Specifics of the Physician Opportunity
As stated, there are two incentive programs for physicians: Medicare and Medicaid. Physicians will choose program participation.
Medicaid: Physicians who see more than 30% of patients paying with Medicaid (20% for pediatricians) are eligible for payments of up to $64,000 over five years. The incentives will be calculated through a formula that multiplies 85% by amounts ranging from $35,000 in the first year to $10,000 in subsequent years.
Medicare: Physicians who do not have a large Medicaid volume but do accept Medicare can receive up to $44,000 over the five years. Additionally, physicians operating in a "health provider shortage area" will be eligible for an incremental increase of 10%, and those delivering care entirely in a hospital environment, such as anesthesiologists, pathologists and ED physicians, are ineligible.
Amount They'll Receive Each Year |
|||||||
| Year They First File | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | Total |
| 2011 | $18,000.00 | $12,000.00 | $8,000.00 | $4,000.00 | $2,000.00 | $0.00 | $44,000.00 |
| 2012 | $0.00 | $18,000.00 | $12,000.00 | $8,000.00 | $4,000.00 | $2,000.00 | $44,000.00 |
| 2013 | $0.00 | $0.00 | $15,000.00 | $12,000.00 | $8,000.00 | $4,000.00 | $39,000.00 |
| 2014 | $0.00 | $0.00 | $0.00 | $15,000.00 | $12,000.00 | $8,000.00 | $35,000.00 |
| 2015 or Later | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Fee reductions: Providers who do not demonstrate meaningful use in 2014 will see, in their 2015 fee schedules from Medicare, a decrease of 1%. An additional decrease will be affected in 2016 and 2017 down to a total of 97% of the regular fee schedule; it can further be reduced to 95% if the Secretary determines that total adoption is below 75% in 2018.