programs at all. As of December, however, CMS expects (demands?) that all states be making Medicaid incentive payments by June, according to a CMS official quoted in the story.

In the grand scheme of things, I’m pretty confident that Medicare, not Medicaid incentives, are going to drive the train here.  That being said, it is worth asking whether the states’ lagging efforts will create serious problems for the MU program. As I see it, it could go either way, but regardless, it’s not a good sign.

Sad Illustration of Government’s Understanding of EHR

Posted on January 17, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently saw a tweet to the National Conference of State Legislatures (NCLS) list of “Top 12 Legislative Issues of 2012.” It’s an interesting look into issues that state legislatures will be dealing with in 2012. Plus, it makes an interesting observation at the outset that state budgets have been cut so much in past years that lawmakers won’t have to focus all of their initial energy on budget shortfalls.

Most of the list is not surprising with managing the state budget and jobs are at the top of the list. However, there are a couple healthcare and health IT related sections in their list of top government issues as well.

One of the issues is Medicaid: Efficiencies and quality. It talks about how the tough economy is making the Medicaid budgets in states a real challenge and many are looking for cost containing actions. Plus, it points to ACO type reimbursement based on patients’ health outcomes, medical homes and streamlining services. The ACO part was quite interesting to me. I wonder how much of an effect lack of Medicaid budget will push forward a new model of healthcare.

The disturbing part of the report comes in the “Health: Reform in the states, health care exchanges, technology and benefits. Here’s the section on health IT, the EHR incentive money and HIEs.

HEALTH INFORMATION EXCHANGE: One focus for state legislatures in 2012 will be how to move health care providers, especially those participating in the Medicaid program, toward the adoption of certified electronic health records (EHRs). Essentially, instead of having a different health record at each doctor or provider you visit, an EHR will serve as one file that all of your doctors can see. EHRs, once fully implemented, are expected to provide doctors and health professionals with easier access to patient histories and data, resulting in cost-savings and better health outcomes by removing costly errors and duplications in services.

I love how this basically assumes that by having widespread adoption of EHR software, that we’ll then have one patient record that each doctor you visit can see instead of having a different health record at every doctor. Of course, those of us in the EHR world know that this is a far cry from the reality of EHR software today. In most cases you can’t even share a patient record with someone using the same EHR software as you let alone sharing a patient record with a doctor who is using a different EHR.

The sad part is that whoever wrote these legislative issues must have realized that there was some issue with EHR software exchanging information, because then they wrote the following about the state HIE initiatives.

In addition, states are responsible for building and implementing health information exchanges (HIEs) where those EHRs can be accessed by health care providers. HIEs function like an online file cabinet where your medical record is securely stored, and can be accessed by any doctor or health care professional you visit. By mid-year 2012, every state should have Medicaid EHR Incentive programs in place and will be working toward building an HIE by late 2014 or early 2015 as required by deadlines attached to federal cooperative agreements.

So, wait. If EHR software has created one file where any doctor can access our patient record, then why do we need “an online file cabinet” for our medical records? We know the answer is that we need the online filing cabinet because EHR software isn’t connected and there isn’t one patient record. Each doctor maintains their own patient record and that’s not going to change any time soon.

The above quote also implies that every state is working towards an HIE program per the federal program. I must admit that I haven’t gone through every state, but is every state working on an HIE? I certainly know there are a lot of states working on some sort of HIE project, but I didn’t think that every state had funding for HIE. I guess maybe the question is whether there is any state that doesn’t have some sort of HIE program in the works.

Reading issues described like this, you can understand how government passes legislation with limited understanding. Based on this resource, EHR software creates one patient record. Wouldn’t that be nice if it were the case?

Emdeon Gets in the Holiday Spirit with Donation of EHR Technology

Posted on December 21, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I’ve blogged before about the importance of decreasing the digital divide in this country in order to truly move healthcare interoperability forward. As I mentioned last month, “Only those patients who have access to these digital healthcare technologies will begin to clamor for them at their next doctors’ visits. Only patients’ whose doctors in turn have reached out to them via email, text or social media regarding the switch to electronic medical records, development of health information exchange and the benefits to care these will hopefully bring will be ready and willing to go with the digital flow.”

When news came across my somewhat cluttered desk of Emdeon’s initiative to provide electronic health record (EHR) technology to physicians in New Jersey’s underserved communities, I first thought, “Yes! That’s what I’m talkin’ about!” Then I put on my journalist/blogger hat and thought, “Will this truly change anything in these particular communities, or is this just good PR?”

