1. Medicare & Medicaid
EHR Incentive Programs
HIT Policy Committee
December 5, 2012
http://www.cms.gov/EHRIncentivePrograms/

2. Registration and Payment Data
2
http://www.cms.gov/EHRIncentivePrograms/

3. Active Registrations
Active Registrations – October 2012
3
http://www.cms.gov/EHRIncentivePrograms/

4. Active Registrations
Active Registrations – October 2012
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http://www.cms.gov/EHRIncentivePrograms/

5. Medicare Incentive Payments
Medicare Incentive Payments – October 2012 Meaningful Use (MU)
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http://www.cms.gov/EHRIncentivePrograms/

6. Medicare Incentive Payments
Medicare Incentive Payments – October 2012 Meaningful Use
For final CMS reports, please visit: 6
http://www.cms.gov/EHRIncentivePrograms/ http://www.cms.gov/EHRIncentivePrograms/56_DataAndReports.asp

7. Medicare Incentive Payments
Medicare Incentive Payments – October 2012 Meaningful Use
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http://www.cms.gov/EHRIncentivePrograms/

8. Medicaid Incentive Payments – October 2012
(Both MU and AIU)
Medicare Incentive Payments
For final CMS reports, please visit:
http://www.cms.gov/EHRIncentivePrograms/56_DataAndReports.asp 8
http://www.cms.gov/EHRIncentivePrograms/

9. Medicaid Incentive Payments – October 2012
Medicare Incentive Payments
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http://www.cms.gov/EHRIncentivePrograms/

10. EHR Incentive Programs
EHR Incentive Programs –
October 2012 Totals
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http://www.cms.gov/EHRIncentivePrograms/

11. EHR Incentive Programs –
EHR Incentive Programs
October 2012 Totals
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http://www.cms.gov/EHRIncentivePrograms/

12. October – by the numbers
October – By the Numbers
Eligible Hospitals
0 5,011 Total
17.90% 0.8252 17.90% 4,114 Total
64.62% Registered
3,238 Paid
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http://www.cms.gov/EHRIncentivePrograms/

13. October – by the numbers
October – By the Numbers
Registered Eligible Professionals
19.28% 521,600 Total EPs
38.10%
Registered Medicare
EPs (222,307)
42.62%
Registered Medicaid EPs
(100,558)
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http://www.cms.gov/EHRIncentivePrograms/

14. October – by the numbers
October – By the Numbers
Paid Eligible Professionals
11.91% 2.13%
16.90% 521,600 Total EPs
Medicare EPs (88,138)
69.07% Medicaid EPs (62,100)
MAO EPs (11,117)
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http://www.cms.gov/EHRIncentivePrograms/

15. October – by the numbers
October – By the Numbers
• Nearly 65% of all eligible hospitals have received
an EHR incentive payment for either MU or AIU
• Nearly 65% have made a financial commitment to put an
EHR in place
• Approximately 26% or 1 out of every 4 Medicare
EPs are meaningful users of EHRs
• Approximately 31% -- nearly 1 out of every 3 --
Medicare and Medicaid EPs have made a financial
commitment to an EHR
• 58% of Medicare EPs receiving incentives specialists
(non primary care)
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http://www.cms.gov/EHRIncentivePrograms/

16. Medicare & Medicaid Payments
Medicare & Medicaid Payments for November 2012
DRAFT ESTIMATES ONLY
Providers Paid Oct-12 LTD
Medicare EPs – [ESTIMATED] 8,250 107,250
Medicaid EPs (AIU + MU) [ESTIMATED] 4,000 66,100
Medicaid/Medicare Hospitals** [ESTIMATED] 525 3,750
Total Number of UNIQUE Providers Paid 12,775 177,100
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http://www.cms.gov/EHRIncentivePrograms/

17. Medicare & Medicaid Payments
Medicare & Medicaid Payments for November 2012
DRAFT ESTIMATES ONLY
Payments Oct-12 LTD
Medicare EPs [ESTIMATED] $150,000,000 $1,850,000,000
Medicaid EPs [ESTIMATED] $73,000,000 $1,395,000,000
Medicaid/Medicare Hospitals [ESTIMATED] $645,000,000 $6,000,000,000
Total $868,000,000 $9,245,000,000
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http://www.cms.gov/EHRIncentivePrograms/

18. EHR Incentive Programs
Attestation Data
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http://www.cms.gov/EHRIncentivePrograms/

19. Highlights
• On average all thresholds were greatly exceeded, but
every threshold had some providers on the borderline
• Drug formulary, immunization registries and patient list
are the most popular menu objectives for EPs
• Advance Directives, Clinical Lab Test Results, and Drug
Formulary for hospitals
• Transition of care summary and patient reminders were
the least popular menu objectives for EPs
• Transition of Care and Reportable Lab Results for hospitals
• Little difference between EP and hospitals
• Little difference among specialties in performance, but
differences in exclusions and deferrals
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http://www.cms.gov/EHRIncentivePrograms/

