The Electronic Health Record (EHR) Incentive Program, commonly known as Meaningful Use, began making payments to eligible professionals in May 2011. Since then, the number of cardiologists receiving Meaningful Use incentive payments has climbed substantially to a total of 12,948 as of March 2013.
This represents an increase of 9,279 cardiologists over the preceding 12 months qualifying for payment incentives and substantially exceeds the American College of Cardiology’s (ACC) informal goal of an additional 8,000 cardiologists. This success can be attributed, in part, to efforts by the ACC’s Advocacy Division and the Informatics and Health Information Technology Task Force, which operates under the ACC’s Science and Quality Division.
Cardiologists comprise a disproportionately large share of providers awarded incentive payments and the total amount of the payments awarded. Cardiologists make up 2.5 to 3 percent of all physicians in the U.S., but as of March 2013 cardiologists represented 7.5 percent of all providers receiving payments, and the total amount awarded to them totaled 7.6 percent of $2.9 billion.
One reason is the relatively large proportion of practicing cardiologists who have Meaningful Use eligible functioning EHRs in their practices. Recent reports suggest that 55 percent of cardiologists have incorporated eligible EHRs as opposed to 40 percent of all physicians. Cardiologists receiving EHR incentive payments represent nearly 50 percent of the estimated 26,000 practicing cardiologists in the country.
While cardiology leads in the adoption and meaningful use of EHR systems, the goal remains for all eligible professionals to utilize certified EHRs. The ACC has a number of tools, including archived webinars, FAQ sheets and other materials at CardioSource.org/HealthIT. These resources help members understand the EHR Incentive Program, select certified EHR solutions and satisfy the technical requirements for the incentive payments. There are also tools to help practices improve interoperability and the exchange of health information.
For those who have yet to participate or expect to begin participating this year, the ACC has information on the particular measures reported by cardiologists and their success rates with them. The task force includes staff and members who can provide advice on the use of healthcare information solutions in everyday practice.
Participants in the Meaningful Use program begin with at least two years of Stage 1, focusing on the implementation of the EHR and incorporating the EHR into workflow. Those who started in 2011 or 2012 will soon face the challenges of implementing the next phase of the adoption of EHR technologies (Stage 2), which began in 2014. Stage 2 incorporates additional requirements of the EHR vendor community that will position medicine to take advantage of better data interchange and interoperability. It also increases the requirements on clinicians, particularly for measurement and assessment of the quality of care. Cardiology is actually well positioned to respond to these changes, given our emphasis on evidence-based, guidelines-driven clinical care.
Unless there is a change in the law, cardiologists and other physicians who do not implement EHRs will face reductions in their Medicare payments. Specifically, cardiologists who do not complete their first year of participation in the EHR Incentive Program by Oct. 1, 2014 will face a 1 percent penalty in 2015, and the penalties increase to at least 3 percent in 2017 for those not participating by 2016.
While this may not seem like a great deal of money, it can become so if coupled with a decision not to participate in the Physician Quality Reporting System (PQRS) and value-based purchasing programs (where applicable), which also include penalties for not participating. In addition to the resources focusing on EHR adoption, the ACC compiled tools and information to assist cardiologists interested in the PQRS and value-based purchasing programs at CardioSource.org/Advocacy/Physician-Payment.aspx. ACC staff members also are available to answer questions or concerns.
Dr. Oetgen is executive vice president of science, education and quality for the American College of Cardiology.