EHR Incentive Programs

Eligible Hospital Information

Over 5,000 eligible hospitals and critical access hospitals (CAHs) can participate in the EHR Incentive Programs and receive payments. Most eligible hospitals and CAHs will be able to receive incentive payments from both the Medicare and Medicaid EHR Incentive Programs.

For more information about participation in both programs, click on the following links to download tip sheets about eligibility and incentive payment calculations for your hospital:

Medicare Eligible Hospitals

The following hospitals are eligible to participate in the Medicare EHR Incentive Programs:

  • "Subsection (d) hospitals" in the 50 states or DC that are paid under the Inpatient Prospective Payment System (IPPS)
  • Critical Access Hospitals (CAHs)
  • Medicare Advantage (MA-Affiliated) Hospitals

Eligible hospitals and critical access hospitals (CAHs) can qualify for incentive payments under the Medicare EHR Incentive Program if they successfully demonstrate meaningful use of certified EHR technology. Hospitals can begin receiving EHR incentive payments in any federal fiscal year (FY)  from FY 2011 to FY 2015, but payments will decrease for hospitals that start receiving payments in 2014 and later. Incentive payments to eligible hospitals and CAHs are based on a number of factors, beginning with a $2 million base payment.

Eligible hospitals and CAHs that do not successfully demonstrate meaningful use of certified EHR technology will be subject to Medicare payment adjustments beginning in FY 2015..

Medicaid Eligible Hospitals

The following hospitals are eligible to participate in the Medicaid EHR Incentive Programs:

  • Acute care hospitals (including CAHs and cancer hospitals) with at least 10% Medicaid patient volume
  • Children's hospitals (no Medicaid patient volume requirements)

Under the Medicaid EHR Incentive Programs, eligible hospitals can qualify for incentive payments if they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology during the first participation year or successfully demonstrate meaningful use of certified EHR technology in subsequent participation years. Medicaid hospitals that qualify for EHR incentive payments may begin receiving incentive payments in any year from federal fiscal year (FY) 2011 to FY 2016. There are no payment adjustments under the Medicaid EHR Incentive Programs.

 

Special Note: Are You Eligible for Both Programs?
Unlike eligible professionals, eligible hospitals and CAHs that qualify can receive incentive payments under both the Medicare and Medicaid EHR Incentive Programs. Hospitals that are eligible for EHR incentive payments under both Medicare and Medicaid should select “Both Medicare and Medicaid” during the registration process, even if they plan to apply only for a Medicaid EHR incentive payment in the first year of participation by adopting, implementing, or upgrading certified EHR technology. Dually-eligible hospitals can then attest through CMS for their Medicare EHR incentive payment at a later date, if they so desire. It is important for a dually-eligible hospital to select “Both Medicare and Medicaid” from the start of registration in order to maintain this option.

Hospitals that register only for the Medicaid program (or only the Medicare program) will not be able to manually change their registration (i.e., change to “Both Medicare and Medicaid” or from one program to the other) after a payment is initiated and this may cause significant delays in receiving a Medicare EHR incentive payment.

Meaningful Use for Hospitals

Under the Medicare and Medicaid EHR Incentive Programs, eligible hospitals and CAHs can receive incentive payments for showing that they have used certified EHR technology in ways that can positively impact patient care. In order to do this, hospitals must attest to the “meaningful use” of a certified EHR by reporting on:

  • 14 required core objectives
  • 5 of 10 menu set objectives
  • 15 clinical quality measures

You can download a complete set of meaningful use specification sheets that outline the requirements for each of the core and menu objectives you need to meet by clicking here.
 

To learn more about meaningful use and why it’s important, visit our Meaningful Use Overview page.

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