Driving High Performance: Health Information Technology Reimbursement Program

This component of the American Recovery and Reinvestment Act of 2009 will provide $17.2 billion to encourage providers to implement or enhance HIT systems. In this paper, Accenture reviews:

• Aspects of the federal match for payments made by states to eligible Medicaid providers and the reimbursement of 90 percent of a state’s administrative expenses related to the implementation and oversight of electronic health record (EHR) technology incentives.
  
  
• Potential benefits to Medicaid programs realized by increasing the number of Medicaid providers using HIT, including improved quality of care and reduced spending.
  
  
• Challenges faced by states in rapidly and appropriately implementing a reimbursement program.
  
  

This paper begins by looking at the funds flowing from the HITECH Act to physicians and hospitals through the Medicaid and Medicare programs. These will be in the form of incentives for the “meaningful use” of certified EHR technology.

By exchanging information electronically and using key health data to inform decisions, EHR systems can be used to support the provision of comprehensive care management and coordination of care. They can also help reduce unnecessary and duplicative services while providing research opportunities that can further inform and advance program improvements.

Challenges facing Medicaid agencies include:

• The complexity and timing of the program.
• The need to effectively educate, support and reward providers.
• Extensive technical and reporting requirements and limited staff resources.
  
  

The challenges and complexities involved mean that Medicaid agencies can benefit from reliable guidance, effective program management and HIT support as they implement and monitor such programs. Successful implementation can lead to:

• Accurate tracking and reporting on federally-required measures.
• Resolution of difficult technical issues as they arise.
• Establishment of clearly interpreted policies and guidance for reimbursement.
  
  

Effective implementation and operation of the reimbursement program is central to increasing the number of Medicaid providers using HIT and realizing the benefits of improved quality and efficiency.

Medicaid agencies can develop, implement and oversee effective HIT reimbursement programs by helping providers to fully understand the scope and nature of the incentives and providing guidance on requirements and standards needed for reimbursement. An experienced, multi-disciplined system management team should establish and roll out the HIT reimbursement program.

The team should attain consensus among multiple stakeholder groups to drive the transformational program and achieve high performance. This may entail training individuals in key organizations to accelerate the certification process. The system team and senior management must collaborate with states and state-designated entities to develop and implement a sustainable HIT framework.