Business Benefits or Incentive Maximization? Impacts of the Medicare EHR Incentive Program at Acute Care Hospitals

Rajesh Mirani, Anju Harpalani
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引用次数: 8

Abstract

This study investigates the influence of the Medicare EHR Incentive Program on EHR adoption at acute care hospitals and the impact of EHR adoption on operational and financial efficiency/effectiveness. It finds that even before joining the incentive program, adopter hospitals had more efficient and effective Medicare operations than those of non-adopters. Adopters were also financially more efficient. After joining the program, adopter hospitals treated significantly more Medicare patients by shortening their stay durations, relative to their own non-Medicare patients and also to patients at non-adopter hospitals, even as their overall capacity utilization remained relatively unchanged. The study concludes that many of these hospitals had implemented EHR even before the initiation of the incentive program. It further infers that they joined this program with opportunistic intentions of tapping into incentive payouts which they maximized by taking on more Medicare patients. These findings give credence to critics of the program who have questioned its utility and alleged that it serves only to reward existing users of EHR technologies.
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商业利益还是激励最大化?医疗保险EHR激励计划对急症护理医院的影响
本研究旨在探讨医疗保险电子健康档案激励计划对急症护理医院电子健康档案采用的影响,以及电子健康档案采用对营运及财务效率/效能的影响。研究发现,即使在加入激励计划之前,采用医疗保险的医院也比未采用医疗保险的医院有更高的效率和效果。采用者在财务上也更有效率。加入该计划后,相对于他们自己的非医疗保险患者和非医疗保险医院的患者,采用该计划的医院通过缩短住院时间,治疗了更多的医疗保险患者,即使他们的总体能力利用率保持相对不变。研究得出结论,这些医院中的许多甚至在激励计划启动之前就已经实施了电子病历。这进一步推断,他们加入这个项目是出于机会主义的意图,即利用激励支出,通过接受更多的医疗保险患者来实现激励支出的最大化。这些发现为该项目的批评者提供了证据,他们质疑该项目的实用性,并声称该项目的目的只是为了奖励电子病历技术的现有用户。
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