A quick bit of background: Emdeon is partnering with the U.S. Department of Health and Human Services’ (HHS) Office of Minority Health, New Jersey Health Information Technology Extension Center (NJ-HITEC), the state’s REC, and the HIMSS Latino Community. Through the initiative, Emdeon will donate Emdeon Clinician licenses to 100 healthcare providers who practice within medically underserved areas and/or healthcare provider shortage areas, as designated by the Health Resources and Services Administration (HRSA), according to a recent Emdeon press release. The company will waive the license fee for these physicians for one year.

The same press release also mentions “EHR adoption is lower among providers serving Hispanic patients who are uninsured or rely on Medicaid, and is lower among providers serving uninsured, non-Hispanic black patients than among providers serving privately insured, non-Hispanic white patients.”

The initiative sounds like a great idea, but the one-year stipulation got me thinking (a bad habit, I know). What will these physicians, who presumably can’t really afford this technology now, do after their year is up? I reached out to Miriam Paramore, Senior Vice President – clinical and government services at Emdeon, to learn more about the ins and outs of the program.

How did the initiative come about?
Miriam Paramore: During the fall of 2010, leaders from the Office of Minority Health (OMH) and Health Information Technology issued a public, written request to health IT vendors, asking them to pay special attention to healthcare providers within underserved communities. This initiative is known as The Alliance to Reduce Health IT Disparities. Emdeon is serving as a private partner with the OMH to offer access to health IT products and services to providers within undeserved communities in New Jersey. We were thrilled to volunteer and to work within these communities.

Has Emdeon ever done anything like this before?
We’re happy to do part of this effort with HHS and it is the first time we’ve partnered with them.  We have great empathy for the challenges of the physicians in underserved communities and we want to help.

What sort of challenges do small physician practices in underserved communities typically encounter?
In addition to challenges like poverty and health disparities amongst their patient population, providers in underserved communities and smaller practice offices face expensive costs associated with on-boarding EHRs. Emdeon created the Emdeon Clinician solution as an affordable EHR “lite” solution for these small practice physicians or those working in underserved communities. They now have an affordable, easy-to-use solution that will help them to qualify for federal HITECH stimulus dollars without unnecessary disruption and expense of a full-blown EHR system.

How will you work with these 100 physician practices to ensure they are able to continue using the donated EHR after the year-long license expires?
Once the 12-month period expires, providers will be able to continue using Emdeon Clinician for only $99 per provider, per month. Emdeon usually has a $500 implementation and training fee [that, for this program,] has been discounted to a one-time fee of $200 for the providers participating in this project. This is a considerable discount and the fee would only have to be paid once. We will begin outreach to these providers in advance of the expiration date so they are aware of the opportunity to remain with Emdeon Clinician for the low fee following the initial 12-month period.

How will Emdeon work with NJ-HITEC and the HIMSS Latino Community throughout this year to ensure that these practices receive continued training and support?
Emdeon has taken the lead with managing this initiative between all partners with monthly meetings to monitor progress. We have a dedicated project manager, who has mapped a process with the internal team to assist with implementing these physicians as soon as possible. Our custom phone number (1-855-840-7120) connects interested providers directly with a dedicated clinical sales executive who can assist them throughout the enrollment process.

The NJ-HITEC and HIMSS Latino partners are assisting in the recruitment of providers who practice within medically underserved areas for this program from their vast networks across New Jersey communities. These partners are working cooperatively with Emdeon to create a strategy that focuses upon identifying and recruiting providers within underserved communities who are willing to adopt EHRs, especially those interested in qualifying for federal incentive dollars.

How many practices do you anticipate being eligible, and how many do you expect will apply?
While we aren’t sure how many will apply, the HHS OMH recognized that the counties of Camden, Essex and Passaic have the largest percentage of underserved communities. Through our collaborative efforts with the OMH, HIMSS Latino and NJ HITEC, we hope to reach many of those physicians within those counties to take advantage of the 12-month program.

How will Emdeon and its partners determine if this program is a success?
Together with our partners, we believe success will be donating all 100 licenses to providers in underserved communities. The reporting element of this project will help OMH understand the progress of EHR adoption in the context of how long implementation takes in its entirety.

So it seems that Emdeon and its partners certainly have their ducks in a row when it comes to aiding and abetting these physicians before, during and even after the program is technically over. I’ll be interested to see if this model will, in fact, be successful, and if it can be supported in other underserved areas across the nation.

For more information on participating in the program, check out: http://www.emdeon.com/newjersey/

Will a Decrease in the Digital Divide Lead to an Uptick in EMR Adoption?

