Providers could lose out on EHR incentive pay

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.