Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

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The Billion-Dollar EHR Incentive States

Of the more than $31 billion paid to eligible providers and hospitals through the EHR Incentive Programs as of Sept. 30, 2015, more than 44 percent of total incentive dollars clustered in eight states.

- Government investment in promoting adoption of electronic health records largely follows a trail to the most populous states. Of the more than $31 billion paid to eligible providers and hospitals through the Medicare and Medicaid EHR Incentive Programs as of the end of September 2015, more than 44 percent of total incentive dollars clustered in eight states, each of which topped $1 billion in payments received, according to data from the Centers for Medicare and Medicaid Services (CMS).

Analysis of EHR Incentive Program payments by state.

The two most populous states, California and Texas, have each exceeded $2 billion in payments since the inception of the programs. Other states in the billion-dollar club are, in descending order, Florida, New York, Illinois, Pennsylvania, Ohio and Michigan.

HealthITInteroperability.com took a closer look at the incentive outlays using various filters on CMS data sets. Among the findings:

The top seven states in total payments follow the exact pattern of population. Michigan is the outlier in payments received, ranking eighth, with the tenth highest state population. Georgia, which has the eighth largest population, ranks tenth in payments received.

Washington and Massachusetts rank highly in Medicaid payments — ninth and tenth, respectively — but have relatively lower Medicare rankings to keep their total payments out of the top 10.

California has by far the largest provider count in the programs, a margin 25 percent greater than the next-closest state, New York. Texas, Florida, Pennsylvania, Illinois, Ohio, Massachusetts, Michigan and North Carolina round out the top 10 by number of providers. Massachusetts has the highest number of providers of any state with less than $1 billion in payments received.

Among the states with the highest payment totals, Illinois, Pennsylvania and Michigan rank the highest in terms of percentage of office-based physicians who have demonstrated meaningful use (MU) through Medicare. In Illinois, 52 percent of office-based physicians have demonstrated MU (53 percent in urban settings and 38 percent in rural settings). Pennsylvania matches Illinois at 52 percent (52 percent urban, 47 percent rural), followed closely by Michigan at 51 percent (53 percent urban, 43 percent rural). Payment leader California ranks 46th among states with only 34 percent of office-based physicians having demonstrated MU (34 percent urban, 24 percent rural). Texas ranks near the middle of the pack with 44 percent of office-based physicians having demonstrated MU (45 percent urban, 36 percent rural).

Also among the top payment states, Florida leads the way in terms of Medicare-eligible hospitals (96 percent) that have demonstrated MU. Rural, small rural and critical access hospitals in Florida exceeded the national average for demonstrating MU. Michigan’s numbers closely tracked Florida’s, with 95 percent of Medicare-eligible hospitals having demonstrated MU. Michigan hospitals in the rural, small rural, critical access and small urban categories all exceeded the national average. In contrast, California ranked in the bottom 10 with 88 percent of Medicare-eligible hospitals having achieved MU. California hospitals in the small rural and urban categories trailed the national average. Texas ranked only two slots higher than California on this measure, with slightly better success in small rural and urban areas.

Photo credit: Creative Commons License

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