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Why the Medicaid EHR incentive program is a no-brainer

August 11, 2011 | Molly Merrill, Associate Editor

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ASHEVILLE, NC – Meaningful use expert Jim Tate has written that the Medicaid EHR incentive program reminds him of 'zero entry' swimming pools: very easy to get into, with almost no barriers. Given its less stringent requirements compared to the Medicare EHR incentive program, Tate writes, he's surprised that more eligible professionals are "not jumping into this incentive program with both feet."

Healthcare IT News asked Tate to expound on his blog post, which noted that the most attractive component of the Medicaid EHR program vs. the Medicare program was that to apply and receive the first year incentive EPs don’t have to be using an EHR. That's because EHR adoption is defined as having "acquired, purchased or secured access to certified EHR technology." In other words, says Tate, a signed contract means EPs are eligible to apply and attest their state Medicaid agency.

[See also: $400M in EHR incentives delivered]

Q: Since you say the Medicaid incentive program is “the way to go,” why is it "easier" than the Medicare program and are there any other differences that you could highlight that providers may not be clear on?
A: The Medicaid incentive program is easier in that in an Eligible Provider's initial year they don't have to achieve meaningful use, as is required in the Medicare incentive program. In addition, there are no potential penalties and the incentives are not front-end loaded. To receive the maximum Medicare incentive an EP must begin in 2011 or 2012. In the Medicaid program they can wait as long as 2016 to enter the incentive program and still receive maximum incentives.
 
Q: What could be some of the reasons that Medicaid EP's may not be “jumping into this incentive program with both feet?” Could it be related to not enough patient volume to meet the quota, price of EHR, or could it simply be that providers are unaware?
A: I think many Medicaid EPs who meet the patient volume threshold simply do not know how low the bar is to receive first year incentives. The price of an EHR isn't an issue as the first year Medicaid incentives are $21,5000, more than enough to offset the cost of the technology.
 
Q: What was some of the feedback you received on this blog?
A: Many were surprised that under the Medicaid incentive program they could apply for the initial $21,500 incentive solely on the basis of a signed contract.
 
Q: What is the single most important advice you could give to providers about the Medicaid incentive program?
A: Go to CMS.gov and use the widget titled "Medicare and Medicaid EHR Incentive Programs" to see if you qualify as an eligible Medicaid EP based on your patient volume.
 
Jim Tate is author of The Incentive Roadmap: The Meaningful Use of Certified Technology: Stage 1. He blogs at HITECHAnswers.
 

Related Topics:
  • Asheville
  • Jim Tate
  • Meaningful Use
  • Medicare
  • Oklahoma
  • Electronic Health Records

Reader Comments (4)Login to Post a Comment

JimTate says: reply to dch
August 15, 2011 | 10:52AM GMT

dch, I would like to connect and hear more of your opinions. We are on the same side here. Thanks for your passion, that is what helps keep HIT adoption from going off the tracks. You can contact me through Twitter @jimtate. Keep the faith, sometimes that is all we have.

dch says: Apology
August 13, 2011 | 4:23PM GMT

Mr. Tate, I was presumptuous and premature in assuming (from looking at your Linked-In profile) that you were not a clinical end-user.

Yes, the state-level EHR system I use daily is a very fine example of what one ought NOT be. I've yet to find a clinical end-user who likes it. Only the administrative bean counters see value in it. Even Joint Commission complained about it during a recent site visit.

I'm a life-time geek who learned C programming language from Kernighan and Ritchie's first edition book, and actively design/maintain websites avocationally. I like technology, but have grown a little wiser over the decades re: where it should fit in my life. I also have some sense of what is reasonable to demand from technology.

What I know so far re: EHR technologies is that MUCH work remains to be done before they are a seamless match with clinical work flow. Coding gnome techies complain about obstinate, inflexible Luddite clinicians rather than adapting their products to the clinicians.

Why?

Product immaturity and insufficient market competition ... i.e., they don't have to, and don't know how to.

When a doc hates a product, what can she do? Migration of existing patient data to a new product is prohibitively expensive. I believe firmly that dispensing with proprietary vendor data lock (via standardization of data constructs) will grease competitive innovation and drop prices.

I see HITECH as a searing indictment of the lack of prime time readiness of contemporary EHR products. Nobody had to carrot/stick an iPhone into my hand ... or into the hands of most physicians. By contrast, federal mandates have been adopted to force docs to swallow the bitter castor oil that currently passes for EHR products.

dch says: no brainer?
August 12, 2011 | 12:22PM GMT

Nice sales talk.
Mr. Tate has something to sell.
He's definitely NOT an end-user.

* Obstacle number one: EHR usability
* Obstacle number two: EHR vendor data lock (too hard for end-users to switch products… reducing innovative competition and elevating prices)
* Obstacle number three: Medicaid itself. Few clinicians want to take Medicaid. The risk/benefit ratio is simply not favorable. It's often better to do pro bono work instead.

So, I disagree that this is a "no-brainer."

JimTate says: Medicaid EHR incentives
August 12, 2011 | 1:17PM GMT

Glad you read the article where I was quoted on my belief that the Medicaid EHR incentive program is vastly superior to the Medicare incentive program to those who are eligible. I don't believe there is much doubt about that. In addition, both programs are voluntary and my comments were directed to those who have decided to participate. I agree with the anonymous writer that much improvment is needed in EHR technology. To set the record straight, I have been involved in direct patient care for over 30 years in inpatient and ambulatory domains and the last few used an EHR to document, so I have certainly been an end-user. I agree that EHR usability is an issue and hope the baby is not thrown out with the bath. Sounds like the commenter has had some bad EHR experiences, so have I.

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