Study: CHCs' EHR data may be more concise than Medicaid claims data
Networked EHRs provide new opportunities for obtaining more comprehensive data on health services received, especially among populations that are not continuously insured, according to research published in the July edition of Annals of Family Medicine.
“Relying solely on Medicaid claims data is likely to substantially underestimate the quality of care,” wrote Jennifer E. DeVoe, MD, from the department of family medicine at Oregon Health And Science University in Portland, and colleagues.
The researchers aimed to create individual-level linkages between EHR data from a network of community health centers (CHCs) and Medicaid claims from 2005 through 2007 to examine congruence between these data sources and to identify sociodemographic characteristics associated with documentation of services in one data set versus the other.
DeVoe and colleagues studied receipt of preventive services among all established diabetic patients in 50 Oregon CHCs who had ever been enrolled in Medicaid (N = 2,103). “We determined which services were documented in EHR data versus in Medicaid claims data and we described the sociodemographic characteristics associated with these documentation patterns,” they wrote.
In 2007, the following services were documented in Medicaid claims but not in the EHR:
“In contrast, the following services were documented in the EHR 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 glycated hemoglobin tests,” the authors found. “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.
“This finding suggests that assessing performance in CHCs based on Medicaid claims alone would be inaccurate, especially in certain subpopulations,” the authors stated.
EHR data from CHC networks provide a new resource for policy makers to better understand health services delivery in CHC populations, the researchers claimed. “Policymakers and payors need to look beyond Medicaid claims data to measure population health and CHC quality performance. EHR databases will be key to the study of how health reform policies implemented under the Patient Protection and Affordable Care Act of 2010 affect the uninsured and underinsured," they wrote.
"Information from EHR data will be more accurate than administrative claims data; thus, it is imperative to further develop and validate important EHR data resources and to evaluate the extent to which EHR data can be used to supplement (or substitute for) claims data. Our results also show the potential usefulness of combining EHR and claims data sources for use in comparative effectiveness and translational research.”
“Relying solely on Medicaid claims data is likely to substantially underestimate the quality of care,” wrote Jennifer E. DeVoe, MD, from the department of family medicine at Oregon Health And Science University in Portland, and colleagues.
The researchers aimed to create individual-level linkages between EHR data from a network of community health centers (CHCs) and Medicaid claims from 2005 through 2007 to examine congruence between these data sources and to identify sociodemographic characteristics associated with documentation of services in one data set versus the other.
DeVoe and colleagues studied receipt of preventive services among all established diabetic patients in 50 Oregon CHCs who had ever been enrolled in Medicaid (N = 2,103). “We determined which services were documented in EHR data versus in Medicaid claims data and we described the sociodemographic characteristics associated with these documentation patterns,” they wrote.
In 2007, the following services were documented in Medicaid claims but not in the EHR:
- 11.6 percent of total cholesterol screenings received;
- 7 percent of total influenza vaccinations;
- 10.5 percent of nephropathy screenings; and
- 8.8 percent of tests for glycated hemoglobin.
“In contrast, the following services were documented in the EHR 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 glycated hemoglobin tests,” the authors found. “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.
“This finding suggests that assessing performance in CHCs based on Medicaid claims alone would be inaccurate, especially in certain subpopulations,” the authors stated.
EHR data from CHC networks provide a new resource for policy makers to better understand health services delivery in CHC populations, the researchers claimed. “Policymakers and payors need to look beyond Medicaid claims data to measure population health and CHC quality performance. EHR databases will be key to the study of how health reform policies implemented under the Patient Protection and Affordable Care Act of 2010 affect the uninsured and underinsured," they wrote.
"Information from EHR data will be more accurate than administrative claims data; thus, it is imperative to further develop and validate important EHR data resources and to evaluate the extent to which EHR data can be used to supplement (or substitute for) claims data. Our results also show the potential usefulness of combining EHR and claims data sources for use in comparative effectiveness and translational research.”