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Electronic Health Records: 16% of Hospitals, 9% of Doctors Get Medicare Incentive Pay

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The percentage of hospitals and physicians getting Medicare incentive payments for “meaningful use” of electronic health record (EHR) technology seems to be lower than officials at the U.S. Department of Health and Human Services (HHS) had been hoping back in January 2011.

Investigators at the U.S. Government Accountability Office (GAO) responded to questions from Congress about the EHR incentive program by comparing the number of Medicare providers who had received EHR incentive payments with the number of Medicare providers eligible to receive the payments.

The investigators found that 16% of the 4,855 eligible hospitals and 9% of the 600,172 eligible health care professionals have received EHR incentive payments for 2011, the first year for which EHR incentive payments were available, Linda Kohn, a GAO director, writes in a letter summarizing the GAO’s EHR meaningful use incentive payment research 

EHR Incentive Payments, 2011
  Percentage of eligible providers receiving payments Number of providers eligible
Hospitals 16% 4,855
Doctors 9% 600,172
Source: GAO

The 761 hospitals that received the payments collected a total of $2.3 billion. The median amount was $1.7 million, and the actual payments ranged from $22,300 to $4.4 million. The theoretical hospital payment maximum was about $6.4 million, Kohn says.

The 56,585 physicians and other professionals who received the incentive payments aimed at health care professionals collected a total of $967 million in incentive payments, or about $17,100 each. For health care professionals, the theoretical maximum payment was $19,800, Kohn says.

Physicians in general practice — primary care providers — were about 80% more likely to get the EHR payments than specialists were, and urban doctors were more likely to get the payments than other doctors were.

Kohn and other GAO staffers did not compare the share of incentive payments going to urban doctors and hospitals, or to primary care doctors and specialists, with the share of Medicare hospitals that are in urban areas, or the share of Medicare doctors who are primary care doctors or are in urban areas.

The GAO analysis includes hospitals affiliated with Medicare Advantage plans, but it includes health care professionals affiliated with the plans only if the professionals also continue to participate in the traditional Medicare Part B physicians services plan, Kohn says.

Congress included the law that created the EHR meaningful use Medicare provider incentive payment program in the American Recovery and Reinvestment Act of 2009 (ARRA).

Most Medicare providers also treat patients who have other types of coverage, such as commercial health insurance. Health policymakers have been hoping that encouraging Medicare providers to use EHR technology in a serious way could make the entire U.S. health care system more efficient.

In January 2011, HHS officials reported that about 81% of eligible U.S. hospitals and about 41% of the office-based physicians eligible to receive health care professional incentive payments intended to participate in the incentive payment program.

At that time, officials said they believed about 30% of the eligible physicians already had a basic EHR system in place.


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