Volume 53 | Number 2 | April 2018

Abstract List

Yanick N. Brice Ph.D., M.P.A., Karen E. Joynt M.D., M.P.H., Christopher P. Tompkins Ph.D., Grant A. Ritter Ph.D.


To examine trends in hospital post‐acute utilization indicators and to determine whether improvement in these indicators is associated with attesting to meaningful use ().

Data Sources

Medicare claims‐based, repeated measures on 30‐day hospital‐wide all‐cause readmission and emergency department () utilization rates for 160 short‐stay hospitals (2009–2012); Medicare Incentive Program Payments files (2011–2012); and other hospital and market data.

Study Design

Interrupted time series with concurrent comparison group.

Principal Findings

Propensity score‐weighted multilevel models for change demonstrate that 30‐day readmission rates (unadjusted) fell from 13.4 percent in 2009 to 12.1 percent in 2012. Similarly, 30‐day utilization declined from 18.9 percent to 17.3 percent during the same period. However, and non‐ hospitals were indistinguishable vis‐à‐vis performance. Controlling for hospital and market characteristics, was unrelated to 30‐day readmission. In contrast, 30‐day utilization deteriorated.


Hospitals with Stage 1 designation did not show significantly higher improvement on post‐acute utilization compared to their counterparts without. To achieve gains in quality and safety, potentially associated with s, and to advance care coordination and patient engagement, the regulators should strengthen accountability by linking comprehensive, outcomes‐based performance measures to specific objectives.