This study investigates the influence of the Medicare EHR Incentive Program on EHR adoption at acute care hospitals and the impact of EHR adoption on operational and financial efficiency/effectiveness. It finds that even before joining the incentive program, adopter hospitals had more efficient and effective Medicare operations than those of non-adopters. Adopters were also financially more efficient. After joining the program, adopter hospitals treated significantly more Medicare patients by shortening their stay durations, relative to their own non-Medicare patients and also to patients at non-adopter hospitals, even as their overall capacity utilization remained relatively unchanged. The study concludes that many of these hospitals had implemented EHR even before the initiation of the incentive program. It further infers that they joined this program with opportunistic intentions of tapping into incentive payouts which they maximized by taking on more Medicare patients. These findings give credence to critics of the program who have questioned its utility and alleged that it serves only to reward existing users of EHR technologies.
This study investigates electronic health records (EHR) adoption among inpatient hospitals in response to the first operational year of the Medicare EHR Incentive Program. Profile analysis of public attestation datasets finds both system adoption rates and implemented functionalities to have been significantly influenced by the incentive program's attributes. Key dates and periods in the program's well-publicized timeline were usually accompanied by spikes in the number of attested systems and/or dips in advanced functionalities. The implication is that hospitals have responded to the program by swiftly implementing EHR systems with capabilities just sufficient to meet program requirements, in order to be able to promptly file attestations and thus claim their incentive payments.The program therefore appears to have yielded mixed results. While it seems to have induced more hospitals to acquire EHR systems, the implemented systems generally possess minimal functionalities, suggesting that adopters have leveraged the program's rules in order to maximize their own short-term gains.
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