Making an IMPACCT: A Report on the Effect of EHR Tools on Children’s Health Insurance Coverage in Community Health Centers

Making an IMPACCT: A Report on the Effect of EHR Tools on Children’s Health Insurance Coverage in Community Health Centers

By William JA Pinnock & Aleksandra Sumic, OCHIN Research Associate

With the expansion of the Children’s Health Insurance Program (CHIP) and Medicaid under the Affordable Care Act, many previously uninsured children gained new opportunities for health care. But, along with this expansion of coverage, new and unexpected issues arose in the form of coverage gaps, with approximately 28% of children losing their insurance after 12 months. From this, researchers at OCHIN and OHSU Department of Family Medicine asked:  What can we do to avoid these coverage gaps? The answer: IMPACCT Kids Care.

The Innovative Methods for Parents And Clinics to Create Tools (IMPACCT) for Kid’s Care was a three year study funded by the Patient-Centered Outcomes Research Institute (PCORI). The purpose of the study was to investigate how a new suite of electronic health record (EHR)-based tools — a tracking form for insurance coverage, insurance notification pop-ups, and reporting tools — could assist community health centers with keeping children continuously insured. Community health centers were selected because they provide primary care services to many children who are at risk for un-insurance and are well-positioned to help families obtain and retain children’s coverage. In addition, advancements in EHR systems in CHC’s made it possible for these tools to be introduced in settings that would benefit from their assistance.

With IMPACCT coming to an end, the researchers found some hopeful results. Though tool adoption was low among clinics, with approximately 15% of all pediatric patients having the tool used on them, positive effects could be seen. Tool usage was positively associated with pediatric patients receiving the recommended preventive care. Also, it was seen that the use of the IMPACCT tools was positively associated with CHIP and Medicaid patients remaining insured. In addition, usage of the tool had a positive association with uninsured patients being insured at follow up visits. Finally, it was shown that there was a positive association with tool use and uninsured patients returning for a follow up visit.

Although tool adoption was low among clinics, these results offer a glimpse at how a more robust use of these kinds of tools could improve insurance coverage rates and receipt of recommended care. The results warrant further exploration of the association between EHR-based insurance support tools and improved coverage rates and receipt of care in community health centers.