MeHI eQuality Incentive ProgramSolicitation No. 2015-MeHI-01 Question & Answer Webinar - November 12, 2014

Massachusetts eHealth Institute

eQuality Incentive Program (“eQIP”)Solicitation No. 2015-MeHI-01

Question & Answer WebinarNovember 12, 2014

©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.2

Introduction

Legal Considerations

MeHI Overview

eQuality Incentive Program (eQIP) Overview

− Eligibility Criteria

− Milestones

− Application Process and Timelines

Questions

Agenda

Introduction / Presenters

Host: Judith Iwanski, Manager, eHealth eQuality Program

Laurance Stuntz, MeHI Director

Sean Kennedy, Director, Health Information Exchange

Ross Venables, Grants and Contracts Administrator

Please hold all questions to the end

[May type questions into the “questions” section]




The Solicitation has been posted to the MassTech website & Comm-Buys, the Commonwealth’s procurement portal.

To the extent anything stated/presented in this webinar is inconsistent with the RFP, the Solicitation written documents shall govern.

MassTech reserves all rights to amend, modify or otherwise clarify the Solicitation & any written answers to questions presented.


Legal Considerations (cont.)

It is the Respondent’s responsibility to check MassTech and/or Comm-Buys websites for addenda or modifications to the Solicitation.

Please review the Solicitation carefully.− Non-responsive applications will be rejected.


MassTech Overview

The Massachusetts Technology Collaborative (MassTech) was established pursuant to Massachusetts General Laws Chapter 40J. MassTech is an independent authority of the Commonwealth of Massachusetts.

MeHI (Massachusetts eHealth Institute) is a non-divisible component of MassTech. MeHI functions as a business division of MassTech


MeHI is the designated state agency for:

Coordinating health care innovation, technology and competitiveness

Accelerating the adoption of health information technologies

Promoting health IT to improve the safety, quality and efficiency of health care in Massachusetts

Advancing the dissemination of electronic health records systems in all health care provider settings

MeHI is a division of the Massachusetts Technology Collaborative, a public economic development agency

8

MeHI Overview

• Tech Hub Collaborative• Big Data Consortium• Advanced Manufacturing

Collaborative• Innovation Index

• Mass Broadband 123• MassVetsAdvisor

• Interoperable EHR Adoption• Connected Communities• eHealth Services & Support• eHealth Cluster

Massachusetts eHealth Institute

MeHI | Vision, Mission, Goals


10

eHealth Services &

Support

Connected Communities

eHealth eQuality

MeHI Initiatives 2014 - 2015

Outreach &Operations

eHealthCluster

Development

Innovation • Insight • Collaboration • Accountability

CORE VALUES

Overview of the eHealth eQIP Solicitation


MeHI Goal: − Advancing dissemination of EHRs in all provider settings and− Facilitate networking through Mass HIway

Recent survey of MA providers:− BH organizations behind other sectors in EHR adoption

• Primary care providers – 96% adoption rate• Among specialty providers – 86% adoption rate• Among BH organizations – 55% adoption rate

− 50% among independent BH orgs (100% among affiliated)

c. 224, Acts of 2012:− MeHI to give priority to organizations that are:

• Generally not eligible for Medicare or Medicaid EHR Incentive Programs &• Lack access to other resources to implement interoperable EHRs

− Including mental health facilities & community-based BH providers

eHealth eQuality Program / Background


BH services− Evaluate/treat people with mental health or substance use disorders

• Provided by a professional health care worker, or • Substance abuse treatment services licensed or approved by MA DPH

BH Providers− Must provide direct patient care, and be:

• Licensed clinicians, or • Authorized to provide care under supervision of a licensed professional

Affiliated– Entities under common control or governance (e.g. subsidiary) or– Joined together contractually or through shared entity (e.g., LLC)

Patient Services Revenue̶O Net PSR (from 3rd party payers), PLUS̶O Revenue under a state or local contract to provide BH services

