Study shows electronic health information exchanges could cut billions in Medicare spendingSeptember 13, 2017
Spending on entitlement programs like Medicare and Medicaid consumes some two-thirds of all federal spending, but new research from the University of Notre Dame shows that information technology investments in health care lead to significant spending reductions -- potentially in the billions of dollars.
Health Information Exchanges (HIEs), which are typically nonprofit technology companies that make it possible for hospitals and health providers to share medical data, are beginning to show their promised value to the health care system, according to "Reducing Medicare spending through electronic health information exchange: The role of incentives and exchange maturity," forthcoming in Information Systems Research by Idris Adjerid and Corey Angst, IT professors in Notre Dame's Mendoza College of Business, and Julia Adler-Milstein of the University of California San Francisco.
Many HIEs were created because hospitals needed better ways to exchange medical data. Photocopying, mailing and faxing records were inefficient. The research shows that when HIEs appear in regional markets, there are massive cost savings. For that very reason, there is long-standing interest in implementing HIEs nationally.
"We are the first to use nationally representative samples and robust approaches to show that HIEs are having a meaningful effect on health care spending," Adjerid says. "We find significant spending reductions in health care markets that have established operational HIEs, with an average savings of $139 per Medicare beneficiary per year (1.4 percent decrease). This equals a $3.12 billion annual reduction in spending if HIEs were to be implemented nationally in 2015 (the most recent year complete Medicare spending data was available)."
"Not all health care markets see the same amount of reduced spending from HIEs," he says. "We find that spending reductions are greater in health care markets where providers have financial incentives to use an HIE in ways that reduce spending. We also find that more mature HIEs -- those that have been around longer -- are more effective at reducing costs."
The researchers collected annual data from a seven-year period (2003 through 2009) to compare average Medicare spending per beneficiary (adjusted for regional variation in age, race and gender) in health care markets with an operational HIE relative to those without an operational HIE. They analyzed these data using advanced econometric models that accounted for factors such as health care delivery infrastructure, regional hospital quality, health IT adoption, patient demographics and economic factors.
Uncertainty surrounding the value of HIEs has thus far led to lukewarm support for these technologies. By showing that HIEs are, in fact, having a meaningful impact on health care spending, the research should impact the policy and health care debate. "We realize the HIE model is not static -- new vendor-driven models are emerging as market dynamics change. What we show is that the ability to electronically exchange medical data can result in savings in the overall health system, which should encourage new models of exchange," Angst says.
"Our results focusing on the interplay between HIE value and financial incentives in health care are highly relevant to an active debate on how to best design payment models to incentivize high-quality and cost-effective care," Adjerid says. "This research is also important because it highlights the conditions under which HIEs can have the largest impact. Policymakers and health care entities need to ensure that financial incentives align with the goals of HIEs and give them sufficient time to mature before expecting promised value."
University of Notre Dame
Related Health Care Articles:
Pesearchers at Partners HealthCare published a study showing that Partners Pioneer ACO not only reduces spending growth, but does this by reducing avoidable hospitalizations for patients with elevated but modifiable risks.
According to a newly released NEJM Catalyst Insights Report, health care executives and industry insiders expect patients -- more than any other stakeholder -- to be the big losers of any comprehensive health care plan from the Trump administration.
Marking six years since the start of the Syrian conflict (15 March), a study in The Lancet provides new estimates for the number of medical personnel killed: 814 from March 2011 to February 2017.
The January issue of Health Affairs includes a study that explores a much-discussed issue in global health: the role of governance in improving health, which is widely recognized as necessary but is difficult to tie to actual outcomes.
Global lung cancer researchers and patient advocates today emphasized that new models of delivering care and communicating about cancer care play an important role in the fight against lung cancer.
Texas has experienced a roughly 6 percentage-point increase in health insurance coverage from the Affordable Care Act, according to new research by experts at Rice University and the Episcopal Health Foundation.
Training informal health-care providers in India improved the quality of health care they offered to patients in rural regions, a new study reports.
The Affordable Care Act has substantially decreased the number of uninsured Americans and improved access to health care, though insurance affordability and disparities by geography, race/ethnicity, and income persist.
Among adults enrolled in an integrated health care system, receipt of primary care at integrated team-based care practices compared with traditional practice management practices was associated with higher rates of some measures of quality of care, lower rates for some measures of acute care utilization, and lower actual payments received by the delivery system, according to a study appearing in the Aug.
The quality of health care provided to US military veterans in Veterans Affairs (VA) facilities compares favorably with the treatment and services delivered outside the VA.
Related Health Care Reading:
The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care
by T. R. Reid (Author)
A New York Times Bestseller, with an updated explanation of the 2010 Health Reform Bill
Bringing to bear his talent for explaining complex issues in a clear, engaging way, New York Times bestselling author T. R. Reid visits industrialized democracies around the world--France, Britain, Germany, Japan, and beyond--to provide a revelatory tour of successful, affordable universal health care systems. Now updated with new statistics and a plain-English explanation of the 2010 health care reform bill, The Healing of America is required reading for all those... View Details
An American Sickness: How Healthcare Became Big Business and How You Can Take It Back
by Elisabeth Rosenthal (Author)
A New York Times bestseller.
