Meaningful Use and Hospital Performance on Post-Acute Utilization Indicators.

Area of Science:

• Health Services Research
• Health Informatics
• Public Health Policy

Background:

• Meaningful Use (MU) programs incentivize electronic health record (EHR) adoption.
• Post-acute care utilization indicators, such as readmission and emergency department (ED) rates, are key measures of hospital quality.
• The association between MU attestation and improvements in these utilization indicators remains under investigation.

Purpose of the Study:

• To analyze trends in hospital post-acute utilization indicators between 2009 and 2012.
• To determine if achieving Meaningful Use (MU) is associated with improved 30-day hospital readmission and ED utilization rates.

Main Methods:

• Utilized Medicare claims data for 160 short-stay hospitals from 2009-2012.
• Employed interrupted time series analysis with a concurrent comparison group.
• Applied propensity score-weighted multilevel models to assess changes in utilization rates.

Main Results:

• Overall 30-day readmission rates decreased from 13.4% to 12.1%, and ED utilization from 18.9% to 17.3% between 2009 and 2012.
• Hospitals attesting to Meaningful Use (MU) showed no significant difference in performance improvement compared to non-MU hospitals.
• MU attestation was unrelated to 30-day readmission rates, and ED utilization unexpectedly deteriorated in MU hospitals.

Conclusions:

• Meaningful Use (MU) Stage 1 designation did not lead to significant improvements in post-acute utilization indicators.
• To realize quality gains potentially linked to EHRs, regulators should link MU objectives to comprehensive, outcomes-based performance measures.
• Strengthening accountability through performance-based measures is crucial for advancing care coordination and patient engagement.