Medicare Incentive Payments to United States Ophthalmologists for Use of Electronic Health Records: 2011-2016

OBJECTIVE: To investigate ophthalmologists’ rate of attestation to meaningful use of their electronic health record (EHR) systems in the Medicare EHR Incentive program and their continuity and success in receiving payments in comparison to other specialties. DESIGN: Administrative database study PARTICIPANTS: Eligible professionals participating in the Medicare EHR Incentive Program METHODS: Based on publicly available data sources, subsets of payment and attestation data were created for ophthalmologists and for other specialties. The number of eligible professionals attesting was determined using the attestation data for each year and stage of the program. The proportion of attestations by EHR vendor was calculated using all attestations for each vendor. MAIN OUTCOME MEASURES: Numbers of ophthalmologists attesting by year and stage of the Medicare EHR Incentive program, incentive payments, and number of attestations by EHR vendor RESULTS: 51.6% of ophthalmologists successfully attested to meaningful use in the peak year of participation, compared to 37.1% of optometrists, 50.2% of dermatologists, 54.5% of otolaryngologists, and 64.4% of urologists. Across the six years of the program, ophthalmologists received an average of $US 17,942 in incentive payments compared to $US 11,105 for optometrists, $US 16,617 for dermatologists, $US 20,203 for otolaryngologists, and $US 23,821 for urologists. Epic and Nextgen were the most frequently used EHRs for attestation by ophthalmologists. CONCLUSIONS: Ophthalmology as a specialty performed better than optometry and dermatology but worse than otolaryngology and urology in terms of the proportion of eligible professionals attesting to meaningful use of EHRs. Ophthalmologists were more likely to remain in the program after their initial year of attestation compared to all eligible providers. The top 4 vendors accounted for 50% of attestations by ophthalmologists.