The stimulus package passed by Congress in early January, 2009, provides financial incentives for implementing and using en Electronic Health Record (EHR or EMR for Electronic Medical Record.) These incentives would be available for physicians starting in 2011 or 2012. The incentives start big, and end small.  After the incentives comes the penalty for not using an EHR.  This penalty will be 1% in 2015, and 5% in 2019.

This is the second penaly CMS will impose for physicians not using technology.  The MIPPA bill passed in July of 2008 provides physicians an incentive for using a qualified e-Prescribing system starting in 2009, and ends by imposing a penalty on groups that do not implement e-Prescribing.   The e-Prescriing system, as currently written provides a 2% penalty in 2014, and for each year thereafter, for those groups not using a qualified e-Prescribing system.  See the article in Codapedia on e-Prescribing for the percentage incentives and penalties for each year.

Taken together, as currently written by Congress, physician practices have the potential of a gradually increasing penalty for not using this technology. 

The stimulus package provides for up to $44,000/physician with higher amounts in the early calendar years (not years of use).  By the fifth year of the incentive, it is reduced to $2,000.  The incentive is front loaded, presumably to help with buying a system and implementing it.  The bill does not provide details about how the money will be given to doctors, whether it will start in 2011 or 2012, or what "meaningful" use of an EHR means.  CMS will work out those details.