HIPAAMIPPATRHCAARRAPPACA Era: Connecting the Health Care Legislation Dots

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Are you having trouble navigating through the murky waters of health care legislation? Fear not! We have broken down the complexities of the HIPAAMIPPATRHCAARRAPPACA Era, provided an illustration of each initiative in action, and explained what your IT vendor should be doing to help you comply with today's health care legislation.

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  • 1. HIPAAMIPPATRHCAARRAPPACA EraConnecting the Health Care Legislation Dots

2. Wait What? 3. A Legislation Smorgasbord HIPAA Health Insurance Portability & Accountability Act MIPAA Medicare Improvements for Patients & Providers Act TRHCA Tax Relief & Health Care Act ARRA American Recovery & Reinvestment Act PPACA Patient Protection & Affordable Care Act 4. HIPAA 1996 In short, electronic transactions: 5010/ICD-10 The 5010 Rules requiring the changeoverfrom 4010 to 5010 transactions and from ICD-9 to ICD-10, fall under the administrativesimplification portion of HIPAA 5. MIPPA 2008 In short, Medicare ePrescribing Program Established the Medicare ePrescribingprogram that requires eligible professionalswith prescriptive privileges to eRx permissiblemedications for Medicare Part B fee-for-service patients or suffer a paymentadjustment 6. TRHCA 2006 In short, Physician Quality Reporting System(PQRS) Established the Physician Quality ReportingInitiative (now known as PQRS) to collectclinical data so that the government coulddefine value and purchase value 7. ARRA 2009 In short, Meaningful Use of certified EHRs HITECH, which is 60 pages of ARRA,establishes the MU programs to accelerateand reward adoption of interoperablecertified electronic health record technology 8. PPACA 2010 In short, defining and purchasing value foraffordable care Seeks to reduce the number of uninsuredAmericans and make care affordable bydefining value and purchasing value 9. What do they have in common? All of these pieces of legislation have anincreased focus on process andtechnology The two major laws enacted under ourcurrent administration (ARRA andPPACA) accelerate transformationthrough the use of health IT 10. Is it time to retire? Providers are utterly overwhelmed trying tofigure out what systems are impacted, how toalign disparate dates of compliance, designroadmaps, or even figuring out how close toretirement they are It is nearly impossible to put all the piecestogether and translate them into usablehealth IT workflows without a strongtechnology partner 11. HIPAAMIPPATRHCAARRAPPACA in Action 12. Health & HumanServicesFactory 13. Status QuoPay-for-Service Data ProviderCEHRTHealth & HumanServicesFactory 14. Status QuoPay-for-ServiceProviderCEHRT DataHealth & HumanServicesFactory 15. Status QuoPay-for-Service Provider CEHRT DataHealth & HumanServicesFactoryComparativeEffectivenessResearch 16. Status QuoPay-for-Service Provider CEHRT DataHealth & HumanServicesFactoryComparativeEffectivenessGuidelinesResearch 17. Status QuoPay-for-Service Provider CEHRT DataHealth & HumanServicesFactoryComparativeEffectivenessGuidelinesResearch 18. Status QuoPay-for-Service Provider CEHRT DataEducate MeasuresHealth & Guidelines HumanServicesFactoryComparativeEffectivenessResearch 19. Status QuoPay-for-Service Provider CEHRT Data Clinical DecisionEducate Measures SupportHealth &Guidelines HumanServicesFactoryComparativeEffectivenessResearch 20. Status QuoPay-for-ServicePerformanceProviderCEHRTData Provider CEHRT Data Clinical DecisionEducate Measures SupportHealth &Guidelines HumanServicesFactoryComparativeEffectivenessResearch 21. New Status QuoPay-for-ValueStatus QuoPay-for-ServicePerformanceProviderCEHRTData