GAO analyzes federal health IT incentives

Medicaid EHR incentives typically went to nonprofit, independent acute-care facilities in Southern cities last year, report finds.

Hospitals that received Medicaid incentive payments in 2011 for achieving meaningful use of electronic health records typically were nonprofit, independent acute-care facilities in Southern cities, according to a report released Thursday by the General Accounting Office.

The Health Information Technology for Economic and Clinical Health (HITECH) Act requires GAO to monitor the impact of its provisions, including whether certain types of providers are more likely to participate in the EHR incentive programs than others.

One finding was that, at least in the early stages of the program, hospitals were more likely to participate in the Medicaid EHR incentive program than the Medicare incentive program. On the other hand, the median payment through Medicaid of $613,512 was less than half as much as the comparable Medicare payment.

In total, 1,964 hospitals received $1.7 billion in Medicaid EHR incentive payments in 2011, ranging from $7,528 to $7.2 million, according to the report. About half of those hospitals received 80 percent of the distributed incentive payments. In addition, 45,962 providers – about one-third of those thought to be eligible -- received Medicaid incentive payments. Hospitals and other providers combined received $2.7 billion in payments for the year.

GAO also found that acute-care hospitals were 1.7 times more likely than critical-access hospitals to have received a Medicaid incentive payment; and children’s hospitals were 1.6 times more likely to have received the payment than a critical-access hospital. Critical-access hospitals are typically in rural areas with few health-care resources, and they provide limited services compared with acute-care hospitals.

Larger hospitals with more beds were twice as likely to have received payments as the smallest hospitals, according to the report.

Other findings:

  • In the South, 46 percent of hospitals received Medicaid incentive payments, compared with 15 percent in the Northeast.
  • Of the hospitals receiving Medicaid incentives, 62 percent were in urban areas, 80 percent were acute-care hospitals, 57 percent were nonprofits and 57 percent were not part of a hospital chain.

As for medical professionals, 97 percent received the maximum amount of $21,250. The number of providers participating in the Medicaid incentive program was three times the number participating in the Medicare incentive program. The cumulative amount paid by the two programs was about the same.

Among providers receiving Medicaid incentives, 83 percent were in urban areas, 51 percent were specialty-practice physicians, 23 percent were general-practice physicians and just 1 percent were physician assistants.

Nearly half had signed agreements to receive technical assistance in EHR implementation from a regional extension center.