Posted on November 10, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

There’s a lot of talk in the healthcare industry right now about bringing health management tools to the consumer. Whether it’s apps for your iPhone or iPad, games to play on your Wii, or free-standing health-and-wellness kiosks at your local pharmacy, digital applications seem to the delivery method of choice right now. I think those of us in the healthcare IT industry sometimes take for granted that not everybody in the US has a smartphone, computer or even Internet access, which to me always begs the question: How great are these bright and shiny health apps if the populations that need them most don’t have access to them? And aren’t Meaningful Use and Accountable Care incentives/payments targeted towards government-sponsored healthcare recipients? The most likely patient population to NOT have reliable access to the Internet?

It’s this concept of a digital divide in healthcare that I am starting to believe will truly bend the curve when it comes to absolute interoperability – the secure sharing of information between patient, provider, payer, vendor, government, etc., anytime, anywhere. Only those patients who have access to these digital healthcare technologies will begin to clamor for them at their next doctors’ visits. Only patients’ whose doctors in turn have reached out to them via email, text or social media regarding the switch to electronic medical records, development of health information exchange and the benefits to care these will hopefully bring will be ready and willing to go with the digital flow.

I was intrigued by a recent news story on NPR the other morning that detailed a recently unveiled government plan – the Connect to Compete Initiative – to offer cheaper broadband access and computers to low-income families. The story pointed out that “about one-third of Americans – that would be 100 million people, give or take – do not have Internet access in their homes.” (I’d be interested to know how many of that population are on Medicare or Medicaid, or have no insurance at all.) Participating companies will offer broadband service to eligible families for $10 a month, while others will offer computers for as little as $150.

Further investigating into the story dug up a more detailed report from Reuters, which explained that eligible families will be those who have at least one child enrolled in the National School Lunch Program. According to a recent Commerce Department report on U.S. broadband adoption, only 43 percent of households with annual incomes below $25,000 had broadband access at home, while 93 percent of households with incomes exceeding $100,000 had broadband.

I think this is a step in the right direction, and am pleasantly surprised that it’s being enacted by the government – who got this digital healthcare ball rolling downhill fast in the first place.

As more and more low-income/average/middle-class Americans – or whatever we want to call ourselves – begin to speak out about the systemic inequalities we experience in this country’s financial, healthcare and educational systems, it’s nice to think (naively perhaps) that somebody just might be listening. As we see an increase in adoption of digital technologies in the consumer space, so too do I think we’ll see a correlating increase in adoption of healthcare IT by the providers that care for them.

Pediatrics Face Unique Set of EMR Challenges

Posted on October 26, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

My recent blog about Sandhills Pediatrics and its successful implementation of an EMR prompted, fortunately, a very intriguing comment from Chip Hart, a Director of Sales and Marketing at Physicians’ Computer Company who also maintains the blog “Confessions of a Pediatric Practice Consultant: True Stories from the land of Pediatric Practice Management.” He wrote: “I’ll spare everyone the diatribe about how ARRA deals with pediatricians and how only about 1/2 of them qualify, as I write to make one quick statement.” There’s a story there, I thought to myself. So, being an avid observer of pediatric EMR news and views, I reached out to him to gauge his thoughts on where healthcare IT solutions fit in the world of pediatricians.

What sort of challenges are you seeing pediatric practices facing when it comes to implementing EMR systems?
“On one hand, most of the challenges they face are hardly unique to pediatrics: resistance to change, practice differences, the lack of time and resources to be trained and configured properly, poor support, etc.

“Specific to pediatrics, there are two major issues.  First, children are not simply small adults and EMRs, as a rule, are written for adult medicine. There are many pediatric-specific features and functionality that a pediatric practice needs that simply aren’t met by your large, generic system. Simply claiming “pediatric templates” isn’t enough.

“Second, although every specialty complains about the hit that EMRs take on their productivity, pediatricians are obviously in the worst shape. Their volume is the highest and their payment is the lowest. Just adding a minute to each encounter means an extra 30 minutes of charting a day … and I hear stories, daily, of practices adding another 1 to 2 hours! Pediatricians can’t afford to see 5-percent fewer patients. Radiologists can. And pediatricians really like to eat dinner with their families.

“One second-tier issue is that less than 50 percent of all pediatric practices don’t qualify for ARRA and the regional extension centers (RECs), as a rule, don’t understand the Medicaid rules well.  Thus, we have clients and potential clients calling us to ask how they can get money they’ll never get, or to tell us some crazy thing a REC person told them.”

