To secure your EHR Incentive Payments and take a crucial step towards optimizing health care quality through technology, you must complete a registration process that leads you to meaningful use. This guide will walk you through each essential step, ensuring that eligible professionals (EPs) and hospitals know exactly how to qualify for and receive these financial incentives
Eligible Professionals and Hospitals: Who Qualifies for Incentive Payments?
Eligible professionals and hospitals fall into distinctive categories for EHR Incentive Payments. These incentive programs are available for certain health care providers, including but not limited to, physicians, dentist, certified nurse midwives, nurse practitioners, and physician assistants working in Federally Qualified Health Centers or Rural Health Clinics that are led by an eligible physician.
For hospitals, the program is open to acute care hospitals, including critical access hospitals (CAHs), as well as children’s hospitals. Whether you are an EP or part of a hospital, you are required to demonstrate meaningful use of certified EHR technology to qualify for the incentive payments.
Program Requirements
The requirements to qualify for the EHR Incentive Programs are numerous and detailed. First, you must have an active National Provider Identifier (NPI) and be registered in the National Plan and Provider Enumeration System (NPPES). Once those prerequisites are met, you’ll need to navigate to the CMS registration and attestation system to complete your registration.
For EPs eyeing the Medicaid EHR Incentive Program, it is critical to confirm that your state’s Medicaid program is ready to support your participation. Conversely, for Medicare, participants must proceed with an understanding of the reporting period, maximize their incentive payments by carefully selecting when to start reporting, and by confirming their technology meets certification requirements.
You must select either the Medicare or Medicaid program during registration since you cannot receive incentives from both simultaneously for the same reporting period. And finally, an important note for EPs: a switch between Medicare and Medicaid programs is permitted once after the first year of participation, offering some flexibility based on changing practices or patient populations.
Meaningful Use: Meeting Clinical Quality Measures and Objectives
The crux of securing EHR Incentive Payments is demonstrating meaningful use, which requires adherence to a specific set of core objectives and clinical quality measures (CQMs). These objectives are designed around meaningful EHR usage that improves patient care, ensures privacy and security, and enhances public health outcomes.
EPs must meet several meaningful use objectives, including core and menu set objectives, and report on specified CQMs. Stage 2 of Meaningful Use, for instance, calls for greater focus on health information exchange and patient care coordination, setting high targets for e-prescribing and incorporating lab results into the EHR.
These stages of evolution are preparing providers for Stage 3 meaningful use, which will be integrated into the Medicare Merit-based Incentive Payment System (MIPS). Meeting these expectations is critical since not only do they qualify you for incentives, but not meeting them by specific deadlines can result in Medicare payment adjustments.
The Role of Public Health in the Exchange of Health Information
Public health is a significant focus in health information exchange, which is a cornerstone of the EHR Incentive Programs. By using EHR technology, health care providers can contribute to a broader health ecosystem that improves disease monitoring, outbreak management, and health promotion activities.
Engaging with the public health aspect involves reporting specific information to public health agencies. This could be subject to the meaningful use criteria, which specify that data must be submitted in a structured and standardized format favored by healthcare facilities. The integration of clinical practice with public health goals not only furthers the EHR objectives but it also has the potential to greatly enhance population health outcomes.
By following this guide to register for meaningful use incentive payments, you are setting the groundwork for better, more efficient, and informed patient care, while also aligning with broader public health objectives. It’s a win-win for providers and patients alike, with the added benefit of financial incentives to support your transition to advanced health information technology.
Eligible Professionals and Hospitals: Who Qualifies for Incentive Payments?
Eligible Professionals (EPs), who aim to qualify for EHR incentive payments, must choose between the Medicare and Medicaid programs, as they cannot receive incentives from both for the same reporting year. For Medicare, EPs can earn up to $44,000 over five consecutive years through meaningful use of certified EHR technology. Those in Health Provider Shortage Areas may receive additional incentives. The Medicaid EHR Incentive Program, now known as the Medicaid Promoting Interoperability (PI) Program, offers EPs up to $63,750 over six years. EPs have the option to switch between programs once before 2015 post initial payment.
