title: Meaningful Use of Electronic Health Records by Outpatient Physicians and Readmissions of Medicare Fee-for-Service Beneficiaries.
abstract: Nearly one-fifth of hospitalized Medicare fee-for-service beneficiaries are readmitted within 30 days. Participation in the Meaningful Use initiative among outpatient physicians may reduce readmissions.
  
  
  
  To evaluate the impact of outpatient physicians' participation in Meaningful Use on readmissions.
  
  
  
  The study population included 90,774 Medicare fee-for-service beneficiaries from New York State (2010-2012). We compared changes in the adjusted odds of readmission for patients of physicians who participated in Meaningful Use-stage 1, before and after attestation as meaningful users, with concurrent patients of matched control physicians who used paper records or electronic health records without Meaningful Use participation. Three secondary analyses were conducted: (1) limited to patients with 3+ Elixhauser comorbidities; (2) limited to patients with conditions used by Medicare to penalize hospitals with high readmission rates (acute myocardial infarction, congestive heart failure, and pneumonia); and (3) using only patients of physicians with electronic health records who were not meaningful users as the controls.
  
  
  
  Thirty-day readmission.
  
  
  
  Patients of Meaningful Use physicians had 6% lower odds of readmission compared with patients of physicians who were not meaningful users, but the estimate was not statistically significant (odds ratio: 0.94, 95% confidence interval, 0.88-1.01). Estimated odds ratios from secondary analyses were broadly consistent with our primary analysis.
  
  
  
  Physician participation in Meaningful Use was not associated with reduced readmissions. Additional studies are warranted to see if readmissions decline in future stages of Meaningful Use where more emphasis is placed on health information exchange and outcomes.
authors.affiliation: *Department of Healthcare Policy & Research †Center for Healthcare Informatics & Policy, Weill Cornell Medical College, New York, NY ‡Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN §Department of Pediatrics, Weill Cornell Medical College ∥New York-Presbyterian Hospital ¶Department of Medicine, Weill Cornell Medical College, New York, NY.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Unruh
authors.forename: Hye-Young
authors.initials: HY
authors.lastname: Jung
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Vest
authors.forename: Lawrence P
authors.initials: LP
authors.lastname: Casalino
authors.forename: Rainu
authors.initials: R
authors.lastname: Kaushal
mesh_terms: D001291:Attitude of Health Personnel; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D018588:Fee-for-Service Plans / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D062527:Meaningful Use / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D009203:Myocardial Infarction / Q000453:epidemiology; D009518:New York / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011014:Pneumonia / Q000453:epidemiology; D014481:United States