The Health Information Technology for Economic and Clinical Health (HITECH) provisions included in the 2009 American Recovery and Reinvestment Act (ARRA) set ambitious goals for developing electronic health information as one tool to reform health care delivery and improve health outcomes. The HITECH Act accelerated the industry's adoption of Electronic Health Record (EHR) technology through the Medicare and Medicaid Promoting Interoperability (PI) Programs, formerly the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, by providing financial incentives for hospitals and Medicare and Medicaid providers to adopt, implement, upgrade, and meaningfully use certified EHR technology. Over time, the focus of HITECH shifted from certified EHR adoption and meaningful use to health information exchange and interoperability. If not for HITECH, the health information technology (HIT) landscape would not be where it is today.

Throughout the life of the program, CMS and the Medicaid Enterprise Team (MeT), formerly the Medicaid EHR Team, identified program challenges and gaps and provided technical assistance and support to states to address gaps. The MeT and CMS supported collaboration amongst states, provide clarity around reporting requirements, and shared national trends and best practices. This is the retrospective close out report for over a decade of HITECH work by CMS, the states, and the MeT. This report includes:

• Background on the HITECH Program
• Methods of information gathering
• Summary of MeT Program activities and lessons learned
• Lessons learned provided by state and federal stakeholders in 2022
• Best practices and recommendations for consideration in the following areas:
  • What CMS could implement in the future
  • What future contracting/supporting funders could do
  • What CMS could do to facilitate strong partnerships with states
  • Recommendations for Medicaid Enterprise Systems
  • Potential funding or support ideas for Medicaid Enterprise Systems