Electronic health records are increasingly becoming an integral part of Medicare's accountable care organizations (ACOs), according to the Centers for Medicare & Medicaid Services' 2014 quality and financial performance results.
The results, released this week by CMS, show that the Medicare ACOs have improved the quality of care of Medicare beneficiaries and are generating financial savings, although few of them earned bonuses.
EHRs appear to be a factor to these successes. Pioneer ACOs showed improvements in 28 of 33 quality measures and experienced average improvements of 3.6 percent across all quality measures compared to 2013.
Particularly strong improvement was seen in qualification for an electronic health record incentive payment (77 percent to 86 percent), as well as in medication reconciliation (70 percent to 84 percent) and screening for clinical depression and follow-up plan (50 percent to 60 percent), both easier to implement with EHR clinical decision support tools.
Of the 92 shared savings program ACOs, those that reported in both 2013 and 2014 improved on 27 of 33 quality measures, including use of an EHR, as well as screening for tobacco use and cessation, and screening for high blood pressure, both part of the Meaningful Use program requirements.
EHRs and interoperability are fundamental aspects of ACOs' ability to coordinate patient care and meet their performance goals. For instance, the final rule implementing the MSSP, issued November 2011, notes that the quality measure, "percent of PCPs who successfully qualify for an EHR Incentive Program Payment" will be given double the weight proposed initially by CMS to stress the importance of EHR adoption among ACOs.
The Department of Health and Human Services Office of Inspector General also has jumped into the fray, adding to its 2015 work plan in June a plan to review the extent that providers participating in ACOs in the Medicare Shared Savings Program use EHRs to exchange health information to achieve their care coordination goals. The OIG also will assess providers' use of EHRs to identify best practices and possible challenges in their progression toward interoperability.
CMS continues to use payment reform and new payment models to spur more providers to use EHRs, making them integral to providers' success in these models.