EHRs Could Improve Insurance Utilization and Outcomes

Electronic health records (EHRs) have the potential to improve health insurance utilization and care continuity among low-income individuals, a new study suggests.

The Affordable Care Act, required—and in some cases subsidized—health insurance for certain segments of Americans. One of the benefits of the law is that low-income individuals, depending on where they live, now have a way to obtain care for the first time.

Since expansion of EHRs has come at a time when many new patients are entering the system, a group of researchers hypothesized that EHR data could be an excellent tool for monitoring healthcare utilization.

To test their theory, researchers from Oregon Health and Science University looked at three data sets, including EHR coverage data, reimbursement data, and Medicaid coverage data. These data sets included data from 69,189 pediatric patients receiving care throughout 96 Oregon safety net clinics in the Oregon Community Health Information Network. They found that there was a high level of “agreement” between the reimbursement and Medicaid data sets, and that in some cases the EHR data was more accurate. This means that the methods used in the study can be employed in the future as a feasible method for measuring the agreement of insurance information that could be adapted to other settings and, if replicated, could support insurance continuity for large numbers of Americans.

“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,” researchers wrote in the Journal of the American Medical Informatics Association. “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.”

Click here to read the full study.

Mary Butler is the associate editor at The Journal of AHIMA.

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