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 will be required to attach 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 Data

The time period that the data will come 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 or 2013 are not able to change the Medicare Cost Report data time period.

Eligible Hospitals that begin participation in Program Year 2014 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 applications started in Payment Years 2014 and 2015.

Hospital Fiscal Year Start

Program Year 2014

Program Year 2015

January

January 1, 2012 through December 31, 2012

January 1, 2013 through December 31, 2013

February

February 1, 2012 through January 31, 2013

February 1, 2013 through January 31, 2014

March

March 1, 2012 through February 28, 2013

March 1, 2013 through February 28, 2014

April

April 1, 2012 through March 31, 2013

April 1, 2013 through March 31, 2014

May

May 1, 2012 through April 30, 2013

May 1, 2013 through April 30, 2014

June

June 1, 2012 through May 31, 2013

June 1, 2013 through May 31, 2014

July

July 1, 2012 through June 30, 2013

July 1, 2013 through June 30, 2014

August

August 1, 2012 through July 31, 2013

August 1, 2013 through July 31, 2014

September

September 1, 2012 through August 31, 2013

September 1, 2013 through August 31, 2014

October

October 1, 2012 through September 30, 2013

October 1, 2013 through September 30, 2014

November

November 1, 2012 through October 31, 2013

November 1, 2013 through October 31, 2014

December

December 1, 2012 through November 30, 2013

December 1, 2013 through November 30, 2014

Last Revised: February 3, 2015