The number of physicians and hospitals that have registered for the Medicare or Medicaid electronic health record (EHR) incentive program has surpassed 100,000, according to the Centers for Medicare and Medicaid Services.

As of the end of September, 88,399 physicians and hospitals have signed up for the Medicare program, 24,030 for the Medicaid program and 2,215 hospitals that are eligible for both incentive programs, for a total of 114,644 registrants. In August, the count was 90,000. Thirty-three states have opened their Medicaid EHR incentive programs. 

[Cover story: ICD-10's ten-year reign of fear.]

In September alone, 16,877 physicians and 23 hospitals registered for the Medicare program, said Robert Tagalicod, director of CMS’ Office of eHealth Standards and Services.

As of Sept. 30, CMS has paid more than $850 million in EHR incentives in total, $357.4 million for the Medicare program and $492.6 million under Medicaid, he said in an Oct. 5 meeting of the Health IT Policy Committee’s meaningful use panel. Healthcare providers, vendors and public officials are reporting to the panel over two days what they have learned from meeting stage 1 meaningful use that can inform discussions for stage 3 that the panel is just beginning.

CMS has provided Medicare EHR incentive payments to 3,772 physicians and 158 hospitals that have successfully attested to demonstrating meaningful use since opening attestation in April. Providers who participate in the Medicaid incentive program do not have to attest to meaningful use measures in their first year of participation but receive a payment for adopting, implementing or upgrading certified EHRs.

CMS has captured data from 8,300 providers who have attested so far to meeting stage 1, but Tagalicod cautioned that “we’re looking at early attesters, so it’s a little early to draw conclusions but they look promising.”

On average, providers greatly exceeded the thresholds for meaningful use core and menu measures, but every threshold has some providers on the borderline, he said.

For example, providers reported using computerized physician order entry on average for 87 percent of patients who had at least one medication order when it was required for 30 percent of those patients; electronic prescribing, for which 40 percent of orders were to be transmitted electronically but reported 77 percent; and care summary provided electronically at 88 percent when the required threshold was for 50 percent of transitions and referrals.

“The EHR incentive programs are already helping our healthcare system move from where we are today to where we need to be in the future by promoting the adoption of EHR and health information exchange,” Tagalicod said.

[See also: The 5 roadblocks HIEs face. And this Q&A: On the trials and tribulations of unlocking patient data.]

Patrick Conway, director of CMS’ Office of Clinical Standards and Quality and chief medical officer, said difficulties stem from the fact that EHRs and quality measures that are electronically specified are relatively immature. The Office of the National Coordinator for Health IT lists 1,209 certified EHRs and modules from 579 vendors and developers, as of September.

Providers also are burdened with having to report similar measures to multiple quality programs, he said.CMS plans to align the quality measure reporting among its various programs, including the Inpatient Quality Reporting and Physician Quality Reporting System and meaningful use. 

“We are working towards allowing clinical quality measure data submitted via certified EHRs to apply to all quality reporting programs,” Conway said. A longer term vision could be hospitals and clinicians reporting through a single mechanism and receiving credit for multiple CMS programs.