The Medicare Electronic Health Record Incentive Program: provider performance on core and menu measures

Area of Science:

• Health Informatics
• Healthcare Policy
• Electronic Health Records

Background:

• The Medicare Electronic Health Record (EHR) Incentive Program aimed to promote the adoption and meaningful use of EHRs among eligible healthcare providers.
• Measuring provider performance on specific meaningful use measures is crucial for evaluating program effectiveness and identifying areas for improvement.

Purpose of the Study:

• To assess the performance of eligible healthcare providers in meeting the meaningful use measures set by the Centers for Medicare & Medicaid Services (CMS).

Main Methods:

• Utilized the Medicare Electronic Health Record Incentive Program Eligible Professionals Public Use File (PUF), encompassing data from 237,267 eligible providers through May 31, 2013.
• Conducted a cross-sectional analysis of 15 core and 10 menu measures related to EHR function utilization as reported in the PUF.

Main Results:

• Providers exhibited strong performance across all core meaningful use measures, with 90-100% compliance frequently observed, even for measures with lower thresholds.
• Primary care physicians (PCPs) outperformed specialists in areas like computerized order entry and medication list maintenance, while specialists excelled in problem list management and patient summary provision.
• A significant majority (90.2%) of eligible providers claimed at least one exclusion, with half claiming two or more, indicating potential program loopholes or challenges.

Conclusions:

• Eligible healthcare providers are largely successful in attesting to CMS meaningful use requirements, frequently surpassing minimum thresholds.
• Despite high attestation rates, the prevalence of exclusions suggests a need to re-evaluate and potentially increase program requirements in future iterations.
• The findings indicate that while providers are meeting current meaningful use criteria, the program's stringency may require adjustment to drive further advancement in EHR utilization.