Critical Access, Small Hospitals Lagging In Meaningful Use

Posted on August 14, 2013 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or

Many critical access hospitals and other smaller hospitals are falling behind on Meaningful Use and may be at risk for being slapped with Medicare reimbursement penalties in 2015, according to a study reported in Health Data Management.

The study, which appeared in the journal Health Affairs, was conducted by Mathematica Policy Research and the American Hospital Association.  Its bottom line conclusion was that smaller and rural hospitals were less likely than other hospitals to have met Stage 1 criteria, and that very few had all of the IT systems in place needed to reach Stage 2, HDM reports.

The researchers noted that between 2011 and 2012, the percentage of hospitals with at least 200 beds getting Meaningful Use almost doubled, but that those with less than 100 beds had a lower rate of Meaningful Use compliance. Meanwhile, the proportion of critical access hospitals that received a Meaningful Use payment in 2012 fell slightly from the previous year.

The study also concluded that teaching hospitals had a higher rate of Meaningful Use compliance than non-teaching hospitals, and that a small percentage of government-owned and non-profit hospitals received MU incentive payments compared with for-profit facilities.

According to Health Data Management, the study isolated three challenges faced by critical access and smaller hospitals:

* Low patient volume complicates long-range planning and limits ability to maintain adequate cash flow,

* The hospitals may not be able to offer competitive salaries for skilled information technology professionals, and

* Smaller hospitals may have difficulty finding a suitable I.T. vendor.

It’s not lost on the ONC that these hospitals face significant disadvantages in getting their Meaningful Use program rolling. About a year ago, the agency rolled out a campaign intended to get 1,000 critical access and small rural hospitals meaningfully using certified EMR technology by the end of 2014. To get things rolling, ONC is spending up to $30 million for Regional Extension Centers targeting these facilities.

But as I see it, funding more REC activity is far from enough. The plain fact is that mounting a Meaningful Use program is time consuming and expensive, so much so that some smaller hospitals simply make it happen without help. Maybe the time has come for the feds to offer grants outright to hospitals struggling with these challenges.