Medicare and Medicaid Incentive Programs

The Centers for Medicare and Medicaid Services (CMS) incorporates performance measurement into many current incentive programs.

CMS Electronic Health Record (EHR) Incentive Program

The CMS Electronic Health Record (EHR) Incentive Program, also known as "Meaningful Use," provides financial incentives to eligible professionals and hospitals as they adopt, implement, upgrade, or demonstrate "meaningful use" of certified EHR technology. Eligible professionals who participate in the program must use certified EHR technology to collect, store, and report quality measures during a reporting period in a payment year to satisfy the requirements. Resources available to physicians interested in achieving meaningful use are listed below:

The Physician Quality Reporting System (PQRS)

The Physician Quality Reporting System (PQRS) is a voluntary reporting program for eligible physicians. PQRS encourages physicians to report data on quality measures for services furnished to Medicare Part B Fee-for-Service beneficiaries through a combination of incentive payments and payment adjustments. Click here for more information from the CMS PQRS Website and ACP PQRS Resources.

Electronic Prescribing (eRx) Incentive Program

The eRx program requires electronic transmission of prescription or prescription-related information between a prescriber, dispenser, pharmacy benefit manager, or health plan either directly or through an intermediary. Eligible professionals can earn a 1% incentive payment in 2012 and those who are not successful electronic prescribers may be subject to a penalty of 1% of Medicare Part B allowed charges. The Electronic Prescribing (eRx) program is separate from and in addition to PQRS. Click here for more information on the CMS Electronic Prescribing Incentive Program and various ACP ePrescribing Resources.