UPI Would Greatly Benefit California’s Workers’ Compensation System

While the federal government pushes for widespread interoperability of healthcare information systems and secure health information exchange, its longstanding prohibition of funding unique patient identifier (UPI) implementation seems to contradict this goal. A UPI would effectively provide an index for patients in electronic health records and billing systems across the nation. Boehm & Associates supports implementing a national UPI in order to increase the security of health information exchange while optimizing the efficiency of communications between organizations both in terms of providing care and coordinating compensation.

Currently, organizations tend to rely on names, dates of birth, and Social Security numbers to identify patients, but this methodology leaves significant room for error due to data entry discrepancies and omissions. The Social Security number is the only unique piece of data involved in the matching process. Unfortunately, the Social Security number was not originally intended to be used as a national identifier, and it is not always provided during patient intake or indexed within information systems. A UPI would provide a consistent, dedicated index within the healthcare industry. In the context of California’s workers’ compensation system, this translates to a highly functional bridge between providers, insurance carriers, and the Workers’ Compensation Appeals Board—all organizations that rely primarily on their own internal identifiers at the present. Specific benefits of utilizing a UPI include but are not limited to:

  • Reduced likelihood of insurance carriers returning claims on the basis of being unable to identify the patient in their systems;
  • Increased accuracy when matching patient data to litigated workers’ compensation claims, expediting the initial lien filing process; and
  • Reduced burden on non-provider lien claimants in the process of obtaining substantiating documentation from treating providers.

The House Appropriators’ FY2017 report maintains language that prohibits funding development of a UPI; however, several healthcare and health IT organizations commended the House Appropriators for their “inclusion of report language relating to patient matching” in a letter sent on October 4. The U.S. Department of Health and Human Services (HHS) is permitted to work with the private sector in order to develop a national strategy for handling UPI’s. Thus, it may be beneficial for private sector providers to show their support for this opportunity through solidarity and initiate the process with the explicit aim for unified national adoption.

Boehm & Associates will continue to monitor the progress towards crafting one of the final and most crucial pieces of this interoperability puzzle.