EHRs can 'significantly' increase reimbursement over time

Electronic health records can increase reimbursement without upcoding, according to a study published recently in the Journal of the American Medical Informatics Association (JAMIA).

The researchers, from Drexel University and its College of Medicine, tracked patient activity and reimbursement of 30 ambulatory practices for two years after the practices implemented EHRs. They found that the practices' reimbursement "significantly" increased even though the number of patient visits decreased over the two years. They also found no evidence of upcoding; instead the increases were due to an uptick in ancillary services, such as wound care, ultrasounds, immunizations and drawing blood.  

"The bottom line result--that EHR implementation is associated with increased revenues--is reassuring and offers a basis for further EHR investment," the researchers noted. "While the productivity losses are consistent with field reports, they also reflect a type of efficiency--the practices are receiving more reimbursement for fewer seeing patients."

The authors added that for the practices still seeing fewer patients after two years, the likely solution would be advancing their EHR functionality to include analytics. "Although they may still see fewer patients, with EHR analytics, they can focus on seeing the right patients," the authors said.

The study did not address the correlation between the EHRs and the rise in ancillary services. However, it can be inferred that EHRs' clinical decision support tools, such as checklists and alerts, were reminding physicians not to overlook services the patient may need, such as immunizations or periodic lab tests requiring blood draws.

Other studies have suggested that while EHR adoption initially impedes productivity and reduces the number of patients treated, over time physicians adjust and get used to them.

To learn more:
- read the abstract