The Impact of Market Factors on Meaningful Use of Electronic Health Records among Primary Care Providers:

• In Event: The Role of Big Data and Machine Learning in Health Care: Challenges and Opportunities

Abstract

Background: Using federal funds from the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, the Centers for Medicare and Medicaid Services funded the 2011-2021 Medicaid EHR incentives programs throughout the country.

Objective: Identify the market factors associated with Meaningful Use of EHRs after primary care providers (PCPs) enrolled in the Florida – EHR incentives program through Adopting, Improving, or Upgrading (AIU) an EHR technology.

Research design: Retrospective cohort study using 2011-2018 program records for 8464 Medicaid providers.

Main Outcome: Meaningful Use (MU) achievement after first-year incentives. 

Independent Variables: The resource dependence theory and the information uncertainty perspective were used to generate key independent variables, including county’s rurality, educational attainment, poverty, HMO penetration, and number of PCPs per capita. 

Analytical Approach: All the county rates were converted into three dichotomous measures corresponding to high, medium, and low terciles. Descriptive and bivariate statistics were calculated.  A generalized hierarchical linear model was used because Meaningful Use data were clustered at the county level (level 2) and measured at the practice level (level 1). 

Results: Overall, 41.9% of Florida Medicaid providers achieved Meaningful Use after receiving first-year incentives. Rurality was positively associated with Meaningful Use (P<.001). Significant negative differences in Meaningful Use achievements were obtained when we compared the ‘high’ terciles with the ‘low’ terciles for poverty rates (P=.002), HMO penetration rates (P=.02), and number of PCPs per capita (P=.01). 

Author

• Pierre K. Alexandre, Florida Atlantic University
  Presenting Author