ARTICLES

Hospital Characteristics Associated With Achievement of Meaningful Use

Diana, Mark L. PhD¹; Harle, Christopher A. PhD²; Huerta, Timothy R. PhD³; Ford, Eric W. PhD⁴; Menachemi, Nir PhD⁵

Author Information

¹associate professor, Department of Global Health Systems and Development, Tulane University, New Orleans, Louisiana

²assistant professor, Department of Health Services Research, Management & Policy, University of Florida, Gainesville

³associate professor, Family Medicine and Biomedical Informatics, Ohio State University, Columbus

⁴research associate, Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland

⁵professor, Department of Health Care Organization and Policy, University of Alabama at Birmingham

For more information about the concepts in this article, contact Dr. Diana at [email protected].

Journal of Healthcare Management 59(4):p 272-286, July–August 2014.

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Abstract

EXECUTIVE SUMMARY

The objective of this study was to identify factors associated with hospitals that achieved the Medicare meaningful use incentive thresholds for payment under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. We employed a cross-sectional design using data from the 2011 American Hospital Association Annual Survey, including the Information Technology Supplement; the Centers for Medicare & Medicaid Services report of hospitals receiving meaningful use payments; and the Health Resources and Services Administration's Area Resource File. We used a lagged value from 2010 to determine electronic health record (EHR) adoption. Our methods were a descriptive analysis and logistic regression to examine how various hospital characteristics are associated with the achievement of Medicare meaningful use incentives.

Overall, 1,769 (38%) of 4,683 potentially eligible hospitals achieved meaningful use incentive thresholds by the end of 2012. Characteristics associated with organizations that received incentive payments were having an EHR in place in 2010, having a larger bed size, having a single health information technology vendor, obtaining Joint Commission accreditation, operating under for-profit status, having Medicare share of inpatient days in the middle two quartiles, being eligible for Medicaid incentives, and being located in the Middle Atlantic or South Atlantic census region. Characteristics associated with not receiving incentive payments were being a member of a hospital system and being located in the Mountain or Pacific census region.

Thus far, little evidence suggests that the HITECH incentive program has enticed hospitals without an EHR system to adopt meaningful use criteria. Policy makers should consider modifying the incentive program to accelerate the adoption of and meaningful use in hospitals without EHRs.