Medicare Promoting Interoperability Program

Key facts

Administered by

Centers for Medicare and Medicaid Services (CMS)

Legal basis

HITECH Act (2009); regulations at 42 CFR Part 495

Participants

Eligible hospitals and critical access hospitals (CAHs)

Former name

Medicare EHR Incentive Program (Meaningful Use), renamed in 2018

Updated through

The annual Medicare inpatient prospective payment system (IPPS) rule

What is the Medicare Promoting Interoperability Program?

The HITECH Act of 2009 created the Medicare and Medicaid EHR Incentive Programs, widely called Meaningful Use, to pay providers that adopted and used certified EHRs. Incentive payments later gave way to penalties: hospitals that do not demonstrate meaningful use now receive lower Medicare payments.

CMS renamed the hospital program Medicare Promoting Interoperability in 2018 and shifted its focus from basic adoption to electronic exchange and patient access. Physicians and other clinicians moved to the Promoting Interoperability performance category of the Merit-based Incentive Payment System (MIPS) under MACRA, and Medicaid incentive payments ended in 2021.

How the program works

Hospitals report for a minimum continuous EHR reporting period each year, attest to required measures and must reach a minimum total score that CMS has raised over time. They also report electronic clinical quality measures (eCQMs). Current objectives include:

• Electronic Prescribing, including a query of a prescription drug monitoring program (PDMP).
• Health Information Exchange, through referral loop measures, bidirectional exchange or participation in TEFCA.
• Provider to Patient Exchange, giving patients timely electronic access to their health information.
• Public Health and Clinical Data Exchange, such as immunization registry, syndromic surveillance and electronic case reporting.
• Protect Patient Health Information, including a security risk analysis and a SAFER Guides attestation.

Why the Promoting Interoperability Program matters

The program links hospital IT choices directly to Medicare revenue:

• Hospital revenue: a hospital that is not a meaningful EHR user loses part of its annual Medicare payment update, and critical access hospitals face a cost reimbursement reduction.
• Health IT strategy: measure changes, such as new public health reporting or TEFCA options, drive hospital purchases and developer roadmaps.
• Vendor due diligence: hospitals attest that they will cooperate with ONC direct review of their certified health IT, which ties program status to developer compliance.
• Information blocking: under a 2024 HHS final rule, a hospital that HHS determines committed information blocking is not a meaningful EHR user for the relevant year.