A Washington Post Notable Book of the Year
At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems.
In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place... View Details
Jonas and Kovner's Health Care Delivery in the United States, 11th Edition
by James R. Knickman PhD (Editor), Anthony R. Kovner PhD (Editor)
This fully updated and revised 11th edition of a highly esteemed survey and analysis of health care delivery in the United States keeps pace with the rapid changes that are reshaping our system. Fundamentally, this new edition presents the realities that impact our nation’s achievement of the so-called Triple Aim: better health and better care at a lower cost. It addresses challenges and responses to the Affordable Care Act (ACA), the implementation of Obamacare, and many new models of care designed to replace outmoded systems. Leading scholars, practitioners, and educators within... View Details
Essentials of the U.S. Health Care System
by Leiyu Shi (Author), Douglas A. Singh (Author)
Essentials of the U.S. Health Care System, Fourth Edition is a clear and concise distillation of the major topics covered in the best-selling Delivering Health Care in America by the same authors. Designed for undergraduate and graduate students in programs across the health disciplines, Essentials of the U.S. Health Care System is a reader-friendly, well organized resource that covers the major characteristics, foundations, and future of the U.S. health care system. The text clarifies the complexities of health care organization and finance and presents a solid overview of how the various... View Details
Policy & Politics in Nursing and Health Care, 7e (Policy and Politics in Nursing and Health)
by Diana J. Mason RN PhD FAAN (Author), Deborah B Gardner RN PhD FAAN FNAP (Author), Freida Hopkins Outlaw PhD RN FAAN (Author), Eileen T. O'Grady (Author)
Featuring analysis of cutting-edge healthcare issues and first-person stories, Policy & Politics in Nursing and Health Care, 7th Edition is the leader in helping students develop skills in influencing policy in today’s changing health care environment. Approximately 150 expert contributors present a wide range of topics in this classic text, providing a more complete background than can be found in any other policy textbook on the market. Discussions include the latest updates on conflict management, health economics, lobbying, the use of media, and working with communities for... View Details
Maternity and Women's Health Care, 11e (Maternity & Women's Health Care)
by Deitra Leonard Lowdermilk RNC PhD FAAN (Author), Shannon E. Perry RN PhD FAAN (Author), Mary Catherine Cashion RN BC MSN (Author), Kathryn Rhodes Alden EdD MSN RN IBCLC (Author)
The #1 maternity book in the market is getting even better. Maternity and Women's Health Care, 11th Edition provides evidence-based coverage of everything you need to know about caring for women of childbearing age. Not only does this text emphasize childbearing concerns like newborn care, it also addresses wellness promotion and management of women's health problems. In describing the continuum of care, it integrates the importance of understanding family, culture, and community-based care. Boasting new medication alerts and updated content throughout, this edition covers the new... View Details
The American Health Care Paradox: Why Spending More is Getting Us Less
by Elizabeth H. Bradley (Author), Lauren A. Taylor (Author), Harvey V. Fineberg (Foreword)
Foreword by Harvey V. Fineberg, President of the Institute of Medicine
For decades, experts have puzzled over why the US spends more on health care but suffers poorer outcomes than other industrialized nations. Now Elizabeth H. Bradley and Lauren A. Taylor marshal extensive research, including a comparative study of health care data from thirty countries, and get to the root of this paradox: We've left out of our tally the most impactful expenditures countries make to improve the health of their populationsinvestments in social services.
In The American Health Care... View Details
Sultz & Young's Health Care USA: Understanding Its Organization and Delivery
by Kristina M. Young (Author), Philip J. Kroth (Author)
Health Care USA, Ninth Edition offers students of health administration, public health, medicine, and related fields a wide-ranging overview of America's health care system.
Combining historical perspective with analysis of current trends, including the implementation of the Affordable Care Act (ACA) and the Medicare Access & CHIP Reauthorization Act (MACRA), this thoroughly updated edition charts the evolution of modern American health care, providing a complete examination of its organization and delivery while offering critical insight into the issues that the U.S. health system... View Details
Global Health Care: Issues and Policies
by Carol Holtz (Author)
Global Health Care: Issues and Policies, Third Edition provides students with current information on various global health topics. Written by academic authors, scientists and health practitioners, the text prepares students with a basic perspective of health policy issues from various geographical regions, and explains how they are affected by significant world events. The text addresses international health and healthcare at both the undergraduate and graduate levels.
New to the Third Edition
Updated content reflecting trends and issues
New content on sex trafficking, social... View Details
Public Health Nursing: Population-Centered Health Care in the Community, 9e
by Marcia Stanhope RN DSN FAAN (Author), Jeanette Lancaster RN PhD FAAN (Author)
Prepare for a successful career as a community/public health nurse! Public Health Nursing: Population-Centered Health Care in the Community, 9th Edition provides up-to-date information on issues that impact public health nursing, such as infectious diseases, natural and man-made disasters, and health care policies affecting individuals, families, and communities. Real-life scenarios show examples of health promotion and public health interventions. New to this edition is an emphasis on QSEN skills and an explanation of the influence of the Affordable Care Act on public... View Details