Study Says Overcharging by the Hospital Might Be Overstated

Posted on August 1, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Despite concerns first raised a few years ago, hospitals do not seem to be abusing their electronic data systems to generate bigger bills and boost their income — at least according to authors of a large study released Tuesday. Other leaders in the field say the jury’s still out.

The concern over possible misuse of records grabbed headlines in 2012 after an investigation by the Center for Public Integrity and the New York Times found that some hospitals using electronic records were billing Medicare for significantly more than hospitals that still used paper records.

After the stories appeared, the Departments of Justice and Health and Human Services sent hospitals a strongly worded letter warning them against misusing the ease of electronic forms to pad their bills.

Source

What an interesting study. I especially like the part of the article where they suggest that hospitals aren’t charging more for their services because of EHR because the hospitals had already been maximizing their revenue for a long time before EHR. It’s a fine point that’s worthy of consideration. I don’t think it’s as true in some ambulatory practices, but in the hospital world they’d made a lot of efforts to maximize their revenue even without EHR.

One angle the article above doesn’t cover is that many people were suggesting that this EHR over billing of services was fraud on the part of these organizations. I’ve always thought that was ridiculous. Sure, fraud exists and is facilitated by technology in many cases. However, what the majority of hospitals are doing to maximize revenue isn’t anywhere close to fraud. The problem is that Medicare and other payers have been able to avoid paying for services that were rendered, but never billed. If EHR has increased claims (and this study suggests it hasn’t), then I’d submit it was because hospitals are finally charging for all of the services their rendering.

What do you think? Does EHR increase the cost of healthcare by charging for all of the services provided? Does EHR facilitate fraudulent claims?