When confronted with CPI’ s findings, doctors and hospitals predictably pushed back, arguing that patients are older and sicker than they have been in the past. But when CPI checked out that claim, reporters found it wasn’t really true. Some providers also claimed they had been underpaid for their services in the past, and electronic medical records would help them get what is due to them.
Schulte told me that he had witnessed sales pitches in which hospitals were told by sellers that the computerized-record “machines would pay for themselves, because they could bill more aggressively. Before, they were leaving money on the table,” Schulte said in our interview. “The machines are allowing them to code higher.”
Given the billions the government has invested in promoting them as the route to cheaper and better care, abuse of electronic medical records is troubling. The health reform law contained provisions designed to speed along and encourage adoption of such records.
One CPI piece introduced us to Dr. Robert Kolodner, who headed the government’s drive for the new technology in 2007. He acknowledged to CPI that billing abuse took a back seat to efforts aimed at encouraging use of the technology. He said officials were certain that the savings achieved by computerizing medicine would be so great that billing abuse, “while needing to be monitored, was not something that should be put as the primary issue at that time.” When the Obama team arrived in late 2008, it was sympathetic to the pleadings of the technology companies, which would benefit handsomely from the technology.
The press effectively bought in to the conventional wisdom about the technology—promoting the virtues of electronic medical records whenever an advocate for them had something quotable to say. There has been scarcely a nod to the downsides of electronic medical records in the press, until the CPI expose and the Times report.
The two efforts present a good case that it’s time for a closer look at whether the promised cost savings can really be achieved in a healthcare system that’s weighted so heavily in favor of providers.
Correction: The reporting team on the Center for Public Integrity series on Upcoding included David Donald, not Donald David, as we initially reported. CJR regrets the error.