Report: About 45,000 Medicaid providers will qualify for health IT incentives

About 45,000 office-based physicians--including nearly all physicians who practice at federally qualified health centers (FQHCs) and half of office-based pediatricians--may be eligible for up to $63,750 to improve and maintain their health IT systems because of their participation in Medicaid, according to an analysis by researchers at the George Washington (GW) University. 

The GW report examined the Medicaid health IT adoption incentives contained in the American Reinvestment and Recovery Act (ARRA) of 2009. The law included about $49 billion in investments in HIT, including financial incentives for healthcare providers who treat Medicaid or Medicare patients and who can demonstrate meaningful use of technology.

The research was conducted by GW faculty at the Geiger Gibson/RCHN Community Health Foundation Research Collaborative, located in the Department of Health Policy at the GW University School of Public Health and Health Services in Washington, D.C.

This study underscores the importance of the Medicaid amendments to the successful transformation of the U.S. health information infrastructure, according to its authors. They found that tens of thousands of physicians who care for millions of low-income Medicaid patients will be eligible for federal incentive funding to help them establish, upgrade and operate EHRs.

Beginning in 2011, office-based physicians whose patient mix includes at least 30 percent Medicaid beneficiaries are eligible for a total reimbursement of up to $63,750 over six years, as long as they are able to demonstrate meaningful use of health IT. The report also found that the lower 20 percent threshold can be used in the case of pediatricians.

The authors said that physicians who predominantly practice at FQHCs and other settings can qualify if 30 percent of their patient base is characterized as "needy," including those covered by Medicaid, those who receive uncompensated care and patients who are charged income-related sliding scale fees.

GW researchers estimated about 15 percent of all office-based physicians would qualify for the Medicaid health IT incentives, including nearly 99 percent of FQHC physicians. If all qualifying physicians apply for the Medicaid incentives and receive the maximum level of payments, the federal government would invest more than $2.8 billion in health IT.

"The ARRA Medicaid incentives offer a critical first step in the transformation of healthcare practices on which millions of Medicaid beneficiaries rely," noted GW's Leighton Ku, PhD. "Successful implementation will depend on comprehensive guidance from HHS as well as ongoing technical assistance to both states and providers."

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