Where are your Peers on Meaningful Use Payments?

2011 was the first year for receiving ARRA’s EHR Incentive Payments.  Just how much Meaningful Use money has CMS distributed, and how many providers got paid?    

Action item: Make it a priority to get Meaningful Use Funds in 2012  When Congress approved the appropriations for the EHR Incentive program, they provided for about $32 billion in gross payments, with $2 billion for program administration, leaving $30 billion in cash outflow to providers.  As of the end of November, CMS has paid out a little over $1.8 billion to providers under Medicare and Medicaid.  $1.8 billion down, $28.2 billion to go.  Is this a program success?   The incentive phase of this program is budgeted to pay out stimulus funds through 2016 for Medicare; the Medicaid incentives run a little longer, going through 2021 for Medicaid EP’s, and 2019 for Medicaid Hospitals.  Of course, payments are very front-end-loaded.  The first year is the biggest year for any provider, under any aspect of this program, and payments tend to dwindle down in later years.   It is also important to note that qualifying for payment is not a one-time deal.  Every year, providers must re-apply and re-qualify.  Of course we all get to qualify under the easiest set of Meaningful Use criteria (Stage 1) for at least the first two years, but even that is not a slam-dunk.  Second year qualification is harder if for no other reason that providers must maintain threshold values in each criterion for the entire year, rather than just any 90 day period.  So one of the first questions of interest in the payouts is “how many organizations have qualified as Meaningful Users of EHR Technology”.  The answer is surprisingly, “a small percentage”.   Here’s how the $1.8 billion has been paid out:

But these numbers do not in themselves tell us how many providers have actually been paid under Meaningful Use, as opposed to the Adopting, Implementing or Upgrading (AIU) provision of Medicaid, under which it is not necessary to achieve Meaningful Use.  CMS does not separate out those hospitals receiving AIU payments vs Meaningful Use Payments.  However, there is one interesting statistic that may help us impute this split.  Medicare made payments to 411 hospitals through November of 2011, and Medicaid made payments to 802 hospitals in that same period. 

A little analysis on these numbers leads us to the conclusion that a large percentage of hospitals paid under Medicaid are likely to be AIU alone.  Here’s the logic stream:

1. Of the 802 hospitals receiving Medicaid payments, most would qualify to receive Medicare stimulus payments (if they achieve Meaningful Use);
2. Medicare has no AIU provision, so all 411 hospitals receiving Medicare funds attested to Meaningful Use;
3. Therefore something close to 391 hospitals, or 48% of stimulus recipients (802 – 411 = 391), probably did so under AIU. 

 

So, by digging deeper into the numbers, we see that fewer that fewer than 14 percent of the country’s hospitals have received stimulus funds, and only about half of those have attested to Meaningful Use … after one full year’s program eligibility. 

 I don’t know about you, but I’m not sure I would call that a rousing success in “stimulating” the healthcare industry.  Not yet, anyway. 

 To keep track of CMS progress on EHR Stimulus Payments, click and bookmark: http://www.cms.gov/EHRIncentivePrograms/56_DataAndReports.asp

Comments

[Carol]

Jay,
Great and informative post to start the New Year!
Carol