title: Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults.
abstract: To compare the agreement of electronic health record (EHR) data versus Medicaid claims data in documenting adult preventive care. Insurance claims are commonly used to measure care quality. EHR data could serve this purpose, but little information exists about how this source compares in service documentation. For 13 101 Medicaid-insured adult patients attending 43 Oregon community health centers, we compared documentation of 11 preventive services, based on EHR versus Medicaid claims data. Documentation was comparable for most services. Agreement was highest for influenza vaccination (κ =  0.77; 95% CI 0.75 to 0.79), cholesterol screening (κ = 0.80; 95% CI 0.79 to 0.81), and cervical cancer screening (κ = 0.71; 95% CI 0.70 to 0.73), and lowest on services commonly referred out of primary care clinics and those that usually do not generate claims. EHRs show promise for use in quality reporting. Strategies to maximize data capture in EHRs are needed to optimize the use of EHR data for service documentation.
authors: Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA.
authors: John
authors: J
authors: Heintzman
authors: Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA.
authors: Steffani R
authors: SR
authors: Bailey
authors: OCHIN, Inc, Portland, Oregon, USA.
authors: Megan J
authors: MJ
authors: Hoopes
authors: OCHIN, Inc, Portland, Oregon, USA.
authors: Thuy
authors: T
authors: Le
authors: OCHIN, Inc, Portland, Oregon, USA Kaiser Permanente Northwest Center for Health Research, Portland, Oregon, USA.
authors: Rachel
authors: R
authors: Gold
authors: Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, Oregon, USA.
authors: Jean P
authors: JP
authors: O'Malley
authors: OCHIN, Inc, Portland, Oregon, USA.
authors: Stuart
authors: S
authors: Cowburn
authors: Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, Oregon, USA.
authors: Miguel
authors: M
authors: Marino
authors: Department of Family Medicine and Community Health, Virginia Commonwealth University, Richmond, Virginia, USA.
authors: Alex
authors: A
authors: Krist
authors: Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA OCHIN, Inc, Portland, Oregon, USA.
authors: Jennifer E
authors: JE
authors: DeVoe
mesh_terms: D000328:Adult; D057286:Electronic Health Records; D006801:Humans; D007345:Insurance Claim Review; D008484:Medicaid / Q000706:statistics & numerical data; D014481:United States
keywords: Claims Data; Electronic Health Records; Medical Care Delivery; Preventive Services; Quality of Care