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EHR incentive payments could exceed $22.5B estimate


By Joseph Conn
Posted: March 3, 2014 - 2:00 pm ET
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It seems possible the federal electronic health-record incentive payment program will surpass its current $22.5 billion estimated total payout, based on the latest numbers from the CMS.

The incentive payment program, created under the American Recovery and Reinvestment Act of 2009, has paid out more than $20.9 billion since 2011, funding 89% of eligible hospitals and 65% of physicians and other eligible professionals, according to the latest program report from the CMS.

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To date, 4,477 hospitals of 5,011 total eligible ones have received more than $13.8 billion in payments under the Medicare or Medicaid programs, or both, the CMS data show.

Physicians and eligible professionals—which include dentists, optometrists, podiatrists and chiropractors, under the Medicare program—have received nearly $4.2 billion, Physicians, certified nurse midwives, nurse practitioners and physician assistants under the Medicaid program have shared a little more than $2.6 billion. Physicians under the Medicare Advantage program have received $315.7 million.

Thus far, 342,643 physicians and eligible professionals have been paid under all three programs.

The most recent working estimate, issued in 2012, of the total expected payments under all EHR incentive programs has been $22.5 billion, which means current expenditures are already at 93% of that total.

The current estimate of the total program payout was revised downward from an earlier 2009 estimate of around $27 billion.

The EHR incentive payment program is not subject to an appropriation, which means it is not limited by a specific dollar amount cap, only by the time and eligibility limits spelled out in the statute and program rules.

Payments under the Medicare portion of the program are scheduled to continue through 2016, while payments under the Medicaid section could run through 2020. Annual payments in the later years of both programs are for lesser amounts than in the early years.

Follow Joseph Conn on Twitter: @MHJConn


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