In addition, some ARRA programs will not kick into full gear until later this year, such as the Medicare and Medicaid Incentive Program for electronic health records (EHR) adoption, which is authorized through 2021. Health care providers that meet the guidelines and prove they are engaged in "meaningful use" of their EHRs will be able to receive enhanced reimbursement through Medicare and Medicaid. While dually eligible individual practitioners will be forced to choose one program (Medicare or Medicaid), acute care and critical access hospitals will be able to take advantage of both if they meet the Medicaid volume thresholds.

Grant funding in the health care field is certainly entering a new era ushered in by the Patient Protection and Affordable Care Act (Health Reform Act). In terms of the potential for new grant programs in the future, the Health Reform Act is making major investments in three key areas: 1) workforce development, 2) overall health care quality and 3) comprehensive care management models. The effects of its passage are already being felt in the grants arena as the Health Reform Act has restructured and re-authorized some grant programs that were previously available on an annual basis or newly created through the ARRA. Several grant programs under the Equipment to Enhance Training of Health Professionals umbrella, which was originally created through ARRA, were amended and reopened with deadlines in late May. Likewise, the annual grant funding available for Area Health Education Consortiums (AHECs), which are responsible for the training of health care professionals in a particular region, was split into two streams (infrastructure and model projects) under the provisions of the Health Reform Act. Both AHEC programs were due May 26, 2010.

Unfortunately, sometimes the billions of dollars in annual grant funding available get forgotten in the commotion over the ARRA and Health Reform Act. $400 billion per year was available through grants prior to the ARRA and these annual funds continue to flow. One such annual program, the Telehealth Network Grant Program (TNGP) was recently released and is due June 14, 2010. TNGP offers up to $750,000 over a three-year period for projects that create telehealth or telehomecare networks. TNGP funds will not be invested in start-up projects but instead will be awarded for scale-up activities associated with successful initiatives that are already underway.

In conclusion, the most accurate description of the current health care funding landscape might seem to be "chaos." With several forces at play (annual funding, ARRA, Health Reform) and no unifying structure, funding priorities are a moving target. The good news is that all these forces add up to an unprecedented amount of funding that will continue to be available for health care projects. Maybe chaos isn't so bad.