Alternative Payment Models and Hospital Engagement in Health Information Exchange

Authors

Sunny C. Lin, Portland State UniversityFollow
John M. Hollingsworth, University of Michigan Medical School and School of Public Health
Julia Adler-Milstein, University of California, San FranciscoFollow

Sponsor

This study was supported in by the Agency for Healthcare Research and Quality Grants 1R01HS024525 01A1 and 1R01HS024728 01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.

Published In

The American Journal of Managed Care

Document Type

Post-Print

Publication Date

2019

Subjects

Health care delivery, Health services administration

Abstract

Objectives:

To assess whether hospital participation in alternative payment models (APMs) is associated with greater engagement in health information exchange (HIE) along 4 dimensions: volume of patients for whom information is exchanged, diversity of information types, breadth of partner types, and depth of technical approach.

Study Design:

Pooled, cross-sectional analysis of data on US hospitals from 2014–2015.

Methods:

APM participation came from Leavitt Partners data, Medicare public use files, and the American Hospital Association (AHA) Annual Survey. We used Medicare data to measure HIE volume for 798 hospitals attesting to stage 2 Meaningful Use and the AHA Information Technology Supplement to measure HIE diversity, breadth, and depth for 1730 hospitals. We used mixed-effects regression to estimate the association between participation in APMs and each dimension of HIE.

Results:

Compared with nonparticipating hospitals, full-year APM participation was associated with lower HIE volume (data were sent for 11 percentage points fewer discharges; P = .003), greater HIE diversity (of 4 data types, 0.3 more were transmitted; PPP = .004).

Conclusions:

Our finding that APM participation was associated with greater HIE diversity, breadth, and depth suggests that value-based payment may be spurring improvements in HIE infrastructure. However, our finding that APM participation is associated with lower HIE volume suggests that there may be an incentive to focus HIE investments on a limited number of partners.

Description

This is the author's manuscript: Published in final edited form as: Am J Manag Care. 2019 Jan 1; 25(1): e1–e6. Published online 2019 Jan 1.

Locate the Document

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6526138/

Persistent Identifier

https://archives.pdx.edu/ds/psu/32408

Citation Details

Lin, S. C., Hollingsworth, J. M., & Adler-Milstein, J. (2019). Alternative Payment Models and Hospital Engagement in Health Information Exchange. The American journal of managed care, 25(1), e1.