At the recent Healthcare Information and Management Systems Society's (HIMSS) 2011 Government Health Information Technology (GHIT) Conference and Exhibition, Jessica Kahn, technical director for Health IT at Centers for Medicare and Medicaid Services (CMS), gave us a glance at the Medicaid electronic health record (EHR) incentive program that resulted from the HITECH Act. The voluntary program launched with 11 states in January 2011, and 17 states have launched as of early June 2011. Most remaining states are anticipated to launch by the end of year.

As of late June 2011, 12 states are making payments, with $28 million paid to date to eligible professionals (doctors, nurses, physician assistants, dentists). There are 8,326 eligible providers registered so far, and 1,325 have been paid. Louisiana, considered a "pace-car" state, has paid the most. One lesson learned is that states initially underestimated how many incentive payments would be made in the first quarter. States had to guess how many providers might receive the incentives, and many states had to go back and ask the federal government for more money.

CMS is investing time and resources into technical assistance to enable states' success. Activities to ensure success include accepting draft state Medicaid HIT plans in order to save time; employing communities of practice to share templates and best practices on what worked and what didn't; and peer-to-peer support with some states offering the code for how to develop the systems.

Kahn highlighted program successes like testing and interfacing the CMS registration and attestation system with 35 states. She also noted the success of provider and stakeholder outreach and education. There has been much collaboration with the Office of the National Coordinator for Health Information Technology (ONC) in messaging for consumers, privacy, certification, and the EHR incentive program. However, the program doesn't come without challenges. The multistate solutions were a great idea, but were not as easy to operate at a federal level. CMS is used to funding initiatives one state at a time, so things got a little hairy with multistate collaboration. Vendors and states should work on best practices to share how they can improve these processes in the future.

Kudos to states that have moved forward so quickly on this initiative while staring down the barrel of looming deadlines for significant projects like health insurance exchanges. Since states are managing multiple health-related initiatives, it is amazing the level of progress many have made. Remember that this is a 10-year program, and though states are only five months into the program, they have made significant progress in creating new system capacities.

For more insight into the GHIT Conference, please see the Analyst Recap of the event.