Primary Outcomes (explanation)
In order to calculate EHR summary scores for practices that used a certified EHR, the Office Systems Survey (OSS) measured 53 functions (for example, prescribing medications, ordering laboratory tests and other procedures, and care management and coordination) that are thought to be connected to improved care, although a causative link is not yet empirically proven for many. These functions were sorted into five domains: completeness of information, communication about care outside the practice, clinical decision support, increasing patient engagement, and medication safety. If practices were to use all 53 functions for three-fourths or more of their patients, the total composite score would equal 100. In addition to calculating this score, composite scores were calculated for the five OSS domains. (Baseline scores cannot be estimated because application data on EHR/other health IT use are only available for 13 of the 53 functions.) Based on the total composite score for each treatment practice, CMS calculated payments during each demonstration year. Practices received their payments in the fall following the end of each demonstration year.