Large Urban Hospitals Grab More EHR Incentive Payments

GAO report reveals which hospitals and professionals got the lion's share of Medicare electronic health record incentive dollars in 2011.

12 EHR Vendors That Stand Out
12 EHR Vendors That Stand Out
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In 2011, large urban hospitals, acute care hospitals, and healthcare facilities in the southern United States were more likely than other facilities to receive Medicare electronic health record (EHR) incentive program checks, according to research from the U.S. Government Accountability Office (GAO).

In Electronic Health Records: Number and Characteristics of Providers Awarded Medicare Incentive Payments for 2011, a report based on data collected between January 3, 2011 to April 2, 2012, GAO examined the number and unique characteristics of healthcare providers that were awarded Medicare incentive payments in 2011 under the Centers for Medicare and Medicaid EHR incentive programs. The program rewards providers that implement EHRs and meet certain Meaningful Use requirements to verify that they are using EHRs to improve the delivery of care.

The research revealed that in 2011 approximately $2.3 billion in Medicare EHR incentive payments was awarded to hospitals and professionals. Of that total, $1.3 billion was awarded to 761 hospitals, or 16% of the estimated 4,855 eligible U.S. hospitals.

Individual hospital awards varied widely, ranging from $22,300 to $4.4 million each; the median payment amount was $1.7 million. About 61% of hospitals accounted for about 80% of the total amount of incentive payments awarded to hospitals.

[ For more background on e-prescribing tools, see 6 E-Prescribing Vendors To Watch. ] Among hospitals awarded an incentive payment for 2011, GAO found that:

-- the largest proportion (44%) was located in the South, and the lowest proportion (12%) was in the Northeast;

-- about two-thirds (67%) were in urban areas;

-- more than four-fifths (86%) were acute care hospitals; and

-- almost half (46%) were in the top third of hospitals in terms of number of beds.

GAO's research also revealed that about $967 million in Medicare EHR incentive payments was awarded to 56,585 professionals, representing about 9% of the estimated 600,172 professionals eligible for the program. Among professionals awarded an incentive payment in 2011, GAO found that:

-- the largest proportion (32%) was located in the South, and the lowest proportion (17%) was located in the West;

-- a significant majority (89%) were in urban areas;

-- 50% were specialty practice physicians and 38% were general practice physicians;

-- 71% did not previously participate in CMS's incentive program for electronic prescribing; and

-- 46% were in the top third in terms of 2010 Medicare Part B charges, and 51% were in the top third for 2010 Medicare Part B patient encounters.

A closer examination of the numbers also showed that general practice physicians were 1.8 times more likely than specialty practice physicians to receive an incentive payment. Professionals who had previously participated in CMS's electronic prescribing program were almost four times more likely to successfully receive an incentive payment than those who had not participated in the electronic prescribing program, and professionals who had signed an agreement to receive technical assistance from a Regional Extension Center were more than twice as likely to have been awarded an incentive payment.

The report's findings highlight those areas where more work needs to be done, said Sharon Canner, senior director of advocacy programs at the College of Healthcare Information Management Executives (CHIME).

"The report points out where work is needed to assist those who have not attested," Canner said. "Communication and outreach by CMS and ONC, webinars, FAQs and other resources have been helpful in responding to industry questions, but clearly more efforts will be needed since the bar will be raised for Stage 2. The report also notes geographic differences, which should be helpful in targeting more clearly just where assistance is needed."

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