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  • Title: Using the electronic health record for assessment of health insurance in community health centers.
    Author: Hatch B, Tillotson C, Angier H, Marino M, Hoopes M, Huguet N, DeVoe J.
    Journal: J Am Med Inform Assoc; 2016 Sep; 23(5):984-90. PubMed ID: 26911812.
    Abstract:
    OBJECTIVE: To demonstrate use of the electronic health record (EHR) for health insurance surveillance and identify factors associated with lack of coverage. MATERIALS AND METHODS: Using EHR data, we conducted a retrospective, longitudinal cohort study of adult patients (n = 279 654) within a national network of community health centers during a 2-year period (2012-2013). RESULTS: Factors associated with higher odds of being uninsured (vs Medicaid-insured) included: male gender, age >25 years, Hispanic ethnicity, income above the federal poverty level, and rural residence (P < .01 for all). Among patients with no insurance at their initial visit (n = 114 000), 50% remained uninsured for every subsequent visit. DISCUSSION: During the 2 years prior to 2014, many patients utilizing community health centers were unable to maintain stable health insurance coverage. CONCLUSION: As patients gain access to health insurance under the Affordable Care Act, the EHR provides a novel approach to help track coverage and support vulnerable patients in gaining and maintaining coverage.
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