Health IT Policy Committee MeetingJune 10, 2014

Data Analytics Update

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PROGRESS AND PERFORMANCE

Progress and performance among Eligible Professionals in the first 3 years of the EHR Incentive Program

- Who achieved meaningful use in first 3 years?- Who is achieving meaningful use year-over-year?- How does performance on meaningful use objectives

vary?

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Majority of eligible professionals have attested to stage 1

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Professionals(n=537,600) 59% 15% 17% 5% 3%

Attested MU AIU onlyRegistered EHR Incentive Program Enrolled RECNot participating

Note: Categories are hierarchical and mutually exclusive. For example, a professional that has attested to meaningful use and received an AIU payment and is enrolled with an REC is counted only in the Attested MU category. MU is meaningful use. AIU is adopt/implement/upgrade to certified EHR technology. REC is Regional Extension Center.

Variation in Meaningful Use attainmentby physician age, specialty, group size

4Note: Physician specialty and age are from the CMS EHR Incentive Programs and the 2011 American Medical Association Masterfile. Group size is the number of providers counted under the same billing ID in the 2013 PECOS dataset. All physician data were merged via NPI to the CMS EHR Incentive Program data through April, 2014.

Likelihood of ever attesting to Stage 1 meaningful use among physicians, April 2014

Age

Specialty

Group size

Relative Risk

Variation in Meaningful Use attainmentby area characteristics

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Urban/Rural

Primary Care HPSA

% county population Hispanic

% county population black

% county population in poverty

Note: County-level information is pulled from the 2012 Area Resource File. Urban is metropolitan; Rural is non-metropolitan. Primary Care Health Professional Shortage Areas (HPSA) is calculated at the zip code level, based on the CMS Primary Care HPSA zip code definitions from 2014. Based on CMS EHR Incentive data through April, 2014.

Likelihood of ever attesting to Stage 1 meaningful use among physicians, April 2014

Relative Risk

Variation in Meaningful Use attainmentby technical assistance, delivery characteristics

6Note: Regional Extension Center enrollment as of May 4, 2014. Patient-Centered Medical Home (PCMH) certification reflects National Committee for Quality Assurance PCMH certification as of May, 2014. State Innovation Model reflects professionals in states with Model Testing awards from CMS to implement a State Health Care Innovation Plan to transform health care delivery systems through multi-payer payment reform and other state-led initiatives. Beacon Community reflects professionals located in zip codes that were part of the Beacon Community Program. All data are merged by physician NPI to CMS EHR Incentive Program data through April 2014.

Regional Extension CenterParticipation

PCMH Certification

State Innovation Model

Beacon Community

Likelihood of ever attesting to Stage 1 meaningful use among physicians, April 2014

Relative Risk

PROGRESS AND PERFORMANCE

Progress and performance among Eligible Professionals in the first 3 years of the EHR Incentive Program

- Who achieved meaningful use in first 3 years?- Who is achieving meaningful use year-over-year?- How does performance on meaningful use objectives

vary?

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Majority of eligible professionals return to attest year after year

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2011-2013 attestation patterns among Medicare professionals who first attested to meaningful use in 2011

58kMedicare eligible

professionalsattested in 2011

2011 2012 2013

75% attested in 2011, 2012, and 2013

19% skipped 2013

75%

44% of providers who attested in 2011 and skipped 2012 returned in 2013

16%

16% skipped 2012

Year 1 Year 2 Year 3

84%

7%

9%

9%

9% skipped 2012 and 2013.

84% attested in 2012

Attestedin year

Attested ever butskipped current year

Note: Providers skipping a year include providers who may have retired or no longer be in active practice. Based on analysis of CMS Medicare and Medicaid EHR Incentive Program Electronic Health Record Products Used for Attestation public use data file, March 2014. http://www.healthdata.gov/data/dataset/cms-medicare-and-medicaid-ehr-incentive-program-electronic-health-record-products-used

Some types of physicians were more likely to skip both 2012 and 2013 than others

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Overall rate 9%

Rate by characteristic

Behavioral Health 18%

Non-Direct Patient Care 12%

Primary Care 9%

Medical Surgical Specialty 9%

Solo practice 15%

2-5 providers 12%

6-10 providers 10%

11-50 providers 9%

51+ providers 7%

Rural 11%

Urban 9%

Percent of physicians in 2011 attestation cohort who skipped attestation in 2012 and 2013 by characteristic

Note: Physician specialty and age are from the CMS EHR Incentive Programs and the 2011 American Medical Association Masterfile. Group size is the number of providers counted under the same billing ID in the 2013 PECOS dataset. Urban is metropolitan; Rural is non-metropolitan. All physician data were merged via NPI to the CMS EHR Incentive Program data through April, 2014. Does not include Medicare Advantage providers.

PROGRESS AND PERFORMANCE

Progress and performance among Eligible Professionals in the first 3 years of the EHR Incentive Program

- Who achieved meaningful use in first 3 years?- Who is achieving meaningful use year-over-year?- How does performance on meaningful use objectives

vary?

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Performance relative to core objective thresholds increases with each payment year and new cohort

Attestation Year 1 Attestation Year 2** Attestation Year 3**0

10

20

30

40

50

60

70

80

90

100

7884 86

808582

2011 cohort 2012 cohort** 2013 cohort**

**Average performance relative to core objective thresholds statistically higher (p<0.001) than reference year/cohort (attestation year 1 and 2011 cohort) in regression model controlling for other physician and practice characteristics. Cohort indicates the year the physician first attested to Medicare Meaningful Use. Score is the average percentage by which the professional exceeded the threshold across all core objectives. Based on Medicare attestation data through April 2014.

Average performance relative to core objective thresholds by cohort and year of attestation, Medicare physicians

Physicians in their 3rd year of meaningful use

scored an average of86% above the thresholds across all core objectives

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Physicians in larger practices and participating in PCMH have higher average performance relative to core objective thresholds

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Performance by characteristic

Solo practice 78%

2-5 providers 79%

6-10 providers 79%

11-50 providers 80%

51+ providers 85%

PCMH Certified 87%

Not PCMH Certified 82%

Average performance relative to core objective thresholds by group size and PCMH certification

No major differences by other characteristics such as

physician age and urban/rural location

Note: Group size is the number of providers counted under the same billing ID in the 2013 PECOS dataset. Patient-Centered Medical Home (PCMH) certification reflects National Committee for Quality Assurance PCMH certification as of May, 2014. All physician data were merged via NPI to the CMS EHR Incentive Program data through April, 2014.

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PLANS FOR NEXT UPDATE

Plans for next update in July:

Early Stage 2 experience

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QUESTIONS?

Questions?