Time running hourglass

CMS EHR INITIATIVE PROGRAM UPDATE

Table of Contents

Introduction

How many changes have you experienced since you began working in the world of IDD Services?  What’s your typical response?  Do you fight change, clinging to the “good old ways,” kicking and screaming?  Do you endure change, dragging your feet and suffering in silence?  Or do you embrace change, leading the way to true progress through innovation and enthusiasm?

One inevitable change in our world is the shift from paper-based documentation systems to interactive, interoperable systems that will enable true interdisciplinary approaches to services. This is where the CMS Promoting Interoperability Program (previously EHR Incentive Program) comes in. 

Past CMS Actions Concerning EHRs

In 2011, CMS established the Medicare and Medicaid EHR Incentive Programs to encourage Eligible Professionals (EPs) and eligible hospitals, to adopt, implement, upgrade (AIU), and demonstrate meaningful use of certified EHR technology. This marked the start of CMS’s dedicated efforts to improving interoperability and patients’ access to health information across the board. By attaining some pre-set quality goals, facilities could begin earning incentive payments and increase revenues.  

In 2015, CMS proposed a rule that would require long-term care (LTC) facilities and nursing homes to participate in health information exchange.  The intent was that during a patient transfer or discharge, long-term care facilities would be required not only to document an event in the patient’s clinical record, but also to transmit that information to the receiving facility in order to promote continuity of care.

First, EHR use was incentivized, or rewarded. Then, it was a requirement…….see a trend here? 

2018 CMS Changes Impacting EHR Use

Just last month (August 2018), a further rollout of this program was announced. First of all, CMS has renamed the ‘EHR Incentive Programs’ the ‘Promoting Interoperability (PI) Programs’. CMS has also extended the requirement to include the Long Term Care Hospitals Prospective Payment System. Once the various hospital type facilities have received CMS payment incentives (or penalties), ‘Care in the Community’ service providers will likely be a subsequent target for CMS to implement similar EHR interoperability mandates. Long Term Care Provider payments (or penalties) linked to EHR/interoperability initiatives seem inevitable and plans for future expansion into this arena are already mapped out. 

IDD/Special Needs Services - 'How Soon' NOT 'If'

At this point, it’s more a matter of ‘how soon’ than ‘if’. CMS payments to long term care/home health facilities will be based on providers attaining quality metrics that are predetermined, measurable and trackable with an emphasis on the use of EHRs and other electronic means of communication between care providers as well as between care providers and the patients/clients (or caregivers) they serve. Although the eligibility standards and meaningful measures will almost definitely be very different from those expected from acute care institutions, attainment of the standards will be required for payment of incentives (or avoidance of penalties). 

2018 Federal Budget Cuts Mean Service Businesses Change Or Die!

There is no denying that the use of EHRs to document services can increase efficiencies, decrease errors and reduce costs when used effectively. With the massive long term care budget cuts passed under the Bipartisan Budget Act of 2018, providers will no longer be able to run things the old, inefficient way by hiring more and more staff. New ways of thinking, working and administrating will be critical for the survival of IDD service companies. Those companies that refuse to change will fail.

According to the Congressional Budget Office (CBO), there is a $3.5 billion Medicare cut to home health services, and a $1.9 billion Medicare cut to nursing home care. The CMS definition of home health includes care in the community settings; the program names may differ by state but literally all long term care in the community agencies will be impacted. While the cut will not begin until 2019 for home health, it starts Oct.1 2018 for nursing homes with $140 million slashed from care. As we all know, that which begins in Medicare will trickle down to Medicaid.  How long until YOUR operations are affected?

“Change is inevitable, but progress is optional.” – Tony Robbins

Practical Help With Change

The time to start making changes is NOW! Ask yourself – where will I contain costs? What is my highest budget item? What will I do to maintain (and exceed) acceptable quality of consumer care requirements and turn a profit? These difficult questions must be answered sooner rather than later. Burying your head in the sand, working hard and hoping that legislators will recognize your blood, sweat, tears and dedication will not work. Automation is a key (if not the key) to controlling the largest of budget costs, which it does by increasing staff efficiencies and reducing ancillary costs. No matter the size of your organization, paying for an EHR system that costs a fraction of a full time employee makes sense! (Also, EHRs don’t require benefits or rest periods while doing the work of a couple of FTEs.)

Of course, this will demand effort, commitment and leadership skills from owners and administrators but if you choose the right EHR (see Focused Software’s extensive list of solutions) you’ll get all of the customer service, online tools and tech support you need.

