Example of EMR Stimulus Medicare Penalties

Let’s take a look at how much the EMR stimulus Medicare penalties will amount to for those doctors who choose not to show “meaningful use” of a “certified EHR.”

At AAFP I learned that the average physician practice has revenues of about $500,000. Certainly there are many with more and some with less, but you can substitute your number into the calculation. I also learned that the average AAFP user does about 20% Medicare. Of course, each practice can pull up their own figures.

Using these averages, that means that the average practice does about $100,000 in Medicare reimbursement.

The penalties for now showing meaningful use of a certified EHR are:
2015 – 1%
2016 – 2%
2017 – 3%
2018 – 4% (HHS Secretary Option)
2019 – 5% (HHS Secretary Option)
or…using the Medicare numbers above that calculates out to:
2015 – $1000
2016 – $2000
2017 – $3000
2018 – $4000
2019 – $5000

Of course, this doesn’t take into account that many think the penalties will be delayed and may never go into effect. However, is $1000-$5000 of penalties worth the effort to show meaningful use? Although, when you add the Medicare penalties above, no matter the amount, on top of the other Medicare cuts and you can understand the outrage when it comes to Medicare.

This is certainly only one part of the EHR decision making process. However, it does illustrate well why the EMR stimulus penalties aren’t motivating providers to implement EHR software.

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.

10 Comments

  • Medicare has been finding creative ways to reduce reimbursement for quite a few years. This is just the latest scheme. The likeliest outcome for practices that manage to meet MU is that their reimbursements will decline anyway for other reasons. Given the trends, it does not really make sense to think that jumping through these hoops will suddenly be the end of it. So yeah, the penalties are not that huge but a bigger factor I think is that many physicians are just weary of the whole carrot and stick thing. How do you know you’re not just jumping through hoops for what will eventually be an inevitable decline in payment?

  • The ARRA “incentive” penalty “sticks” are an insult to physicians … and like Congress has time and again voted down SGR cuts … the legislators are bound to prevent these nuisance “sticks” too.

    The capacity serving the Medicare population is shrinking at a time when baby boomers are entering Medicare eligibility. More and more PCPs have frozen their practices from taking on new Medicare patients as cost shifting from Medicare to private coverage is becoming more and more a problem.

    Medicare losses resulted in Mayo Clinic severing 3000+ Medicare patients from coverage provided by its Arrowhead Family Medicine Clinic in Glendale, AZ on 1 Jan 2010.

    Any thought that CMS is going to cut Medicare reimbursement for physicians who continue to provide services to Medicare patients due only to bureaucratic artificial ‘meaningful use’ standards is totally laughable.

  • Medicare is a trendsetter for other insurances. I expect and hope that private insurances will follow the Medicare example and also penalize the providers without EMR. That will mean a $25000 a year penalty. It is time for all doctors to join the 21st century and get an EMR.

  • Yea… like that’s going to happen.

    Might want to check around. Practices have already stopped accepting new Medicare pts … and others are shedding Medicare pts.

    Penalties don’t affect practitioners who aren’t treating Medicare pts.

  • Ma, I am ready for the 21st century. Unfortunately, electronic medical records are not. The technology is not adequate for the complexity of our tasks and workflow. I will glady jump into 21st century when the alleged benefits of EMRs are proven. On the contrary, there is considerable evidence that CPOE in particular is dangerous. (2 large studies recently, one showing increased mortality and another stopped because of delays in treatment).

    I am writing this on an iPad and design video games as a hobby. I love technology. I also know that when I am taking a history, it is best to be looking at my patient. Someday I will be able to work as a physician and be fully paperless, but the current crop of EMRs makes me feel like I am communicating in Morse code. If this makes IT people and regulators unhappy, they know what to do. Make a product that works.

  • By the way, one of my hospitals appears to have abandoned their attempt to acheive meaningful use. It was requiring too many resources to whip our tired old EMR into shape.

  • Brian, what do you dislike about the current crop of EMR’s and if you could design the perfect product what are the top three things on your list?

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