Shall we blame health IT for Medicare overpayments? New evidence from Medicare recovery audit program

Keith A. Joiner, Jianjing Lin

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
JournalContemporary Economic Policy
DOIs
StateAccepted/In press - 2025
Externally publishedYes

Keywords

  • audits
  • health information technology
  • healthcare expenditure
  • hospital care
  • improper billing

ASJC Scopus subject areas

  • General Business, Management and Accounting
  • Economics and Econometrics
  • Public Administration

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