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Friday, 15 Dec 2017

Medicare and Medicaid EHR Incentive Program


Medical providers who serve patients receiving Medicare or Medicaid may be eligible to receive financial incentives through the EHR stimulus program.


The program begins in 2011 and continues through 2015. There is a 4-step process to determine if your medical practice will qualify. The process is described below.


A pivotal component for qualifications is meeting the EHR 'meaningful use' requirements. One of the requirements mandates use of CCHIT Certified EHR system.


By implementing acuPortal and acuEHR, AcuMedSoft's solutions, you are one step closer to meeting the 'meaningful use' requirements.

Begin the analysis early to ensure timely qualification for $44,000, or more, in Medicare and Medicaid incentives.


Understand grant qualification and meaningful use requirements in 4 Steps

Step 1: Who qualifies for what?

Step 2: Choose a CCHIT Certified EHR

Step 3: Understand Meaningful Use Requirements

Step 4: Money Distribution Information


Step 1:

If you are one of the following health care professionals you may qualify for the Medicare, Medicaid or both incentive programs, depending on your patient mix:

  • Doctor of
    • Medicine
    • Osteopath
    • Dental Surgery
    • Dental Medicine
    • Podiatry
    • Optometry
  • Dentist
  • Nurse Practitioner, Certified Nurse Midwife, Chiropractor, Physician Assistant

Useful flow chart for determining if you qualify.


Step 2:

Choose an EHR vendor that is CCHIT Certified. This decision is made early on is because without a CCHIT Certified EHR, there is no way you or your practice can receive the financial incentives.


Step 3:

The meaningful use requirements will evolve over time. Mandatory adherence to rules is required to receive cash incentive.

  • Stage 1 (2011 and 2012) sets the baseline for electronic data capture and information sharing.
  • Stage 2 (expected in 2013)
  • Stage 3 (expected in 2015) will continue to expand on this baseline.

Each set of objectives must be met in order to qualify for the yearly financial incentive.

Stage 1 Requirements:

Core Objectives

  • Use CPOE for at least one medication order for more than 30% of patients.
  • Implement drug to drug and drug allergy interaction checks
  • More than 40% of permissible prescriptions written are generated and transmitted electronically.
  • Record demographic info for 50% of patients seen by EP or admitted by hospital.
  • Maintain up to date problem list of current and active diagnoses for 80% of patients.
  • Maintain active medication list for 80% of patients seen by EP or admitted to hospital.
  • Maintain active drug allergy list for 80% of patients seen by EP or admitted to hospital.
  • Record and chart changes in vital signs for more than 50% of patients over age 2.
  • Record smoking status for more than 50% of patients over age 13.
  • Implement one clinical decision support rule for EP's specialty and track compliance with that rule.
  • Report clinical quality measures to the Centers for Medicare and Medicaid Services.
  • Provide >50% of patients with electronic copy of health information upon request within 3 business days.
  • Provide 50% of patients with electronic copy of discharge instructions at time of discharge.
  • Provide clinical summaries for each office visit to more than 50% of patients within 3 business days.
  • Provide clinical summaries for patients for each office visit (EP Only)
  • Reviewin security risk analysis and implementing security updates of Electronic Health Info.

Each of the core objectives must be met unless a provider qualifies for an exclusion.

Menu Objectives

  • Implement drug formulary checks
  • Record advanced directives
  • Incorporate lab results as structured data
  • Generate lists of patients by condition
  • Send reminders to patients (EP only)
  • Provide patients with timely electronic access (EPs only)
  • Provide educational resources
  • Perform medication reconciliation
  • Summary care record for transfers
  • Submit electronic data to immunization registries
  • Submit reportable lab results to public health (hospitals only)
  • Submit electronic surveillance data to public health

A provider must meet 5 of the menu set objectives unless they qualify for an extension, then only 4 must be be met. At least one of the 5 selected menu options must be a population health related objective (one of the last three on the menu list).


Step 4:

Determine when you will begin to receive the funding. This chart is the basic payment plan, and every situation is unique. If you qualify for both Medicare and Medicaid incentives, then your payment will be larger. There are additional programs you can qualify for as well that will increase your maximum yearly payment. Qualification in 2011 maximizes the payment potential, as long as "meaningful use" is demonstrated through all 5 years of program involvement.


Incentive Plans for Eligible Medicare Professionals (PDF)


Incentive Plan for Eligible Medicaid Professionals (PDF)



The main goal for being a "Meaningful User" is to enhance the quality of patient-to-provider communication, increase office efficiency and improve the standards of health care management. The transformation to a digital office is both stressful and exciting.


AcuMedSoft is dedicated in providing secure and reliable healthcare IT solutions that help you achieve meaningful use!