1. Meaningful use
The “stick” that will probably have the biggest impact for most practices comes from not participating in the meaningful use program.
Eligible professionals (EPs) who have not demonstrated meaningful use of electronic health records (EHRs) will face a 1% penalty (or “payment adjustment,” in government-speak) in their Medicare reimbursements in 2015. Penalties are due to increase by 1% each year until 2019, when they will plateau at 5%.
For EPs also not participating in Medicare’s electronic prescribing program, the penalties start at 2% in 2015, also plateauing at 5% in 2019. In addition, all EPs must continue to demonstrate meaningful use every year through 2019 to avoid penalties. A one-time demonstration is not sufficient.
The second program due to switch from paying incentives to imposing penalties is the PQRS.
First adopted in 2006, and made permanent in 2008, it has paid doctors bonuses of between 0.5% and 2% of their annual reimbursements for reporting data from their practice on a broad array of quality measures. (Physicians have been eligible for an additional 0.5% incentive payment for participating in a maintenance of certification program.)
Starting in 2013 however, physicians and practices that had not reported PQRS data will be subject to a 1.5% adjustment to their Medicare reimbursements, rising to 2% in 2016.