A Final Chance for Hospitals to Earn an Incentive by Partnering with WISHIN
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A Final Chance for Hospitals to Earn an Incentive by Partnering with WISHIN

The Wisconsin Department of Health Services (DHS) has announced that 2024 will be the last year it will offer a straight incentive under the HIE pay-for-performance (P4P) program it started in 2021. DHS has identified 166 hospitals in the state that are eligible to receive a share of $8 million available to those that participate in real-time patient data exchange with WISHIN.

DHS is providing these incentive payments to join WISHIN, an independent, not-for-profit, vendor-agnostic HIE that enables immediate and meaningful clinical and whole-person data-sharing amongst all participants in an expanding network that features more than 2,200 sites of care. The incentive payments cover the cost of implementation and WISHIN Pulse subscription fees.

By December 31, 2024, DHS expects all eligible hospitals to obtain a “live” status with WISHIN in three interfaces:

  1. Admit, Discharge, and Transfer (ADT)
  2. Consolidated Clinical Document Architecture (CCDA)
  3. Lab, Pathology and Radiology

*Partial incentive payments will be made if all three are not met

As stated in the DHS MY2024 Hospital P4P Guide, effective 2025 a 1.5% withhold will be applied to all Inpatient and Outpatient Fee-for-Service claims for all hospitals. The 2025 1.5% withhold is in addition to the 3% Potentially Preventable Readmission (PPR) program withhold, which is applied to all IP FFS claims for eligible hospitals. Hospitals that are live, contributing all or any of the three interface categories to WISHIN, are eligible to claw back all or a portion of the 1.5% withhold. Additionally, those hospitals that have met the full live participation by December 31, 2024, are eligible to receive a distribution of the 1.5% withhold from those hospitals that have not met the fully live status.