Eligible Hospitals - Incentive Payments

Hospital incentive payments are based on a formula provided in statute that uses a variety of data points. During the first year of participation in the Medicaid EHR Incentive Program, the Wisconsin Medicaid Agency calculates the aggregate EHR incentive payment for Eligible Hospitals; this is the amount they will receive over the life of the program.

The Wisconsin Medicaid Agency will distribute payments over 3 years according to the following percentages:

  • Payment Year 1: 50% of Aggregate EHR Hospital Incentive Amount
  • Payment Year 2: 40% of Aggregate EHR Hospital Incentive Amount
  • Payment Year 3: 10% of Aggregate EHR Hospital Incentive Amount

Hospital Payment Calculation

Data Needed for Payment Calculation

Eligible Hospitals are required to attach and upload all relevant Medicare cost report sections when submitting their Wisconsin Medicaid EHR Incentive Program application. These sections will be used to determine the incentive payment amount. Below are the data points needed:

Data Point Needed

If you have the 2552-10 (NEW) form

If you have the 2552-96 (OLD) form

Total Discharges (four years of data)

Worksheet S-3, Part 1, Column 15, line 14

Worksheet S-3, Part 1, Column 15, line 12

Total Medicaid Inpatient Bed Days

Distributed by the Medicaid EHR Incentive Program from email address dhsehrincentiveprogram@wi.gov

Distributed by the Medicaid EHR Incentive Program from email address dhsehrincentiveprogram@wi.gov

Total Inpatient Bed days

Worksheet S-3, Part 1, Column 8, sum of lines 1 and 8-12

Worksheet S-3, Part 1, Column 6, sum of lines 1 and 6-10

Total Charges – All Discharges

Worksheet C, Part 1, Column 8, line 200

Worksheet C, Part 1, Column 8, line 101

Total Charges Charity Care

Worksheet S-10, column 3, line 20

Worksheet S-10, Line 30

For further explanation of the cost report data needed please read the Eligible Hospitals FAQ (PDF, 584 KB).

To see a detailed explanation of the formula used to calculate the payment amount, please see CMS's Tip Sheet - Medicaid Hospital Incentive Payments Calculations or refer to Appendix B: Hospital Payment Calculation of the State Medicaid Health Information Technology Plan.

Time Period for Medicare Cost Report Data

Returning Hospital Participants

The time period the data comes from is based upon on the first year the Eligible Hospital participates in the Medicaid EHR Incentive Program, as well as the fiscal year used by the hospital. Eligible Hospitals that received a Wisconsin Medicaid EHR Incentive Program payment in Program Years 2011, 2012, 2013, or 2014 are not able to change the Medicare Cost Report data time period and must submit the Medicare Cost Reports detailed in the previous section for the fiscal years displayed in the application's Hospital Cost Report Data section.

New Hospital Participants

Eligible Hospitals that begin participation in Program Year 2015 or later are required to use the most recent continuous 12-month period for which Medicare Cost Report data is available prior to the Payment Year. Please see below for time period you should use for first year applications started in Payment Years 2015 and 2016.

Hospital Fiscal Year Start

Program Year 2015

Program Year 2016

January

January 1, 2013 through December 31, 2013

January 1, 2014 through December 31, 2014

February

February 1, 2013 through January 31, 2014

February 1, 2014 through January 31, 2015

March

March 1, 2013 through February 28, 2014

March 1, 2014 through February 28, 2015

April

April 1, 2013 through March 31, 2014

April 1, 2014 through March 31, 2015

May

May 1, 2013 through April 30, 2014

May 1, 2014 through April 30, 2015

June

June 1, 2013 through May 31, 2014

June 1, 2014 through May 31, 2015

July

July 1, 2013 through June 30, 2014

July 1, 2014 through June 30, 2015

August

August 1, 2013 through July 31, 2014

August 1, 2014 through July 31, 2015

September

September 1, 2013 through August 31, 2014

September 1, 2014 through August 31, 2015

October

October 1, 2013 through September 30, 2014

October 1, 2014 through September 30, 2015

November

November 1, 2013 through October 31, 2014

November 1, 2014 through October 31, 2015

December

December 1, 2013 through November 30, 2014

December 1, 2014 through November 30, 2015
Last Revised: July 1, 2015