Study: EHR adoption does not consistently reduce Medicaid costs
While commercial EHR adoption may result in better health outcomes, as a stand-alone it does not consistently bring down Medicaid costs in the short term, according to a recent study published in the Center for Medicare & Medicaid Services' Medicare & Medicaid Research Review.
Results suggest that future Meaningful Use (MU) criteria may require modification to specifically target cost savings and coordinate with payment reform efforts, according to study author Julia Adler-Milstein, University of Michigan, and colleagues.
Researchers evaluated ambulatory cost and visit measures from Medicaid claims data for beneficiaries receiving the majority of their care at three Massachusetts eHealth Collaborative pilot communities or in six matched control communities (two control communities per pilot) with low EHR usage.
“We found evidence that EHRs may impact ambulatory medical costs, driven at least in part by changes in visits, but the direction of the effect was not consistent across communities and the net effect was minimal,” Adler-Milstein et al wrote. “This suggests that EHRs, in and of themselves, can facilitate either increases or decreases in cost, and this likely depends on how they are used and the context in which they are used.”
In its conclusion, the researchers noted that because one pilot community achieved savings while another experienced an increase in costs, other factors may be at play that determine whether EHR adoption is triggering savings. Differences in financial incentives and the use of decision support and health information exchange, for example, are factors that impact whether providers financially benefit from EHRs.
Thus more robust MU criteria in decision support and health information exchange, as well as broader efforts to incentivize reductions in healthcare costs, “will likely be essential if the EHR adoption resulting from the recent federal initiatives is to produce cost savings in the Medicaid population,” according to the study.