GAO Report Examines 2011 CMS EHR Incentive Payments

Posted on by Frank J. Rosello

A new report by the Government Accountability Office (GAO) examines how the Medicaid EHR incentive payments were distributed in 2011.

According to the report, released Dec. 13, the amount of Medicaid EHR incentive payments awarded to each hospital ranged from $7,528 to $7.2 million with the median being $613,512.

Some 1,964 hospitals and 45,962 professionals were awarded a total of approximately $2.7 billion in Medicaid EHR incentive payments for 2011. These 1,964 hospitals, which represented 39 percent of the 5,013 eligible hospitals, were awarded a total of $1.7 billion in Medicaid EHR incentive payments for 2011, according to GAO.

The report showed that participation rates, as well as total payments, were higher for hospitals in the Medicaid EHR program when compared to the Medicare EHR program, though the median payment amount in the Medicaid EHR program was less than half as large. About 50 percent of hospitals accounted for about 80 percent of the total amount of Medicaid incentive payments awarded to hospitals.

Among hospitals awarded a Medicaid EHR incentive payment for 2011, GAO found that:

  • The largest proportion (46 percent) were located in the South and the smallest proportion (15 percent) were located in the Northeast;
  • three-fifths (62 percent) were located in urban areas;
  • four-fifths (80 percent) were acute care hospitals;
  • more than half (57 percent) were nonprofit hospitals; and
  • more than half (57 percent) were not members of a chain.

Comparing the hospitals that received incentive awards to the eligible hospitals that did not, GAO found that those with certain characteristics were more likely to have been awarded Medicaid EHR incentive payments for 2011. For example, acute care hospitals were 1.7 times more likely and children’s hospitals were 1.6 times more likely to have been awarded a Medicaid EHR incentive payment for 2011, when compared to critical access hospitals. In addition, hospitals with the highest number of total beds were two times more likely to have been awarded an incentive payment than hospitals with the lowest number of total beds.

The 45,962 professionals awarded a Medicaid EHR incentive payment for 2011 represented 33 percent of the estimated 139,600 professionals eligible for the program and were awarded a total of $967 million in incentive payments, according to the report. Almost all professionals (97 percent) were awarded the maximum incentive payment amount generally available to professionals in 2011 ($21,250). Proportionally, more than three times as many eligible professionals participated in the Medicaid EHR program in 2011 than in the Medicare EHR program, though the total payment amounts in the two programs were nearly equivalent.

Among the professionals who received a Medicaid EHR incentive payment for 2011, GAO found that:

  • The largest proportion (37 percent) were located in the South and the smallest proportion (20 percent) were located in the Midwest;
  • four-fifths (83 percent) were located in urban areas;
  • nearly three-quarters were physicians – either general practice physicians (23 percent) or specialty practice physicians (51 percent) – and the lowest proportion (1 percent) were physician assistants; and
  • almost half (47 percent) had signed agreements to receive technical assistance from a regional extension center.

Article written by Diana Manos, Senior Editor for Healthcare IT News

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