title: Physician Participation in Meaningful Use and Quality of Care for Medicare Fee-for-Service Enrollees.
abstract: OBJECTIVE
  The Meaningful Use initiative has made nearly $30 billion available through incentive programs to encourage provider adoption and use of electronic health records. The objective of this study was to evaluate the impact of outpatient physicians' participation in Meaningful Use on the quality of care provided to Medicare fee-for-service (FFS) enrollees.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  One hundred percent inpatient and outpatient Medicare FFS claims covering the period January 2010 through December 2012.
  
  
  METHODS
  303,110 Medicare FFS enrollees from New York State.
  
  
  METHODS
  Hospitalizations and emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs), diabetic retinopathy screening, diabetic nephropathy screening, colorectal cancer screening, and influenza vaccinations.
  
  
  RESULTS
  Physician participation in the Meaningful Use initiative was not associated with reductions in ACSC-related hospitalizations (0.0 percentage points, 95% confidence interval (CI): 0.0-0.1) or ED visits (0.0 percentage points, 95% CI: 0.0-0.1) relative to the comparison group. Meaningful Use participation was associated with higher odds of colorectal cancer screening (odds ratio (OR): 1.2, 95% CI: 1.1-1.4) relative to the comparison group, but not for diabetic retinopathy screening (OR: 1.1, 95% CI: 1.0-1.2), diabetic nephropathy screening (OR: 1.0, 95% CI: 0.8-1.2), or influenza vaccinations (OR: 1.1, 95% CI: 1.0-1.2). Similar results were found in secondary analyses of dually-eligible beneficiaries participating in both Medicare and Medicaid.
  
  
  CONCLUSIONS
  Physician participation in Meaningful Use was not associated with substantial improvements on six quality measures.
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York.
authors.forename: Hye-Young
authors.initials: HY
authors.lastname: Jung
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York.
authors.forename: Mark Aaron
authors.initials: MA
authors.lastname: Unruh
authors.affiliation: Department of Healthcare Policy and Management, Indiana University, Indianapolis, Indiana.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Vest
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York.
authors.forename: Lawrence P
authors.initials: LP
authors.lastname: Casalino
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kern
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Grinspan
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York.
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Bao
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York.
authors.forename: Rainu
authors.initials: R
authors.lastname: Kaushal
mesh_terms: D000368:Aged; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis; D003930:Diabetic Retinopathy / Q000175:diagnosis; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D018588:Fee-for-Service Plans; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007252:Influenza Vaccines; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D062527:Meaningful Use; D006278:Medicare; D010819:Physician's Role; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D007252:Influenza Vaccines
keywords: Meaningful Use; Medicare; quality of care