Close Close
Popular Financial Topics Discover relevant content from across the suite of ALM legal publications From the Industry More content from ThinkAdvisor and select sponsors Investment Advisor Issue Gallery Read digital editions of Investment Advisor Magazine Tax Facts Get clear, current, and reliable answers to pressing tax questions
Luminaries Awards

Life Health > Health Insurance > Health Insurance

The Catch: More Efficient, Huh?

Your article was successfully shared with the contacts you provided.
Electronic health record (EHR) systems argue that making more effective use of health information technology will do for health care what airline reservation systems have done for the airlines.

Good, widely used EHR systems should reduce administrative costs, help physicians and hospitals do a better job of coordinating care, and reduce the likelihood that providers will duplicate tests patients have already had.

Some naysayers have argued that EHR systems might not be all they’re cracked up to be, pointing out that many EHR promoters, such as large consulting firms, have a financial incentive to hype EHR technology; that many countries with far more efficient health care systems are just starting to use EHR technology; and that converting existing paper patient files into electronic form will be expensive and time-consuming.

Now Danny McCormick, a medical professor at Harvard University, and three colleagues are raising another point: EHR systems might not actually do much to discourage physicians’ tendency to order duplicative tests.

McCormick and his colleages have published a paper on that topic in the latest issue of Health Affairs, a health finance and delivery journal.

The researchers tested the idea that health information technology access could reduce ordering of duplicate tests by analyzing records of 28,741 2008 patient visits to 1,187 office-based physicians.

The researchers also looked at whether physicians had had electronic access to test results.

The researchers found that doctors with electronic test record access were 40% to 70% more likely to order additional blood tests than other physicians were.

“The availability of an electronic health record in itself had no apparent impact on ordering; the electronic access to test results appears to have been the key,” the researchers say in a study abstract. “These findings raise the possibility that, as currently implemented, electronic access does not decrease test ordering in the office setting and may even increase it, possibly because of system features that are enticements to ordering.”


Some employers and health plans have been trying to hold down health care prices in the past few years by returning to plans featuring fewer providers.

Plans are hoping they can negotiate better rates for better quality care by funneling more patients to a relatively small number of highly efficient doctors and hospitals.

Health Net of California Inc., a unit of Health Net Inc., Woodland Hills, Calif. (NYSE:HNT), announced today that is introducing the SmartCare network, a Southern California “tailored network” that will feature complentary care providers, such as chiropractors and acupuncture providers, as well as conventional providers.

Using a plan based on the tailored network will be about 25% cheaper than using a plan based on Health Net’s full health maintenance organization network in the market, Health Net says.

Meanwhile, in the Midwest, Medica, Minneapolis, a carrier, and Fairview Health Services, a provider network, are joining to offer employers in the Minneapolis area access to a defined-contribution accountable care organization (ACO) program.

That program will feature a really narrow network along with primary care providers who will take charge of managing patients’ care.

Enrollee cost for the ACO program may be about 50% lower than the enrollee cost for conventional coverage, Medica says.

The program will provide access to a network of about 2,000 doctors and 350 clinics in the Minneapolis area.


Independence Holding Company (IHC), Stamford, Conn. (NYSE:IHC), is reporting $3.5 million in net income for the fourth quarter of 2011 on $104 million in revenue, compared with a $130,000 net loss on $105 million in revenue for the fourth quarter of 2011.

IHC, a company that sells stop-less program to group health plan sponsors as well as ordinary health coverage, says it is now taking all risk on stop-loss business and is recording higher-than-expected stop-loss sales. The fully insured business also has been more profitable, the company says.


© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.