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CMS Estimates that Medicare EHR Incentive Program Will Penalize Hundreds of Thousands of Eligible Professionals
Sunday, February 22, 2015

At the ONC’s HIT Committee meeting on February 10, 2015, CMS presented data about the Electronic Health Records (EHR) Incentive Program.  The presentation included CMS’s estimate that over two hundred and fifty thousand professionals participating in Medicare will receive a downward payment adjustment for failing to meet meaningful use standards in 2015, which is the EHR Incentive Program’s first penalty year.

Starting in 2015, eligible professionals who are not meaningful users of EHR will be subject to payment adjustments such that they only receive a portion of the Medicare fee schedule payments to which they would otherwise be entitled – 99% in 2015, 98% in 2016, and 97% in 2017 and years thereafter.  CMS estimates that approximately 256,000 professionals will be penalized in 2015, yielding payment adjustment amounts as follows:

Penalty Amount (“Payment Adjustment”) Number of Eligibility Professionals
Under $250 87,000
$250 – $1,000 55,000
$1,000 – $2,000 36,000
Over $2,000 78,000

These  estimates follow-up on CMS’s announcement in December that it expected around 257,000 professionals to be penalized by Medicare in 2015.

At the HIT Committee meeting, CMS also reported the following total active registration numbers for the EHR Incentive Program through December 2014:

  • Medicare eligible professionals:       339,991 (299,998 MDs and DOs)
  • Medicaid eligible professionals:       169,259 (108,966 physicians)

Although it is difficult to put this data in context without more information about participation levels in Medicare and Medicaid generally, the number of registered professionals represents a slight increase from the registration numbers CMS reported to the HIT Committee in December 2014.

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