Eligible Hospitals

The Medicaid EHR Incentive Program is limited to Eligible Professionals (EPs) for six years of participation, and Eligible Hospitals (EHs) for three years. The program provides incentive payments to EPs and EHs as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. The program is slated to end in 2022 but eligible providers interested in participating must begin the application process by 2016.

Eligibility

Defined as:

  • Acute care hospitals (including critical access hospitals) must meet a 10 percent minimum Medicaid patient volume
  • Children’s hospitals (cannot be pediatric wings of larger hospitals) are not required to meet patient volume thresholds
Requirements

Acute care, critical access and children’s hospitals are the only hospital types that are eligible for the Medicaid EHR Incentive Program. Acute care and critical access hospitals must have a Medicaid (Title XIX) patient volume of at least 10 percent of their total volume to be eligible to receive incentive payments. Patient volume is defined by CMS as the percent of Medicaid Title XIX encounters to total hospital encounters for the same 90-day period. Children’s hospitals do not have to meet Medicaid patient volume requirements to receive incentive payments. Click here for more information about eligibility for hospitals.

Adopt, Implement, Upgrade & Meaningful Use

Meaningful use Eligible Hospital participants must adopt (acquire and install), implement (training), upgrade (expand functionality with new version, etc.) or demonstrate meaningful use of certified EHR technology during Year 1 of their program participation. In the two remaining years of their program participation, Eligible Hospitals must demonstrate meaningful use (i.e., how the technology moves beyond being a digital medical chart to a valuable tool to transform health care service delivery and improve health outcomes).

Certified EHR Technology

The Medicaid EHR Incentive Program requires that all EHR products and systems must be certified by the Office of the National Coordinator for Health Information Technology (ONC). For more information, visit the ONC website at https://chpl.healthit.gov/#/search.

Incentive Payments

By meeting all program requirements, Eligible Hospitals may earn an incentive payment based on a formula that includes an annual EHR base amount; a per-discharge amount and a transition factor for each year; a Medicaid share based on inpatient, non-charity care days; and an aggregate EHR payment amount. The aggregate EHR payment estimate, when approved by DCH, is the total incentive payment that will be paid out during three years of participation.

Eligible Hospitals may receive payments from both Medicare and Medicaid Incentive Programs. The exceptions are children's hospitals, which will qualify for Medicaid incentive payments only.

Patient Volume Calculator

For assistance calculating the Medicaid patient volume, contact HP Enterprise Services Contact Center at HP.mapir.outreach@hpe.com or call 800-766-4456 and choose prompt 1 for the Medicaid EHR Incentive Program Support Team.

Getting Started

Step One: Register with CMS. Eligible Hospitals must first register on the CMS Registration and Attestation System website at https://ehrincentives.cms.gov/hitech/login.action.

Step Two: Contact HP Enterprise Services Contact Center at HP.mapir.outreach@hpe.com or call 800-766-4456 and choose prompt 1 for the Medicaid EHR Incentive Program Support Team.


Additional Resources

EHR Fact Sheet for Eligible Hospitals

EHR FAQs for Eligible Hospitals

Medicaid EHR Incentive Program Toolkit for Eligible Hospitals