Physician Participation in Meaningful Use and Quality of Care for Medicare Fee-for-Service Enrollees

the HITEC Investigators

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: The Meaningful Use initiative has made nearly $30 billion available through incentive programs to encourage provider adoption and use of electronic health records. The objective of this study was to evaluate the impact of outpatient physicians' participation in Meaningful Use on the quality of care provided to Medicare fee-for-service (FFS) enrollees. Design: Retrospective cohort study. Setting: One hundred percent inpatient and outpatient Medicare FFS claims covering the period January 2010 through December 2012. Participants: 303,110 Medicare FFS enrollees from New York State. Measurements: Hospitalizations and emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs), diabetic retinopathy screening, diabetic nephropathy screening, colorectal cancer screening, and influenza vaccinations. Results: Physician participation in the Meaningful Use initiative was not associated with reductions in ACSC-related hospitalizations (0.0 percentage points, 95% confidence interval (CI): 0.0–0.1) or ED visits (0.0 percentage points, 95% CI: 0.0–0.1) relative to the comparison group. Meaningful Use participation was associated with higher odds of colorectal cancer screening (odds ratio (OR): 1.2, 95% CI: 1.1–1.4) relative to the comparison group, but not for diabetic retinopathy screening (OR: 1.1, 95% CI: 1.0–1.2), diabetic nephropathy screening (OR: 1.0, 95% CI: 0.8–1.2), or influenza vaccinations (OR: 1.1, 95% CI: 1.0–1.2). Similar results were found in secondary analyses of dually-eligible beneficiaries participating in both Medicare and Medicaid. Conclusion: Physician participation in Meaningful Use was not associated with substantial improvements on six quality measures.

Original languageEnglish (US)
Pages (from-to)608-613
Number of pages6
JournalJournal of the American Geriatrics Society
Volume65
Issue number3
DOIs
StatePublished - Mar 1 2017

Fingerprint

Fee-for-Service Plans
Quality of Health Care
Medicare
Confidence Intervals
Physicians
Odds Ratio
Diabetic Nephropathies
Diabetic Retinopathy
Ambulatory Care
Early Detection of Cancer
Human Influenza
Hospital Emergency Service
Colorectal Neoplasms
Vaccination
Hospitalization
Outpatients
Electronic Health Records
Medicaid
Motivation
Inpatients

Keywords

  • Meaningful Use
  • Medicare
  • quality of care

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Physician Participation in Meaningful Use and Quality of Care for Medicare Fee-for-Service Enrollees. / the HITEC Investigators.

In: Journal of the American Geriatrics Society, Vol. 65, No. 3, 01.03.2017, p. 608-613.

Research output: Contribution to journalArticle

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abstract = "Objectives: The Meaningful Use initiative has made nearly $30 billion available through incentive programs to encourage provider adoption and use of electronic health records. The objective of this study was to evaluate the impact of outpatient physicians' participation in Meaningful Use on the quality of care provided to Medicare fee-for-service (FFS) enrollees. Design: Retrospective cohort study. Setting: One hundred percent inpatient and outpatient Medicare FFS claims covering the period January 2010 through December 2012. Participants: 303,110 Medicare FFS enrollees from New York State. Measurements: Hospitalizations and emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs), diabetic retinopathy screening, diabetic nephropathy screening, colorectal cancer screening, and influenza vaccinations. Results: Physician participation in the Meaningful Use initiative was not associated with reductions in ACSC-related hospitalizations (0.0 percentage points, 95{\%} confidence interval (CI): 0.0–0.1) or ED visits (0.0 percentage points, 95{\%} CI: 0.0–0.1) relative to the comparison group. Meaningful Use participation was associated with higher odds of colorectal cancer screening (odds ratio (OR): 1.2, 95{\%} CI: 1.1–1.4) relative to the comparison group, but not for diabetic retinopathy screening (OR: 1.1, 95{\%} CI: 1.0–1.2), diabetic nephropathy screening (OR: 1.0, 95{\%} CI: 0.8–1.2), or influenza vaccinations (OR: 1.1, 95{\%} CI: 1.0–1.2). Similar results were found in secondary analyses of dually-eligible beneficiaries participating in both Medicare and Medicaid. Conclusion: Physician participation in Meaningful Use was not associated with substantial improvements on six quality measures.",
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