List of 4 Major US Government Incentive Programs for Promoting EHR

Electronic Health Records possess open & powerful tools to improve health outcomes by healthcare providers.

Let’s explore the 4 major US Government Programs that promote the adoption of EHR by healthcare providers.

No.1: Medicare EHR Incentive Program

The Medicare EHR Incentive Program, also known as the Medicare Promoting Interoperability Program, is a program offered by the Centers for Medicare and Medicaid Services (CMS) to encourage healthcare providers to adopt and use EHRs.

• Under the program, eligible healthcare providers who demonstrate meaningful use of certified EHR technology can receive financial incentives
• To qualify for the incentives, healthcare providers must meet certain requirements related to the use of EHRs in patient care, such as capturing and sharing patient data electronically and using clinical decision-support tools
• The program is part of the larger Medicare and Medicaid EHR Incentive Program, which provides financial incentives to eligible healthcare providers
• The program is designed to promote the adoption and use of EHRs among healthcare providers, which can lead to improved patient outcomes and reduced healthcare costs

Note: It is important to note that the Medicare EHR Incentive Program ended in 2021, and has been replaced by the new Merit-based Incentive Payment System (MIPS) Promoting Interoperability Program. The new program continues to incentivize the use of EHRs and health information exchange to improve patient care and health outcomes.

RELATED: EHR & Predictive Analytics: Protecting People from Health Unpredictability

No.2: Medicaid EHR Incentive Program

The Medicaid EHR Incentive Program is a program offered by the Centers for Medicare and Medicaid Services (CMS) to encourage Medicaid providers to adopt and use EHRs) The program provides financial incentives to eligible Medicaid providers who adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology.

• Under the program, eligible healthcare providers who demonstrate meaningful use of certified EHR technology can receive financial incentives for up to six years
• To qualify for the incentives, healthcare providers must meet certain requirements related to the use of EHRs in patient care, such as capturing and sharing patient data electronically and using clinical decision-support tools
• The Medicaid EHR Incentive Program is part of the larger Medicaid and Medicare EHR Incentive Program 
• The program is designed to promote the adoption and use of EHRs among Medicaid providers, which can lead to improved patient outcomes and reduced healthcare costs

Note: It is important to note that the Medicaid EHR Incentive Program has been phased out as of 2021, and has been replaced by the new Medicaid Promoting Interoperability Program. The new program continues to incentivize the use of EHRs and health information exchange to improve patient care and health outcomes among Medicaid providers.

RELATED: CMS & Patient Portal: Promoting Interoperability for Patient Engagement

No.3: What is a Merit-Based Incentive Payment System (MIPS)?

The Merit-Based Incentive Payment System (MIPS) is a program implemented by the Centers for Medicare and Medicaid Services (CMS) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The program aims to promote high-quality, cost-effective healthcare services by tying payment incentives to quality and performance measures.

• Under MIPS, eligible healthcare providers are scored based on four categories: Quality, Promoting Interoperability, Improvement Activities, and Cost
• Each category is weighted differently, with Quality accounting for the highest weight at 40%, Promoting Interoperability at 25%, Improvement Activities at 15%, and Cost at 20%
• Healthcare providers are required to report data for each category to CMS, which is used to calculate their overall score
• The score determines whether a healthcare provider will receive a positive, negative, or neutral payment adjustment under the Medicare Physician Fee Schedule (MPFS) based on their performance

MIPS consolidates and replaces several other quality reporting programs, including the Physician Quality Reporting System (PQRS), the Value-Based Payment Modifier (VM), and the Medicare Electronic Health Record (EHR) Incentive Program for Eligible Professionals (EPs)

The Goal of MIPS 

• To incentivize healthcare providers to improve the quality of care they provide, 
• To reduce costs, and 
• Promote interoperability and health information exchange through the use of certified EHR technology

No.4: The 21st Century Cures Act

The 21st Century Cures Act is a US law that was signed into law in December 2016. The law was designed to accelerate medical innovation, streamline the development of new therapies, and increase funding for medical research.

Some of the key provisions of the 21st Century Cures Act include:

1. Increased funding for medical research: The law provides $4.8 billion in funding to the National Institutes of Health (NIH) over 10 years for research into diseases such as cancer and Alzheimer’s disease.

2. Accelerated drug approval process: The law aims to speed up the drug approval process by allowing the use of more flexible clinical trial designs, allowing for the use of real-world evidence in drug approval, and expanding the use of surrogate endpoints.

3. Expanded use of health information technology (IT): The law provides funding for the development of a nationwide network of health information exchange (HIE) and requires the adoption of common standards for health IT.

4. Mental health and substance abuse treatment: The law provides funding for mental health and substance abuse treatment programs, including grants to states to improve access to these services.

5. Precision medicine: The law provides funding for the Precision Medicine Initiative, which aims to develop personalized treatments based on a patient’s unique genetic makeup.

• The 21st Century Cures Act was seen as a major bipartisan achievement, with support from both Democrats and Republicans
• The law has been praised for its potential to improve medical research, increase access to innovative therapies, and promote the use of health IT to improve patient care

Other Programs that Promote EHR

The US government has implemented various programs and incentives to encourage the adoption of Electronic Health Records (EHR) in healthcare practices. 

1. Meaningful Use

The Centers for Medicare & Medicaid Services (CMS) implemented the Meaningful Use program to encourage healthcare providers to adopt EHRs and use them in a meaningful way to improve patient care. Under the program, eligible healthcare providers can receive financial incentives for meeting certain criteria related to EHR adoption and meaningful use.

2. EHR Incentive Programs

The CMS also offers EHR Incentive Programs that provide financial incentives to eligible healthcare providers who demonstrate meaningful use of certified EHR technology.

3. Health Information Technology for Economic and Clinical Health (HITECH) Act

The HITECH Act, enacted in 2009, provides funding to support the adoption of health information technology, including EHRs, among healthcare providers.

4. Medicare Access and CHIP Reauthorization Act (MACRA)

The MACRA includes provisions to incentivize healthcare providers to use certified EHRs and participate in programs that promote interoperability and data sharing.

5. Office of the National Coordinator for Health Information Technology (ONC) Programs

The ONC offers various programs to support the adoption of EHRs and health information exchange, including the State Health Information Exchange Program and the Community Interoperability and Health Information Exchange Program.

These programs and incentives aim to promote the adoption and meaningful use of EHRs among healthcare providers, which can lead to improved patient care, better health outcomes, and reduced healthcare costs.

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