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. 2025 Feb;50(1):56-62.
doi: 10.1007/s10900-024-01391-0. Epub 2024 Aug 26.

Digital Reimbursement Systems in a Student-Run Clinic

Parsa Nilchian  1 , Subhanik Purkayastha  2 , Gianni Thomas  2 , Kaya L Curtis  2 , Natalia Roszkowska  2 , Elizabeth K Benitez  2 , Tiffany Merlinsky  2 , Michael Farid  2 , Cecilia E W Nicol  2   3 , Ashita S Batavia  2   3 , Pamela Charney  2   3
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Digital Reimbursement Systems in a Student-Run Clinic

Parsa Nilchian et al. J Community Health. 2025 Feb.

Abstract

The increasing reliance on digital tools for standard healthcare practices in uninsured populations is poorly understood. This study aims to assess the impacts of a newly implemented digital reimbursement system at a student-run primary care clinic associated with an academic medical institution serving uninsured New York City residents. Pharmacy records of 94 unique patients receiving a total of 2770 reimbursements between October 17th, 2016, and May 18th, 2023, were analyzed. Patients were divided into two groups (in-person vs. digital) based on their reimbursement preferences type. Demographic analyses were performed in addition to assessing reimbursement volumes, number of refunds, and duration until receipt of payment for each group. The clinic's total monthly reimbursement volume, number of prescriptions, and number of patients for the period before introduction of digital refunds was compared to the period after. The mean age (in-person = 52.7 ± 14.7 years, digital = 54.9 ± 12.9 years) was not statistically different between the groups. Patients in the digital group requested on average more refunds (digital = 47 refunds, in-person = 14 refunds), received higher total reimbursement amount (digital = $1131.24, in-person = $289.36), and they were reimbursed faster (digital = 56 days, in-person = 62 days). Since the introduction of the digital reimbursement option, our three-month reimbursement volume more than doubled from $481 to $1298. The average number of monthly reimbursements increased from 27 to 45 refunds, and the number of monthly patients increased from 6 to 9 patients. In summary, digital reimbursement options can facilitate medication reimbursement among uninsured patients. These results suggest that digital reimbursement systems result in higher utilization, faster refunds, and larger total reimbursements amount for uninsured and underserved patients.

Keywords: Digital reimbursement systems; Digital transformation; Student-run primary care clinic; Uninsured patients.

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Conflict of interest statement

Declarations. IRB compliance statement and ethical adherence: This study was written in compliance with our institutional ethical review board. IRB exception was obtained with the following protocol code: 24-01026970-01. Competing interest: The authors have no personal or institutional interest with regard to the authorship and/or publication of this manuscript.

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