Providers Could Lose Billions in Meaningful Use Pay, Analysis Says

August 18, 2014 in News

Eligible health care professionals and hospitals could be at risk of losing billions of dollars in meaningful use incentive payments as they struggle to meet Stage 2′s stricter criteria, according to an analysis, Modern Healthcare reports.

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.

Analysis Findings

A Modern Healthcare analysis of recently released CMS data shows few eligible professionals and hospitals have attested to Stage 2 of the meaningful use program, with:

  • 1.1% of the estimated 168,000 eligible professionals meeting Stage 2 requirements; and
  • 3.1% of the estimated 2,500 eligible hospitals meeting Stage 2 requirements.

According to Modern Healthcare, the figures suggest about 165,000 eligible professionals and 2,400 hospitals that have already attested to Stage 1 of the program are at risk for losing EHR incentive payments this year.

In addition, the analysis stated that some could face Medicare reimbursement penalties if they do not meet the program’s requirements. 

Under the program, hospitals have until Sept. 30 to demonstrate 90 consecutive days of meaningful use at Stage 2, while eligible professionals have until Dec. 31.

Overall, the analysis estimated that eligible professionals stand to lose about $1.15 billion in Stage 2 incentive payments in 2014. It added that hospitals’ numbers “are sure to be substantial,” but noted that their payment formula is more complicated, making losses harder to estimate.

According to Modern Healthcare, the analysis does not account for health care professionals and hospitals that apply for hardship waivers or those that dropped out of the program in 2014 (Conn, Modern Healthcare, 8/15).

In May, CMS and the Office of the National Coordinator for Health IT issued a proposed rule that would give providers an additional year to upgrade EHR systems to meet reporting requirements for Stage 2 of the meaningful use program. The rule currently is being reviewed by the Office of Management and Budget (iHealthBeat, 8/7).

Reactions

American Hospital Association Director of Policy Chantal Worzala said the organization is “not surprised, but … certainly concerned.” She added, “This is not hospitals waiting for the last minute to turn in their homework,” noting that many have faced “significant problems” getting Stage 2-eligible software delivered and installed.

Robert Tennant, senior policy adviser at the Medical Group Management Association, said the low meaningful use attestation rates highlight “what is clearly a major issue with the [meaningful use] program.” He attributed the low rates in part to software upgrade delays and the difficulty of meeting the program’s criteria.

Meanwhile, Russell Branzell, CEO of the College of Healthcare Information Management Executives, raised concerns about delays in CMS’ response to hardship applications, noting that many meaningful use participants have yet to hear back about their approval status (Modern Healthcare, 8/15).

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