Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data?

Objective To validate electronic health record (EHR) insurance information for low-income pediatric patients at Oregon community health centers (CHCs), compared to reimbursement data and Medicaid coverage data.Materials and Methods Subjects Children visiting any of 96 CHCs (N = 69 189) from 2011 to 2012. Analysis The authors measured correspondence (whether or not the visit was covered by Medicaid) between EHR coverage data and (i) reimbursement data and (ii) coverage data from Medicaid.Results Compared to reimbursement data and Medicaid coverage data, EHR coverage data had high agreement (87% and 95%, respectively), sensitivity (0.97 and 0.96), positive predictive value (0.88 and 0.98), but lower kappa statistics (0.32 and 0.49), specificity (0.27 and 0.60), and negative predictive value (0.66 and 0.45). These varied among clinics.Discussion/Conclusions EHR coverage data for children had a high overall correspondence with Medicaid data and reimbursement data, suggesting that in some systems EHR data could be utilized to promote insurance stability in their patients. Future work should attempt to replicate these analyses in other settings.     

Why "culturally safe" health care?

People need to feel like themselves and believe that the health care is connected to their lives.     

Why not publish in theIrish Journal of Medical Science?

IJMS

Why not publish in theIrish Journal of Medical Science?     

Global directions for reforming health systems and expanding insurance. What is suitable for the Arab Gulf countries?

Most countries are exploring and implementing reforms of their health care systems. The Arab countries in the Gulf are no exception after establishing modern governmental health care systems accessible to all and free of charge. Current problems of the Arab systems include financial, managerial and quality issues. The private sector in these countries has no defined national role and is gowing abruptly and unplanned. The paper presents the major global health reform directions, analyzing the current activities in the Arab Gulf countries and proposing certain practical relevant approaches for health reform, and expansion of insurance in these activites.     

Risks associated with genetic testing: health insurance discrimination or simply business as usual?

Doctors can test patients for mutations that put them at high risk for hereditary forms of such diseases as breast and ovarian cancer. Even though the opportunities for disease prevention using genetic testing will increase with time, the risks of testing, which include insurance loss and employment discrimination, currently make testing problematic. Some have proposed making use of genetic information in health insurance underwriting illegal. But in the current system of risk-based underwriting, it is hard to imagine that insurance companies will willingly forego access to a growing body of information on risk. If the American public chooses to limit the use of genetic information, a reassessment of current laws or methods of paying for health care will be needed.     

Is There a Place for Integrated Medicine in the Western World ? Why not ?

ＴｈｅｔｉｔｌｅｏｆｍｙｐａｐｅｒｑｕｅｓｔｉｏｎｓｗｈｅｔｈｅｒｔｈｅｒｅｉｓｒｏｏｍａｖａｉｌａｂｌｅｉｎｔｈｅｗｅｓｔｅｒｎｗｏｒｌｄｆｏｒａｃｏｍｂｉｎａｔｉｏｎｏｆｔｒａｄｉｔｉｏｎａｌＣｈｉｎｅｓｅｍｅｄｉｃｉｎｅ（ＣＭ）ａｎｄｗｅｓｔｅｒｎｏｒ ｔｈｏｄｏｘｍｅｄｉｃｉｎｅ（ＷＭ）ｔｏｂｅｃｏｍｅａｎｉｎｔｅｇｒａｔｅｄｗｈｏｌｅｏｒａｔｌｅａｓｔ，ｗｈｅｔｈｅｒｔｈｅｔｗｏｍｅｄｉｃｉｎｅｓｃａｎｗｏｒｋｐｅａｃｅｆｕｌｌｙｈａｎｄ ｉｎ ｈａｎｄａｌｏｎｇｔｈｅｃｌｉｎｉｃａｌａ…     

Why do we not yet have combination chemotherapy for chronic hepatitis B?

Despite the emergence of multidrug-resistant strains of hepatitis B virus (HBV) and previous success with combination therapy for other chronic viral infections, we are still using sequential monotherapy for chronic HBV infection. Antiviral-resistant HBV can result in major life-threatening complications. We now have complementary drugs, such as lamivudine and adefovir dipivoxil, with fundamentally different structures and associated with different signature resistance mutations, with adefovir dipivoxil showing antiviral activity against most lamivudine-resistant strains. Studies of combination therapy to date have used traditional endpoints--short-term reduction of HBV DNA levels and HBeAg seroconversion--rather than evolution of resistance. There is now an emerging body of data suggesting that combination therapy can decrease antiviral resistance in HBV infection, the endpoint likely to be of greatest long-term importance, and, rather than adding or replacing an antiviral agent after resistance develops, it is likely to be more effective in treatment-naive patients.