Diana Manos, Senior Editor
Diana Manos is Senior Editor for Healthcare IT News. Located in Washington, D.C., she covers policy and legislation issues surrounding healthcare IT. Follow Diana on Twitter @DManos_IT_News.
Docs willing, but not ready, to collect MU incentives in 2011
WASHINGTON | April 25, 2012
There was a readiness gap between what physicians thought they could do and what they were eligible to do to collect meaningful use incentives last year, a new study finds.
According to the report, which appears in the May issue of Health Affairs, 91 percent of physicians nationwide said they were eligible for federal EHR incentives in 2011, but only ten percent intended to apply for the program, falling on the low side of what the federal government had anticipated.
Before the program started, CMS had estimated that 10 to 36 percent of Medicare-eligible professionals and 15 to 47 percent of Medicaid-eligible professionals would demonstrate meaningful use in 2011.
[See also: Mostashari predicts 'tough period ahead'.]
The new study was based on a 2011 survey of 3,996 physicians, according to its lead author, Chun-Ju Hsiao, a health services researcher at the National Center for Health Statistics (NCHS) within the Centers for Disease Control and Prevention (CDC).
Hsiao and her co-authors, Sandra Decker, Esther Hing and Jane Sisk said their results show that “a great discrepancy exists” between physicians’ intentions to apply for incentives and their readiness to meet even two-thirds of the core objectives for meaningful use. “The 85 percent of physicians likely to be eligible for Medicare incentives face more pressure to meet the requirements,” they said.
Among physicians intending to apply, about 21 percent were ready with the ten core capabilities, the survey found. In Wisconsin, the state with the highest percentage ready with those capabilities, only 32 percent of all physicians reported this degree of readiness.
The authors said the results of their study could help guide the regional extension centers, which aim to help with physician readiness. "The low level of current readiness illustrates the challenges in meeting the federal schedule for financial incentives," they said.
According to the Centers for Medicare & Medicaid Services (CMS), during 2011, the first year of the incentive programs, almost 124,000 eligible professionals, including physicians, had registered for Medicare incentives, and the agency had paid nearly $275 million to 15,000 participants. Medicaid meaningful-use incentives totaled about $220 million and went to approximately 10,500 physicians.
Read the full study here.
pjcasey75 say: Some clarification
There are a couple of broad statements made in this article which may lead to misinterpretation of the facts.
For example: CMS surely expected high participation in the Medicaid incentives in 2011, but not that providers would do so by meeting meaningful use yet. 2011 was the first year of participation in the Medicaid incentive program which program does not require demonstration of meaningful use in year one. Rather, Medicaid providers may obtain a large incentive simply by attesting to Adoption, Implementation or Upgrade (AIU) of a certified EHR system. AIU is a long way from meaningful use. In year 2, providers are required to meet meaningful use. Having received their first check (for most, that was 2011), they cannot receive another one until the following year - meaning that there was practically no incentive to rush to achieve and attest to meaningful use in 2011. Nor could most have done so lacking state administered meaningful use attestation systems in any state that I'm aware of. States were ready for Medicaid AIU attestations, but not for meaningful use. ONC had an alternative route for a mock attestation for RECs, but it couldn't get CMS to cut a check for you. Result - practically no Medicaid providers reached meaningful use.
That being said, the article makes a very good point. Meaningful use is not as easy to achieve as anyone, especially providers, thought it would be. But that is not a bad thing. It only means that we were all further away from having a coordinated computerized healthcare infrastructure than we realized.
The Regional Extension Centers across the U.S. quickly learned by experience that even doctors who were already using EHRs were quite surprised at how much more needed to be done on their part to meet meaningful use requirements. I think that the nation as a whole assumed the mere implementation of an EHR was the biggest part of the challenge. In fact, what is the most challenging part in many cases is post EHR implementation - actually changing how doctors document their encounters to meet meaningful use. That is a bigger hill than most anyone thought.
Which, in my opinion, speaks to the validity of the meaningful use requirements. Beyond the mere implementation of technology, these heightened "use" requirements are essential to ensuring our migration towards a digital healthcare information system means we first and foremost capture the right data (and enough of it) to support the clinical decision support we expect will bring significant improvements in the quality of our outcomes.
Lastly, however, given that the Regional Extension Center program (separate from the EHR incentive program, but a big help to providers on the consulting side) has already met it's goal for enrolling 100K+ providers, their task is now to take those enrolled providers to meaningful use. Providers who are just now waking up in 2012, but who haven't already sign up for REC's federally funded consulting services, will find that REC fees are no longer at a highly subsidized rate. Unless their particular state has stepped up with additional funds, in most cases, there simply isn't any more funding to support new REC enrollees.
Therefore I find it hard to figure out how the results of the study referenced here provide guidance to the RECs going forward. Their plate is full, and there are no more federal REC subsidies to help folks who have just now decided it might be time to apply for CMS EHR incentives and get an EHR.
The RECs are certainly in a better position to help given their increased experience and expertise, but such help won't be cheap unless Congress can find more money. Good luck.