If You Won't Do It For Yourself - Do It For Others!

The services IDD providers afford this vulnerable population are critical! Providers owe it to themselves, their clients/consumers and family stakeholders, as well as their team members, to do all it takes to survive, and thrive, in this new reality. Strong leaders with great integrity will be needed to avoid the unnecessary demise of many IDD service organizations. As the budget cuts come through and margins lessen this rules out the knee-jerk response of just hiring more staff (your most expensive cost item).

 Implementing Focused EHR is easier than you think! Once your direct care staff easily input consumer and service provision data within our EHR, the data can be manipulated to provide output in different formats to facilitate billing, payment, and utilization/quality management tasks and reports.  Automation is the smart and most affordable answer! Call FOCUSED SOFTWARE TODAY!

Implementing an Electronic Health Record NOW can better prepare you for the CMS changes to come

Call NOW – (281) 884 3537 ext. 107

Focused Blog List

2020 (1)
2019 (19)
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  • April 7 | IDD Service Workflow Analysis (IDD Business Management)
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  • March 24 | IDD Service Workflow Optimization (IDD Business Management)
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  • March 10 | Sexual Harassment in the IDD Workplace (IDD Regulatory)
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  • February 24 | The Art Of Compromise In The IDD Workplace (IDD Business Management)
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  • February 10 | Lessons From A(nother) Government Shutdown (IDD Business Management)
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  • February 3 | Strategic Marketing For IDD Service Providers (IDD Business Management)
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  • January 27 | Setting Marketing Goals For Success (IDD Business Management)
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  • January 20 | Developing Marketing Plans For IDD Companies (IDD Business Management)
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  • January 6 | Sex, Sexuality and People with IDD (Intellectual or Developmental Disability – Character and Wellness)
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2018 (41)
  • December 16 | Finding The Right IDD Service Staff – The Interview (IDD Business Management)
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  • December 9 | Finding The Right IDD Service Staff – Essential Prep​ (IDD Business Management)
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  • November 18 | Giving Thanks For IDD Service Vendors (IDD Business Management)
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  • November 11 | Marketing IDD Services and Supports (IDD Business Management)
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  • November 4 | Social Media for the IDD Service Provider (IDD Business Management)
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  • October 21 | SPI Review – Section B Part 2 (IDD Regulatory)
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  • October 14 | HHS SPI Section B Part 1 (IDD Regulatory)
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  • October 7 | SPI (Security and Privacy Inquiry) – Section A (IDD Regulatory)
    We review the latest version (v2.1 06/2018) of the Texas HHS SPI (Security and Privacy Inquiry). Fee-For-Service Long Term Care and IDD providers must have copies of this document on file with the state. Here we go over some salient points in section A.
  • September 28 | BUDDY WALK NYC NDSS 2018 (Intellectual or Developmental Disability – Character and Wellness)
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  • September 23 | CMS EHR PROMOTING INTEROPERABILITY (IDD Business Management)
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  • September 16 | Top 5 Texas Home Living Citations (TxHmL) Part 2 (IDD Business Management)
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  • September 9 | Most Common TxHmL Citations Top 10 part 1 (IDD Business Management, Uncategorized)
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  • September 2 | Are You Multitasking or Faulty-Tasking? (Intellectual or Developmental Disability – Character and Wellness)
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  • August 26 | Direct Care Staff Exodus Part 2 (IDD Business Management)
    There is a crisis in the IDD/special needs service arena – the exodus of direct support employees. The numbers of this critical group of employees is steadily dwindling even as demand increases. We look at ways to improve staff retention in this blog.
  • August 19 | Direct Care Staff Exodus Part 1 (IDD Business Management)
    There is a crisis in the IDD/special needs service arena – the exodus of direct care support staff. The numbers in this critical group of employees is steadily dwindling even as demand increases. We look at reasons for the exodus in this blog.
  • August 12 | Countdown to HCS Compliance – Citations the Top 3 (IDD Business Management)
    The top 3 principles cited during reviews of HCS agencies are varied and can come with significant penalties. We review them in-depth and include staff training and two other key areas. Can you guess what the top 3 HCS citations are? Read on!
  • August 5 | Countdown to HCS Compliance – Citations #4-7 (IDD Business Management)
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  • July 29 | Countdown to HCS Compliance – Citations #10,9,8 (IDD Business Management)
