Source: Health Affairs,, Nov. 6, 2015


Hospitals are struggling to avoid penalties in CMS’ electronic health record incentive program. While three-quarters of U.S. hospitals have adopted at least a basic EHR system, only 40 percent might be able to meet Stage 2 meaningful use criteria to avoid financial penalties in Medicare and Medicaid payments, according to a study published in the journal Health Affairs.

The study used data from the American Hospital Association’s Annual Survey, with the AHA’s IT Supplement survey going out to every U.S. hospital CEO.

The study points out that hospitals that participated in the Medicare/Medicaid EHR Incentive Program reaped financial incentives for meeting meaningful use criteria for their EHR systems in the last four years. In 2015, however, hospitals could face financial penalties for not meeting those criteria at Stage 2 levels.

“The pain points for hospitals are really twofold,”says Chantal Worzala, director of policy for the AHA and one of the study’s authors. “One is dealing with myriad regulatory requirements. There are a lot of complexities and they do not always map to what makes sense in practice. And second is that there are significant financial challenges to getting to the Stage 2 criteria.”

In particular, small and rural hospitals are struggling to implement EHR systems. And as the process moves along, those hospitals risk being left behind, Worzala says.

The Centers for Medicare & Medicaid Services recently released a final rule requiring hospitals to step up to Stage 3 meaningful use by 2018. Stage 3 significantly raises the bar for complex EHR criteria yet again, Worzala adds. The AHA will comment on the proposed final rule, which requires that comment to CMS be received by Dec. 15, she says.

“There is a level of data in the study that supports the notion that the program needs further simplification,”she says. “It may be time to take pause in its pace, because there is a real question whether hospitals will be ready.”

The study’s authors were Worzala, Julia Adler-Milstein, assistant professor at the University of Michigan School of Public Health, Catherine M. DesRoches, senior fellow at Mathematica Policy Research in Cambridge, Mass., Peter Kralovec, executive director at the Health Forum, in Chicago, Gregory Foster, senior data analyst at the Health Research and Educational Trust, Chicago, Dustin Charles, public health analyst at the Office of Planning, Evaluation, and Analysis, Office of the National Coordinator for Health Information Technology in Washington, D.C.,Talisha Searcy director of research and evaluation at the Office of Planning, Evaluation, and Analysis, ONC and Ashish K. Jha, professor of health policy and management at the Harvard T.H. Chan School of Public Health, in Cambridge, Mass.