Physician and Practice-Level Drivers and Disparities around Meaningful Use Progress

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Abstract

Objective.

To identify physician and practice characteristics that are markers of success for meaningful use of electronic health records (EHRs).

Data Sources.

American Medical Association survey, Centers for Medicare & Medicaid Services' (CMS) EHR Incentive, Pioneer Accountable Care Organization, and PECOS Programs, the Office of the National Coordinator for Health IT's Regional Extension Center Program, and National Committee for Quality Assurance Patient-centered Medical Home certification program.

Study Design.

Retrospective analysis of 865,370 physicians' participation in CMS's EHR Incentive Program and progress to stage 1 Meaningful Use between 2011 and 2013. Physician specialty, age, practice size, geographic markers, delivery reform participation, and technical assistance receipt were predictive elements.

Principal Findings.

Medicaid physicians were progressing more slowly to Meaningful Use than Medicare physicians: by 2013, 8 in 10 physicians registered with Medicare had achieved meaningful use, compared to one-third of Medicaid-registered physicians. The strongest predictors of meaningful use were technical assistance (79 percent more likely) and delivery reform participation (34 percent more likely).

Conclusions.

Continued outreach and technical assistance that demonstrates strong interactions between meaningful use of health IT and delivery reform may facilitate further adoption of both initiatives.

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