Vermont Promoting Interoperability Program Overview

The Vermont Promoting Interoperability Program, formerly known as the Electronic Health Record Incentive Payment program, incentivizes Medicaid providers to adopt, implement, and meaningfully use electronic health records. This program, funded mostly by federal dollars, aims to improve interoperability and enhance access to health information for both providers and patients. Over $59 million has been distributed through this program, impacting various aspects of the healthcare system in Vermont. The program timeline, statistics, and impacts on the Vermont Health Information Exchange are highlighted to showcase its significance in advancing healthcare technology and data sharing.

• Vermont
• Promoting Interoperability Program
• EHRIP
• Healthcare Technology
• Medicaid Providers

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1. Post-HITECH Meaningful Use/ HIT Incentive Program VT PROMOTING INTEROPERABILITY PROGRAM

2. PROGRAM OVERVIEW PROGRAM STATISTICS AND TIMELINE PROGRAM IMPACTS AND VHIE ELIGIBLE PROVIDERS Agenda MEANINGFUL USE AND PROGRAM REQUIREMENTS FEDERAL FUNDING SURVEYS AND RESEARCH NEXT STEPS 2 10/7/2024 VERMONT PROMOTING INTEROPERABILITY PROGRAM

3. Program Overview The Electronic Health Record Incentive Payment (EHRIP) program was established in 2009 as part of the Health Information Technology for Economic and Clinical Health (HITECH) act. Incentivizes Medicaid providers adoption, implementation and meaningful use of electronic health records (EHRs) (100% federal funds). States manage financial oversight and monitoring of expenditures for the Medicaid EHRIP (funded federally at 90/10). Re-branded in 2018 to the Promoting Interoperability Program (PIP) to reflect a new phase of EHR measurement focused on interoperability and improving provider and patient access to health information. 3 10/7/2024 VERMONT PROMOTING INTEROPERABILITY PROGRAM

4. $59,042,081 Total Incentive Dollars Paid* Program Statistics 100% of participating Eligible Hospitals (EHs) have successfully reached maximum participation in the program $42,232,273 to 1115 EPs $16,809,808 to 17 EHs Just under 20% of participating EPs in have successfully reached maximum participation in the program** $8,500 subsequent years Incentive payment varies based on EH data calculations $21,250 first year 3517 applications have been paid out Up to 6 years of participation Up to 3 years of participation 4 10/7/2024 VERMONT PROMOTING INTEROPERABILITY PROGRAM

5. Program Timeline Last year to participate in current program Rebranded to Promoting Interoperability Program (PIP) Last year to join EHRIP program 2021 First Program Year of EHRIP 2019 2018 HITECH Act signed 2016 2012 2011 2009 More than $59 million has been dispersed via VT EHRIP/PIP 5 10/7/2024 VERMONT PROMOTING INTEROPERABILITY PROGRAM

6. Program Impact on VHIE National Networks Veterans Administration Transactional Data Flow Cross-Community EHR Query/Retrieve Eligible Professionals and Eligible Hospitals Data Suppliers Lab- Rad- Trans Results Delivery to EHR All other non-eligible health care providers Electronic Health Records or other Clinical Systems at Vermont Health Care Organizations, Labs and Hospitals HCI VHIE Reporting Data Flow Immunization Registry EQHealth Incentive payments have helped to establish a strong foundation for patient clinical data collection and exchange technology in Vermont. That foundation has provided the majority of the data available in the VHIE today. This data enables care management, patient point of care support, population health analysis, and evaluation of health care operations. -Enterprise Architect II, ADS 6 10/7/2024 VERMONT PROMOTING INTEROPERABILITY PROGRAM

7. Incentivizes meaningful use and interoperability of EHRs and other data repositories Valued source of financial support for providers and hospitals Impact of PIP Final program year is 2021 7 10/7/2024 VERMONT PROMOTING INTEROPERABILITY PROGRAM

8. Continued advancement of interoperability and other healthcare reform priorities Future Incentive Programs Impacts Opportunity for continued financial support for providers and hospitals Potential to tie-in/support existing state-funded HIE/HIT programs 8 10/7/2024 VERMONT PROMOTING INTEROPERABILITY PROGRAM

9. Eligible Professional (EP) Types CURRENT PROGRAM EPS POTENTIAL PROGRAM EPS Physician Psychologist (Doctorate and Masters Levels) Nurse Practitioner Licensed Mental Health Counselor Physician Assistant* Licensed Clinical Social Worker Pediatrician Physical and Occupational Therapists Certified Nurse Midwife Naturopathic Physician Dentist Other types to be considered 9 10/7/2024 VERMONT PROMOTING INTEROPERABILITY PROGRAM

10. Current Program Requirements Certified EHR in use At least 30%* Medicaid Patient Volume Performs less than 90% of services in a hospital inpatient or emergency department setting Meet Meaningful Use objectives and measures** 10 10/7/2024 VERMONT PROMOTING INTEROPERABILITY PROGRAM

11. Meaningful Use Objectives CURRENT REQUIREMENTS PROPOSED REQUIREMENTS Protect patient information Public Health and Immunization reporting Electronic prescribing, lab orders, etc. Mental and behavioral health reporting Clinical Quality Measures Social determinants of health reporting Patient electronic access to and engagement with health information Additional HIE priorities Health Information Exchange 11 10/7/2024 VERMONT PROMOTING INTEROPERABILITY PROGRAM

12. ACTIVITIES HITECH FUNDING POST-HITECH FUNDING Design, development and implementation 90% 90% State Plan Amendment Operations 90% 75% State Discretion *Currently awaiting CMS determination Program Administration 90% Regional Opportunities Incentive payments 100% *Based on FMAP 0% (look into this/verify; may be 50%) Services and Onboarding 90% Post HITECH-Incentive Programs- Federal Funding and current information 12 10/7/2024 VERMONT PROMOTING INTEROPERABILITY PROGRAM

13. 2019 SMHP Environmental Scan Respondent Provider Type PROFESSION COUNT PERCENTAGE Nurse Midwife 2 0.68 Nurse Practitioner 2 0.68 Chiropractor 9 3.06 Dentist 10 3.4 Mental/Behavioral Health Care Provider 97 32.99 Naturopath 3 1.02 Optometrist 6 2.04 16% of Other respondents fall into the category of mental/behavioral health care providers Pharmacist 3 1.02 PT or OT 5 1.7 Physician 4 1.36 Other 31 10.54 13 VERMONT PROMOTING INTEROPERABILITY PROGRAM 10/7/2024

14. 2019 SMHP Environmental Scan Interest in Future Incentive Program Would you participate in a potential state- funded program that would provide annual incentive payments for meaningful use of Health Information Technology? ANSWERS COUNT PERCENTAGE Yes 99 33.67 No 50 17.01 Unsure 141 41.96 14 VERMONT PROMOTING INTEROPERABILITY PROGRAM 10/7/2024

15. Upcoming Research SMHP Post-HITECH Incentive Program Interest Survey Environmental Scan 2021 15 10/7/2024 VERMONT PROMOTING INTEROPERABILITY PROGRAM

16. Next steps: Steering Committee: Determine alignment with HIE Plan, Plan State Strategy Identify and convene Incentive Program Subcommittee. Through the subcommittee, provide relevant insight, guidance, and direction towards development of the program. Determine necessary research. State PIP Team Provide operational and administrative support to the relevant subcommittee Continue discussions with local, regional, and federal partners, Develop proposals for Program Specifications, Conduct/manage necessary research, Work with stakeholders to develop SPA. 16 10/7/2024 VERMONT PROMOTING INTEROPERABILITY PROGRAM