Direct Incentives for Physicians and Hospitals
The Medicare and Medicaid incentives consume the vast majority of the stimulus bill's health IT budget. It is expected that physicians will receive the money as part of their usual Medicare and Medicaid reimbursements, starting in 2011 if they qualify.
- How paid: Directly to physicians and hospitals, through the Medicare carriers
- When: Starting in 2011
- Who gets the money: Physicians and hospitals who are "meaningful users" of EHRs. "Meaningful user" still must be precisely defined by regulation, but criteria must include the use of a certified EHR, including electronic prescribing. The EHR must be connected to a health information exchange, and physicians must submit information on clinical quality, along with other measures required by the HHS secretary.
- How much: Up to $44,000 per physician over five years through Medicare. The largest incentives will be in the first year of certification, and decline annually. Hospitals are eligible for base incentive funding of $2 million, plus more based on discharge and patient stay data formulas.
- How allocated: Most likely through Medicare reimbursements.
- Massachusetts share: Estimated $727 million, according to the Mass. Health Data Consortium.
Grant and Loan Programs
Health Information Exchange Planning and Development
Grants to plan new HIE projects, and grants to implement projects already underway.
- Distribution agency: Department of Health and Human Services, Office of the National Coordinator (ONC).
- Who Gets the Funds: States and state-designated entities. Such entities must be committed to improving health care quality and efficiency through health information exchanges, among other requirements. Massachusetts has not designated the entity yet.
- What will be funded: Grants for planning and/or implementation of HIEs.
- How much: To be determined. State matching funds may be required.
- How allocated: Competitive grant process, established through forthcoming regulation.
- When: To be determined, but first ONC must deliver a strategic plan to Congress by May 18, 2009.
EHR Loan Fund
To assist health care providers with the initial capital needed to buy EHR systems.
- Distribution agency: ONC
- Who Gets the Funds: States or Indian tribes
- How much: To be determined. States or Indian tribes must provide $1 of matching funds for every $5 of federal funds. May be coupled with private sector contributions.
- How allocated: Competitive grant process, to be determined in regulation
- When: No earlier than Jan. 1, 2010
Health IT Regional Extension Centers
To provide technical assistance, share best practices and help with implementing EHRs at the local level.
- Distribution agency: ONC
- Who gets the funds: Nonprofits
- How much: To be determined. ONC can fund no more than 50% of the capital and operating funds needed to create and operate a regional extension center. Funding is provided for a maximum of four years.
- How allocated: To be determined
- When: 2009 -2011
Workforce Training Grants
To help clinical and non-clinical health care workers become IT literate, at least at the basic level.
- Distribution agency: HHS in consultation with the National Science Foundation
- Who gets the funds: Higher education institutions, and graduate health professional schools or programs. (Includes medicine, osteopathy dentistry, nursing, pharmacy, behavioral/mental health, and physician assistance studies.)
- How much: To be determined. Fifty percent match required, but could be waived if cost-sharing would be "detrimental to the program.")
- How allocated: HHS grants
- When: To be determined
New Technology Research and Development Grants
To encourage the development of new information technologies.
- Distribution agency: National Institute of Standards and Technology, in consultation with the National Science Foundation.
- Who gets the funds: Higher education institutions and/or federal government laboratories.
- How much: To be determined. Fifty percent match required, not necessarily from the states
- How: Competitive grant process
- When: To be determined
Broadband Opportunity Program
To stimulate the development of broadband service nationwide.
- Distribution agency: Department of Commerce, in consultation with the Federal Communications Commission
- Who gets the funds: State government, nonprofits, and private broadband service providers determined to be working in the public interest
- How much: At least $250 million (for all grants). At least 20% of cost must be shared by the grantee.
- How: Competitive grant process
- When: By the end of FY 2010
