The Wisconsin Department of Health Services (DHS) has released the incentive payment amounts for each Wisconsin hospital for the 2022 Medicaid HIE Pay-for-Performance (P4P) program.
DHS provides incentive payments for hospitals to share data through the Wisconsin Statewide Health Information Network (WISHIN). The HIE P4P program was developed in 2021 to implement the requirements of the 2019 Wisconsin Act 185. DHS notes “the sharing of health information data facilitates better patient care, reduces costs, and makes access to patient information easier.” The incentive payments, in aggregate, equal roughly 2.1 years’ worth of WISHIN subscription fees based on WISHIN’s 2022 fee schedule.
Hospitals can qualify for the maximum incentive if they share data in each of the following WISHIN interface categories:
- Admission, Discharge, and Transfer (ADT) messages
- Consolidated Clinical Document Architecture documents, also known as CCDAs or electronic care summaries
- The combination of Lab, Pathology, and Radiology results
The available incentives vary based on each hospital’s relative Medicaid claims volume and the volume of data shared with the WISHIN network. Hospitals can qualify for incentive payments from $15,000 to $40,000 per interface category. Hospitals participating in all interface categories can receive up to $120,000.
DHS will expect the hospitals that contracted during or before 2021 to have made progress in 2022 to qualify for incentive payments this year. Hospitals that were in work or live with the specified interfaces before 2021 will also receive incentive payments for 2022.
Hospitals that have not participated with WISHIN thus far can receive the incentive payment for 2022 if they contract with WISHIN by December 31 of this year.
As of 2021, WISHIN will provide reports to DHS on the status of each hospital; no separate attestation by hospitals is required. Incentive payments will be available again in 2023.
By the end of December 2023, DHS expects all Wisconsin hospitals to be sharing data with WISHIN. DHS intends for withholds to begin in 2024 and only those hospitals in the WISHIN network will be able to recoup the withheld amounts.