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13 States Share System for EHR Incentive Payments [Industry Contributed]

The Medical Assistance Provider Incentive Repository is an IT tool that processes incentive payments awarded to health-care providers that adopt electronic health records.

Editor’s Note: Sue Arthur is vice president of U.S. Health and Life Sciences Industry for HP Enterprise Services.

When incentive programs to encourage health-care providers to adopt electronic health records and other health information technology projects were being developed, federal and state regulators faced a daunting challenge. Not only did they have to track billions in payments to qualified providers and verify their progress in implementing the technology, but they also had to verify individual provider eligibility while minimizing the potential for fraud, waste and abuse. Plus, do it all at minimal expense to taxpayers.

And no magic wands allowed.

Joking aside, a group of 13 states took that challenge to heart.  The states and their technology partner, Hewlett-Packard, came together to develop the Medical Assistance Provider Incentive Repository application. Called MAPIR, it’s a first-of-its-kind IT tool designed to improve accountability and program efficiencies while maximizing return to health-care providers, taxpayers and patients. Since going live last summer, MAPIR has processed more than $550 million in incentives to hospitals, physicians, pharmacists, nurse practitioners and other eligible providers in the 13 MAPIR states.

HP and the MAPIR Collaborative, as it has come to be called, earlier this year were commended by the National Governors Association and awarded NGA’s 6th annual Public-Private Partnership Award.

“The MAPIR project is an example of how technology and innovation can help states achieve real cost containment and efficiency,” said Pennsylvania Gov. Tom Corbett.

The key to MAPIR’s success has been keen cooperation across state lines by its 13 members: Arkansas, Connecticut, Delaware, Florida, Georgia, Indiana, Kansas, Massachusetts, Oregon, Pennsylvania, Rhode Island, Vermont and Wisconsin.

The collaborative effort came in response to a plea from the Centers for Medicare and Medicaid Services (CMS) for states to work together to reduce costs. The MAPIR states agreed to share development expenses equally among themselves and with CMS, significantly reducing costs to individual states. The MAPIR Collaborative also quickly identified individual needs, so they focused on common ground rather than differences.

The collaboration provides a forum for representatives from various Medicaid programs to discuss operational issues and implementation strategies. They share operational processes and work products to reduce the burden on individual states. For example, user and provider manuals were developed once as a foundation, then customized to reflect state-specific screens and terms, saving many hours of research and work.

Based on service-oriented products, MAPIR was developed according to Medicaid Information Technology Architecture (MITA) principles. It integrates into existing Medicaid systems, maximizing savings and improving efficiencies.  MAPIR relies on a provider portal, provider data, a financial system and encounter data sources to support the processing of incentive applications.  States can obtain MAPIR at no cost and run it on their own Medicaid Management Information System.

While it’s operating smoothly and tracking growing amounts of incentive payments, MAPIR’s development is ongoing, with continual refinements agreed upon by a formal governance structure made up of representatives from each state and HP.  The MAPIR governance structure allows all members to provide oversight and input in the ongoing development of the application. The shared knowledge, best practices and experience of participants from 13 Medicaid programs enhances the development process.

MAPIR is an example of good government at work. Its success is a reflection of 13 individual states’ willingness to unite to obtain business efficiencies, share costs, learn from each other and coordinate the administration of an important federal program.


Miriam Jones is a former chief copy editor of Government Technology, Governing, Public CIO and Emergency Management magazines.