Medicaid eligible professionals are registering to participate in the Meaningful Use program at a higher level than was initially anticipated by the federal government. However, Medicare EPs have higher MU attestation rates than Medicaid registrants, according to new data from the Office of the National Coordinator for Health Information Technology.

ONC’s Dawn Heisey-Grove told an April 7meeting of the Health IT Policy Committee that more EPs have registered with the Medicaid program than was originally estimated. Presenting data from the Medicare and Medicaid EHR Incentive Programs through February 2015, Heisey-Grove said the estimate from the Stage 2 Meaningful Use rule published in 2012 projected 145,000 Medicaid EPs, but the actual number is 176,000 Medicaid EP registrants—and registration rates have not yet plateaued. 

Also See: CMS Extends EHR Attestation Deadline for EPs to March 20

The original estimate for Medicare EPs was 393,000 and the actual number is 369,000 registrants. And, while the total number of EPs registered for both Medicare and Medicaid was initially projected to be 538,000, that number now stands at 546,000 actual registrants.

“Most of that increase is by Medicaid professionals,” Heisey-Grove observed. “If you look at registration as a marker of intent to participate in the program, we see an ongoing increasing trend in that participation rate. However, we also note that Medicaid professionals are participating at a higher level than was originally anticipated and that will have impacts as we look through the program going forward, because Medicaid providers are on different timelines than Medicare.”

According to Heisey-Grove, Medicaid EPs can begin the Meaningful Use program as late as 2016 and receive incentive payments with final year incentive payments paid through 2021, while 2014 is the last year for Medicare EPs to begin the program and receive incentive payments with 2016 as the final year that incentives may be paid.

Nonetheless, Heisey-Grove also reported to the HIT Policy Committee that EPs registered with the Medicare program have higher Meaningful Use attestation rates than Medicaid registrants, and that less than half of Medicaid EPs attest to MU in the year immediately following receipt of an “Adopting, Implementing and Upgrading” payment. “Only about 32 percent of all Medicaid registered eligible professionals have achieved Meaningful Use compared to 86 percent of the Medicare providers,” she said.

While Medicare EPs are scheduled for Stage 2 two years after they have first attested to Meaningful Use, Medicaid EPs also need two years of Stage 1 before they can progress to Stage 2 but they may skip years between attestations. Yet, that flexibility granted to Medicaid EPs is not serving them well.

“Of all the [176,000] Medicaid registered providers, only 8 percent of them are actually scheduled to attest to Stage 2 in 2014,” said Heisey-Grove. By comparison, 9 in 10 EPs scheduled for stage 2 in 2014 were registered with the Medicare program.

Paul Egerman, a member of the HIT Policy Committee, suggested that the lack of Meaningful Use success achieved to date by Medicaid EPs has to do with the fact that “a lot of the Medicaid providers are practicing in practices or practice environments that have much less of an infrastructure than their [Medicare] counterparts.” Egerman continued: “This program is helping the rich get richer. People who have the IT structures are able to get more of the incentive money than the institutions of the poorer population because they do not have that same capability.”

Heisey-Grove replied that “this population needs extra assistance” and ONC is looking at ways to get it to them. She added that providers who receive assistance from Regional Extension Centers (RECs)—which target the Medicaid eligible professional population—are much more likely to achieve Meaningful Use than Medicaid EPs that don’t receive that assistance.

Sixty-two RECs across the country help primary care and underserved providers navigate the complex EHR adoption process from vendor selection and workflow analysis to implementation and Meaningful Use. According to ONC, the REC network includes 54 percent of all rural providers, 80 percent of all critical access hospitals, and 83 percent of all community health centers.

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