EHR Incentive Program Races Past Milestone

More than 100,000 providers receive Medicare or Medicaid payments for showing Meaningful Use or adopting EHRs--in less time than expected.
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Through May, more than 110,000 eligible professionals and 2,400 hospitals had received payments totaling $5.7 billion under the electronic health record incentive programs of Medicare and Medicaid, according to Marilyn Tavenner, acting administrator of the Department of Health and Human Services.

That total exceeds the 100,000 providers Tavenner and Farzad Mostashari, National Coordinator of Health IT, earlier predicted would receive payments by the end of this year.

In an interview with InformationWeek Healthcare, Mostashari attributed the acceleration in the number of providers attesting to Meaningful Use and receiving Medicare payments partly to a change in attitudes: A growing number of eligible clinicians and hospitals, he said, now believe that Meaningful Use is an achievable goal.

"The vendor systems are kicking in, the upgrades that people were waiting for have happened. They're finding it's not that difficult to go through the attestation process. So we are able to get payments out and that's kind of feeding on itself. When a doctor hears that their buddy down the street got paid, that physician wonders, 'Why don't I do it too?' So it creates that sense of momentum."

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Second, he said, the government-funded regional extension centers are helping many small practices, rural providers, and critical access hospitals move along the road to Meaningful Use.

Of the 133,000 primary care doctors and 10,000 specialists that the regional extension centers (RECs) have enrolled, only 12,000 have received payments so far. But Mostashari noted that "around half of all the Medicaid payments have been to providers working with the extension centers." To get Medicaid incentives--now available in 44 states--providers need only show they have adopted, upgraded, or implemented an EHR in the first year of payment. "So I do think the extension centers deserve credit, particularly since they're working with the group of providers that was most vulnerable to not being able to do this on their own."

Besides having signed up 143,000 providers, the RECs have already helped 70,000 of them go live on their EHRs. "And that's accelerating over time," Mostashari added. "I'm absolutely confident that these local nonprofits are going to get 100,000 providers to Meaningful Use in the next year and a half to two years."

The REC-assisted practices aside, many eligible practitioners don't have EHRs capable of showing Meaningful Use. University of California San Francisco researchers recently reported that, while most California physicians have some kind of EHR, only 30% use EHRs that enable them to meet the Meaningful Use criteria. And in a survey by the Centers for Disease Control and Prevention (CDC), about half of doctors said they planned to apply for the government EHR incentives, but only 11% said they had systems with the requisite features.

Mostashari brushed these studies aside. For one thing, he explained, their information was collected in 2011, so it's already out of date. "[Considering that] we doubled EHR adoption in 24 months," he said, "we're already in a much better place."

Mostashari also said the studies used some questionable assumptions. "The hardest numbers aren't the survey numbers; the hardest numbers are how many people got paid," he said. "And what I see today and what we have to celebrate is that something that we thought would take all of 2012, the providers accomplished in the first six months of the year."

To date, one in five eligible professionals has received a Medicare or Medicaid incentive payment. In addition, 48% of all eligible hospitals and critical access facilities have been paid for adopting, upgrading, implementing, or meaningfully using an EHR.

Asked to predict how many providers will attest by the end of 2012, Mostashari laughed. But he said he expected attestations to crest this fall. "Last year, we had a real surge in the later part of the year, and I suspect there will be a big surge coming in again toward the end of 2012."

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