    Here we review the Texas Top 10 Principles Cited During Reviews: Home and Community-based Services. Let’s explore some of these frequently-cited principles and ways Focused Software can help your company maintain compliance and avoid citations.
  • July 22 | GROWING UP AS A CEO – RESPONSIBILITY (IDD Business Management)
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  • July 1 | IDD Customer Service In the Special Needs Arena (IDD Business Management)
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  • June 24 | Behavioral ABCs and the IDD Service Provider (IDD Clinical Care)
    Let’s review the objective functional analysis of problem behaviors with a common behavioral example that you might have come across.
  • June 17 | Sustaining Change In IDD/Special Needs (IDD Business Management)
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  • June 11 | Planning For Success In IDD/Special Needs (IDD Business Management)
    Not planning for success when instituting change in the IDD or special needs industry is planning for failure. Let’s review 7 key questions to ask when planning for your next successful change endeavor.
  • June 1 | Culture of Change In IDD/Special Needs (IDD Business Management)
    Helping our staff modify their behavior is central to the success of any change effort at work. As IDD execs, we need to realize that the chances of success for our change initiatives (eg buying a new EHR) are much higher if we create a culture of change and get buy-in from our staff first. Find out how in our blog!
  • May 25 | Why Change For IDD Service Providers (IDD Business Management)
    Why change at all? Well it may surprise you to know that none of us really has much of a choice when it comes to change! The question is will the changes you make be well-thought out and intentional OR will they be forced upon you? Read on to find out more!
  • May 18 | Legacy and the IDD Professional (Intellectual or Developmental Disability – Character and Wellness)
    The daily choices we make are consequential. What legacy are you building with each action, day by day? Not just as an IDD service carer but as a leader? Or even a person? Your legacy will be based on the integrity you display to all – your consumers, your staff and even your family at home.
  • May 13 | IDD Providers Busy-ness and Business (IDD Business Management)
    Busy-ness is NOT an IDD Service badge of honor! Are you addicted to busy-ness? The work of an IDD service provider is real however no-one should be eternally busy. Read this new Focused blog to find out why unrelenting busy-ness is bad for you and what you can do to save time, effort and improve your efficiencies.
  • May 6 | The Natural Born Leader Myth in IDD Services (IDD Business Management)
    The myth of the natural born leader can have particularly dangerous effects in the IDD/Special Needs service arena as many owners/execs struggle to lead their organizations through times of significant industry change and cut backs. Administrators in IDD care need to commit to putting in the time and effort needed to become better leaders so these companies offering vital care services to this vulnerable population do not fail.
  • April 30 | Strategic Acquisitions among IDD Service Companies (IDD Business Management)
    Strategic acquisitions among IDD companies is one way to expand businesses and rapidly obtain much needed skills and/or resources. However the acquisition of another company can be as risky as it is potentially rewarding. Read our blog before you pull the trigger to avoid nasty surprises!
  • April 10 | Integrity and the IDD Professional (Intellectual or Developmental Disability – Character and Wellness)
    IDD service professionals are entrusted with the care of a vulnerable set of people. We need to portray certain personal characteristics in order to carry out these responsibilities optimally. Are you a person of character? A leader with integrity? Read our blog and find out!
  • March 20 | EHR/EMR and Quality – VP#4 (IDD Business Management, IDD Clinical Care)
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  • March 6 | EHR/EMR vs Paper Charts – VP#3 (IDD Business Management)
    IDD companies that use paper charts for consumer info waste their most expensive resource (personnel time) daily. You’re not just paying for paper and toner! In this third Value Proposition blog – we review the true Cost of Doing Business (CODB) with paper charts versus an EHR/EMR documentation system.
  • February 20 | EHR/EMR and IDD Service Leadership VP#2 (IDD Business Management)
    The second installment in the 4 part “Value Proposition” series reviews the true leader’s role in attaining efficiency and quality standards in an IDD service agency. It also describes how the use of an electronic medical record system can help a leader keep the bottom line in control.
  • February 6 | Electronic Healthcare Record – Time is Money! VP#1 (IDD Business Management)
    Do you consciously appreciate the fact that you cannot get time back? When you consistently spend time on things that do not better you (monetarily or otherwise) you are wasting time. The first installment in this 4 part “Value Proposition” series reviews the real time, dollars and cents you save with an Electronic Healthcare Record.
  • January 23 | Successful Transition from Paper to Focused EHR (IDD Business Management)
    Implementing an EHR demands disciplined visionary leaders with clear goals and the resilience to manage change. Have you got what it takes?
  • January 9 | Compassionate Care for ALL in IDD Service! (Intellectual or Developmental Disability – Character and Wellness)
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Plugin by Oliver Schlöbe

Photograph: Lorelei (unicorn)