Promising news for Community Services, IDD, and Behavioral Healthcare providers may have just come from the most unlikely of places.  A proposed revision to the regulations on Medicaid Managed Care was published recently, and in it is language that gives MCO, PIHP, PAHP, PCCM entities the latitude to provide incentive funds to providers.  Here is an excerpt of the language from the several hundred page proposed update:

“For example, states could make available incentive payments for the use of technology that supports interoperable health information exchange by network providers that were not eligible for EHR incentive payments under the HITECH Act (for example, long-term/post-acute care, behavioral health, and home and community based providers). The state would be permitted to use the health plan payments as a tool to incentivize providers to participate in particular initiatives that operate according to state-established and uniform conditions for participation and eligibility for additional payments. The capitation rates to the health plans would reflect an amount for incentive payments to providers for meeting performance targets, however the health plans retain control over the amount and frequency of payments.”

The Full rule can be found here.

Of course there are mountains of stipulation and regulation surrounding this idea, but the important thing is that CMS appears to at least acknowledge that helping all providers, not just those that have MD’s and NP’s eligible under the HITECH Act, to obtain technology that supports the exchange of healthcare data is important.  I couldn’t agree more.  Its is a critical step in realizing savings under these managed care plans, and a welcome breath of fresh air for all of us that have been advocating for incentives for these providers for years.