Health Affairs: Most office-based physicians could get EHR incentives

Federal survey data show that more than 80 percent of office-based physicians could qualify for new federal incentive payments to encourage the adoption and meaningful use of EHRs, based on the numbers of Medicare or Medicaid patients, according to an article in this month’s edition of Health Affairs.

Brian K. Bruen, lead research scientist in the department of health policy at the School of Public Health and Health Services at George Washington University in Washington, D.C., and colleagues pooled public use data from the 2007 and 2008 National Ambulatory Medical Care Surveys to measure the use of EHRs by U.S. nonfederal office-based physicians. The surveys included patient visit records from 1,187 physicians in 2008 and 1,357 in 2007, including oversamples of physicians at community centers. Data from 2009 and 2010 have not been publicly released yet.

“However, our analyses also indicate that eligibility for the incentives is likely to vary by specialty: 90.6 percent of physicians working in general or family practice or internal medicine could qualify for incentives, but fewer than two-thirds of pediatricians, obstetrician-gynecologists and psychiatrists may quality,” the authors wrote.

Eligibility and use will also vary by factors such as size and type of practice; physicians in solo practices are much less likely to use EHRs than physicians in other practice settings, the study found.

“Overall, 82.6 percent of office-based physicians could qualify for HITECH incentives if they could attain meaningful use,” the authors wrote. Some 70.5 percent of physicians don’t have an EHR but are eligible for the incentive payments to acquire or upgrade systems. About 15 percent do not have a basic EHR and are not eligible for incentives, while 2.8 percent have a basic EHR but are not eligible. A fourth group of physicians, 12.1 percent, are eligible for incentives and already have a basic EHR system.

“Although the use of EHRs has grown since 2007-09, the general patterns of use have probably not changed much,” stated the authors, who concluded that about one-fifth of office-based physicians do not appear to be eligible for HITECH incentives based on the numbers of Medicare and Medicaid patients they see. This problem is particularly serious for pediatricians, obstetrician-gynecologists and psychiatrists, who are less likely than other specialists to see Medicare patients, the authors wrote.

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