Barriers to Meaningful Use in Medicaid - 2010

Target Population: Adults, Medicaid, Pediatric*, Safety Net

Summary: The Health Information Technology for Economic and Clinical Health Act offers financial incentives for Medicaid providers to adopt and meaningfully use certified electronic health record (EHR) technologies. To ensure that eligible professionals, including physicians, dentists, certified nurse-midwifes, nurse practitioners, and some physician assistants, are able to qualify for and access these incentives, this 2-year project was initiated to study the barriers that Medicaid providers encounter when they try to achieve meaningful use as defined in the Centers for Medicare and Medicaid Services’ (CMS) EHR Incentive Program. The project is designed to develop actionable recommendations to help Medicaid providers take advantage of incentive payments, achieve meaningful use, and ultimately use health information technology (IT) to improve health care for the Medicaid population.

The data collection methods for this project include both in-person and virtual focus groups with physicians, pediatricians, dentists, and mid-level providers. A technical expert panel (TEP) comprised of key stakeholders, including staff from the Office of the National Coordinator for Health IT, CMS, and the Health Resources and Services Administration, will provide guidance on the research plan, data collection design and implementation, data analysis, and the final report recommendations.

These activities will help Federal stakeholders understand the barriers to meaningful use among Medicaid providers and will inform future Federal regulations, particularly in the development of meaningful use criteria for Stages 2 and 3. This project will yield actionable recommendations to increase effective EHR use by Medicaid providers to improve health care quality and will inform the development of recommendations for technical assistance to overcome identified barriers.

• Identify the barriers to eligibility for the incentive payments; barriers to adoption, implementation, or upgrading of EHR systems; and barriers to achieving meaningful use. (Ongoing)
• Develop actionable recommendations to overcome barriers identified above, including but not limited to, technical assistance that could be made available to Medicaid providers. (Upcoming)
• Provide data to inform the meaningful use objectives being developed by CMS for Stages 2 and 3 of the EHR Incentive Program. (Upcoming)

2010 Activities: The key project activities included development of the work plan and research plan, development of the data collection instruments, preparations for clearance for data collection from the Office of Management and Budget, planning for pilot testing, and developing recruitment strategies for both the pilot test and main study. In addition, the TEP was convened in September 2010 to provide input into the research plan and draft data collection instruments. Pilot testing will be completed in January 2011 with data collection for the main study anticipated to begin in summer 2011.

Preliminary Impact and Findings: There are no findings to report at this time.

Strategic Goal: Develop and disseminate health IT evidence and evidence-based tools to support patient-centered care, the coordination of care across transitions, and the electronic exchange of health information to improve quality of care.

Business Goal: Synthesis and Dissemination

*AHRQ Priority Population.