20. Providers Included
This data-only analysis shows our earliest
adopters who have attested, but does not inform
us on barriers to attestation.
At the time of the analysis
• 117,514 EPs had attested
• 117,284 Successfully
• 230 Unsuccessfully (214 EPs have resubmitted
successfully)
• 2,558 Hospital had attested
• All successfully
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http://www.cms.gov/EHRIncentivePrograms/

21. EP Quality, Safety, Efficiency, and
Reduce Health Disparities
Objective Performance Exclusion Deferral
Problem List 97% N/A N/A
Medication List 97% N/A N/A
Medication Allergy List 97% N/A N/A
Demographics 91% N/A N/A
Vital Signs 91% 9% N/A
Smoking Status 91% 0.4% N/A
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http://www.cms.gov/EHRIncentivePrograms/

22. EP Quality, Safety, Efficiency, and
Reduce Health Disparities
Objective Performance Exclusion Deferral
CPOE 83% 17% N/A
Electronic prescribing 81% 20% N/A
Incorporate lab results 92% 4% 36%
Drug-formulary checks N/A 14% 15%
Patient lists N/A N/A 26%
Send reminders to patients 61% 0.5% 81%
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http://www.cms.gov/EHRIncentivePrograms/

23. EP Engage Patients and Their
Families
Objective Performance Exclusion Deferral
E – Copy of Health Information 97% 70% N/A
Office visit summaries 79% 2% N/A
Patient Education Resources 49% N/A 49%
Timely electronic access 73% 1% 67%
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http://www.cms.gov/EHRIncentivePrograms/

24. EP Improve Care Coordination
Objective Performance Exclusion Deferral
Medication reconciliation 90% 3% 54%
Summary of care at transitions 90% 3% 84%
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http://www.cms.gov/EHRIncentivePrograms/

25. EP Improve Population and
Public Health
Objective Performance* Exclusion Deferral
Immunizations 35% 45% 20%
Syndromic Surveillance 6% 25% 69%
*Performance is percentage of attesting providers who conducted test
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http://www.cms.gov/EHRIncentivePrograms/

26. EH Quality, Safety, Efficiency,
and Reduce Health Disparities
Objective Performance Exclusion Deferral
Problem List 95% N/A N/A
Medication List 98% N/A N/A
Medication Allergy List 98% N/A N/A
Demographics 96% N/A N/A
Vital Signs 92% N/A N/A
Smoking Status 93% 0.6% N/A
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http://www.cms.gov/EHRIncentivePrograms/

27. EH Quality, Safety, Efficiency,
and Reduce Health Disparities
Objective Performance Exclusion Deferral
CPOE 85% N/A N/A
Advance directives 96% 0.5% 8%
Incorporate lab results 95% N/A 14%
Drug-formulary checks N/A N/A 15%
Patient lists N/A N/A 40%
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http://www.cms.gov/EHRIncentivePrograms/

28. EH Engage Patients and Their
Families
Objective Performance Exclusion Deferral
E – copy of health information 96% 69% N/A
E – copy of discharge
95% 66% N/A
Instructions
Patient education resources 73% N/A 58%
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http://www.cms.gov/EHRIncentivePrograms/

29. EH Improve Care
Coordination
Objective Performance Deferral
Medication reconciliation 85% 70%
Summary of care at transitions 82% 91%
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http://www.cms.gov/EHRIncentivePrograms/

30. EH Improve Population
and Public Health
Objective Performance* Exclusion Deferral
Immunizations 50% 15% 35%
Reportable Lab Results 16% 6% 77%
Syndromic Surveillance 21% 3% 75%
*Performance is percentage of attesting providers who conducted test
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http://www.cms.gov/EHRIncentivePrograms/

31. REC Reported Challenges
Full report: http://dashboard.healthit.gov/data/
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http://www.cms.gov/EHRIncentivePrograms/

32. Overall Top Ten MU Measures
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http://www.cms.gov/EHRIncentivePrograms/

33. Practice Issue Challenges
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http://www.cms.gov/EHRIncentivePrograms/

34. Vendor Issue Challenges
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http://www.cms.gov/EHRIncentivePrograms/

35. Top Five Challenges by Practice Type
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http://www.cms.gov/EHRIncentivePrograms/

36. Top Five MU Measures
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http://www.cms.gov/EHRIncentivePrograms/

37. For questions, please contact:
Robert Anthony
Office of E-Health Standards and Services
Centers for Medicare & Medicaid Services
robert.anthony@cms.hhs.gov
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http://www.cms.gov/EHRIncentivePrograms/