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Meaningful Use of Electronic Health Records by Outpatient Physicians and Readmissions of Medicare Fee-for-Service Beneficiaries.

TitleMeaningful Use of Electronic Health Records by Outpatient Physicians and Readmissions of Medicare Fee-for-Service Beneficiaries.
Publication TypeJournal Article
Year of Publication2017
AuthorsUnruh MA, Jung H-Y, Vest JR, Casalino LP, Kaushal R
Corporate AuthorsHITEC Investigators
JournalMed Care
Volume55
Issue5
Pagination493-499
Date Published2017 05
ISSN1537-1948
KeywordsAttitude of Health Personnel, Electronic Health Records, Fee-for-Service Plans, Heart Failure, Humans, Meaningful Use, Medicare, Myocardial Infarction, New York, Patient Admission, Patient Readmission, Pneumonia, United States
Abstract

BACKGROUND: Nearly one-fifth of hospitalized Medicare fee-for-service beneficiaries are readmitted within 30 days. Participation in the Meaningful Use initiative among outpatient physicians may reduce readmissions.

OBJECTIVE: To evaluate the impact of outpatient physicians' participation in Meaningful Use on readmissions.

SUBJECTS AND RESEARCH DESIGN: The study population included 90,774 Medicare fee-for-service beneficiaries from New York State (2010-2012). We compared changes in the adjusted odds of readmission for patients of physicians who participated in Meaningful Use-stage 1, before and after attestation as meaningful users, with concurrent patients of matched control physicians who used paper records or electronic health records without Meaningful Use participation. Three secondary analyses were conducted: (1) limited to patients with 3+ Elixhauser comorbidities; (2) limited to patients with conditions used by Medicare to penalize hospitals with high readmission rates (acute myocardial infarction, congestive heart failure, and pneumonia); and (3) using only patients of physicians with electronic health records who were not meaningful users as the controls.

MAIN OUTCOME: Thirty-day readmission.

RESULTS: Patients of Meaningful Use physicians had 6% lower odds of readmission compared with patients of physicians who were not meaningful users, but the estimate was not statistically significant (odds ratio: 0.94, 95% confidence interval, 0.88-1.01). Estimated odds ratios from secondary analyses were broadly consistent with our primary analysis.

CONCLUSIONS: Physician participation in Meaningful Use was not associated with reduced readmissions. Additional studies are warranted to see if readmissions decline in future stages of Meaningful Use where more emphasis is placed on health information exchange and outcomes.

DOI10.1097/MLR.0000000000000695
Alternate JournalMed Care
PubMed ID28079709
Category: 
Faculty Publication