Medicare Incentives: Beginning in 2011 physicians who are “meaningful users” of “certified EMR/EHR technology” will be eligible to receive up to $44,000 paid out over a five-year period in the form of incentive payments through Medicare reimbursements. Medicare incentives are based on “meaningful use” and are not tied to the actual cost of acquiring or maintaining an EHR.

According to the Centers for Medicare and Medicaid Services (CMS), the incentive payment is equal to 75 percent of Medicare allowable charges for covered services furnished by the eligible provider in a year, subject to a maximum payment in years 1-5.

An additional 10% incentive bonus payment is available to physicians operating in a designated Health Professional Shortage Area (HPSA); for more information visit www.hpsafind.hrsa.gov.

The maximum payment for the first year is $18,000 (2011 and 2012) and bonus payments decline each subsequent year within the five-year period. Incentives will be paid out on a per provider basis.  Bonus payments will phase out in 2016. See the table below for details.

Medicaid Incentives: Non-hospital based physicians whose Medicaid patient caseload is at least 30% may be eligible for up to $63,500 in Medicaid incentive payments over a five-year period. Physicians must demonstrate “meaningful use” of a certified EMR/EHR product. However, physicians must decide to receive either Medicare or Medicaid incentives, not both. Hospitals will be eligible for both incentives. 

The federal government has yet to indicate whether it will designate CCHIT as an official certifying body. According to Dr. David Blumenthal, National Coordinator for Health IT, he said it would be “premature to talk about the implications of any particular set of certification criteria that CCHIT or anybody else has put forward or will put forward.” At this time, CCHIT certification is not a guarantee that an EHR system will allow doctors to qualify for incentive payments, according to federal officials. The Office of the National Coordinator for Health Information is expected to release an interim final rule by January 31, 2010, which will include a certification process for organizations to become certifying bodies, and how health IT companies can obtain certification.

Rest assured, once the federal government releases the final EHR certification and meaningful use rules, First Insight will submit maximEyes to be tested and certified in accordance with the federal government health IT certification program.