$18 Billion Might Be Spent to Stimulate EHR Adoption

I love how people are saying that $18 billion will be spent on EHR adoption due to what has been dubbed the HITECH act. My question is how did they come up with the $18 billion number? I guess you could say that it’s the max that the government has permitted to be spent. However, if that’s the case, then shouldn’t people be saying that $18 billion MIGHT be spent to stimulate EHR adoption?

Seriously, what if doctors don’t like any of the certified EHR (whatever that turns out to be) and decide not to implement an EHR? What if Medicaid and Medicare make “meaningful EMR use” so difficult to achieve that most doctors who implement an EHR don’t actual see the stimulus from the government?

I’m not trying to say that the government isn’t going to pay our billions of dollars to those who have implemented an EHR. I have a feeling that billions will be paid out as medicare and medicaid bonuses. However, I don’t know how they got the number of $18 billion. For all we know, it could end up being $2 billion.

Plus, we have to ask ourselves the purpose of the HITECH act. Many have said that it’s to “stimulate EHR adoption.” I have a strong feeling that those existing EHR users will be the ones who benefit most. If $15 billion of the $18 billion allocated goes to existing EHR users, then that doesn’t sound like a good investment used to increase EHR adoption to me.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • You hit it on the nail- docs are leary from past Medicare projects where the promised money turned out to be nominal at best, none at worst. This time the cost is even higher as the number of c-EHR systems fall (only 50 certified last year).

    I don’t get it- why pay out up to a quarter million dollars on a 5 year c-EHR implementation, with all the associated hard work to be “meaningful” when all you get back at best is $42000.00?

    I say to Congress: “Shove it”.


  • The maximum payment for providers who implement by 2011 is $44,000 over 5 years (but Rural providers can get more). If every provider in the US did this, it would equate to 410,000 providers. I believe there are around 600,000 private practicing providers. It would make sense for the government to assume that some would take longer to implement and there are diminishing funds per the bill for implementing in later years. So the total funding relative to the number of providers and the funding per provider seems to make sense assuming a scaled up implementation of EHR.
    Dr. Borg, While some systems can cost a quarter of a million for 5 years, I think that is more the exception than the norm. A certified system like ours can be bought for less than $30,000 for 5 years – and that includes everything except the PC and Internet connection. That leaves the provider with over $14,000 to do with as he/she pleases.
    As others have pointed out, especially with this funding, the real issue will be change and the usability of systems. Will providers find systems that make them more, not less, productive and will they be willing to change from paper? The MGMA has done EHR surveys that tell us what we knew – the two biggest issues stopping EHR use are Usability and Cost. The government and falling prices have solved the cost issue. Now will systems be usable enough and providers willing to change enough so that the systems actually get adopted? We are seeing 80% growth year over year well before the funding was announced.

  • Hi Catherine:

    What is your system? My MDNG numbers are mostly to show the cost of “significant use”. Look at how they would apply to your EMR-

    Actually, it’s $298,000.00 over 5 years. The portions of $50000.00 (extra part-time “meaningful use” staffer) and $125000.00 (cost of extra 5 minutes per encounter to log in the reporting info) would still apply. So using your system over 5 years would cost $175000.00 – $14000.00 = $161000.00 to the providers that are able to install and use it correctly. You also need to realize that there is another condition- IF everything goes well with the government, since in past demonstration projects only 1 in 5 in one and in another 2 in 5 actually got paid, and then only partially.

    The cost of purchasing a c-EHR is the AVERAGE, so that means that 50% of those foolish enough to participate in this scheme will pay even more than the average for their c-EHRs, and some, like your customers, will pay less.

    You can see then that the only “winner” is Obama and his IT advisers from GE, Allscripts, and Cerner.


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