A study in the Journal of the American Medical Informatics Association examined the rates of agreements of insurance information — whether the patient had Medicaid coverage at the time of the visit — contained in the EHR with Medicaid and reimbursement data. Researchers analyzed approximately 288,000 encounters by approximately 70,000 children between 2011 and 2012 reported in the Oregon Community Health Information Network EHR and compared it to claims data and Medicaid coverage data from Oregon Medicaid program’s dataset.
Researchers found EHRs had high levels of agreement with both claims data and Medicaid data in identifying which patients had Medicaid coverage at the time of the visit. EHR data matched 87 percent of reimbursement data and 95 percent of Medicaid coverage data.
Researchers suggest clinics can use EHR data to inform staff, patients and caregivers about health insurance coverage and the need to reenroll in plans or research new coverage options.
“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. “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.”
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