Helping providers achieve EHR meaningful use to enhance care.
First, remember that all organizations seeking electronic health record (EHR) adoption incentives must register with the Centers for Medicare & Medicaid Services (CMS) for either the Medicare or Medicaid pathway. Following is a summary of CMS requirements, along with resources to help you achieve meaningful use.
The Medicare EHR Incentive Program will provide payments to eligible professionals (EPs) who demonstrate meaningful use of certified EHR technology. The following providers are eligible to participate in the Medicare program: doctor of medicine or osteopathy, a doctor of dental surgery or dental medicine, a doctor of podiatric medicine, a doctor of optometry, or a chiropractor.
Eligible professionals participating in this program can receive a maximum incentive payment of $43,720 over a continuous five-year period. An additional 10% incentive is available for EPs who provide services in a Health Professional Shortage Area (HPSA). Medicare incentive payments will continue through 2016 (see graph below).
The last year to begin participation and receive an incentive payment is 2014. Medicare eligible professionals that do not successfully demonstrate meaningful use by 2015 will have a payment adjustment in their Medicare reimbursement.
The Medicaid EHR Incentive Program will provide payments to eligible professionals who demonstrate meaningful use of certified EHR technology. The following providers are eligible to participate in the Medicaid program: physicians, nurse practitioners, certified nurse-midwives, dentists, and physician assistants who practice in a federally qualified health center (FQHC) or rural health clinic (RHC) led by a physician assistant.
EPs participating can receive a maximum incentive payment of $63,750 over a six-year period, choosing a commencement date prior to the end of 2016. An exception applies to pediatricians with a Medicaid patient volume of at least 20%; they will qualify for two-thirds of the stimulus dollars, totaling $42,500. However, if that pediatrician is able to show a 30% Medicaid patient volume, he or she will qualify for the full $63,750. Medicaid meaningful use payments will be distributed through 2021 (see graph below).
Each state is responsible for managing its Medicaid meaningful use program. Check with your state’s health department or the CMS website for more details and links to individual programs.
Medicaid EPs who also treat Medicare patients will be subject to payment adjustments beginning in 2015 if they do not successfully demonstrate meaningful use.