Medicare and Medicaid electronic health record payments are estimated to have blasted through $10.3 billion to a total of 180,200 physicians and hospitals through December since the program’s inception. December’s payments of $1.25 billion were driven by the largest amount of hospital payments for an individual month, according to Robert Anthony, a specialist in CMS’ Office of eHealth Standards and Services.

“We will pay out in December more than $1 billion in Medicare and Medicaid hospital payments, our single largest month of payments by a factor of almost three, and a total of $1.2 billion. It will bring our year-to- date, although it’s not our program year-to-date, to over $10.3 billion paid out in incentives as of the end of December,” he said at the Jan. 8 Health IT Policy Committee meeting.

The Centers for Medicare and Medicaid Services will post final figures later this month as it captures more complete data. The incentive program has been operating long enough now that some providers, specifically hospitals so far, are now return participants. So CMS lists only unique providers paid, Anthony said.

[See also: Mostashari: No cap on EHR incentive payouts.]

During December, CMS estimated that it paid 10,000 Medicare eligible physicians $175 million and 4,200 Medicaid physicians $80 million. In December, 850 hospitals under the combined programs received $1 billion, Anthony said.

Since the program’s inception through December, CMS has paid 106,000 Medicare physicians, 70,000 Medicaid physicians and 4,200 hospitals, according to CMS figures.

[See also: EHR incentives top $9B.]

The number of eligible providers registered for the EHR incentive program was 84 percent of hospitals, 43.9 percent of Medicare physicians, and 19.9 percent of Medicaid professionals signed up as of November.

This year will be significant because 2011 and 2012 were years when Medicare providers who began participation could receive full incentive payments. That won’t be the case for providers just beginning to participate in 2013, Anthony said.

“So we want to see what kind of a driver that will be,” he noted, adding that “2013 will be the deciding year for many people as far as payment adjustment.”

Just in the first few days of the year, large numbers of providers have attested. “On Jan. 2, we had 2,200 eligible professionals come in and attest, the first day after New Year’s that people could do so, which I thought was impressive, until I started to see the daily numbers afterwards, and realized that we’re starting to see those numbers virtually every day,” he said.

Anthony anticipates more smaller and rural hospitals to register to attest this year. They lack the infrastructure needed, and the regional health IT extension centers (RECs) plan to get those hospitals ready.

Some committee members inquired if there were indicators or dashboards to demonstrate if providers were realizing value from quality measures they testified to for incentives. Meaningful use sets providers on an escalator of requirements, first to capture data, then to exchange information and finally to improve health outcomes.

“I think it would be incredibly valuable to think through a small set of good indicators that would not only tell us about progress along the path but also the $10 billion laying the groundwork for improving outcomes,” said Christine Bechtel, vice president of the National Partnership for Women and Families.

Anthony said CMS wants to determine the impact of meaningful use but it’s early in the process.

“We have a lot of people who have used their software for 90 days to record data. The claims that we might see now are not necessarily the claims that were impacted by the use of an EHR. We might not see that impact for another 18 to 24 to 36 months," he said. "When you move into Stage 2 and Stage 3, at what point and what do you look at to see the impact? Ultimately, the goal is to look long term to see the kind of impact this actually has."