Should you choose the Medicare or Medicaid Incentive plan?
Deciding whether to opt for Medicare vs. Medicaid incentives will involve “running the numbers” once all the details of the programs are available as well as how well prepared you are in advance. Below is a comparison chart of the primary components of the Medicare and Medicaid Incentive plans.
Medicare |
Medicaid |
|
Eligibility linked with threshold patient volumes? |
No threshold Medicare patient volumes to qualify for additional Medicare incentives |
Have patient volume of at least 30% attributable to Medicaid patients. |
Meaningful use required each year? |
Yes - Physicians must purchase or lease the system, integrate it into your practice and be “meaningfully” using it before you’ll receive any money. Then they must successfully demonstrate meaningful use for each year of participation in the program. |
No - Medicaid eligible professionals can receive incentive payments for adopting, implementing or upgrading (A/I/U) to certified EHR technology in the first year of participation. Must successfully demonstrate meaningful use in subsequent participation years. |
Meaningful Use Definition |
MU definition is common for Medicare |
States can adopt certain additional requirements for MU |
Year 1 max incentive payment |
$18K |
$21,250 |
Incentives in Additional Years |
$12K, $8K, $4K and $2K for the next four years for those starting to receive benefits in 2011 |
Physicians will be eligible to receive up to $8,500 annually for five additional years to support the "meaningful use" of EHRs |
Maximum Incentives |
Maximum reimbursement of $44K over a period of 5 years ($48.4K in HPSA) (For calendar years 2011–2016) |
Reimbursement of up to 85% of allowable EHR costs not to exceed a maximum of $63,750 per provider over six years (for calendar years 2011-2021) |
Starting year |
2011 (Confirmed) |
2011 (Probable) |
Latest start date to maximize incentives |
2012 |
2016 |
Incentive Expiry |
No Medicare incentive for those who are meaningfully using an EHR after 2014; Last payment made in 2016 |
No Medicaid incentive payment to be made after 2021 or for more than 5 years |
Additional Incentive for HPSA |
10% additional |
None |
Linked to Allowed Charges? |
Yes - $24000 in Medicare Allowed Charges (75% of $24K = $18K) required to maximize reimbursement |
No – Medicaid Incentive payment not linked with Allowed Charges. |
Penalties for not demonstrating meaningful use of a certified EHR |
Begins to cut payments to doctors in 2015 |
No such punitive cuts |
Implemented by |
Federal Government (option available nationally) |
State Governments will implement voluntarily (may not be available in all States). Check the latest update here. |
Applicable to |
Only physicians, subsection(d) hospitals and CAHs |
5 types of EPs, acute care hospitals (including CAHs) and children’s hospitals |
Our consulting services do not cost you anything. So why not contact us today for a FREE DEMO of an EMR for your specific specialty by simply completing our FREE Demonstration Form.
You have nothing to lose, and everything to gain! Free EMR is not a myth. When you bundle our other services with an EMR, you will be able to tell your other colleagues about your latest ‘Free EMR’.