Study: Many Physicians Eligible for Incentives but Lack EHRs

Many physicians are eligible for federal incentive payments for the meaningful use of electronic health records but lack a basic EHR system, according to a study published in the journal Health Affairs, Healthcare IT News reports.

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs can qualify for incentive payments through Medicare and Medicaid. Eligibility for the incentive payment programs is based on the number of Medicare and Medicaid patients seen.

For the study, researchers used data from the 2007 and 2008 National Ambulatory Medical Care Survey to gauge EHR use by nonfederal, office-based physicians (Merrill, Healthcare IT News, 3/8).

Key Findings

Overall, researchers found that nearly 83% of office-based physicians are eligible for either the Medicare or Medicaid incentive program. They noted that:

  • About 76% of physicians could qualify for the Medicare incentive program; and
  • About 15% could qualify for the Medicaid incentive program.

Physicians must choose to participate in either the Medicare or the Medicaid incentive program. Because the Medicaid program likely would offer higher incentive payments, researchers assumed that most physicians eligible for the Medicaid program would pursue it (Conn, Modern Healthcare, 3/8).

The study also found that:

  • 70.5% of physicians are eligible for either the Medicare or Medicaid incentives, but do not have a basic EHR system;
  • 14.6% of physicians are not eligible for incentives and do not have a basic EHR;
  • 12.1% of physicians are eligible for incentives and have a basic EHR; and
  • 2.8% of physicians are not eligible for incentives and have a basic EHR system (Healthcare IT News, 3/8).

In addition, researchers found that eligibility for the EHR incentive programs varied by medical specialty. For example, 91% of general practice, internal medicine and family practice specialists are eligible for incentives, compared with 53% of pediatricians.


Researchers recommended that policymakers broaden eligibility requirements for the incentive payments to help more specialists qualify for the programs (Modern Healthcare, 3/8).

The study authors wrote that "if after the HITECH incentives have been implemented, research reveals that physicians still are not generally using EHRs and that further incentives would lead to commensurate gains in the quality and efficiency of care, there would be stronger basis for recommending changes in the incentive structure" (Healthcare IT News, 3/8).

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