More open doors for Optometrists: Medicaid.

When the HITECH wagons were first circled, we heard about the two incentive streams, Medicare and Medicaid. The AOA EHR Affiliate Program (aka "the state roadshow") also promoted both streams. There was a big problem however: Optometrists were not eligible for the Medicaid stream. Even though many were being faithfully reimbursed for their Medicaid claims, Optometrists were not recognized as Eligible Providers under any state Medicaid program.

In the fall of 2011, that began to change. Illinois was the first state to open its doors recognizing OD's as Eligible Providers. Thanks are due to the Illinois College of Optometry and Illinois Eyecare Institute for blazing that trail. Other states have followed suit, including Minneapolis and Alabama. We can expect a wave of acceptance across the country now. As of early January, 43 states had launched their Medicaid programs.

What does this mean for you as an Optometrist?

• It means you may have an option to go the Medicaid route. I say "may" because you need to check this out in your state, maybe even be ready to give it a push through your state optometric association.
• Eligibility for Medicaid programs requires that a minimum of 30% of your patients are Medicaid patients. 
• Understand that the Medicaid incentive programs are different than Medicare. They vary somewhat by state but, generally speaking, the timelines, the rules and the reimbursements are favourable. Click here to read some insights from the Wisconsin Medicaid program that may be applicable to your own state's program. 
• Yes, you can switch from Medicare to Medicaid. You can do it up front or mid stream. Click here to read a good article on switching incentive programs.

Whether you choose Medicare or Medicaid, it's important to move with respect to EHR adoption and the transformation of health care. If you don't qualify for either program, don't be fooled. With or without the incentive money, it still matters. Embracing EHRs is about the survival of your business in the health care reform world.

Alistair Jackson, M.Ed.