Meaningful use checks are coming, and time is running out to get on board

The Centers for Medicare and Medicaid Services (CMS) on May 19 mailed the first Medicare checks, totaling $75 million, to physicians who had attested that they had achieved meaningful use of their electronic health records (EHRs). Juan Salazar, an internist from McAllen, Texas, and three physicians from the multispecialty West Broadway Clinic of Council Bluffs, Iowa, each received $18,000 in the initial installment of meaningful use payments that can total up to $44,000 for Medicare providers.

Nearly $64,000 is available to each eligible professional from state Medicaid programs, which have dispensed $83 million in incentive payments to hospitals and doctors since January. But Medicaid patients or other “needy individuals” must comprise 30% of a physician’s practice (or 20% of a pediatric practice) for that doctor to be eligible for Medicaid incentives. Far more doctors in private practice are eligible for Medicare bonuses for meaningful use.

What effect will the Medicare payments have on the colleagues of doctors who receive meaningful use checks? Erica Drazen, managing partner, emerging practices, for CSC Consulting, says that the actual arrival of checks from Medicare will encourage more doctors to acquire EHRs and show meaningful use. Until now, she says, some doctors have wondered whether they would really get the promised funds.

“Remember, there was a pay for performance initiative for docs and nobody got much money out of it,” she says. “Then there was an e-prescribing program, and the money was pretty small. So people are skeptical about incentives. Are the thresholds going to be achievable, and is the money really going to be there?”

Now that people are actually getting checks, Drazen says, “It will show that this is achievable. Will this convince somebody who’d decided they weren’t going to implement an EHR? Probably not. But it’s another sign that this is real.”

The first payments to other physicians may encourage some doctors who may have been putting off buying an EHR to move ahead, Drazen says. She adds that physicians can earn $3,000 more if they qualify for the payments in 2011 or 2012 than if they wait until 2013 to file their first application. Also, doctors who don’t do anything face financial penalties, starting in 2015. Their Medicare payments will be lowered by 1% that year, with reductions rising to as much as 5% in subsequent years.

While the meaningful use payments won’t cover the full cost of an EHR, “this is a one-time deal,” Drazen points out. “It’s a substantial chunk of money, and you’re not going to have another chance to get it. So if you figure, ‘I’ve got to get an EHR, it’s going to be the standard of practice and I have to get it done,’ this would be the time to do it.”

The only doctors who probably won’t, Drazen says, are those who plan to retire or sell their practices, or who earn so much they don’t care about the penalties.

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