Overview of the EHR Incentive Programs

The Medicare and Medicaid EHR Incentive Programs was set by the Stage 1 Final Rule by developing requirements for the electronic capture of clinical information, involving giving sufferers with electronic copies of health data.

The Stage 2 final rule expanded upon the Stage 1 criteria with a main concentration on ensuring that the EHRs’ meaningful use supported the priorities of the National Quality Strategy. The use of health information technology was motivated by the Stage 2 criteria for continuous quality betterment at the point of care and the exchange of data in the most structured format possible.

Announcements

• For public health agency and clinical data registry reporting, a centralized repository is established to assist the eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) find entities that accept electronic public health information. To access the form, please click here.
• The Calendar Year (CY) 2017 Changes to the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center proposed rule (CMS-1656-P) was released on the day of July 6, 2016. The proposed rule consists of numerous changes that will straightly impact the Medicare electronic health record (EHR) Incentive Program. 
  • For further information about the proposed rule and potential changes to the program, review the CMS Proposes Hospital Outpatient Prospective Payment Changes for 2017 fact sheet.
  • Please click here to access the proposed rule
• A proposed rule for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was released on the day of April 27, 2016. The Sustainable Growth Rate formula was replaced by MACRA by paying clinicians for the value and quality of care they give. To make these changes through a single framework was proposed known as the “Quality Payment Program”, which has 2 paths: the Merit-Based Incentive Program System (MIPS) and Alternative Payment Models (APMs).
  • For more information over the proposed Quality Payment Program and its potential changes for Medicare, eligible professionals presently eligible for the Medicare EHR Incentive Program, please do visit the official website.
  • Entire Medicaid eligible professionals or experts, eligible hospitals, and CAHs should visit or refer to their State Medicaid offices for data on attestation timeframes for the 2015 program year.
  • The final rule for the Quality Payment Program is anticipated to be issued in late 2016.

 Review of EHR Incentive Program
On the day of February 17, 2009, the American Recovery and Reinvestment Act of 2009 (ARRA) was enforced. Titles XVIII and XIX of the Social Security Act (the Act) was amended by Title IV of Division B of ARRA by developing incentive payments to EPs, eligible hospitals, and CAHs, and Medicare Advantage Organizations to encourage and support the adoption and meaningful use of interoperable health information technology and eligible or qualified EHRs. Under the HITECH Act, these incentive programs are part of a broader attempt to increase the adoption of HIT and utilization of qualified EHRs.

Starting in the year of 2011, the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs were developed to motivate eligible professionals (EPs) and eligible hospitals to accept, execute, update (AIU), and indicate meaningful use of certified EHR technology.
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CMS issued a final rule on October 2015 that specifies criteria that EPs, eligible hospitals and CAHs must meet in case to participate in the EHR Incentive Programs in the year of 2015 through 2017 (Modified Stage 2) and in Stage 3 in 2017 and beyond.