EMRs trump Medicaid for wealth of detailed data

As more states begin launching Medicaid electronic health record (EHR) Meaningful Use incentive programs, healthcare organizations using those EHRs may find that they can start obtaining a more comprehensive picture related to patient quality of care--rather than just by relying on Medicaid claims data alone, according to a new study published in the Annals of Family Medicine.

Last week, the Centers for Medicare and Medicaid Services (CMS) announced that four states--Arizona, Connecticut, Rhode Island, and West Virginia--have joined 17 other states in going live this year with their Medicaid EHR incentive programs. Most states are expected to roll out their Medicaid MU programs by this summer or fall.

When researchers in Oregon studied receipt of preventive services among more than 2,100 diabetic patients in 50 state community health centers who had been Medicaid enrollees, they reported in their Annals article numerous differences in the amount and types of data they were able to collect when it came to EHR data.

In particular, they noticed that the following services were documented in the patients' EHRs but not in Medicaid claims: 49.3 percent of cholesterol screenings; 50.4 percent of influenza vaccinations; 50.1 percent of nephropathy screenings; and 48.4 percent of hemoglobin A1c tests. Patients who were older, male, Spanish-speaking, above the federal poverty level, or who had discontinuous insurance were more likely to have services documented in the EHR--but not in the Medicaid claims data.

Also, networked EHRs from the health centers may provide new opportunities for obtaining more comprehensive data on health services received--especially in those discontinuously insured populations, the researchers said. They added that the EHR databases can be linked and compared with claims databases--such as Medicaid--and may prove to contain more "robust data" for the measurement of primary and preventive care services utilization in vulnerable populations.

For more details:
- see the Annals of Family Medicine article
- view the list of states participating in the Medicaid EHR incentive program
- see CMIO article on the Medicaid MU incentive program