Barriers to Meaningful Use in Medicaid - 2011

Summary: The Health Information Technology for Economic and Clinical Health Act (HITECH) 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-midwives, nurse practitioners, and some physician assistants, are able to qualify for and access these incentives, this 2-year project is studying 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 provides 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.

Data for this project are being collected from 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 (ONC) for Health IT, CMS, and the Health Resources and Services Administration, has provided guidance on the research plan, data collection design, and implementation plan. The panel will also provide guidance on data analysis and final report recommendations.

These activities will help Federal stakeholders understand the barriers to meaningful use among Medicaid providers and will help inform future Federal regulations.

Project Objectives:

• 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. (Ongoing)
• Provide data to inform the meaningful use objectives being developed by CMS for Stages 2 and 3 of the EHR Incentive Program. (Upcoming)

2011 Activities: In October, the study team received approval from the Office of Management and Budget to conduct the focus groups, which will be held in 2012. Subsequently, pilot testing of the focus group questionnaires was conducted among one in-person focus group, one virtual focus group, and two one-on-one interviews; one with a private family physician with no EHR and the other with a private practice pediatrician with no EHR. The team experienced challenges recruiting non-adopters of EHR to the pilot discussions, but among the pilot participants the discussions were found to be helpful to the project team. The remainder of the project timeline includes conducting a total of 17 focus groups (three in-person, 14 virtual), analyzing the findings, and developing a final report.

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

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

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

* This target population is one of AHRQ's priority populations.