Health Information Management

GAO reports on progress of EHR Incentive Program payments

HIM-HIPAA Insider, November 4, 2013

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by Jaclyn Fitzgerald, Associate editor

CMS awarded approximately $6.3 billion in Medicare EHR Incentive Program payments in 2012, according to a report released by the U.S. Government Accountability Office (GAO). That’s more than twice the $2.3 billion in incentive payments eligible professionals (EP), eligible hospitals, and critical access hospitals (CAH) received in 2011, GAO reported. CMS awarded incentive payments to a greater number of hospitals in 2012 than in 2011, and some hospitals and EPs were more likely than others to receive these payments.

From 2011 to 2012, the number of eligible hospitals that received incentive payments nearly tripled. In 2012, CMS awarded incentive payments to 2,291 eligible hospitals, which represented approximately 48% of all eligible hospitals in the U.S., according to GAO. Comparatively, 16% of eligible hospitals (777) received payments in 2011, GAO reported.

Acute care hospitals were twice as likely as CAHs to receive incentive payments in 2012. Additionally, rural hospitals were more than three times as likely to receive incentive payments in 2012 as they were in 2011, according to the report.

The number of EPs that received incentive payments more than tripled from 2012 to 2011, and 75% of EPs participating in 2012 were new to the program. Approximately 31% of all EPs (183,712) received incentive payments in 2012, whereas just 10% of EPs (58,331) received incentive payments in 2011, according to the report. General practice physicians were 1.5 times more likely than specialists to receive incentive payments in 2012.

While these statistics are promising, it’s important to remember that work still needs to be done. The final day for eligible hospitals and CAHs to submit attestation to receive a 2013 incentive payment for the Medicare EHR Incentive Program is November 30. Deadlines for 2013 attestation under the Medicaid EHR Incentive Program are available on the CMS website.

And don’t forget about the other side of the Medicare EHR Incentive Program: payment adjustments. Beginning January 1, 2015, CMS will apply payment adjustments to Medicare physician fee schedule rates of EPs who do not demonstrate meaningful use before October 1, 2014. Beginning October 1, 2014, eligible hospitals that have not proved to be meaningful users will see adjustments applied to the percentage increase to the Inpatient Prospective Payment Systems payment rate. CMS would apply CAH adjustments to the cost reporting period in which the CAH was unable to demonstrate
meaningful use.

Visit the CMS site for more information on EHR Incentive Program.



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