Are there different sets of challenges for those that are private practices versus those that are hospital/healthcare system affiliated?
“Unquestionably – the big one being that hospital/health system pediatricians simply won’t have a choice or even a voice in the process. Yes, I’ve worked with some who appear to be at the table, but in the end … you get what they hand you. Right now, Epic is pushing everyone out but that pendulum will swing back.

Also, those employed physicians don’t have to consider the impact on their productivity in the same way. I’ve met too many peds offices whose docs didn’t take home checks for a few months after implementation – that’s not right.”

Why do you think practices like Sandhills “get it” in terms of moving forward with HIT implementations, and just being forward thinkers in general?
“If I could answer that question, I’d only be working with those practices! Every successful practice I know is successful in a different way for different reasons, but there is one common trait I see in many of them: They run their practices like the businesses they are. Keep the docs in the exam rooms, where they can generate revenue, and hire professionals to actually run the business. Just because it says “MD” after your name doesn’t mean you’re the best-qualified person to run your office. Would Dirk Nowitski or Lebron James make good coaches? I doubt it.

“In the case of Sandhills, they have some excellent, excellent staff who bring some non-healthcare experience to the table. Although I’ve seen it fail, having some management that comes from outside the healthcare system to ask and answer some tough questions pays off for a lot of practices.

“We’ve enjoyed working with them.  I should also add that they, like the other ‘heads up’ clients I know, realize that we’re on the same team. That helps tremendously.”

How long have you offered the PCC EMR? What sort of up tick in implementations have you seen since ARRA/HITECH came about?
“Our PM has had pediatric clinical features (immunization tracking, registry interfaces, well visit recall, etc.) for almost 30 years, but the official EMR itself was released about 2 years ago.

“When ARRA was first announced, we received a lot of calls, all along the lines of, “Where do I get my free money?”  It was very frustrating to explain that it would be state dependent (about a quarter of them still can’t get it) and half of our clients will never qualify due to the Medicaid requirements.

“Things are starting to settle down and get organized.  Still, we are busier right now than we have ever been. We are telling potential clients they might get installed in May or June. A nice problem to have, but it’s not fun to get some excited only to explain it will be 6 months, especially when it used to be 6 weeks!”

Are any of your pediatric clients thinking of becoming involved in ACOs?
“Thinking?  Yes.  They’re all being told how if they don’t get big, they’ll be out of business, which is utter BS. The rules, as we know them now, seem to make no sense whatsoever for pediatricians. I did see a compelling presentation by Colleen Kraft at the AAP NCE last week that very much supported the ACO-esque model she employs, but I think her situation is both unique and not potentially an ACO.

“With some issues – 5010, PCMH, etc. – we take a pro-active stance. With ACOs, I’m glad to let someone else jump first.”

How will your solutions enable your customers to integrate with ACOs or coordinated care programs?
“Far too soon to tell.  In general, I can say, “Hey, we have had really good reports that have tracked patient populations for years.”  Our clients use them all the time, as it’s both good medicine and good business.  As a practical tool, I’d put our patient recall program up against anyone’s – your front desk can crank out a list of kids who need flu shots or asthma followups in seconds – but we don’t know quite what the ACOs will need.

“One thing we’ve learned, though: when a small peds office puts its data in the hands of a large entity, it’s worth double-checking the results. For more than 20 years, I’ve helped our clients fight insurance companies (which an ACO emulates) and the insurance companies never have the data right. Ever. So if a private peds office can work with us and still be in an ACO, they’ll be able to confirm the accounting.

“Here’s my prediction: As ACOs grow, the practices who participate are going to regret losing control of their data. I’m really going out on a limb there, I know.

What do you think is the greatest challenge being faced by pediatrics when it comes to keeping up with healthcare IT?
“Not getting run over by the Juggernaut.  Everyone else’s demands are put ahead of the pediatricians and the peds usually get served what everyone else is eating.  And it rarely suits them.

“I also tell them all the time: ignore the Meaningful Use money. Completely. And ignore the “deal” that you can get from your local hospital/IPA/etc. Pick the EHR that suits you the most and go with that. All the discounts or federal checks in the world won’t make up for even a 5-percent hit in your productivity or having to spend an extra 10-20 hours a month on charting or IT work. If you do like the local deal, great!  But don’t feel like you have to leap in.”

So there you have it folks. I’d be interested to hear from a pediatrician or two who has gone through or is going through some sort of HIT implementation as a follow-up to these views. Feel free to get in touch with me via the comments section below.

