Hennig-Schmidt, Heike, Juerges, Hendrik and Wiesen, Daniel (2019). Dishonesty in health care practice: A behavioral experiment on upcoding in neonatology. Health Econ., 28 (3). S. 319 - 339. HOBOKEN: WILEY. ISSN 1099-1050

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Abstract

Dishonest behavior significantly increases the cost of medical care provision. Upcoding of patients is a common form of fraud to attract higher reimbursements. Imposing audit mechanisms including fines to curtail upcoding is widely discussed among health care policy-makers. How audits and fines affect individual health care providers' behavior is empirically not well understood. To provide new evidence on fraudulent behavior in health care, we analyze the effect of a random audit including fines on individuals' honesty by means of a novel controlled behavioral experiment framed in a neonatal care context. Prevalent dishonest behavior declines significantly when audits and fines are introduced. The effect is driven by a reduction in upcoding when being detectable. Yet upcoding increases when not being detectable as fraudulent. We find evidence that individual characteristics (gender, medical background, and integrity) are related to dishonest behavior. Policy implications are discussed.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Hennig-Schmidt, HeikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Juerges, HendrikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wiesen, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-156001
DOI: 10.1002/hec.3842
Journal or Publication Title: Health Econ.
Volume: 28
Number: 3
Page Range: S. 319 - 339
Date: 2019
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1099-1050
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
MEDICAL-STUDENTS ATTITUDES; INDIVIDUAL RISK ATTITUDES; GENDER-DIFFERENCES; PERSONALITY-TRAITS; CREDENCE GOODS; FINANCIAL INCENTIVES; REPORTED BEHAVIOR; HOSPITALS RESPOND; FIELD EXPERIMENT; LABMultiple languages
Economics; Health Care Sciences & Services; Health Policy & ServicesMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/15600

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