Critical Access Hospitals’ Receipt of Medicare and Medicaid Electronic Health Record Incentive Payments (FMT Policy Brief #37)


This policy brief has three purposes: 1) to describe current Critical Access Hospital (CAH) participation in the Medicare and Medicaid EHR incentive programs; 2) to compare CAH participation by state; and 3) to evaluate the differences in CAH participation by hospital characteristics.


  • As of September 2014, 1,194 Critical Access Hospitals (CAHs) (89%) had received any Medicare and/or Medicaid Electronic Health Record (EHR) incentive payments.
  • 150 CAHs received Medicaid incentives for adoption, implementation, or upgrade (AIU) only, while 1,031 and 696 CAHs received incentives for meaningful use (MU) from Medicare and Medicaid, respectively. A total of 683 CAHs (51%) received both Medicare and Medicaid MU incentives.
  • By state, the percentage of CAHs receiving any EHR incentive payment ranged from 44% in Hawaii to 100% of CAHs in eight states (Arkansas, Florida, Maine, Massachusetts, New Mexico, Pennsylvania, Vermont, and Virginia). The percentage of CAHs that received MU incentive payments ranged from 44% in Hawaii to 100% in Vermont and Virginia.
  • CAHs that received any EHR incentives, including AIU and/or MU, were significantly more likely to have 25 beds (the maximum number of beds for a CAH), and to have more Medicare and Medicaid inpatient discharges, but less likely to be private for-profit, than those that did not receive an incentive.
  • Compared to CAHs that only received AIU incentives, CAHs that received MU incentives were significantly more likely to have 25 beds and to be accredited by the Joint Commission or the American Osteopathic Association, but less likely to be system members.


Health Information Technology (HIT) Quality