Thursday, January 13, 2011

Launch of EHR Incentive Program

Important Facts about EHR adoption and the EHR Incentive Program
Recent Survey Findings

Acute Care Hospitals
  • According to the most recent results of the American Hospital Association’s Survey of IT adoption, 15.1 percent of acute care non-federal hospitals have adopted at least a “basic” EHR. This represents growth of nearly 75% since 2008.
  • In addition, 80.8 percent of acute care non-federal hospitals plan to apply for EHR incentive payments.
    Of those hospitals, 80.1 percent plan to apply in 2011 or 2012.1

Figure 1. Percent of Acute Care Non-Federal Hospitals With at Least a “Basic” Electronic Health Record (2008 2010)2
*Significantly above previous year estimate at p≤0.05

Figure 2. Percent of Acute Care Non-Federal Hospitals Planning to Apply for EHR Incentive Payments

Office-based Physicians
  • According to the most recent results from the National Center for Health Statistics Survey of IT adoption in physician practices, 24.9 percent of office-based physicians have adopted at least a “basic” electronic health record. This represents growth of nearly 50% since 2008.
  • Growth in electronic health record adoption was strongest among primary care physicians last year, 29.6 percent of whom have now adopted at least a basic EHR.
  • In addition, 41.1 percent of office based physicians plan to apply for EHR incentive payments. Of those physicians, 79.1 percent plan to apply in 2011 or 2012.1
Figure 3. Percent of Office-Based Physicians Who have Adopted at Least a “Basic” Electronic Health Record2
* Significantly above 2008 estimate at p≤0.05
** Significantly above 2009 and 2010 all physician estimates at p≤0.05

Figure 4. Percent of Office-Based Physicians Who are Planning to Apply for EHR Incentive Payments


1 Hospital Source: American Hospital Association Information Technology Survey, 2008-2010. Physician Source: National Center for Health Statistics, National Ambulatory Medical
Center Survey, 2008-2010.
2 “Basic” electronic health records are defined as electronic capability for managing: Physicians: Patient demographic information, patient problem lists, patient medication lists, clinical notes, orders for prescriptions, and viewing laboratory and imaging results; Hospitals: Patient demographic information, physicians’ notes, nursing assessments, patient problem lists, patient medication lists, discharge summaries, lab and radiologic reports, diagnostic test results, and orders for medications. They are defined in the following sources: Physicians: Hsiao CJ, et al. Electronic Medical Record/Electronic Health Record Systems of Office-based Physicians: United States, 2009 and Preliminary 2010 State Estimates Health E Stats. National Center for Health Statistics, Centers for Disease Control. Hospitals: Jha AK, et al. Use of Electronic Health Records in U.S. Hospitals. N Engl J Med. 2009 360;16

Four-fifths of the nation’s hospitals, and 41 percent of office-based physicians, currently intend to take advantage of federal incentive payments for adoption and meaningful use of certified electronic health records (EHR) technology, according to survey data released today by the Office of the National Coordinator for Health Information Technology (ONC). The survey information was released as the registration period opened for the Medicare and Medicaid EHR Incentive Programs.

David Blumenthal, M.D., M.P.P., the National Coordinator for Health Information Technology, said the survey numbers represent a reversal of the low interest in EHR adoption in previous years. He credited leadership from the medical community and the federal government for the improved prospects for adoption and use of health information technology (health IT).

“For years we have known that electronic health records would improve care for patients and bring about greater cost effectiveness in our health sector, yet adoption rates by health care providers remained low,” Dr. Blumenthal said. “In 2009, Congress and the President authorized major new federal support for EHR adoption and use, and in combination with medical professional and hospital leadership. I believe we are seeing the tide turn toward widespread and accelerating adoption and use of health IT.”

The data released today comes from surveys commissioned by ONC and carried out in the course of regular annual surveillance by the American Hospital Association (AHA) and the National Center for Health Statistics (NCHS), an agency of HHS’ Centers for Disease Control and Prevention (CDC).

The AHA survey found that 81 percent of hospitals plan to achieve meaningful use of EHRs and take advantage of incentive payments. About two-thirds of hospitals (65 percent) responded that they will enroll during Stage 1 of the Incentive Programs, in 2011-2012.

The NCHS survey found that 41 percent of office-based physicians are currently planning to achieve meaningful use of certified EHR technology and take advantage of the incentive payments. Four-fifths of these, or about a third of all office-based physicians (32.4 percent), responded that they will enroll during Stage 1 of the programs. Only 14 percent of respondents said they were not planning to apply for meaningful use incentives.

Additional survey data from NCHS show that significantly increasing numbers of primary care physicians have already adopted a basic EHR, rising by 50 percent from 19.8 percent of primary care physicians in 2008 to 29.6 percent in 2010. Basic EHRs provide a beginning point for use of electronic health records in physician offices, but most physicians would need to further upgrade their EHR systems or their use of the systems in order to qualify for meaningful use incentive payments.

Incentive payments for the adoption and meaningful use of certified EHR technology were authorized in the Health Information Technology Economic and Clinical Health Act (HITECH) in 2009. Incentive payments will be made through the Medicare and Medicaid programs. High rates of adoption and meaningful use could result in as much as $27 billion in incentive payments over 10 years.

Non-hospital-based physicians and other eligible professionals can obtain incentive payments of as much as $44,000 under Medicare or $63,750 under Medicaid. Under both Medicare and Medicaid, eligible hospitals may receive millions of dollars for implementing and meaningfully using certified EHR technology.

Provider registration for the Medicare EHR Incentive Program and some Medicaid EHR Incentive Programs opened Jan. 3, 2011. Most states will allow provider registration to begin for their Medicaid EHR Incentive Programs during the spring and summer of 2010.

