title: Medicaid Stage 1 Meaningful Use EHR Incentive Payments Are Associated With Higher Quality but Not Improvements in Quality.
abstract: This was a retrospective cohort study of ambulatory care quality by physicians who received payment for Medicaid Stage 1 Meaningful Use (MU) in 2012 using New York State Medicaid Claims (2010-2013). Eight quality measures were used to compare performance of physicians who received payments to Adopt, Implement, or Use (AIU) an electronic health record in 2011 but not for MU in 2012 (AIU-only group) and physicians who cared for Medicaid patients but received no payments (no-incentive group), using propensity score-weighted difference-in-difference logistic regression analyses, clustering by physician. In all, 13 697 physicians and 913 476 patients were studied. In 2010, the MU group scored higher than both groups (vs AIU-only in 3 of 8 measures, 0.8-1.3 adjusted percentage points; vs no-incentive, 2 of 8 measures, 0.9-2.0 adjusted percentage points). The difference-in-difference analysis found no additional improvements in quality over time relative to either control group. Longer follow-up is needed to determine the effects of Stage 2 MU.
authors.affiliation: 1 Weill Cornell Medical College, New York, NY.|2 New York Presbyterian Hospital, New York, NY.|3 Health Information Technology Evaluation Collaborative, New York, NY.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Grinspan
authors.affiliation: 1 Weill Cornell Medical College, New York, NY.
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Bao
authors.affiliation: 1 Weill Cornell Medical College, New York, NY.|3 Health Information Technology Evaluation Collaborative, New York, NY.
authors.forename: Alison
authors.initials: A
authors.lastname: Edwards
authors.affiliation: 1 Weill Cornell Medical College, New York, NY.|3 Health Information Technology Evaluation Collaborative, New York, NY.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Johnson
authors.affiliation: 1 Weill Cornell Medical College, New York, NY.|2 New York Presbyterian Hospital, New York, NY.|3 Health Information Technology Evaluation Collaborative, New York, NY.
authors.forename: Rainu
authors.initials: R
authors.lastname: Kaushal
authors.affiliation: 1 Weill Cornell Medical College, New York, NY.|2 New York Presbyterian Hospital, New York, NY.|3 Health Information Technology Evaluation Collaborative, New York, NY.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kern
mesh_terms: D000328:Adult; D057286:Electronic Health Records / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D062527:Meaningful Use / Q000458:organization & administration*; D008484:Medicaid / Q000458:organization & administration*; D008875:Middle Aged; D009518:New York; D058996:Quality Improvement / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration*; D012052:Reimbursement, Incentive / Q000458:organization & administration*; D014481:United States; D055815:Young Adult
keywords: Medicaid; New York; electronic health records; meaningful use; quality