Providers could lose out on EHR in­cen­tive pay

Modern Healthcare - - LATE NEWS - —Joseph Conn

Bil­lions of dol­lars in fed­eral elec­tronic health-record in­cen­tive pay­ments ap­pear to be in jeop­ardy as hos­pi­tals, physi­cians and other el­i­gi­ble pro­fes­sion­als that got an early start on the pay­ment pro­gram face a more strin­gent set of cri­te­ria this year, ac­cord­ing to a Mod­ern Health­care anal­y­sis of new CMS data.

So far, only a tiny frac­tion of par­tic­i­pants have met the bench­marks.

There are about 2,500 el­i­gi­ble hos­pi­tals and 168,000 physi­cians and other el­i­gi­ble pro­fes­sion­als that first met the pro­gram’s Stage 1 re­quire­ments in 2011 or 2012 and re­main el­i­gi­ble for par­tic­i­pa­tion this year.

But of those early par­tic­i­pants in the pro­gram, cre­ated un­der the Amer­i­can Re­cov­ery and Rein­vest­ment Act of 2009, only 3.1% of el­i­gi­ble hos­pi­tals and 1.1% of el­i­gi­ble physi­cians and other pro­fes­sion­als have cleared the more strin­gent and nom­i­nally re­quired Stage 2 mean­ing­ful-use re­quire­ments this year.

As a re­sult, the re­main­ing physi­cians and other pro­fes­sion­als stand to lose about $1.15 bil­lion in Medi­care Stage 2 EHR in­cen­tive pay­ments, the anal­y­sis shows. De­ter­min­ing how much hos­pi­tals could lose is more dif­fi­cult, be­cause their pay­ment for­mula is more com­plex and in­cludes a fac­tor for pa­tient vol­ume.

Given that hos­pi­tals have re­ceived 60% of the to­tal Medi­care EHR in­cen­tive pay­ments so far, the num­bers are sure to be sub­stan­tial.

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