For participating hospitals under Medicare, a maximum of four years of incentive payments is possible. Medicaid’s PI Program also encourages the adoption of EHRs among eligible hospitals, allowing a significant initial payment of $21,250 to EPs, followed by yearly payments of $8,500.
Incentive Payment Highlights for EPs and Hospitals:
- Medicare: $44,000 for EPs over 5 years; Extra for shortage areas; 4 years for eligible hospitals.
- Medicaid (PI Program): $63,750 for EPs over 6 years; $21,250 initial payment, then $8,500 yearly for hospitals.
The focus is clear–adopting and meaningfully using certified EHR systems is vital, seeking to enhance healthcare outcomes and patient care.
Program Requirements
Participation in the Medicare and Medicaid EHR Incentive Programs requires Eligible Professionals (EPs) to meet a set of prerequisites that ensure they are not only adopting health information technology but are also optimizing its use to improve patient care. EPs must be enrolled as Medicaid providers and should maintain this status throughout the participation period to remain eligible for incentive payments.
Medicare’s program has specific requirements for eligible professionals to follow. An essential requirement is meeting the Medicare patient volume criteria, which varies by professional roles. As for Medicaid, EPs need to meet patient volume criteria, which entail having a minimum of 30% Medicaid patient encounters, or 20% for pediatricians. However, encounters with beneficiaries of the Children’s Health Insurance Program (CHIP) are not factored into Medicaid’s volume criteria.
Moreover, all EPs, particularly those participating in the NY Medicaid EHR Incentive Program, must adhere to enrollment rules, which include being an active NY Medicaid fee-for-service provider, having an associated ETIN, and fulfilling the conditions for being a payable NY Medicaid Provider. There are also specific certification criteria for the EHR technology being utilized, with EPs expected to partake in meaningful use objectives.
Importantly, professionals need to understand the financial aspects of the incentive payments, with Medicaid offering an initial $21,250 incentive for EPs who successfully demonstrate meaningful use in their first year. In contrast, Medicare calculates the incentive as 75% of the EP’s allowable charges for covered services—with a cap.
Providers must weigh these parameters against the potential for future payment reductions, which Medicare has slated for those not employing certified EHR technology meaningfully. Conversely, Medicaid does not plan to reduce payments but allows states the discretion to establish their eligibility criteria for incentive payments.
Reporting Period and Attestation Process
The reporting period for EPs under the Medicare and Medicaid EHR Incentive Programs constitutes a continuous, fixed interval during which EPs demonstrate meaningful use of certified EHR technology. EPs must then complete an attestation process where they confirm, typically through an online portal system, that they have indeed met the meaningful use criteria within the specified reporting period. In New York, for example, EPs must submit their attestations online using the NY Medicaid EHR Incentive Program attestation portal and follow by mailing a signed hard copy of their attestation.
EPs must ensure their attestations accurately reflect their meaningful use actions, backed by proper documentation such as EHR reports, screenshots, and communication with public health registries—documentation that must be retained for at least six years post-attestation. In the event that an EP cannot meet Medicaid patient volume requirements, they can still attest to meaningful use via the CMS registration and attestation system to prevent Medicare payment adjustments.
Certification Criteria and Requirements for Health Information Technology
To qualify for incentive payments under both Medicare and Medicaid programs, the EHR technology employed must meet certification criteria defined by the Office of the National Coordinator for Health Information Technology (ONC). These criteria aim to assure that the EHR system is capable of supporting meaningful use objectives, which includes the efficient and secure exchange of health information and the improvement of care quality.
Certified EHR technology must fulfill functionality standards such as maintaining patient demographics and clinical health information, including vitals and smoking status, in coded formats. Additionally, it should provide clinical decision support, electronic exchange of health information to enhance care coordination, and the capability to report on clinical quality measures.
The certification requirements advance progressively through at least three stages of meaningful use, with each stage elevating the standards for functionality and care quality improvement. This stepwise approach demands meticulous planning and execution from EPs, as a later start means a more rapid transition through the stages is necessary to comply with CMS’s timelines and to be eligible for the maximum incentive payments.