MeHI reserves the right to further define terms used in this Solicitation

eQIP: Definitions


All organizations receiving eQIP grant must:− Use CEHRT

• 2011, 2014 or voluntary certification acceptable

− Submit a questionnaire to HIMSS A-EMRAM• To determine EHR adoption baseline

− Generate Transformation Plan

− Commit to achieving all milestones

− Submit reports & attend annual in-person event

eQIP: Program Requirements


Organizations must meet all 7 criteria:1) Provide clinical care

2) Provide primarily BH services− >50% patient services revenue from BH services in MA

3) Hold valid license to provide BH programs and services, or − Clinical providers have valid professional licenses

4) Be organized as a not-for-profit corporation

5) Have no financial relationship/affiliation with health care system− Some exceptions apply

6) Serve a large proportion of public payer clients− >50% patient service revenue is public payer

7) Not eligible for the EHR Incentive Payment Programs− Some exceptions apply

Attestation of compliance required

eQIP: Eligibility Criteria

16

eQIP | Detailed Eligibility Criteria

Eligibility Criteria Method of Substantiation*

1.

Provide BH clinical care services in MA Statement of Operations/Income Statement indicating Patient Service Revenue* (PSR) for any month (6/1/14 through 9/30/14)

2.

Hold license to provide BH clinical care programs/services in MA, ORIts providers have valid professional licenses

Currently valid license(s) to provide BH clinical care programs/services (by DPH) or MA DMH certification as provider of BH services

3.

Provide primarily BH services(>50% of annual PSR from BH services in MA)

Documentation indicating (1) Percent of PSR for last SFY and(2) Source/amount for all BH PSR (private payer(s), Medicaid, Medicare etc.)

4.Is a not-for-profit corporation Certificate of Good Standing for a not-for-

profit corporation in MA

** Patient Services Revenue = NPSR (3rd party payers) + revenue under a state or local contract to provide BH services

17

eQIP | Detailed Eligibility Criteria (cont.)

Eligibility Criteria Method of Substantiation

5.No financial relationship/affiliation to a health care system

Corporate org chart showing ownership, governance & operational structure

5A.

Organizations that are part of a system meet this criteria . . . IF:

Annual PSR of parent org is <$25M

Documentation: annual PSR of parent org is <$25M

6.

Serve large proportion of public payer clients(>50% of PSR is public payer )

Documentation: portion of PSR from public payer for last SFY

7.Not an Eligible Hospital (“EH”) and providers are not Eligible Professionals (“EPs”)

Documentation: is not an EH and its providers are not EPs

7B.

Organizations that have some EPs meet this criteria . . . IF:

Number of EPs >30% of clinical staff, and

Is either independent or annual PSR of parent org is <$25M

Documentation: total clinical staff & percent of EPs ANDDocumentation: no financial relationship/affiliation or annual PSR of parent org is <$25M


MeHI will consider how the organization intends to use EHR/health IT in light of MA health care policy objectives

− Will look favorably on applicants:• Using health IT to integrate BH with primary care• Serving underserved populations or in medically underserved

areas

MeHI will contract with those Applicants that:– Meet the eligibility criteria

– Clearly describe approach feasibility, organizational ability & capacity, & anticipated impact; and

– Sufficiently demonstrate organizational need & commitment

eQIP: Other Factors


EOHHS SIM Mass HIway Grant− Collaborating with EOHHS (companion grant to eQIP )− Additional funding to maximize EHR interoperability capabilities to

achieve interoperability across the continuum of care

eQIP Milestone 4 requires:− Connection/use of Mass HIway to exercise use case in production

with at least one unaffiliated trading partner &− Approach to operationalizing “opt in” for Mass HIway

Additional SIM funding will assist grantees to:− Achieve greater volume of transactions on the Hiway, &− Increasingly sophisticated use of the HIway

NOTE: Closely aligned to eQIP, but a separate funding program− Will require second application through EOHHS

eQIP: State Innovation Model (SIM) Funding


eQIP: Milestones

Milestone Deliverable

1 Approved Transformation Plan How org will prepare & transform practice to

maximize health IT investments to achieve identified outcomes

Meet Required A-EMRAM Stage 1 & 2 Criteria

Transformation Plan (due within 3-months)

