CMS counts early EHR incentive adopters

By Mary Mosquera
02:20 PM

The Centers for Medicare and Medicaid Services has collected data as of July about healthcare providers that have attested that they meet the first stage of meaningful use, offering a glimpse of the experience of early adopters of certified electronic health records (EHRs).

One of the findings showed that providers used required EHR functions with a higher percentage of patients than was called for in the requirements, according to CMS officials. 

About 77,000 healthcare providers have registered for the Medicare and Medicaid EHR incentive program, according to CMS findings about meaningful use participation. Twenty-one states have launched their Medicaid EHR program, with Arizona, Connecticut, Rhode Island and West Virginia in the past month. CMS also reported that New Mexico and Wisconsin have begun accepting provider registrations as of August 1, bringing the total to 23.

[Related: ONC certified iPad-native EHR, so providers can attest to meaningful use.]

Among preliminary data, 2,383 physicians and other eligible professionals had verified that they met meaningful use requirements under the Medicare program, with 137 attesting unsuccessfully. The analysis did not explain why those providers failed attestation, but the agency will drill down to find the reason behind the numbers, said Robert Tagalicod, the new director of CMS’ Office of e-Health Standards and Services. However, 100 hospitals have attested and all have done so successfully.

The agency is cautious about what the numbers may indicate and is aware that early adopters may have more experience with EHRs than later adopters, he told the Health IT Policy Committee, which advises the Office of the National Coordinator for Health IT, at its Aug. 3 meeting.

“It would be too early to draw conclusions yet, but we will be working closely with the policy committee as well as ONC to understand what these data say to us and how we should interpret them so we can translate them into something more programmatic,” he said.

CMS has paid Medicaid incentives to 3,500 physicians and hospital for adoption, implementation and upgrades of certified EHR technology, and under the Medicare program, 1,000 physicians and hospitals. In total, CMS has issued almost $400 million in incentive payments, Tagalicod said.

Dr. Farzad Mostashari, the national health IT coordinator, however, was enthusiastic about what he has heard from the field and that there is “an incredible amount of movement happening. The changes that are happening may be difficult to see day to day. But from where we are today from where we were two years ago, the transformation is real and it’s happening,” he said.

One particular statistic in CMS’ data is promising. The number of physicians who received meaningful use incentive payments under Medicare increased significantly in July over June, from 329 physicians to 566, said Elizabeth Holland, CMS’ director of health IT initiatives group.“We’re hoping that that will be a continuing trend,” she said.

To receive payments of up to $18,000 in 2011, providers must not only attest that they can demonstrate meaningful use but meet the threshold of $24,000 for allowed charges in claims for covered services to Medicare beneficiaries during 2011.

Also in the July report, CMS included for the first time the medical specialties associated with the eligible physicians and other professionals. The two top specialties are family practice and internal medicine.

Among other findings, providers on average met or exceeded the threshold performance or percentage of a provider’s patients involved in a measure demonstrating an EHR’s functionality, Tagalicod said. For example, providers had to use computerized physician order entry (CPOE) for at least one medication order entered for more than 30 percent of unique patients who have at least one medication on their med list. On average, providers used it for 87 percent of the defined patient population, he said.

[Editor's Desk: This Week in Government Health IT.]

Dr. Neil Calman, a policy committee member and CEO of the Institute for Family Health in New York, said that supported what many have believed about advanced functionality.

“Once you have the capability of doing something in your system, people tend to do it much more than the thresholds we’ve set. So once you start doing e-prescribing, you can do it for everybody. I wouldn’t be surprised if these high levels are maintained as people qualify,” he said.

The most popular menu or choice objectives for attesting providers were to incorporate lab results, conduct drug formulary checks and fulfill patient lists. The least popular were conducting medication reconciliation and summary of care record at transitions, according to the report results.