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Wednesday, July 31, 2013

Meaningful Use Payments Update

$15.5 Billion paid out to date. Not much of an increase over the May numbers. To be expected, I guess.

More reporting:

Eight out of 10 eligible hospitals and 58% of eligible physicians and other medical professionals have received payments totaling $15.5 billion under the federal electronic health record incentive payment program, according to the latest CMS data.

Through June, 4,024 hospitals have shared nearly $9.2 billion dollars to adopt, implement, upgrade and/or meaningfully use certified EHRs under the Medicaid and Medicare EHR incentive payment programs created by the American Recovery and Reinvestment Act of 2009.

In addition, 305,778 physicians and other eligible professionals have been paid more than $6.3 billion under the Recovery Act’s Medicaid, Medicare and Medicare Advantage EHR incentive payment programs, the CMS report said.

There are 4,477 hospitals that have registered for the programs, which leave just 11% of the 5,011 eligible hospitals that have not registered. Meanwhile, 400,960 physicians and EPs have registered, which leaves 24% of the estimated 527,200 eligible physicians and other EPs that have not registered.
"4,024 hospitals have shared nearly $9.2 billion dollars to adopt, implement, upgrade and/or meaningfully use certified EHRs"

Note the weasely boolean "or." "AIU" (Adopt, Implement, or Upgrade to an ONC CHPL Certified EHR system) has been viewed by many skeptics as the "free money" part of the MU program -- a year one "baby steps" initiative for the more marginal Medicaid cohort. On the ambulatory side, if, say, you're a Medicaid Peds or OB provider, sign up for the "free" Practice Fusion and collect $21,250 year one AIU money per doc just for attesting "AIU"
-- without having to meet or exceed the MU Stage 1 criteria (and, notably, without having to comply with that pesky and onerous Core 15 ePHI Security measure set forth in 45 CFR 164.308 et seq).

Well, how are the RECs stacking up? From data I downloaded into Excel off the snazzy ONC Regional Extension Center Dashboard. M1 = you signed up an EP or EH, M2 = they began using an ONC Certified EHR, and M3 means they successfully attested and got paid.

Raw ordinal ranked data are only marginally useful. A variety of weightings would be needed (e.g., outlay per M3, total #of EPs in the state vis those who signed up for REC, REC time in the program, etc) to make better sense of these (and maybe they're mining this stuff internally at ONC, but they aren't publishing any findings publicly). For starters, these are state based data, and a number of REC contracts are multi-state / territory (e.g., two RECs in PA, Several in CA, Qualis covers WA and ID, and tight-lipped Hawaii has to deal with the far-flung Pacific Islands territories). 

My own REC exemplifies the problem. The high and mighty Health IT-leading Utah is #5; its bordering red-headed stepchild anarchic Nevada is 50th (49th, discounting DC) -- but, they are the same HealthInsight REC contract. But Utah, home to Intermountain Healthcare (IHC), is a largely homogenous state that has been an aggregate "early adopter" of HIT going all the way back to DOQ-IT and before. Nevada, on the other hand, is Ground-Zero of the late 2000's financial meltdown and foreclosure crisis.

I'm sure it cheeses certain Utah HealthInsight management to no end that Nevada is "dragging us down" (there's some vestigial QIO chafing there; NV was acquired by UT just prior to my first QIO tenure in 1993). Were one to pool UT and NV REC performance data into one REC contract look, HealthInsight would be solidly and unremarkably mid-pack in a raw data ordinal ranking.


I had no idea about Robert Downey Jr's vocal chops.

More to come...

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