“We are pleased to see this evidence of an enthusiastic early response, and we believe participation will continue to grow, especially as the Nation’s physicians become more familiar with this one-time opportunity to improve care while helping to offset the costs of adopting EHR systems,” said Donald Berwick, M.D., Administrator of the Centers for Medicare & Medicaid Services (CMS).

To qualify for incentive payments, under the Medicare EHR Incentive Program, providers must achieve meaningful use of certified EHR technology, under regulations issued by CMS and ONC. Medicaid providers can receive their first year’s incentive payment for adopting, implementing, and upgrading certified EHR technology but must demonstrate meaningful use in subsequent years in order to qualify for additional payments.

Dr. Blumenthal said the meaningful use process has contributed to the increased willingness of providers to adopt EHR systems, especially because it guides providers through staged objectives for the productive use of EHRs, and because providers can now be assured that Complete EHRs and EHR Modules certified under ONC criteria by ONC-authorized testing and certification bodies can be relied upon to support the meaningful use objectives.

He also pointed to the technical support programs created under the HITECH Act and now operating under ONC, which offer support to providers as they switch from paper records to EHRs. In particular, 62 Regional Extension Centers (RECs) across the nation will offer customized, on-the-ground assistance, especially for smaller-practice primary care providers and for small hospitals and clinics.

“We know that adoption of EHRs and conversion to EHR-based care is expensive and challenging, especially for smaller providers,” Dr. Blumenthal said. “With HITECH, we are able to provide unprecedented funding and technical support programs to help providers make the transition and to help our nation achieve the improvements in health care quality, safety and cost effectiveness EHRs will bring about.”

Dr. Blumenthal also praised medical professional organizations and hospital leaders, who have encouraged members to act soon in taking advantage of HITECH support programs and adopting EHR systems.

Below Dr. David Blumenthal, National Coordinator for Health Information Technology, discusses the importance of registering for the Electronic Health Record Incentive Programs, administered by the Centers for Medicare & Medicaid Services (CMS).

Dr. Blumenthal talks about how the incentive programs are aimed at accelerating the nation's adoption of health information technology. He outlines how health care providers and hospitals can qualify for incentive payments from CMS through the Medicare and Medicaid EHR Incentive Programs by demonstrating the meaningful use of electronic health records. Dr. Blumenthal also discusses the federally supported technical assistance available to help eligible providers and hospitals adopt electronic health records and achieve meaningful use.


Hello, I’m David Blumenthal, National Coordinator for Health Information Technology. I’m pleased and excited to say that the registration process is now open for health care providers to obtain significant incentive payments for adoption and meaningful use of electronic health records.

The incentive payment program is aimed at accelerating the nation’s adoption of health information technology. Healthcare providers throughout the nation can qualify for this funding.

Under the HITECH Act of 2009, Congress set aside up to $27billion dollars over 10 years to help support providers’ adoption and meaningful use of electronic health records. Doctors and other eligible professionals can qualify for incentive payments totaling as much as $44 thousand dollars through Medicare, or $64 thousand dollars through Medicaid. Hospitals can qualify for incentive payments totaling some $2 million dollars or more.

National adoption of health information technology will constitute an historic turning point for health care in America. Starting with adoption and meaningful use of electronic health records health information technology will provide better care for patients, easier care for providers, and long-term health care cost and quality improvement for the nation as a whole.

HITECH programs, combined with professional leadership, are turning the tide toward a future of HIT-assisted and supported health care. After years of sluggish adoption, health care providers are planning to take the plunge. 81 percent of hospitals plan to take advantage of the incentive payment program, and 80 percent of those plan to act during Stage 1 (that’s in 2011 and 2012). That means that two-thirds of the Nation’s hospitals are already planning to act in the next two years.

For their part, 41 percent of the nation’s office-based physicians are also planning to take advantage of the incentive payments program, and 80 percent of those are planning to act during Stage 1. Only 14 percent of physicians say they will not act to become meaningful users of electronic health records. That means that a third of the nation’s office-based physicians are already planning to act in the next two years.

Why are providers choosing to go now?

Availability of incentive payments is one reason. Availability of federally-supported technical assistance is another. The guidance provided through the meaningful use process, which provides clarity regarding how to use electronic health records and assurance that certified electronic health records will support those uses.

And leadership by the nation’s clinical and hospital professional organizations are very important element. Cooperative leadership and unprecedented new resources are making the difference.

We recognize that electronic health record adoption and meaningful use are hard work and big investments, especially for smaller practices of primary care providers. That’s why incentive payments and technical assistance have been made available under HITECH. Incentive payments can offset a significant amount of the investment.

62 Regional Extension Centers across the nation are prepared to offer customized, on-the-ground assistance, especially to providers without significant HIT resources or expertise such as small-practice primary care physicians and small hospitals. All providers owe it to themselves and to their patients to learn about this incentive program and the other supports.

The number of providers already planning to act is gratifying – but we believe that many more still need to learn about the opportunities they have. Acting during Stage 1 means maximum funding through the incentive payment program. Beginning in 2015, providers will see reductions in their Medicare reimbursements for not meeting requirements of meaningful use. We believe it is in providers’ interest, patients’ interest and the nation’s interest to move during Stage 1 to the adoption and meaningful use of electronic health records.

We are committed throughout this process to protecting the privacy of personal health information.

All the information that providers need is at the CMS website at http://www.cms.gov/EHRIncentivePrograms

To contact the Regional Extension Center that serves their area, providers can also find Regional Extension Center contact information at http://HealthIT.HHS.gov/REC

Thank you so much for your time and attention, and good luck with becoming a meaningful user of electronic health records.

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