EHR Incentives

For Medicare participants, the potential incentive is now a maximum of $39,000, and will be paid out over the next 4 years. Physicians practicing in a Health Professional Shortage Area (HPSA) are eligible for an additional 10%.

For the provider’s first payment year, he/she must demonstrate meaningful use for any 90-day period. (All subsequent years—except 2014—require a full year of meaningful use.) Providers who began their first meaningful use reporting period by October 3, 2012 stand to receive the maximum amount of money.

In 2015, a 1% reduction “adjustment” to Medicare reimbursement is scheduled to go into effect for non-meaningful users, increasing to 2% in 2016, and 3% in 2017. To avoid the 2015 penalty, providers can successfully demonstrate meaningful use in 2013 or at the latest, by October 1, 2014.

For Medicaid participants, the potential incentive is a maximum of $63,750, and is paid out over 6 years ($42,500 for pediatricians with 20%-30% Medicaid). The first year does not require demonstration of meaningful use, but can be reimbursement for adoption, implementation, or upgrading to a certified EHR.

Payment Year and Incentive

First Year	Total	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021
2011	$63,750	21,250	8,500	8,500	8,500	8,500	8,500
2012	$63,750		21,250	8,500	8,500	8,500	8,500	8,500
2013	$63,750			21,250	8,500	8,500	8,500	8,500	8,500
2014	$63,750				21,250	8,500	8,500	8,500	8,500	8,500
2015	$63,750					21,250	8,500	8,500	8,500	8,500	8,500
2016	$63,750						21,250	8,500	8,500	8,500	8,500	8,500

There is no penalty for non-participation under Medicaid, but any Medicare revenue generated by a provider who fails to demonstrate meaningful use would be subject to adjustment.

Read more about the differences between the Medicare and Medicaid incentive programs.

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