The amount of the incentive for both EPs and eligible hospitals is dependent on when meaningful use is first achieved.
Eligible Professional (EP) Medicare incentive payment amount
Under the Medicare program, an EP may receive up to $44,000; unless the EP practices in a Healthcare Professional Shortage Area (HPSA), in which case the maximum is $48,400. The following table portrays the Medicare incentive phasing (HPSA amounts are ten percent higher in each year).
Under the Medicaid program, the maximum is $63,500. As discussed above, an EP may make a one-time switch between the Medicare and Medicaid program, in which case the maximum amounts received would be the $63,500 set forth under the Medicaid program.
Eligible Hospital Medicare EHR Incentive amount.
The calculation as to the amount of EHR incentive payment to which a hospital is eligible is somewhat complex. The formula for computing the amount of the eligible hospital EHR incentive payment is as follows:
The Initial Amount is based upon Total discharges and provide two million dollars plus two hundred dollars for each discharge from the 1,150th through the 23,000th discharge, inclusive (Essentially $0 for first 1,149 discharges and $0 for each discharge after 23,000).
The Medicare Share is the total Medicare inpatient days as a percentage of non-charity care inpatient days (i.e., total inpatient days after removing charity care).
Equivalently, (expanding the denominator):
The Transition Factor phases down the payment as time draws closer to 2015 (when all hospitals must be meaningful users or risk a reduction in their Medicare Market Basket Adjustment). Please see Table 2, below for the transition factors.
Putting it all together, the Medicare Eligible Hospital EHR Incentive Payment is computed as follows:
