According to the latest figures from the Centers for Medicare and Medicaid Services, the EHR incentive program has exceeded its total estimated payout of $22.5 billion.

CMS states in the January report that it has paid out a total of $20.937 billion in EHR incentives, with payments of $5.371 billion in 2011, $9.667 billion in 2012, and $5.896 billion in 2013. But these payments do not include another $1.942 billion to eligible hospitals in fiscal year 2014 so far, bringing the total to-date amount the program has paid to $22.78 billion.

In the final rule published in July 2010, CMS estimated the total cost would be $27.4 billion under the “high scenario” over a 10-year timeframe. Yet the estimate was subsequently revised to $22.5 billion in 2012 due to “different assumed penetration rates based on more recent data and analysis, and revised assumptions as to the timing of payments in relation to when meaningful use is achieved based on the actual experience of the programs to date.”

Nevertheless, it now appears that the original “high scenario” might be the more accurate dollar estimate as to the amount that the EHR incentive program will ultimately pay out. Case in point: in its just released fiscal 2015 budget, the Department of Health and Human Services estimated "Medicare health information technology incentive payments" of $1.436 billion to hospitals and $710 million to eligible professionals, respectively, for a total of $2.15 billion next fiscal year. However, that number does not include Medicaid incentive payments, which also factor into the cost of the overall program.

Under the current timeline, 2016 is the last year to receive a Medicare EHR incentive payment and the last year to initiate participation in the Medicaid EHR incentive program, while 2021 is the last year to receive a Medicaid EHR incentive payment. However, the program’s timelines in recent months have been changed. Stage 3 doesn’t start until 2017, which likely would require revisions of the participation and incentive payment timelines. (For more information about program timeline changes, click here.)


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