So far, the early participants racing to qualify for federal subsidies for health information technology are high-stepping the hurdles put in their paths to payment, according to a federal official.
Head of the pack
Early EHR subsidy recipients may have experience
But that same official, speaking last week at a meeting of the federally chartered Health IT Policy Committee, warned against over-reliance on these early, easy results. Those physicians and organizations fastest out of the starting blocks are also most likely to have had years of experience using their IT systems, so meeting this first round of eligibility criteria will come easier for them than for less experienced IT users to follow.
Robert Tagalicod, the director of the Office of eHealth Standards and Services at the CMS, told members of the IT advisory body that more than 77,000 providers have registered for the electronic health-record incentive payments available either under the federal Medicare program or state Medicaid programs, both created by the American Recovery and Reinvestment Act of 2009.
Twenty-one states have their Medicaid EHR incentive programs up and running and receiving provider registrations, Tagalicod said.
Under the ARRA, the Medicare EHR incentive program has a more stringent set of first-year eligibility requirements than do the various state-run Medicaid programs. With Medicare, providers must attest that they've used their certified EHRs to meet either 19 or 20 meaningful-use criteria, whereas under the first year of the Medicaid program, providers need only “adopt, implement or upgrade to” a certified EHR.
Through July, under Medicare, 66 hospitals and 1,078 physicians and others practitioners, collectively known as “eligible professionals,” have attested and been paid as meaningful users of their EHR systems, according to the CMS. Under Medicaid, 199 hospitals and 3,334 EPs have received EHR incentive payments, the CMS reports.
Combined, the programs have paid out nearly $400 million, Tagalicod said. Early estimates peg the federal outlay for the life of both programs as high as $27 billion, however, so both programs are still in their infancies.
Under the Medicare EHR incentive program, the starting gun sounded Oct. 1, 2010, for hospitals to begin linking 90 consecutive days of meaningful use of their certified EHRs. To qualify under the Stage 1 criteria set by federal rulemaking last summer, hospitals must meet 14 mandatory “core” requirements plus their choice of five out of 10 optional “menu” criteria.
For physicians and eligible professionals under Medicare, the race to meet 90 days of meaningful use began Jan. 1 this year. EPs must attest to having met 15 core meaningful-use criteria and five out of 10 menu criteria.
Tagalicod told Health IT Policy Committee members that, on average, all of the meaningful-use thresholds have been greatly exceeded by these early applicants, although every threshold had some providers on the borderline.
According to Tagalicod, there is “little difference” between hospitals and EPs in the size of the gaps between the criteria and their actual performances.
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