American Recovery and Reinvestment Act Recovery Act Health Information Technology: State EHR Adoptio

1
American Recovery and Reinvestment Act (Recovery
Act) Health Information Technology State EHR
Adoption Loan Program

• The adoption of health information technology
  (health IT) is one of the major policy priorities
  of the recently passed Recovery Act. The Recovery
  Act package includes 2 billion in appropriated
  funds to support a series of grants, loans, and
  technical assistance programs designed to aid
  providers with the adoption of EHRs and to spur
  health information exchange at the state,
  regional, and local levels.

2
The Recovery Act authorizes Office of National
Coordinator (ONC) to award competitive grants to
states to develop EHR adoption loan programs for
health care providers

• Who qualifies? States or Indian tribes may
  provide loans to health care providers that agree
  to submit federally-specified quality
  measurements reports to CMS, use the EHR to
  exchange health information, and submit a plan
  for maintaining the EHR over time.
• Level of Funding. The stimulus package is silent
  on the overall amount of funding that will be
  devoted to the loan program and does not specify
  a maximum grant amount. States must provide a
  cash match equal to 1 in state funds for every
  5 in federal funds. States may couple their
  grants with private sector contributions in an
  attempt to increase the amount of the loan
  funding they can offer providers.
• Use of Funds. Providers may use loans to purchase
  or enhance the use of a certified EHR, train
  personnel to use EHR, and exchange health
  information.
• When How Will Funds Be Awarded. The stimulus
  package does not include details about the grant
  application process in which ONC will engage,
  stating only that the program may begin no sooner
  than January 1, 2010.

1/10/2010
2
3
Health Care Authority potential tasks to take
advantage of the EHR adoption loan program.

• Strategic Plan. Include a plan on what projects
  will be assisted, the distribution of funds and
  how healthcare providers involved intend to
  maintain and support the certified EHR
  technology.
• Secure Funding. 20 match is required. OHCA is
  requesting SFY2011 funding.
• Third Party Vendor. Secure a vendor that will
  make loans to health care providers that meet the
  strategic plan requirements. Report quality data
  to Health and Human Services (HHS) on any
  measures adopted by the federal government.
• Contract Monitor / Principal Investigator. Audit
  the loan program and insure sustainability.

4
Incentive Description

• The Recovery Act provides states the opportunity
  to incentivize providers to implement electronic
  health records (EHR) systems. This program does
  not require a state match. The cost to the state
  would be an FTE to run the program and the cost
  of IS changes. Providers implementing an EHR
  system, meeting specific criteria, will receive
  incentive payments . The program will be active
  from SFY2011 through SFY2015. Incentive payment
  will decrease each successive year as follows

5
Incentive Description (cont)

• Incentive payments for facilities with eligible
  EHR systems will also be available between SFY
  2011 and SFY 2015. Incentive payments for
  facilities will be up to 2,000,000. There is
  also an additional incentive based upon total
  discharges (numbering between 1,150 and 23,000)
  available to facilities. The incentive payments
  will decrease each successive year as follows

The formula for facilities considered critical
access will result in slightly higher incentive
payments. If 10 of the Oklahoma Medicaid
providers and eligible medical facilities
participate in the EHR incentive program, it
could bring more than 100,000,000 additional
federal dollars into the Oklahoma economy.
6
Timeline
Oct
Nov
Dec
Jan 2010
Aug 2009
Sep
Agency creates a budget request for LOAN state
match
Agency creates a budget request for INCENTIVE
state match
CMS issues guidance
Apply for LOAN authorization through CMS process
CMS award letters
7
Timeline (cont)
Aug
July
June
Feb 2010
March
April
May
Oct
Sep
Legislature approves LOAN INCENTIVE State match
funding
RFP for Oklahoma bank to operate LOAN
Complete pre-rule process
Board approval of rules
RFP awarded
Banks able to make EHR loans
Agency can accept INCENTIVE Applications