Electronic Health Records: Number and Characteristics of Providers Awarded Medicare Incentive Payments for 2011-2012

What GAO Found

Hospitals and health care professionals, such as physicians, were awarded a total of approximately $6.3 billion in Medicare electronic health records (EHR) incentive payments for 2012, which is more than twice the $2.3 billion awarded to hospitals and professionals for 2011. Almost half of eligible hospitals and less than a third of eligible professionals received Medicare EHR incentive payments for 2012.

For 2012, the 2,291 hospitals that were awarded payments represent 48 percent of the eligible hospitals and an increase compared to 2011, when 777 hospitals, or 16 percent of those eligible, were awarded payments. Nationwide, 72 percent of hospitals were new to the program; that is, they were awarded an incentive payment for the first time. Participation varied among hospitals with certain characteristics. For example, acute care hospitals were nearly twice as likely as critical access hospitals to have been awarded an incentive payment for 2012. In addition, hospitals in rural areas were 3.1 times more likely to have been awarded an incentive payment for 2012 compared to 2011, a slightly greater increase than for hospitals overall.

Additionally, 183,712 professionals were awarded payments for 2012, which represents 31 percent of the eligible professionals and an increase compared to 2011, when 58,331 professionals, or 10 percent of those eligible, were awarded incentive payments. Nationwide, 75 percent of professionals that were awarded an incentive payment for 2012 were new to the program. General practice physicians were 1.5 times more likely than specialty practice physicians to have been awarded an incentive payment for 2012. In addition, professionals with the lowest total amount of Medicare Part B charges were 3.3 times more likely to have been awarded an incentive payment for 2012 compared to 2011, which was a slightly greater increase than for professionals overall.

Why GAO Did This Study

Widespread use of health information technology, such as EHR, has the potential to improve the quality of care patients receive and reduce health care costs. The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009 (Recovery Act), among other things, provided funding for various activities intended to promote the adoption and meaningful use of certified EHR technology, including the Medicare and Medicaid EHR programs. Starting in 2011, these programs have provided incentive payments for hospitals and professionals that demonstrate meaningful use of certified EHR technology and meet other program requirements established by the Centers for Medicare & Medicaid Services (CMS). This report provides information on certain providers, including hospitals and professionals, that were awarded Medicare EHR incentive payments for 2011 and 2012. Using data from CMS and other government and private sources, GAO determined the number and percentage of eligible providers awarded Medicare incentive payments; determined the amount of Medicare EHR incentive payments awarded to providers; and examined the characteristics of providers that were awarded Medicare EHR incentive payments.