HIT spotlight: Which EHR incentive program is right for you?

15 February 2011

As a service to our members, the Medical Society of Virginia (MSV) will feature a monthly Q&A on your most frequently asked questions regarding the evolving sphere of health information technology (health I.T.). These articles will also be featured on MSV’s new eCommunity on health I.T. – to join, please visit the MSV Connect eGroup landing page by logging in with your MSV user name and password. Click on the Add/Change Subscriptions link in the upper right corner and choose the option you’d like to join the health information technology eGroup.

Q: I know there is money available for electronic health records (EHR). What do I need to do?
A: On Jan. 3, the Centers for Medicare and Medicaid Services (CMS) opened registration for the Medicare electronic health record (EHR) incentive program. Eligible professionals can receive up to $44,000 over five years under this program for the meaningful use of a certified EHR. Participation in the program can begin as early as 2011, although physicians enrolling in the program in 2012 may still receive up to the maximum amount of total incentive payments. Click here to learn more about the registration process.

Virginia’s portal for enrolling in the Medicaid EHR incentive program will open later this year. Eligible professionals participating in this program can receive up to $63,750 in incentive payments over six years but must meet patient volume thresholds in order to qualify. 

Q: What is the money for?
A: Eligible providers will need to demonstrate “meaningful use” of a certified EHR. In year 1, these criteria are different for the Medicare and Medicaid programs.

• Under the Medicare program, the reporting period for year 1 is 90 days. You will provide data, through the EHR incentive program Web site, regarding 26 objectives and clinical quality measures that are detailed in the stage 1 criteria for meaningful use. The data will take the form of yes/no responses or numerator/denominator attestation. To meet certain objectives, 80 percent of the provider’s patients must have records in the certified EHR technology. Click here to review information from CMS on the stage 1 criteria for meaningful use.
• In year 1, those participating in the Medicaid EHR incentive program will attest that they have taken one of the following actions:
  • Adopted (acquired and installed) certified EHR technology capable of meeting meaningful use. To see if your product is certified, click here.
  • Implemented (commenced utilization of) certified EHR technology.
  • Upgraded to certified EHR technology.

Q: Should I apply for the Medicare or the Medicaid funds?
A: First you will want to find out if you are eligible for either the Medicare or Medicaid EHR incentive programs. CMS has created several tools to help you determine which program is best for you based on your patient panel:

• Interactive eligibility tool for eligible professionals – Are you eligible to participate in the Medicare or Medicaid EHR incentive programs? Answer a few yes/no questions to determine which program is right for you.
• Flow chart – Determine your eligibility by following this simple flow chart.

If you find you are eligible for both programs, you’ll need to choose one program. Most providers will maximize their incentive payments by participating in the Medicaid EHR incentive program. Remember – before 2015, you may switch programs only once after the first incentive payment is initiated – so make sure to fully investigate your eligibility for the two programs.