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The Medicare Electronic Health Record Incentive Program: Provider Performance on Core and Menu Measures

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Keywords: Electronic medical records;meaningful use;CMS;HITECH Act

Objective: To measure performance by eligible health care providers on CMS's meaningful use measures.

Data Source: Medicare Electronic Health Record Incentive Program Eligible Professionals Public Use File (PUF), which contains data on meaningful use attestations by 237,267 eligible providers through May 31, 2013.

Study Design: Cross-sectional analysis of the 15 core and 10 menu measures pertaining to use of EHR functions reported in the PUF.

Principal Findings: Providers in the dataset performed strongly on all core measures, with the most frequent response for each of the 15 measures being 90–100 percent compliance, even when the threshold for a particular measure was lower (e.g., 30 percent). PCPs had higher scores than specialists for computerized order entry, maintaining an active medication list, and documenting vital signs, while specialists had higher scores for maintaining a problem list, recording patient demographics and smoking status, and for providing patients with an after-visit summary. In fact, 90.2 percent of eligible providers claimed at least one exclusion, and half claimed two or more.

Conclusions: Providers are successfully attesting to CMS's requirements, and often exceeding the thresholds required by CMS; however, some troubling patterns in exclusions are present. CMS should raise program requirements in future years.

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