Seventy percent of hospitals surveyed said the upfront cost of EHR systems was a key barrier to achieving the meaningful use definition.

The formula for hospital incentive payments, according to the report, includes a base payment of $2 million and factors in total discharge volume, the level of charity care, percentage of inpatient days paid for by Medicare or Medicaid and an annual transition factor that scales back the payment over time.
"The stimulus incentives to comply with the new requirements for purchasing, deploying and maintaining interoperable EHRs do not come near to compensating the overall costs," a PriceWaterhouse Coopers analysis reported.
The Centers for Medicare and Medicaid Services (CMS) estimated that the total payment to Medicare and Medicaid providers will be between $14 billion and $27 billion over 10 years. The total number will depend on the number of providers that actually qualify.

While hospitals are eligible to receive Medicare incentive payments from 2011 to 2016, penalties for failing to meet meaningful use requirements will begin in 2015 and will be phased in through 2017, when they become permanent, the report said.

"Hospitals recognize the benefits of health IT tools and support moving toward a technologically advanced health care system," the AHA concluded. "The push to implementation must be thoughtfully executed, however, for the health care system to realize the quality and cost benefits of health IT. The financial and human limits of hospitals should be considered, as well as realistic implementation time frames."

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