News Feature | September 10, 2013

Disparities In Incentive Payments May Foreshadow Penalties

Source: Health IT Outcomes
Greg Bengel

By Greg Bengel, contributing writer

A recent study found that small, rural, nonteaching hospitals are lagging behind in meeting meaningful use requirements and are at risk for electronic record penalties

The Baltimore Sun reports on a study from Mathematica Policy Research in Cambridge, MA, which reveals significant disparities as to who is receiving meaningful use incentive payments – and small and rural hospitals are especially at risk for electronic record penalties.

According to the 2009 Health Information Technology for Economic and Clinical Health Act, providers must show that their EHR systems can perform tasks that represent meaningful use by 2015 with providers that do not meet the requirements incurring penalties. According to the article, the CMS reports that more than 3,750 hospitals have received a total of $8.8 billion in incentive payments as of July, reward for meeting MU.

Catherine DesRoches, lead author of the Mathematica study, said it found disparities in which types of hospitals are on track to meet the goals, and in which regions those hospitals practice. DesRoches worked with the American Hospital Association to analyze Medicare data to see which types of hospitals were receiving incentive payments, and thus which were on track toward hitting those meaningful use goals.

"The program appears to be working,” DesRoches is quoted. “You are seeing this really nice increase in the number of hospitals getting paid for meaningful use, but it's not uniform."

According to the article, “Hospitals in the Northeast were most likely to receive incentive payments, compared to those in other parts of the country, with the West trailing. In 2012, 47 percent of Northeast hospitals got the payments, followed by 41 percent of hospitals in the South, 32 percent in the Midwest and just under 29 percent in the West.”

Further, less than 30 percent of government-owned hospitals got incentive payments in 2012. Also, teaching hospitals were shown to be more likely to receive payments than nonteaching hospitals, and for-profit hospitals more likely than not-for-profits.

But perhaps of most concern to DesRoches and her researchers is the case of small and rural hospitals. Her study found that more than 50 percent of hospitals with 200 or more beds received payments, compared to only about 27 percent of hospitals with fewer than 100 beds. Only 10 percent of critical-access hospitals received payments in 2012.

The Baltimore Sun reports, “These smaller hospitals may have difficulty coming up with the financial resources to implement an EHR system meeting the requirements, they may have trouble attracting the proper support staff to manage the EHRs and they may also have trouble competing with larger clinics for the systems, the study authors point out.” The article quotes DesRoches, who says of these hospitals, “The further they fall behind, the more at risk they are for penalties.”