Completed HIE Use Case Development Form Email from MeHI indicating achievement of required A-EMRAM Stage 2 criteria

2 Meet Required A-EMRAM Stage 3 criteria Email from MeHI indicating achievement of required A-EMRAM Stage 3 criteria Description of certified EHR technology

3 Meet Required A-EMRAM Stage 4 & 5 criteria Email from MeHI indicating achievement of required A-EMRAM Stage 5 criteria Updated description of certified EHR technology

4 Transacting on the Mass HIway Copy of Mass HIway participation agreement Attestation from that production transactions are being sent/received for the use case Approach to operationalize “opt in” for the Mass HIway


Transformation Plan shall describe, at a minimum: − Anticipated Outcomes

• Operational and/or clinical outcomes being targeted• Better integration of behavioral with physical health care

− Current Health IT State− Desired Future IT State− Gap Analysis− Grant Approach

• Approach to meeting each milestone• How advancements in use of health IT will support achieving

identified operational and/or clinical outcomes• How organization will protect electronic health information • The timeline of major activities

− Including dates to meet M1, M2, M3 and M4

Plan shall incorporate A-EMRAM gap assessment findings

eQIP: Transformation Plan

22

eQIP | Milestones

Milestone 1 (15% of total incentive) = required EMRAM* Stage 1 & 2 – Desktop access to clinical information, unstructured data, multiple data sources,

intra-office/informal messaging– Beginning of a CDR with orders and results, computers may be at point-of-care,

access to results from outside facilities

Milestone 2 (25% of total incentive) = required EMRAM* Stage 3– Electronic messaging, computers have replaced the paper chart, clinical

documentation and clinical decision support

Milestone 3 (35% of total incentive) = required EMRAM* Stage 4 & 5– Computerized Provider Order Entry, Use of structured data for accessibility in

EMR and internal and external sharing of data– Personal health record, online tethered patient portal

________________________

HIway Milestone 4 (25% of total incentive) = Transacting on Mass HIway – “Floating” Milestone– Organizations can meet the HIway Milestone at any time after meeting M-1– Must be integrated into the EHR

*NOTE: some requirements may not be applicable to BH organizations

23

eQIP: A-EMRAM Stages – overview

US Ambulatory EMR Adoption Model SM

eQIPMilestone

Stage Cumulative Capabilities

Stage 7 HIE capable, sharing of data between the EMR and community based EHR, business and clinical intelligence

Stage 6 Advanced clinical decision support, proactive care management, structured messaging

M-3

Stage 5 Personal health record, online tethered patient portal

Stage 4 CPOE, Use of structured data for accessibility in EMR and internal and external sharing of data

M-2Stage 3 Electronic messaging, computers have replaced the paper chart, clinical

documentation and clinical decision support

M-1

Stage 2 Beginning of a CDR with orders and results, computers may be at point-of-care, access to results from outside facilities

Stage 1 Desktop access to clinical information, unstructured data, multiple data sources, intra-office/informal messaging

Stage 0 Paper chart based

HIMSS Ambulatory EMR Adoption Model (A-EMRAM)O̶ Focus on key IT systems that need to be implemented for achieving higher levels of access,

quality, efficiency and safety


eQIP: Tiered & Graded Payment Structure

REVENUE TIERSSmall Organizations $1 Million up to 10 MillionMedium Organizations $10 Million + up to 25 MillionLarge Organizations $25 Million + up to 50 MillionVery Large Organizations Greater than $50 Million

Milestones

Org. Size M-1 M-2 M-3

Small $ 4,950 $ 8,250 $ 11,500

Medium $ 7,425 $ 12,375 $ 17,325

Large $ 9,900 $ 16,500 $ 23,100

Very large $ 12,375 $ 20,625 $ 28,875

M-HIway (floating milestone) Total

Small $ 8,250

Organizations can meet the HIway Milestone at any time after meeting M-1.

