study-using-family-practice-ehrs-to-improve-insurance-stability

Study: Using Family Practice EHRs to Improve Insurance Stability

Most of the time on this blog, we focus on how electronic health records or electronic medical records affect physicians (especially primary care physicians). And, although one 2014 survey of the American College of Physicians member sample found that family practice physicians were spending 48 minutes per day on electronic records, the effects of family practice EHR software are generally very positive. Electronic records improve efficiency by a tidy 6% per year, and federal incentives have made getting started with EHRs a smart financial move. As of 2013 — getting newer data is difficult — 69% of physicians reported that they had already applied or intended to apply for the Medicare and Medicaid EHR Incentive Programs.

But now a new study is looking at how family practice EHRs affect patients — or more specifically, their insurance coverage.


Study Details

Health insurance is closely related to overall health, but it’s sometimes difficult for patients to keep track of their information. Or in other cases, patients are unaware of the choices that they have regarding coverage. Researchers from Oregon Health and Science University wanted to know if the information recorded in EHRs could enable primary care physicians to validate insurance coverage and then help patients to enroll in or retain their health insurance to provide them with more stable care.

In order to test whether EHR data could be accurately used for this purpose, the researchers compared three separate data sets for the same 69,189 pediatric patients, all of whom were being treated in 96 different clinics included in the Oregon Community Health Information Network. Those three data sets were EHR coverage data, reimbursement data and Medicaid coverage data.

Study Findings

The EHR data set was found to be highly accurate for the purposes of insurance coverage, the researchers found. EHR coverage information had a “high” agreement level with the reimbursement and Medicaid data, and in some cases was even more accurate than the latter two data sets. “Given that insurance significantly predicts healthcare utilization and outcomes, assistance with coverage enrollment and retention could be a potentially crucial service for clinics to provide and could be facilitated by data and tools from the EHR,” the study concludes. “Building tracking systems to improve insurance coverage is arguably as (or more) important to patients’ health as systems to improve blood pressure and lipid levels. Our study presents validation for using the EHR as a source of health insurance information, and suggests that confidence in this information is possible.”

The full study has been published online under the title “Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data?”

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