Medicare vs. Medicaid Incentives

How to Choose between Medicare and Medicaid Incentives

EHR incentives can be earned through Medicare or Medicaid*. Although the requirements are similar, there are important differences to consider when making the selection.

Physicians who are eligible for both programs will likely find participation under Medicaid to be a preferable option because the incentives are higher, the first year provides rewards for adoption/purchase without requiring demonstration of meaningful use, and the program offers more flexibility in terms of time frames.

To participate under Medicaid, however, a provider must have a practice that is 30% Medicaid (20% for pediatricians), based on number of patient encounters. Qualification is reevaluated annually. Some providers are eligible only under Medicaid—nurse practitioners, certified nurse-midwives, dentists, and physician assistants who practice in a Federally Qualified Health Center or rural health clinic that is led by a physician assistant.

Major Differences between Medicare and Medicaid

medicare-vs-medicaid-chart

*The Medicaid programs are run by individual states, so requirements and processes may vary somewhat from the Medicare program and from each other. CMS maintains a list of websites by state.

For information specific to the EHR incentives under Medicaid, the following additional resources are available: CMS Medicaid State Information and CMS FAQ.