In 2011, The Centers for Medicare & Medicaid Services (CMS) established the Medicare and Medicaid EHR Incentive Programs to encourage clinicians, eligible hospitals, and Critical Access Hospitals to adopt, implement, and upgrade to Certified Electronic Health Record Technology (CEHRT) and to demonstrate meaningful use of CEHRT. CMS renamed the EHR Incentive Programs to the Promoting Interoperability (PI) Programs in April 2018.
Historically, the Programs consisted of three stages:
- Stage 1 set the foundation for the Promoting Interoperability Programs by establishing requirements for the electronic capture of clinical data, including providing patients with electronic copies of health information.
- Stage 2 expanded upon the Stage 1 criteria with a focus on advancing clinical processes and ensuring that the meaningful use of EHRs supported the aims and priorities of the National Quality Strategy. Stage 2 criteria encouraged the use of CEHRT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible.
- Stage 3 In October 2015, CMS released a final rule that established Stage 3 in 2017 and beyond. Stage 3 focuses on using CEHRT to improve health outcomes. This rule also modified Stage 2 to ease reporting requirements and align with other CMS programs.
The programs are now moving beyond the existing requirements of meaningful use to a new phase of CEHRT measurement with an increased focus on interoperability and improving patient access to health information. The term Meaningful Use is still used generally to reference meeting a set of reporting requirements, while the reporting programs themselves are referred to as Promoting Interoperability Programs.
The Medicare Promoting Interoperability Program is one of the four categories of reporting included in the CMS Quality Reporting Program. Participants attest to the QPP Promoting Interoperability Measures and Objectives in the PI category. Clinical Quality Measures are reported separately as part of the Quality category. Medicare Clinicians eligible for the program are expected to participate and receive positive, neutral or negative payment adjustments depending on their participation score.
The Medicaid Promoting Interoperability Program includes both the Medicaid Promoting Interoperability Measures and Objectives and electronic Clinical Quality Measures (eCQMs). Participation by eligible Medicaid professionals is optional. Successful participants receive an incentive payment. There is no penalty for non-participation.
Program Participation and Technical Assistance
Medicaid Eligible Professionals (EPs) participating in the Medicaid Promoting Interoperability Program may contact their State Medicaid Agencies with inquiries about the program. In Arizona, Health Current is available to provide fee-free educational assistance and support for the PI Program. Contact Health Current at 602-688-7210 or via email at firstname.lastname@example.org. Detailed information about Arizona’s Medicaid Promoting Interoperability Program can be found on:
- This Health Current website at Arizona Medicaid PI Program
- The AHCCCS website at Arizona Medicaid Electronic Health Records Incentive Program
Medicaid Hospitals participating in the Medicaid Promoting Interoperability Program with inquiries about their participation may contact their State Medicaid Agency for assistance. In Arizona, hospitals may contact AHCCCS at EHRIncentivePayments@azahcccs.gov or 602-417-4333.
Medicare Eligible Clinicians are now part of the CMS Quality Payment Program (QPP). They may contact the QPP help desk for assistance at email@example.com or by calling 1-866-288-8292. Practices with 15 or fewer providers are also eligible for assistance through the CMS Small, Underserved, and Rural Support initiative. Choose a state on the SURS Support Map to view contact information for your state’s selected assistance provider.
Medicare and Dually Eligible Hospitals (Medicare and Medicaid) participating in the QPP may contact the QualityNet help desk for assistance at firstname.lastname@example.org or 1-866-288-8912.