Online Program

Challenges Facing Pediatricians Participating in Electronic Health Records Incentive Programs

Wednesday, November 4, 2015 : 10:30 a.m. - 10:42 a.m.

Rachel Meadows, MPA, PolicyLab The Children’s Hospital of Philadelphia, Philadelphia, PA
Kathleen Noonan, JD, Children's Hospital of Philadelphia, Philadelphia, PA
Although the intent of the federal Meaningful Use (MU) program is to improve the health of children and adults through adoption and use of electronic health records (EHRs), the program’s current structure disadvantages pediatricians compared to adult providers, leading to wide variability in pediatrician participation across states, from less than 10% in New Jersey, Georgia and Hawaii to nearly 70% in North Dakota.

Pediatricians seeking MU payments for using EHRs must exceed a 20% patient threshold of Medicaid-insured children, whereas adult providers can participate through the Medicare EHR incentive program, which has no patient threshold.

Qualifying for the MU program through Medicaid is more difficult than through Medicare because 1) Medicaid participation is based in part on each state’s reimbursement rates and policies; 2) children enrolled in a state’s separate Children’s Health Insurance Program (CHIP) are excluded from the patient threshold calculation; and 3) a lack of centralized reporting for pediatricians interested in receiving incentives creates a cumbersome process compared to Medicare’s single central federal repository.

Pediatrician participation in the MU program can be increased through several policy solutions including: 1) universally allowing providers to include CHIP patients in their patient threshold; 2) no longer requiring a patient threshold for pediatricians’ MU participation; and 3) collaborating with private payers and health systems to offer tax credits or payment incentives to pediatricians who do not meet the patient threshold.

Learning Areas:

Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Describe the main obstacles pediatricians face to participate in the Meaningful Use program. Identify three solutions for increasing pediatrician participation in the meaningful use program across the country.

Keyword(s): Medicaid, Public Health Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Communications and policy associate at PolicyLab at The Children’s Hospital of Philadelphia (CHOP) and a member of the PolicyLab leadership team. I provide strategic policy and planning support for research projects throughout PolicyLab, and oversee all of PolicyLab’s external communications, including a comprehensive redesign of PolicyLab’s web site. I am focused on understanding the larger policy environment and using both traditional media and social media to ensure that PolicyLab research informs program and policy decisions.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.