More Medicare EHR incentive payments going to specialists than to PCPs

August 16, 2012

A much higher percentage of Medicare incentive payments for adopting EHRs has gone to specialists than to PCPs. Public and private reports contain some good news, however.

You and your primary care colleagues are adopting electronic health record (EHR) systems at about the same pace as specialists, but a greater percentage of the Medicare incentive payments for adopting and using EHRs went to specialists last year. Still, eligible primary care physicians (PCPs) overall were more likely to receive the incentive payments than were eligible specialists.

Those are among the conclusions to emerge from two recent government studies of EHR use among doctors. Meanwhile, a related private-sector study finds that midlevel providers-physician assistants (PAs), advanced practice registered nurses (APRNs), and nurse practitioners (NPs)-are more interested in using the pharmaceutical features of EHRs than are doctors.

A data brief from the National Center for Health Statistics (NCHS) found that 58% of the nation’s PCPs and 55% of specialists have adopted EHRs. But a Government Accountability Office (GAO) report to Congress on the Medicare incentive payment program to encourage EHR use found that 50% of the physicians who received payments in 2011 were specialists, compared with 38% who were general practice physicians.

On the other hand, according to the GAO, only 8% of specialists who were eligible to receive incentive payments actually did so, compared with about 14% of PCPs. Overall, 56,585 healthcare professionals, about 9% of those who were eligible, received a total of about $967 million in Medicare EHR incentive payments. The largest proportion of recipients, 32%, was located in the South, and 89% were in urban areas.

The NCHS study found that the proportion of EHR adopters increases with the size of a practice. Only 29% of physicians in solo practices use them, compared with 86% of those in practices with at least 11 physicians. Similarly, only 50% of physicians in doctor-owned practices had adopted EHRs, compared with 70% of those in academic health centers and virtually 100% in health maintenance organizations.

The NCHS study also revealed that 85% of EHR adopters are either “satisfied” or “very satisfied” with their systems, with 74% reporting that use of an EHR system had resulted in enhanced patient care.

Among physicians not using EHRs, 32% say they do not intend to purchase a system in the next 12 months, and 48% say they have either purchased but not yet installed a system or plan to buy one in the next 12 months.

When it comes to the specific pharmaceutical features of EHR systems, a study from Manhattan Research LLC, a pharmaceutical and healthcare market research firm, finds that 67% of doctors are interested in using the features, compared with 83% of PAs, 79% of RNs, and 76% of APRNs. The study also found that midlevel providers spend more time online for professional purposes and use smartphones more frequently during patient consultations than do physicians.

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