Mismatched Medicare incentives waste valuable time, money

If Medicare’s programs of incentives and penalties to promote the use of e-prescribing and electronic health records (EHRs) have you feeling frustrated, you’re not alone.

A new report from the watchdog Government Accountability Office finds that the Center for Medicare and Medicaid Services (CMS) failed to align the two programs, causing physicians to waste time and money.

For example, the EHR program provides incentives from 2011 to 2016 and introduces penalties beginning in 2015, while the e-prescribing program provides incentives from 2009 to 2013 and provides for penalties from 2012 to 2014, when the program ends.

Both programs require providers to use e-prescribing technology. The EHR program, however, requires providers to adopt certified EHR systems that meet criteria established by the U.S. Department of Health and Human Services. Those criteria include e-prescribing capability, while the e-prescribing program does not have a certification program.

As a result, providers cannot be certain that the systems they buy and install will meet the e-prescribing program requirements. What’s more, the programs have separate reporting requirements, meaning physicians could have to report to both programs beginning this year through 2014.

The American Medical Association (AMA) is asking CMS to fix the problem. "It is unacceptable that while physicians cannot receive incentives from both programs simultaneously, they will be slapped with a penalty if they decide to participate in one over the other,” AMA Secretary Steven J. Stack, MD, said.

The Medicare penalty for not e-prescribing does not begin until next year, but physicians must start using it this year to avoid the pay cut. “The unreasonable penalty policy in the e-prescribing program will force physicians to purchase stand-alone e-prescribing software just to avoid penalties-software that most of them will end up discarding when they transition to a complete EHR system,” Stack wrote.

The GAO recommends eliminating the overlap in reporting requirements and aligning them so that qualifying for incentive programs or avoiding penalties under the EHR program would satisfy requirements for e-prescribing as well.

See the GAO study here.