Meaningful Use: Meeting Clinical Quality Measures and Objectives
To advance patient care and the use of electronic health records (EHR), eligible professionals must not only implement health information technology but effectively apply it within their practice to meet Meaningful Use (MU) objectives. Central to these objectives are Clinical Quality Measures (CQMs), which act as benchmarks for assessing the quality of healthcare. Professionals striving for MU must report CQMs to reveal insights into patient care, ultimately fostering continuous quality improvements.
Under Stage 2 MU, the alignment with the National Quality Strategy emphasizes the use of EHRs to better support key healthcare priorities. Enhanced health information exchange (HIE) and rigorous e-prescribing requirements are pivotal in ensuring seamless care transitions. The patient’s narrative should seamlessly weave through various healthcare environments, driven by structured data exchange among providers and EHR systems.
Transitioning into Stage 3 of MU by 2018 signifies a deeper integration of these practices into broader healthcare objectives, as part of the shift towards the Medicare Merit-based Incentive Program. This stage concentrates on achieving more sophisticated health outcomes by strengthening the focus on robust CQMs and advanced MU objectives.
Core Objectives for Meaningful Use
The move from Stage 1 to Stage 2 MU marks an increase in complexity and commitment. Initially, Stage 1 laid the groundwork, requiring 15 core objectives to establish fundamental EHR technology use. This catered to acquiring clinical data and initiating its electronic exchange, building capabilities like electronic prescribing and summarization of patient care.
However, Stage 2 expanded these foundations, demanding eligible professionals fulfill 17 core objectives out of a total of 20—all aimed at advancing the quality, safety, and efficiency of care delivery. The three remaining objectives are selected from a menu set, offering flexibility to professionals to focus on areas most relevant to their practice.
With Stage 3 on the horizon, participating professionals must keep abreast of the evolving core set requirements, as they will likely consolidate and extend the progress from the earlier stages. This progression underscores a commitment to improving healthcare delivery through the effective adoption and meaningful use of EHR technologies.
Clinical Decision Support and Care Coordination
Clinical Decision Support (CDS) systems represent a pillar of health information technology that directly contributes to the achievement of MU objectives. By offering clinicians tailored knowledge and patient information at crucial care moments, CDS tools have the potential to mitigate errors, bolster patient safety, and lift the quality of healthcare services.
Care coordination is equally significant, centering on the deliberate orchestration of patient care activities and information dissemination across all participating care providers. Integrating patient preferences and addressing any care discontinuities is integral to providing safe, effective care delivery.
Investment into CDS and robust care coordination can drastically increase a healthcare provider’s capability to satisfy MU objectives. These systems and practices not only improve patient outcomes but can further cement a provider’s eligibility for EHR Incentive Program payments, marking a strategic approach to healthcare provision enriched by state-of-the-art technology.
To register with the CMS and begin attesting to meaningful use, you must complete these three main steps:
- Find your vendor’s EHR certification number
- Create a login for the Registration and Attestation System
- Register your EHR
- Find your vendor’s EHR certification number
If you do not have your EMR or EHR certification number, you can look it up on the certified by the ONC HIT Certification Program. You can search this list by vendor or product name. When you find your EHR system, click “add to cart” (you will not be charged for it) and you will be shown the CMS EHR certification ID. You may want to print this page out as you will need the certification number later. If you can not access the EHR certification ID, make sure you have selected the right EHR software. You may have selected the modular EHR product instead of the complete EHR product. If your EMR or EHR system does not have a certification number, you will not be able to register it for meaningful use and receive incentive payments. - Create a login for the Registration and Attestation System
Create a login ID and password on the CMS EHR Incentive Program site. Log in and enter your National Provider Identifier (NPI) number. If you do not have an NPI number, you can apply for one at the National Plan and Provider Enumeration System (NPPES)
This login step can be done anytime before you are ready to register your EHR. - Register your EHR
On the CMS EHR Incentive Program site, register your EHR system by clicking on the “Register” tab and selecting the program type. It will ask if you have a certified EHR, click “Yes.” Select the type of provider you are and enter in your EHR certification ID. Lastly, select the type of entity that will be receiving the government incentive payments.
Confirm that all of the information you have entered is correct on the confirmation page. If everything is correct, submit the registration. You will receive another confirmation page, which you should save for future reference.