Medicaid EMR Stimulus is Voluntary for States

Posted on August 12, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In another great comment from BobbyG (who works for a REC), he talks about the realization that states have the option to opt out of doing the Medicaid part of the EMR stimulus if they want. The following is the full explanation of the discovery and why they’d make such a decision. Plus, it highlights the challenge of understanding all the regulations around the HITECH act.

Here’s just one example of the difficulty you run across. Yesterday we were on a CMS conference call MU incentives presentation in which they said that states’ participation on the Medicaid side was “voluntary.”

We all went “WHAT?! How did we miss that?”

Sure enough: on the CMS website you see “The Medicaid EHR incentive program is voluntarily offered and administered by States and territories. States can start offering their program to eligible professionals (EPs) as early as 2011″

“voluntarily”, “can start”

Not “shall” or “must”.

Now, we knew from the IRF that (paraphrasing here) “there is no statutory basis for the manner via which states disburse incentive payments” but it somehow escaped us that states could simply opt out entirely.

I went back to the ARRA legislation itself (on the assumption that the FR cannot, beyond operational implementation mechanics, mandate additional requirements not in the legislation). Beginning on page 375 you see “Subtitle B—Medicaid Incentives SEC. 4201. MEDICAID PROVIDER HIT ADOPTION AND OPERATION PAYMENTS; IMPLEMENTATION FUNDING.”

You get to page 380 and then only see stuff about the administrative and reporting “requirements” for states getting the “FFP” money (Federal Financial Participation).

And that’s it.

I searched ARRA from beginning to end and found NO explicit wording that states’ Medicaid participation is “voluntary.” You just have to infer it from the Section 4201 language.

What is one potential adverse upshot? Your REC could be signing up a boatload of providers coming in on the Medicaid side, and if your state opts out, well you now have what’s known as “Reputation Risk” writ large (not to mention a torpedo below the waterline in your Ops plan and its milestone payments assumptions).

Why would a state opt out? Because they are only federally funded for 90% of their “reasonable” administrative expenses for the EHR incentive program. They have to find the other 10%. My state (NV) is currently wrestling with a three BILLION dollar budget gap. Similar relative woes exist elsewhere in statehouses (can you say KAHL-EE-FOR-NEEYA?).

You better know where your state stands before recruiting Medicaid providers if you’re a REC or a consultant or VAR, etc.

Meaningful Use Rule Clarification by John Halamka

Posted on July 28, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In MedCity News, John Halamka makes an effort to summarize as simply as possible the Quality Measures:

I’ve been asked to summarize the Quality Measures as simply as possible

a. The Core Measures for All Eligible Professionals, Medicare and Medicaid are in the Final Rule Table 7, page 287. The Measures are

  • Hypertension: Blood Pressure Measurement
  • Tobacco Use Assessment and Tobacco Cessation Intervention
  • Adult Weight Screening and Follow-up

b. If the denominator for one or more of the Core Measures is zero, EPs will be required to report results for up to three Alternate Core Measures. The Alternate Core Measures for Eligible Professionals are in the Final Rule Table 7, page 287. The Measures are

  • Weight Assessment and Counseling for Children and Adolescents
  • Preventive Care and Screening: Influenza Immunization for Patients ? 50 Years Old
  • Childhood Immunization Status

c. The Clinical Quality Measures for Submission by Medicare or Medicaid EPs for the 2011 and 2012 Payment Year (EPs must choose 3) are in the Final Rule Table 6, page 272 . Here’s a summary of the 44 quality measures that CMS posted last week.

d. The Clinical Quality Measures for Submission by Eligible Hospitals and Critical Access Hospitals for Payment Year 2011-2012 are in the Final Rule Table 10, page 303. The Measures are

  • Emergency Department Throughput ’ admitted patients Median time from ED arrival to ED departure for admitted patients
  • Emergency Department Throughput ’ admitted patients Admission decision time to ED departure time for admitted patients
  • Ischemic stroke ’ Discharge on anti-thrombotics
  • Ischemic stroke ’ Anticoagulation for A-fib/flutter
  • Ischemic stroke ’ Thrombolytic therapy for patients arriving within 2 hours of symptom onset
  • Ischemic or hemorrhagic stroke ’ Antithrombotic therapy by day 2
  • Ischemic stroke ’ Discharge on statins
  • Ischemic or hemorrhagic stroke ’ Stroke education
  • Ischemic or hemorrhagic stroke ’ Rehabilitation assessment
  • VTE prophylaxis within 24 hours of arrival
  • Intensive Care Unit VTE prophylaxis
  • Anticoagulation overlap therapy
  • Platelet monitoring on unfractionated heparin
  • VTE discharge instructions
  • Incidence of potentially preventable VTE

Everything clear now?