Provider CEHRT Data Clinical DecisionEducate Measures SupportHealth &Guidelines HumanServicesFactoryComparativeEffectivenessResearch 22. All together now! New Status QuoPay-for-ValueStatus QuoPay-for-ServicePerformanceProviderCEHRTData Provider CEHRT Data Clinical DecisionEducate Measures SupportHealth &Guidelines HumanServicesFactoryComparativeEffectivenessResearch 23. New Status QuoPay-for-ValueStatus QuoPay-for-Service MIPPA - eRxProviderCEHRTPerformanceData Provider CEHRT Data Clinical DecisionEducate Measures SupportHealth &Guidelines HumanServicesFactoryComparativeEffectivenessResearch 24. New Status QuoPay-for-ValueStatus Quo ARRA Meaningful UsePay-for-Service MIPPA - eRxProviderCEHRTPerformanceData Provider CEHRT Data Clinical DecisionEducate Measures SupportHealth &Guidelines HumanServicesFactoryComparativeEffectivenessResearch 25. New Status QuoPay-for-ValueStatus Quo ARRA Meaningful UsePay-for-ServiceMIPPA - eRx ProviderCEHRTPerformanceData Provider CEHRT TRHCA PQRS Data Clinical DecisionEducate Measures SupportHealth &Guidelines HumanServicesFactoryComparativeEffectivenessResearch 26. New Status QuoPay-for-ValueStatus Quo ARRA Meaningful UsePay-for-ServiceMIPPA - eRx ProviderCEHRTPerformanceData Provider CEHRT TRHCA PQRS Data Clinical DecisionEducate Measures SupportHealth &Guidelines HumanServicesFactoryPPACA Define ValueComparativeEffectivenessResearch 27. PPACA QuoVBMNew Status Pay-for-ValueStatus Quo ARRA Meaningful UsePay-for-ServiceMIPPA - eRx ProviderCEHRT Performance Data Provider CEHRT TRHCA PQRS Data Clinical DecisionEducate Measures SupportHealth &Guidelines HumanServicesFactoryPPACA Define ValueComparativeEffectivenessResearch 28. PPACA QuoVBMNew Status Pay-for-ValueStatus Quo ARRA Meaningful UsePay-for-ServiceMIPPA - eRx ProviderCEHRT Performance Data Provider CEHRT TRHCA HIPAA ICD-10 PQRS DataEducate Measures Clinical Decision SupportHealth &Guidelines HumanServicesFactoryPPACA Define ValueComparativeEffectivenessResearch 29. What can my IT vendor do to help? 30. How your IT Vendor Should Help Meaningful Use and other Dashboards MU and PQRS metrics with analytics on eachprovider Facilitates quick numerators / denominators forMeaningful Use attestation Analytics on your practice with drill-throughdetails 31. How your IT Vendor Should Help Patient Portal Inherent with System If your vendor outsources its Patient Portal, youcould be paying additional license or support fees If your vendor is not equipped with a PatientPortal, you could face an additional Portal vendorand all the integration considerations that go withit 32. How your IT Vendor Should Help Single database solution Always use a certified, complete EHR, meaningthe practice management and electronic healthrecord are part of the same solution A certified, quality vendor can seamlessly provideboth 33. How your IT Vendor Should Help EHR Direct PQRS Must be certified to do EHR Direct PQRS, not betatesting 34. How your IT Vendor Should Help Support thats more than just a phonecall (and two continents) away Initiative toolkits for Meaningful Use, PCMH,PQRS, etc. Consulting support with domain experts U.S.-based staff that is well-trained, friendly andconsiderate of your time and needs 35. How your IT Vendor Should Help Ongoing Client Educational Offerings Provides free educational webinars Offers a wealth of articles, white papers, casestudies, tips and tricks to help you become moreknowledgeable about the industry and yourspecialty Provides CEU-approved opportunities Consistently communicates about new features 36. How your IT Vendor Should Help Quality Improvement OrganizationAlignment 37. Are you getting enough fromyour vendor during thisHIPAAMIPPATRHCAARRAPPACAEra of Health Care?