STREAMLINING HEALTHCARE SM

DISTRIBUTION310 Montgomery Street • Alexandria, VA 22314-1516 Phone: (703) 549-4432 • Fax: (703) 549-6495 • www.HIDA.org

EPs in Medicare EPs in Medicaid

Active Registrants 123,921 49,051

Number that Qualified for Payments 15,255 14,089

2011 Incentive Payments $274,590,000 $295,760,910

Average Total Payment Per Provider $18,000 $20,992

Total Payments $570.35 million

Electronic Health Records: Physicians52% of Physicians Plan to Participate in EHR Incentive Programs

ELECTRONIC HEALTH RECORD INCENTIVE PROGRAMFifty-two percent of office-based physicians intend to enroll in the Medicare and Medicaid electronic health records (EHR) incentive programs, according to a recent survey from the Centers for Disease Control and Prevention (CDC). The percentage of physicians who have adopted basic EHR systems has doubledi from 17 to 34% between 2008 and 2011. With $570.35 million awarded in government incen-tives in 2011, EHR stakeholders anticipate continued investments by physician offices in health information technology (IT).ii

Eligible professionals (EPs) in the Medicare program are primarily physicians, while the Medicaid program is open to other healthcare pro-fessionals (not hospital-based) that serve a minimum Medicaid patient volume of 30%.

Medicare: From 2011–2016, EPs can receive up to $44,000 over 5 years under the Medicare EHR Incentive Program. • Medicareeligibleprofessionalsmustbeginparticipationby2012to

receive the maximum EHR incentive payment.• MedicareEPswhodonotimplementEHRby2015willface

a payment reduction penalty of 1%, increasing each year to a maximum 5% reduction.

Medicaid: From 2011–2021, EPs can receive up to $63,750 over 6 years under the Medicaid EHR incentive program.• EPsmayparticipatefor6yearsthroughoutthedurationofthe

incentive program, which continues through 2021. • ThefinalyeartobeginparticipationintheMedicaidEHRincentive

program is 2016.• ThereisnoMedicaidpenaltyforfailuretoadoptEHR.

Note: EPs that are eligible for both the Medicare and Medicaid programs must choose one upon registration. Before 2015, an EP may switchprogramsjustonceafterreceivingthefirstincentivepayment.

continued on reverse side…

Medicare Incentive Payments in 2011, by Provider

Source: CMS Data, December 2011

1,088Cardiology

914Podiatry

691Gastroenterology

545Orthopedic Surgery

497Urology

474General Surgery

405Neurology

383Nephrology

3,377Family

Practice

3,074Internal

Medicine

3,807Other

STREAMLINING HEALTHCARE SM

DISTRIBUTION310 Montgomery Street • Alexandria, VA 22314-1516 Phone: (703) 549-4432 • Fax: (703) 549-6495 • www.HIDA.org

USAGE OF EHR SOFTWARE BY PHYSICIAN OFFICE SIZEOver 70% of physician practices with more than 10 doctors are using EHR software. EHR usage has increased among each practice size over the past 16 months, according to an SK&Aiii survey released in late 2011. In addition to practice size, the report noted that patient volume and the number of exam rooms are factors that influence EHR adoption.

DISPARITY IN STATE MEDICAID INCENTIVESAccording to the Centers for Medicare & Medicaid Services, 43 states have opened registration for the Medicaid EHR program, but 17 states have not provided any Medicaid incentives for EHR adoption. However, a total of 33 state Medicaid programs have distributed over $2.5 billion in 2011 to EPs and hospitals participating in the Medicaid EHR program. Below are the top six states in Medicare and Medicaid payment incentivesiv for providers, and the bottom six.

MEANINGFUL USE UPDATE – STAGE TWOThe U.S. Department of Health & Human Services (HHS) has delayed Stage Two requirements until 2014 and is allowing EPs that successfully met Stage One Meaningful Use criteria in 2011 to poten-tially obtain bonus incentives in 2013. Initially, EPs would have been required to meet Stage Two requirements by 2013.

HHS published proposed Stage Two meaningful use criteria on February 23, 2012. Among the criteria, the proposal focuses on improving patient access to health information online and electronic communication between healthcare providers. For more information about the federal EHR incentive program and the Stage Two criteria, visit www.cms.gov/ehrincentiveprograms.

Top Six States in Incentives Paid to EPs Total

Texas $82,102,209

Ohio $69,008,457

Pennsylvania $63,357,532

Florida $49,967,921

Wisconsin $33,162,511

Tennessee $25,547,256

Bottom Six States in Incentives Paid to EPs Total

North Dakota $90,000

District of Columbia $108,000

Idaho $630,000

Wyoming $693,500

Montana $702,000

South Dakota $1,584,000 Source: CMS Data, December 2011

0%

10%

20%

30%

40%

50%

60%

70%

80%

1 2 3 to 5 6 to 10 11 to 25 26 or more

Number of Physicians

n October 2010n July 2011

Source: CMS Data, December 2011

Physician NursePractitioner

Dentist CertifiedNurse-Midwife

PhysicianAssistant

Other

$220,174,410

$51,637,750

$13,557,500 $6,630,000 $3,527,500 $1,098,965

Note: 33 states have distributed EHR incentives through Medicaid programs, while 17 have not.

Source: CMS Data, December 2011

Medicaid Incentives Paid to EPs in 2011

i “Electronic Medical Record/Electronic Health Record Use and Meaningful Use Incentive Payments By Office-Based Physicians: United States, 2010 and Preliminary 2011 State Estimates ,” Centers for Disease Control & Prevention, November 2011.

ii “EHR Incentive Programs,” Centers for Medicare & Medicaid Services, retrieved in February 2012.iii “Survey of Physician Office Usage of Electronic Health Records Software,” SK&A, A Cegedim Company, October 24, 2011iv “Year-to-date combined Medicare and Medicaid payments by state,” CMS, December 2011.