A George Washington University School of Public Health and Health Services report states that according to national data, there are over 45,000 Medicaid providing physicians eligible for Electronic Health Record (EHR) funding support through the American Reinvestment and Recovery Act (ARRA). According to the report, over 15 percent of physicians carry a Medicaid caseload of greater than 30 percent. These physicians would be eligible for up to $62,750 over six years in reimbursement if they meet ‘meaningful use’ criteria set by the government.  Pediatricians that meet a 20 percent Medicaid threshold qualify for funding of lesser value. 

The Medicaid incentives through ARRA are different than those for traditional and Medicare providing physicians.  This is due to the state administration of the Medicaid program alongside the very real financial constraints of Medicaid service providers. As noted by Dr. Kristin Voellinger, a pediatrician in a small private practice in Illinois, “The payout for electronic health records for me is over 2 decades. It makes no financial sense to make the leap, so I will wait it out…”

This sentiment is echoed throughout the small practice community. The financial commitment is also more risky for heavy Medicaid caseload providers due to the irregularity and inconsistency of state reimbursement for Medicaid services. Last spring, Voellinger came close to shutting down her practice due to the state of Illinois’ late payments of over 100 days, straining her ability to pay her employees and keep her doors open. Yet she continues to provide care for her patients with over 40 percent relying on Medicaid as their primary insurance.

For physicians like Voellinger, the incentives highlighted by the study are vital to her taking the electronic leap. According to the report, the incentives include upfront financing for Medicaid providers (reimbursement in the first year), many of whom do not have the cash on hand to invest in EHR technology. As $49 billion is slated for HIT, Medicaid may have a place at the table if providers take notice and respond to federal incentives.

Voellinger speaks for many of her colleagues when she says, “Where do I find out more…?” Ah, but that would be the State Medicaid Agency. State Medicaid agencies are responsible for making the federal incentives available to Medicaid providers. This is one barrier noted by the report: “Incentivizing states to rapidly pursue implementation." Let’s hope they can pass on the good word from the feds; we’ll keep our fingers crossed.

Also Interesting:

[+] FISMA—a roadblock for EHRs?

[+] GE offers no-interest loans to promote EHR software

[+] Community Health Centers: An EHR helping hand, please?

[+] States take bigger role in promoting EHR adoption

[+] New study cites poor uptake of electronic health records

[+] Patients cheer on EHR technology, not afraid of privacy risks