$ 33,000

Medium $ 12,375 $ 49,500

Large $ 16,500 $ 66,000

Very large $ 20,625 $ 82,500

Application Process and Evaluation Criteria

Application: Timeline Chart


Task Date

Solicitation Posted October 23, 2014

Webinars November 6, 2014 @ 12:00pm, ESTNovember 12, 2014 @ 12:00pm, EST

Final Questions Due November 17, 2014 @ 5:00pm, EST

Final Question & Answer File Posted November 21, 2014

Electronic Applications DueSent to [email protected]

December 11, 2014 @ 3:00pm EST

Hard Copy Applications Due December 11, 2014 @ 3:00pm, EST

Anticipated Awards Date January 28, 2015

mailto:[email protected]

Application Process

The following must be submitted by December 11, 2014 at 3:00 p.m.:

To: [email protected]:− An electronic version (.pdf or .doc) of the Application, including the

Authorized Applicant’s Signature and Acceptance Form (Attachment B) and Attachments – with signatures

− Include Solicitation number in subject heading

To: MassTech offices (Westborough) − 1 unbound original Application, including Acceptance Form (Attachment

B) and Attachments – with original signatures− 1 unbound copy− 4 bound copies (no three ring binders)



Application

Application packages must include the following:− Proposal Narrative (8-page limit)̶O Substantiation Form ̶O Officer’s Certification Form ̶O Signed Organizational Approval Letter stating support for

the proposed project. ̶O Application Summary Sheet Form̶O Authorized Application Signature and Acceptance Form


Proposal Narrative

Abstract: Organization overview & summary of approach to objectives− Current health IT state− How planned IT advancements will support identified outcomes− IMPORTANT: Abstract will serve as the proposal summary for

reviewers and contracting

Statement of Need: Why organization needs these grant funds

Project Approach: Approach to using health IT to meet each milestone − Timeline to reach milestones & complete grant requirements (by 1/15/2017)

EHR product: Complete EHR Current Product Table (if applicable)− Vendor, product, version, CHPL #, status, care setting, extent used

Mass HIway status:− If currently using Mass HIway

• How connected (LAND, webmail, EHR Direct) & how using

− If not using Mass HIway, describe how intend to use the HIway


Proposal Narrative (cont.)

Health System Integration: Efforts to integrate BH with other medical care− Examples: coordinated treatment plans; continuity of care

In-Kind Resources: Resources organization intends to provide to supplement or support incentive payments− Provide estimated value

Value of Investment: How incentive payments will achieve long-term benefits & meet MA policy goals− (Examples) Leverage HIT/interoperable EHR systems to improve patient

health, coordination of care across providers, transitions of care or provide reduction in HC costs

Anticipated Challenges: Outline anticipated challenges/problems in meeting milestones− Ways in which organization will address anticipated challenges


Evaluation Criteria

Applications will be reviewed against the following criteria:− Compliance:

• Applicant met each of the seven (7) eligibility criteria– Need:

• Applicant described why the funding needed (how other funds/resources are insufficient)

– Feasibility: • Applicant described feasible approach to meeting milestones & achieving a

more advanced state of integration/use of health IT– Ability:

• Applicant demonstrated ability to meet guidelines/conditions of Solicitation– Capacity:

• Applicant indicated organization’s capacity to carry out approach to meeting milestones

– Commitment: • Applicant demonstrated commitment to Program intent & meeting all

milestones− Impact:

• Applicant addressed how it will use HIT to support health care policy objectives


Solicitation – Questions?

Questions / Responses

Questions may be submitted to the address set forth in Section 4.1 or by e-mail to [email protected]

All questions must be received by 5:00 p.m. on November 17, 2014 − Submission of questions by e-mail strongly encouraged

Review Q&A File (posted on RFP page) prior to submitting questions− Further questions/clarification may be added after the webinars

• Notification of updates will not be sent• Applicants have responsibility to check website for updates

Questions/Responses – posted by 5:00 p.m. on November 21, 2014 − On the MassTech and Comm-Buys websites



eHealth eQuality Solicitation No. RFP-2015-MeHI-01

BH eQuality Incentive Program “eQIP”

Thank you

Healthcare

MeHI eQuality Incentive ProgramSolicitation No. 2015-MeHI-01 Question & Answer Webinar - November 12, 2014