EHR incentive programs in 2011: A letdown?

The Medicare and Medicaid electronic health record incentive programs seem to be getting mixed reviews, to some extent. Many laud the initiatives as a way to jumpstart the adoption of EHRs and move the healthcare industry into the electronic age. As of September 30, more than 114,000 eligible professionals and hospitals had registered for the program, and the Centers for Medicare & Medicaid Services had dished out more than $850 million in incentive payments. That doesn't even include the incentive payments that providers are still working on to earn in 2011.

Brian Klepper and David Kibbe, however, note in a recent post on KevinMD.com that while these developments are encouraging, 2011 will be a "disappointing year" for the programs. Kibbe is a senior advisor for the American Academy of Family Physicians, while Klepper is Chief Development Officer of WeCare TLC. 

The government, they say, hoped that a larger numbers of providers have would adopt EHRs starting in 2011.

"[I]n reality, by the end of the year the percentage of physicians using EHRs won't likely rise much above the current 20 to 25 percent rate," they write.

What's more, an article at Government Health IT points out that while more than 100,000 providers have registered, only 3,772 physicians and 158 hospitals so far have successfully attested to Meaningful Use.

Not everyone agrees that this year, the program's first, is a letdown, though. "There really has been a surge in buying EHRs," Tony Ryzinski, senior vice president of product management and marketing at Sage Healthcare, says. "Hospital penetration is already pretty high."

Ryzinski expects 2012 and 2013 to see increased adoption of EHRs when smaller physician practices transition to them.

Meanwhile, Christine Kelly, president of Baltimore-based CMK Consulting, adds that achieving Meaningful Use and earning the incentive takes more than merely buying and using an EHR system. "It requires a lot of work," she says. "You need certified EHRs and training [in addition to meeting the Meaningful Use measures]. It's exceedingly ambitious to buy [an EHR system] in 2011 and meet Meaningful Use in the same year." 

Kelly also expects many providers to join the program next year. "You can still get the full $44,000 Medicare incentive payment if you start in 2012, since you have until 2016 [to earn the last bonus]," she says.

Providers also better understand how the program works now that it's operational and there's less confusion about whether its funding will be cut.  "This money is set aside. This isn't a part of [the Patient Protection and Affordable Care Act, which people are trying to overturn]. It's part of the American Recovery and Reinvestment Act, [so it's safe]," she notes.

Even Klepper and Kibbe note that the participation levels for 2011 aren't necessarily a bad thing, since this year and next are an opportunity for providers to "clean house." 

"Many older, costly and difficult-to-implement legacy EHRs will be replaced by less expensive, more agile systems that have been developed specifically for Meaningful Use and are deliverable in the cloud as Software-as-a-Service," they write. "Transitions like these take time, but the dynamics are foreseeable." - Marla

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