title: Accountable care organization hospitals differ in health IT capabilities.
abstract: OBJECTIVE
  The aim of this study was to evaluate health information technology (IT) adoption in hospitals participating in accountable care organizations (ACOs) and compare this adoption to non-ACO hospitals.
  
  
  METHODS
  A cross-sectional sample of US nonfederal, acute care hospitals with data from 3 matched sources: the 2013 American Hospital Association (AHA) Annual Survey, the 2013 AHA Survey of Care Systems and Payments (CSP), and the 2014 AHA Information Technology Supplement.
  
  
  METHODS
  To compare health IT adoption in ACO- and non-ACO hospitals, we created measures of Meaningful Use (MU) Stage 1 and Stage 2 core and menu criteria, patient engagement-oriented health IT, and health information exchange (HIE) participation. Adoption was compared using both naïve and multivariate logit models.
  
  
  RESULTS
  Of the 393 ACO hospitals and 810 non-ACO hospitals, a greater percentage of ACO hospitals were capable of meeting MU Stage 1 (50.9% vs 41.6%; P < .01) and Stage 2 (7.6% vs 4.8%; P < .05), having patient engagement health IT (39.8% vs 15.2%; P < .001), and participating in HIE (49.0% vs 30.1%; P < .001). In adjusted models, no difference was found between ACO and non-ACO hospital ability to meet MU Stage 1 or Stage 2, but ACO hospitals were more likely to have patient engagement health IT (odds ratio (OR), 2.20; 95% CI, 1.59-3.04) and be HIE participants (OR, 1.41; 95% CI, 1.03-1.92).
  
  
  CONCLUSIONS
  ACO-participating hospitals appear to be focused more on adopting health IT that aligns with broader strategic goals rather than those that achieve MU. Aligning adoption with quality and payment reform may be a productive path forward to encourage hospital health IT adoption behavior.
authors.affiliation: Ohio State University, 273 Northwood-High Building, 2231 North High St, Columbus, OH 43201. E-mail: Daniel.Walker@osumc.edu.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Walker
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Mora
authors.forename: Ann
authors.initials: A
authors.lastname: Scheck McAlearney
mesh_terms: D060866:Accountable Care Organizations / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D005260:Female; D005102:Health Expenditures; D066275:Health Information Exchange / Q000191:economics* / Q000639:trends; D006291:Health Policy; D006761:Hospitals / Q000639:trends*; D006801:Humans; D008297:Male; D008490:Medical Informatics / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D011050:Policy Making; D015397:Program Evaluation; D014481:United States