What Is The Purpose Of The Center For Medicare And Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) is part of the U.S. Department of Health and Human Services. CMS oversees many federal healthcare programs, including those that involve health information engineering such as the meaningful utilize incentive program for electronic health records (EHR).

Reimbursement and regulatory functions

In add-on to Medicare (the federal health insurance program for the elderly) and Medicaid (the federal needs-based program that helps with medical costs), CMS administers the Children'southward Health Insurance Program (Flake), the Wellness Insurance Portability and Accountability Act (HIPAA) and central portions of the 2015 Medicare Access and CHIP Reauthorization Act (MACRA) law.

MACRA includes programs such as Merit-Based Incentive Payment Arrangement (MIPS) in which physicians and healthcare organizations are reimbursed based on their scores on healthcare quality and patient satisfaction measures. The approach is besides known as value-based reimbursement. CMS as well administers alternative payment models (APMs) for healthcare providers such as bundled payments for groups of healthcare organizations, and accountable care organizations, which are reimbursed based on positive medical outcomes.

Since passage of the Health Information Technology for Economic and Clinical Wellness Human activity in 2009, CMS has been charged with running the meaningful use plan, which is in its final phase with nearly $30 billion of incentive funds having been paid out to healthcare providers.

Under meaningful apply, and now the MIPS part of MACRA, CMS determines whether healthcare providers have successfully used health IT systems, and sets Medicare and Medicaid reimbursement rates for healthcare providers that apply federally certified wellness IT systems.

ONC-affiliated agency

The Office of the National Coordinator for Wellness Information technology (ONC), another Health and Human Services agency that works closely with CMS, is responsible for approval certified health IT systems and updating health information privacy and security regulations under HIPAA.

Meaningful use has been credited for driving the widespread adoption of EHRs amid hospitals and physicians. As of 2015, ONC reported that 96% of nonfederal astute care hospitals were using certified EHR systems. At the end of 2015, 56% of office-based physicians were using certified EHRs.

History of CMS

After Medicare and Medicaid were established in 1965, the Social Security Assistants -- through the then Department of Health, Instruction and Welfare -- administered federal health programs.

In 1977, the onetime Health Care Financing Administration (HCFA) took over administration of Medicare and Medicaid. In 2001, HCFA became CMS.

This was last updated in August 2016

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