Doc participation in Meaningful Use dynamic, variable

The number of New York physicians who joined the Meaningful Use program grew significantly in its first two years, but was "dynamic" and may contribute to a "digital divide," according to a new study published in the June issue of Health Affairs.

The researchers, from the Weill Cornell Medical College, studied the participation rates of New York's 26,368 doctors in 2011 and 2012. Only 8.1 percent of them participated in the Medicare program in 2011 and 6.1 percent in the Medicaid program. The numbers jumped to 23.9 percent in the Medicare program and 8.5 percent in the Medicaid program in 2012. However, 13.8 percent of those in the Medicare program in 2011 dropped out in 2012; more than half of those in the Medicaid program did so, prompting concern.

"If large numbers of providers discontinue participation after receiving initial payments, the value of public investments made through the Meaningful Use incentive programs may be reduced," the researchers warned. "Additionally, the programs may alter healthcare delivery in unknown ways if physicians who consistently participate are systematically different from nonparticipants."

They also found that participants were more likely to be from bigger practices, with larger patient volume, previous EHR users, male and in less populous counties.

"The use of EHRs has been associated with quality and safety improvements," the researches continued. "However, systematic differences between physicians who adopt EHRs and those who do not increase the risk of creating a digital divide, with patients of physicians who do not use EHRs receiving care of lower quality than patients of providers who use these systems."

They added that ensuring "sustained participation" will become more challenging, as Meaningful Use's latter stages require increased EHR usage and reporting. What's more, "federal programs that could help address challenges to achieving Meaningful Use for later stages are coming to a close," they said.

Although more physicians are using EHRs, adoption seems to be leveling off, even though the penalty phase of the Meaningful Use program has begun. However, EHRs increasingly are needed to participate in health reform initiatives and obtain reimbursement.

To learn more:
- read the abstract