While rural providers have adopted health IT at the same time or at greater rates as their urban counterparts, meaningful use varies dramatically among them, according to a recent HealthAffairs study.

About 97.2 percent of rural hospitals with fewer than 100 beds initially achieved meaningful use; a rate consistent with larger hospitals with more than  400 beds, at about 97.4 percent. Critical access hospitals had slightly lower meaningful use achievement rates at about 92 percent.

However, many rural providers failed to continue achieving meaningful use after the initial year, which leads to a greater financial disadvantage.

"This study demonstrates that although rural providers’ overall initial health IT adoption rates were higher than those of urban providers, substantial adoption disparities exist within the rural community," the study's author and public health analyst for the ONC, Dawn M. Heisey-Grove said.

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"Rural providers and hospitals," she added, "were more likely to skip subsequent years of meaningful-use achievement and may require additional assistance to support their ongoing use of health IT and sustain delivery and payment reform efforts.”

For example, 91 percent of rural podiatrists and about 88 percent of rural optometrists achieved meaningful use, compared to only 9.5 percent of rural dentists.

Furthermore, 38 percent of rural providers skipped at least one year after initial meaningful use achievement, compared to 34 percent of urban counterparts. Critical access hospitals and small rural hospitals had the highest rates of skipping at least one year, with about 16 percent and 13 percent, respectively.

Patient engagement may also continue to be a barrier, as many rural providers lack consistent access to a mature broadband.

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Receipt of technical assistance from a Regional Extension Center increased the rate of meaningful use achievement among rural providers. Nearly 60 percent of providers that received technical assistance achieved meaningful use, compared with only about 23 percent of providers who hadn't received help.

The study is based on a 2013 National Electronic Health Records Survey conducted by the National Center for Health Statistics. Adoption rates were determined by the use of an EHR system within the practice based on 2014 Medicare attestation data.

Meaningful use achievement was garnered by attestation or payment from the incentive programs from 2011 to 2014, analyzing data from 548,961 hospitals and providers.

Twitter: @JessiefDavis