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Meaningful Use and Hospital Performance on Post‐Acute Utilization Indicators
Author(s) -
Brice Yanick N.,
Joynt Karen E.,
Tompkins Christopher P.,
Ritter Grant A.
Publication year - 2018
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12677
Subject(s) - medicine , interrupted time series , emergency department , acute care , incentive , pay for performance , quality management , emergency medicine , propensity score matching , accountability , hospital readmission , payment , health care , operations management , nursing , finance , psychological intervention , business , management system , political science , law , economics , microeconomics , economic growth
Objectives To examine trends in hospital post‐acute utilization indicators and to determine whether improvement in these indicators is associated with attesting to meaningful use ( MU ). Data Sources Medicare claims‐based, repeated measures on 30‐day hospital‐wide all‐cause readmission and emergency department ( ED ) utilization rates for 160 short‐stay hospitals (2009–2012); Medicare EHR Incentive Program Payments files (2011–2012); and other hospital and market data. Study Design Interrupted time series with concurrent comparison group. Principal Findings Propensity score‐weighted multilevel models for change demonstrate that 30‐day readmission rates (unadjusted) fell from 13.4 percent in 2009 to 12.1 percent in 2012. Similarly, 30‐day ED utilization declined from 18.9 percent to 17.3 percent during the same period. However, MU and non‐ MU hospitals were indistinguishable vis‐à‐vis performance. Controlling for hospital and market characteristics, MU was unrelated to 30‐day readmission. In contrast, 30‐day ED utilization deteriorated. Conclusions Hospitals with MU Stage 1 designation did not show significantly higher improvement on post‐acute utilization compared to their counterparts without. To achieve gains in quality and safety, potentially associated with EHR s, and to advance care coordination and patient engagement, the regulators should strengthen accountability by linking comprehensive, outcomes‐based performance measures to specific MU objectives.