Jacobs Center Suite 626
2001 Sheridan Road
Bingyang LiPh.D. Candidate
Ph.D. (expected), Managerial Economics & Strategy, Kellogg School of Management, Northwestern University, 2014
M.S., Health Services Research, School of Public Health, University of Michigan, 2009
B.S., Biology & B.A., Economics, Peking University, China, 2007
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Job Market Paper
Electronic Medical Records (EMR) have great potential to improve the efficiency and effectiveness of patient care delivery. However, the use of EMR could enable hospitals to engage in ``revenue-enhancing practice'' such as upcoding, thereby raising health care expenditures and potentially jeopardizing quality. This study uses a longitudinal multistate patient discharge dataset to examine the effect of EMR adoption on medical coding and billing in inpatient settings. I find that the fraction of patients who are assigned to higher-paying DRGs increases significantly after EMR adoption. I estimate that this type of billing change alone increases the reimbursement for inpatient services by $1.3 billion annually. The effect of EMR on coding and billing is particularly strong among for-profit hospitals, financially distressed hospitals, Medicare patients, and billing codes where upcoding potential was previously less exploited. Hospitals document more diagnoses but do not perform more procedures. These findings together reveal that hospitals are sophisticated in their use of EMR as a tool to boost revenue.
“Effect of Overlapping Patient Population on Interoperability of Hospitals' Electronic Medical Records”
Health information exchange enables patients' health information to follow them between care delivery settings in order to support care coordination and avoid duplicate services. From the social-welfare perspective, the interoperability among hospitals’ EMR systems is beneficial because it helps to fully utilize the potential of EMR. However, from the hospitals’ perspective, this may not be the case because free information exchanges can reduce patients’ costs of switching to other providers and achieving interoperability can be costly. At the current stage, EMR systems of unaffiliated hospitals are largely not interoperable due to both technical reasons and hospitals’ unwillingness to share their own patients’ information. This study examines hospitals’ decisions of whether to be interoperable with their neighboring hospitals by testing the hypothesis that information exchanges are more beneficial for some hospitals than others and if the benefits are large enough, hospitals are willing to be interoperable with others. I use a logistic difference-in-differences model and find that sharing a larger patient population with neighboring hospitals that are already using mutually interoperable EMR systems makes a new adopter more likely to join the “network” by adopting an EMR system that is interoperable with them. In addition, I find that this effect is more prominent for hospitals with less market power, such as smaller hospitals, which worry more about patient volume and are more likely to use interoperability as a competitive advantage to compete for patients.
Research Interests: Health Economics, Economics of Innovation, Applied Microeconomics, Industrial Organization