Medicare’s EHR Incentive Program is Key To Universal Health IT Adoption among Primary Care Physicians, Study Finds

FOR IMMEDIATE RELEASE:  Monday, Aug. 3, 2015

WASHINGTON, DC — Federal policy would best serve universal adoption of electronic health records by extending the Medicare incentive program that supported primary care physicians’ efforts to buy electronic health records or upgrade their current systems to comply with meaningful use requirements.

That’s the conclusion in a one-pager summary of research by Robert Graham Center visiting scholar alumnus Dr. Troy Russell, MD, MPH. The research, “Primary Care Physicians Are More Likely to Participate in Medicare EHR Incentives than Other Eligible Physicians after Considering Differences in Income,” was published in the Aug. 1 American Family Physician.

Russell and his colleagues reviewed data from 2014 Physician Compare and 2012 Medicare claims files to identify the factors that might affect a physician’s decision to purchase an EHR with meaningful use capabilities. Their investigation looked at physician demographic data and practice environment in 2012 to determine how they might predict EHR incentive participation two years later. Alongside other known factors they found that primary care physicians were more likely than their subspecialist counterparts to seek and ultimately participate in the EHR incentive program after adjusting for relatively lower Medicare allowed income,.  The authors propose that primary care physicians may be more sensitive to Medicare incentives to overcome the cost of EHRs and other barriers to attain meaningful use. 

“We looked at the barriers and the potential role of Medicare income on the decision to implement EHRs and ultimately participate in the EHR incentive program,” Russell said of the research. Conventional wisdom would predict that primary care doctors, who statistically have relatively less practice income to finance the $15,000 to $75,000 per physician in initial EHR costs, would be less likely to make such an investment. “If individual primary care doctors are motivated only by the economics of it, they might be less likely to implement EHRs – due to a relatively high investment to protect a small source of income. One might assume that low Medicare compensation could serve as an indicator of reduced ability to pay for an EHR or jump through the multiple hoops to qualify for meaningful use payment. But we found that when adjusting for income, primary care physicians – despite the well-known overall and Medicare income disparity and the relatively higher up-front costs – seem to see the most advantage in using EHRs and decide to take the leap. As a whole they’re on the front end of the curve and our results echo conclusions from prior studies, including reports from Agency for Healthcare Research and Quality.”

Increases in EHR adoption trend likely stemmed from funding from the American Recovery and Reinvestment Act of 2009, which made EHR investment more viable, according to Russell.

“These results build on previous findings suggesting that PCPs may be more responsive to incentive assistance and therefore the most likely affected by expiring incentive payments,” Russell and his coauthors conclude in the paper. “Extending incentives to achieve widespread EHR use among all practices, and focusing these on smaller practices and those with lower practice income, such as PCPs, may still be needed to help these providers afford prohibitive upfront cost of EHR implementation.”


About the Robert Graham Center

The Robert Graham Center for Policy Studies in Family Medicine and Primary Care works to improve individual and population health by enhancing the delivery of primary care. The Center staff generates and analyzes evidence that brings a family medicine and primary care perspective to health policy deliberations at local, state, and national levels.

Founded in 1999, the Robert Graham Center is an independent research unit affiliated with the American Academy of Family Physicians (AAFP). The information and opinions contained in research from the Center do not necessarily reflect the views or policy of the AAFP.