EHR users to get preference in CMS pilot

Physicians who want to participate in the Centers for Medicare & Medicaid Services' new Comprehensive Primary Care Initiative need to be able to demonstrate that they are successful users of electronic health record technology, CMS' Center for Medicare and Medicaid Innovation (CMMI) announced last week.

The pilot program is a joint Medicare/private payer initiative made possible by the Affordable Care Act (ACA) and geared to strengthen primary care. Primary care practices that choose to participate will be given resources to better coordinate care for Medicare patients; those who better coordinate care for patients will get bonuses. About 75 primary care practices will be selected to participate in each market in the program, which recently were announced as: Arkansas, Colorado, New Jersey, Oregon, and regions in New York, Oklahoma and Ohio/Kentucky.

While full eligibility criteria has yet to be released, CMMI has posted the application pre-screening tool. CMMI cut right to the chase, saying: "Our selection criteria will favor practices that [h]ave providers who have achieved Stage 1 Meaningful Use of health information technology (HIT) or have existing utilization of certified electronic health record (EHR) systems." Other preferences include practices that receive at least 60 percent of revenue from payers participating in the initiative and those working toward providing a medical home.

Additional preferences toward physicians who use EHRs also are apparent. For instance, the initiative noted that Meaningful Use should be used to coordinate care across the "medical neighborhood" and that physicians need to be able to provide 24/7 access to care and use patient data tools that give "real time personal health care information to patients in need."

"Effective use of health information technology is central and essential to support the delivery of high-value comprehensive primary care in this initiative," CMS explained in a FAQ document, comparing the pilot program to other CMS initiatives.

The Comprehensive Primary Care Initiative is just one program stemming from the ACA that relies heavily on health IT. These programs could all be adversely affected if the ACA is struck down by the Supreme Court later this month.

To learn more:
- here's the update on the Initiative
- read the FAQ document

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