Why the ACA is Making Accurate Patient Identification Mission Critical

The ACA as a Reality

Whether you support or oppose the Affordable Care Act (ACA) – the 2010 law that was designed to:

— increase the quality and affordability of health insurance

— lower the uninsured rate by expanding public and private insurance coverage

— reduce the costs of healthcare for individuals and the government

the fact of the matter is, the law is not going anywhere. The latest statistics show that approximately 4.2 million people have enrolled in health plans as a result of the ACA, foreshadowing the inevitability that patient visit volume is bound to spike especially when you factor new patients from the ACA along with the looming retirement of baby boomers.

How the ACA Impacts Patient Identification

As the number of visits increases, the potential risk of creating a duplicate medical record and or/overlay also dramatically rises. Not to mention the fact that increases in eligibility for new patients entering the healthcare rolls also means that we could potentially see a precipitous rise in medical identity theft and healthcare fraud, already an egregious problem in the industry evidenced by the most recent Ponemon Institute Report that indicated medical identity theft cases increased by 19% in the last year.

The urgency to adopt and implement salient patient identification systems that provide 100% accuracy and help link a patient to a unique electronic medical record that properly attributes clinical information, especially across Enterprise Master Patient Indexes (EMPIs) where patients may be identified in different locations, is palpable.

The ACA, Data Integrity & Interoperability

As the healthcare industry becomes uber focused on establishing stricter data integrity policies in light of the increased interconnected ecosystem that directly promotes sharing patient data across disparate systems through the use of Health Information Exchanges (HIEs) and Integrated Delivery Networks (IDNs), the advent of the ACA places even more pressure on facilities to implement patient identification technologies that eliminate duplicate medical records and other disparities that can negatively effect patient data integrity. Accurate patient identification is the cornerstone of data integrity and must be addressed if any facility has realistic hopes of joining HIEs with a clean conscience that their EHR systems contain exact information and are equipped with modern technology tools to ensure continued integrity.

Several patient identification technologies can play a key role in helping to ensure the transfer of clean patient data by preventing the creation of duplicate medical records and overlays and eliminating the possibility of fraud and medical identity theft at the point of service, especially as the volume of patients exponentially increases from passage of the ACA and aging baby boomers. The key for healthcare providers is choosing a technology that has been tested and certified by accredited and recognized third parties and offers the ability to store a patient’s identity template in a standardized format so information can easily and cleanly be exchanged with other systems.

As the ACA works out it’s kinks, and more people successfully enroll, the need to solidify modern tools that ensure 100% accurate patient identification becomes mission critical.

What are some other potential problems that you think the ACA will cause for patient identification in healthcare? Please share them with us in the comments!