{"title":"Shall we blame health IT for Medicare overpayments? New evidence from Medicare recovery audit program","authors":"Keith A. Joiner, Jianjing Lin","doi":"10.1111/coep.12680","DOIUrl":null,"url":null,"abstract":"<p>The observation of increasing healthcare bills with health IT adoption could arise in two fashions: the <i>bill-inflation</i> and <i>complete-coding</i> mechanisms. Prior studies using claims data may not distinguish between them, as both lead to similar patterns in claims data. Using data from the Medicare Recovery Audit Program, which reviews Medicare Parts A and B fee-for-service claims, we examine how the overpayments/underpayment rate for hospitalization changes as hospitals adopt electronic medical records (EMRs). Our finding of little correlation between EMRs and overpayments but lower underpayments in EMR hospitals suggests EMRs improve coding and documentation. The results have potentially important policy implications.</p>","PeriodicalId":47364,"journal":{"name":"Contemporary Economic Policy","volume":"43 2","pages":"343-361"},"PeriodicalIF":1.7000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Contemporary Economic Policy","FirstCategoryId":"96","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/coep.12680","RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0
Abstract
The observation of increasing healthcare bills with health IT adoption could arise in two fashions: the bill-inflation and complete-coding mechanisms. Prior studies using claims data may not distinguish between them, as both lead to similar patterns in claims data. Using data from the Medicare Recovery Audit Program, which reviews Medicare Parts A and B fee-for-service claims, we examine how the overpayments/underpayment rate for hospitalization changes as hospitals adopt electronic medical records (EMRs). Our finding of little correlation between EMRs and overpayments but lower underpayments in EMR hospitals suggests EMRs improve coding and documentation. The results have potentially important policy implications.
期刊介绍：
Contemporary Economic Policy publishes scholarly economic research and analysis on issues of vital concern to business, government, and other decision makers. Leading western scholars, including three Nobel laureates, are among CEP"s authors. The objectives are to communicate results of high quality economic analysis to policymakers, focus high quality research and analysis on current policy issues of widespread concern, increase knowledge among economists of features of the economy key to understanding the impact of policy, and to advance methods of policy analysis.
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