| 来源类型 | Working Paper |
| 规范类型 | 报告 |
| DOI | 10.3386/w26455 |
| 来源ID | Working Paper 26455 |
| How do Hospitals Respond to Payment Incentives? | |
| Gautam Gowrisankaran; Keith A. Joiner; Jianjing Lin | |
| 发表日期 | 2019-11-18 |
| 出版年 | 2019 |
| 语种 | 英语 |
| 摘要 | A literature has found that medical providers inflate bills and report more conditions given financial incentives. We evaluate whether Medicare reimbursement incentives are driven more by bill inflation or coding costs. Medicare reformed its payment mechanism for inpatient hospitalizations in 2007, increasing coding costs. We first examine whether increased extra reimbursements from reporting more diagnoses lead hospitals to report more high bill codes. We find that increases in reimbursements within narrow patient groups led to more high bill codes before 2007 but not after. Using the payment reform, we then test for costly coding by comparing hospitals that adopted electronic medical records (EMRs) to others. Adopters reported relatively more top bill codes from secondary diagnoses after the reform, exclusively for medical patients, with a negative effect for surgical patients. This is consistent with EMRs lowering coding costs for medical discharges but increasing them for surgical ones. We further use a 2008 policy where Medicare implemented financial penalties for certain hospital-acquired conditions. EMR hospitals coded relatively more of these conditions following the penalization, lowering revenues. Together, this evidence is contrary to bill inflation but consistent with costly coding. Reducing coding costs may increase inpatient Medicare costs by $1.04 billion annually. |
| 主题 | Public Economics ; National Fiscal Issues ; Health, Education, and Welfare ; Health ; Development and Growth ; Innovation and R& ; D |
| URL | https://www.nber.org/papers/w26455 |
| 来源智库 | National Bureau of Economic Research (United States) |
| 引用统计 | |
| 资源类型 | 智库出版物 |
| 条目标识符 | http://119.78.100.153/handle/2XGU8XDN/584127 |
| 推荐引用方式 GB/T 7714 | Gautam Gowrisankaran,Keith A. Joiner,Jianjing Lin. How do Hospitals Respond to Payment Incentives?. 2019. |
| 条目包含的文件 | ||||||
| 文件名称/大小 | 资源类型 | 版本类型 | 开放类型 | 使用许可 | ||
| w26455.pdf（450KB） | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 | ||
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