In­for­ma­tion tech­nol­ogy Primed for ex­plo­sive growth

Modern Healthcare - - SPECIAL REPORT -

Two fed­eral health in­for­ma­tion tech­nol­ogy in­cen­tive pro­grams will likely trig­ger ex­plo­sive growth in 2012 in the adop­tion and mean­ing­ful use of elec­tronic health-record sys­tems by of­fice­based physi­cians, but adop­tion rates will rise more slowly at hos­pi­tals.

Ac­cord­ing to re­cent data from the National Cen­ter for Health Sta­tis­tics, an arm of the Cen­ters for Dis­ease Con­trol and Pre­ven­tion, physi­cian adop­tion of “fully func­tional” EHRS reached 17% in 2011, up from less than 7% in 2009 when the Amer­i­can Re­cov­ery and Rein­vest­ment Act passed. The fed­eral stim­u­lus law cre­ated two fed­eral EHR in­cen­tive pay­ment pro­grams un­der Medi­care and Med­i­caid and au­tho­rized about $27 bil­lion in spend­ing for them.

As a point of ref­er­ence, a fully func­tional EHR comes clos­est to what physi­cians need to qual­ify for Stage 1 mean­ing­ful-use cri­te­ria un­der the Medi­care EHR in­cen­tive pay­ment pro­gram. Providers un­der the Med­i­caid EHR pro­gram also must meet mean­ing­fu­luse cri­te­ria later, but not in their first year of par­tic­i­pa­tion.

The year 2012 will mark the sec­ond, and fi­nal, chance for physi­cians and other “el­i­gi­ble pro­fes­sion­als” to jump into the Medi­care in­cen­tive pro­gram and get the max­i­mum pay­ment of $44,000 for be­com­ing a mean­ing­ful user of their EHR sys­tems.

Only 10,155 physi­cians and other EPS had signed up and re­ceived a Medi­care EHR pay­ment through Novem­ber 2011, the most re­cent month data was avail­able from the CMS. But that num­ber of paid providers had jumped 75% from Oc­to­ber. An­other 11,140 EPS had been paid un­der the Med­i­caid EHR pro­gram through Novem­ber, up 28% in a month.

Ex­pect a stam­pede of physi­cians and other clin­i­cians to join them this year.

Com­bined, the Medi­care and Med­i­caid EHR in­cen­tive pro­grams paid out more than $1.8 bil­lion through Novem­ber 2011, but the Medi­care pro­gram didn’t start mak­ing pay­ments un­til May, and at year’s end not all states, many of which are cash-strapped be­cause of the stag­nant econ­omy, had Med­i­caid EHR pro­grams up and run­ning.

As 2011 closed, 41 states had Med­i­caid EHR in­cen­tive pro­grams at least reg­is­ter­ing par­tic­i­pants, with two more states ex­pected to join them by Jan­uary 2012. Of the 41 state pro­grams in op­er­a­tion, 38 were ad­vanced enough to be pay­ing providers, so get­ting all 50 state pro­grams mak­ing pay­ments should ac­cel­er­ate the cash flows to par­tic­i­pat­ing providers.

More than $1.4 bil­lion of those Medi­care and Med­i­caid EHR pay­ments made in 2011 went to hos­pi­tals. Slightly more than 1,200 hos­pi­tals re­ceived in­cen­tive pay­ments, with the av­er­age pay­ment com­ing in at about $1.1 mil­lion.

John Hoyt is ex­ec­u­tive vice pres­i­dent of HIMSS An­a­lyt­ics, the mar­ket re­search arm of the Health­care In­for­ma­tion and Man­age­ment Sys­tems So­ci­ety. The HIMSS An­a­lyt­ics EHR adop­tion model tracks the climb up the elec­tronic health-record sys­tem us­age lad­der for more than 5,200 hos­pi­tals. Its rungs start at Stage 0, with lit- tle to no sys­tem adop­tion, through Stage 7, which in­cludes com­plete EHR adop­tion, plus in­for­ma­tion ex­change ca­pa­bil­i­ties.

In ag­gre­gate for hos­pi­tals, the climb has been painfully slow since 2009 through the third quar­ter of 2011, the most re­cent quar­ter for which HIMSS data is avail­able. Since 2009, the me­dian rank­ing for U.S. hos­pi­tals re­mains stuck in Stage 3, and that won’t change for 2012, Hoyt says.

But the good news for this year, he says, will be the sig­nif­i­cantly higher num­ber of hos­pi­tals adopt­ing sys­tems at the up­per rungs of the model, Stages 5, 6 and 7. Those are the stages bench­marked by EHR func­tions needed for hos­pi­tals to com­plete mean­ing­ful-use re­quire­ments un­der the Medi­care in­cen­tive pro­grams, he says.

Hoyt says 102 hos­pi­tals made it to the elite Stage 6 in 2011, join­ing just 150 or so al­ready there at the start of the year.

“We are see­ing a lot of growth at that high end,” Hoyt says. “Once you make it past Stage 4 and have the docs at the key­board, it’s easy to make a move. That’s a big hill, and it’s eas­ier from there. I see no rea­son for it to slow down. So, I’m con­fi­dent we’ll hit an­other 125” at Stage 6 in 2012, Hoyt says.

—Joseph Conn

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