EHRs can help improve health insurance coverage rates

Capturing health insurance data in electronic health records and improving the synergy of that data between EHRs and health information exchanges (HIEs) could help improve patients' heath insurance coverage rates and reduce coverage lapses, researchers say.

While providers traditionally are not involved in providing insurance enrollment and reenrollment support to patients, according to a new commentary published in eGEMS (Generating Evidence & Methods to Improve Patient Outcomes), EHRs can help providers take on this role and reduce or prevent health insurance gaps. The commentary, written by researchers from Oregon Community Health Information Network, Kaiser Permanente Center for Health Research and elsewhere, used as an example a research project they currently are conducting with eight community health centers with a high Medicaid patient population. Using observation and interviews with staff, they identified several ways that EHRs could enhance the capture of health insurance data, such as insurance application status, and send alerts when a patient's insurance is about to expire.

Improving health insurance coverage rates and retention of insurance would improve patient health and outcomes because there would be fewer unmet medical needs. It also would stabilize providers' revenue streams and support the provision of evidence based care, particularly important for providers in newer payment models which stress value-based programs, such as accountable care organizations.

The research team will now assess the feasibility of implementing these strategies.

"The convergence of increasing EHR adoption, improving HIE functionality and expansions in health insurance coverage options creates new opportunities for clinics to help patients obtain and maintain public health insurance," the authors said. "This emergent ability to exchange health information between payers and providers must be harnessed to improve synergies between HIE and EHRs, in support of keeping patients continuously insured."

At least one other recent study has suggested that EHRs be capitalized to validate a patient's health insurance coverage so that patients can track and maintain insurance benefits. Improved patient care is one of the cornerstones of EHR adoption and the Meaningful Use program.

To learn more:
- read the commentary (.pdf)