Research roundup: Electronic health records don't seem to improve diabetes care; Beefing up adult vaccination rates

Each week KHN reporter Christian Torres compiles a selection of recently released health policy studies and briefs.

Annals of Family Medicine: Typical Electronic Health Record Use in Primary Care Practices And The Quality Of Diabetes Care -- Federal officials and health policy experts believe that electronic health records (EHRs) will improve patient care. Researchers measured adherence to diabetes care guidelines as well as patient outcomes over three years at 16 practices using EHRs and 26 practices using paper records. Practices with EHRs did not show signs of better care and providers using them "have not made the necessary changes to both work processes and ways of thinking about care that would lead to improvements in chronic illness management." They conclude: "Ongoing efforts to encourage adoption and meaningful use of EHRs in primary care should focus on ensuring that use succeeds in improving care" (Crosson et al., 5/14).

Urban Institute: The ACA Basic Health Program in Washington State -- This study looks at how a basic health program (BHP) -- a state-run, federally financed program -- in Washington state would function under the health law. These programs allow states the option of using federal funds for some of the people who would otherwise receive subsidies to buy insurance through the state exchanges. The researchers write: "We find that more than 160,000 Washington residents would be eligible for BHP. ... Even with BHP, the exchange in Washington would still cover about 250,000 lives, and BHP would not notably affect premiums in the individual market," and they estimate that Medicaid reimbursements could rise 4-5 percent above current levels (Buettgens and Carroll, 5/10).

Robert Wood Johnson Foundation: Workplace Wellness Programs -- Many employers offer wellness benefits in coordination with their health insurance, and some use incentives -- such as premium discounts, rebates or extra benefits -- to encourage better health. The author of this policy brief notes that "[w]hether rewards for participating in a wellness program are viewed by employees as incentives or penalties may depend on how the program is structured." Because of the health law, employers will be able to raise these wellness incentives beginning in 2014 from 20 to 30 percent of the cost of health benefits. As their programs expand, employers will likely have to address some privacy and discrimination concerns (James, 5/10).

RAND: A Shot In The Arm For Adult Vaccination -- Adults have relatively low rates of vaccination for diseases such as shingles, influenza, HPV and hepatitis A and B, but that could change with the health law along with vaccinations becoming increasingly available outside the doctor's office. This research brief provides several recommendations including the development of better counseling tools for patients. The authors conclude that to make "adult vaccination in office-based settings more routine, stakeholders need to collaborate to integrate advice about vaccination and other efforts to incorporate vaccination into routine office-based care," including incorporating vaccinations into pay-for-performance models of health care, to help create an incentive for doctors (Adamson, 5/16).

Here is a selection of news coverage of other recent research:

MedPage Today: Malpractice Trends: Good News and Bad News 
Results of a new study of medical malpractice claims offer a mix of reassurance and sobering reality.  According to the results, 55.2% of medical malpractice claims that required some defense cost led to litigation. However, of the claims that do go to court, most are ultimately decided in the physician's favor. ... The sobering news is that litigated claims often take months or years to be resolved, according to the study, which was published online May 14 in the Archives of Internal Medicine (Fox, 5/14).

Modern Healthcare: Insurance Exchanges Could Mean Savings For Some, Researcher Says
People who purchase health insurance policies on the individual market may save an average of $280 annually under the healthcare overhaul's coming insurance exchanges, according to projections by a federal researcher. Steven Hill, a senior economist in the Center for Financing, Access and Cost Trends at the Agency for Healthcare Research and Quality, analyzed costs for the 11 million beneficiaries in the individual insurance market in recent years and projected their future costs under the Patient Protection and Affordable Care Act (Daly, 5/16).