Investment Subsidies and the Adoption of Electronic Medical Records in Hospitals

In February 2009 the U.S. Congress unexpectedly passed the Health Information Technology for Economic and Clinical Health Act (HITECH). HITECH provides up to $27 billion to promote adoption and appropriate use of Electronic Medical Records (EMR) by hospitals. We measure the extent to which HITECH incentive payments spurred EMR adoption by independent hospitals. Adoption rates for all independent hospitals grew from 48 percent in 2008 to 77 percent by 2011. Absent HITECH incentives, we estimate that the adoption rate would have instead been 67 percent in 2011. When we consider that HITECH funds were available for all hospitals and not just marginal adopters, we estimate that the cost of generating an additional adoption was $48 million. We also estimate that in the absence of HITECH incentives, the 77 percent adoption rate would have been realized by 2013, just 2 years after the date achieved due to HITECH.

[1]  Leila Agha The effects of health information technology on the costs and quality of medical care. , 2014, Journal of health economics.

[2]  J. McCullough,et al.  The effect of health information technology on quality in U.S. hospitals. , 2010, Health affairs.

[3]  Alastair Baker,et al.  Crossing the Quality Chasm: A New Health System for the 21st Century , 2001, BMJ : British Medical Journal.

[4]  Jeffrey T. Prince,et al.  Information Technology and Patient Health: An Expanded Analysis of Outcomes, Populations, and Mechanisms , 2014 .

[5]  Xulia González,et al.  Do public subsidies stimulate private R&D spending? , 2008 .

[6]  David M Cutler,et al.  Meaningful use : Floor or ceiling ? , 2014 .

[7]  Austan Goolsbee Investment Tax Incentives, Prices, and the Supply of Capital Goods , 1997 .

[8]  Michael E. Miller,et al.  Electronic Health Records , 2014, Annals of Internal Medicine.

[9]  Jinhyung Lee,et al.  The Impact of Health Information Technology on Hospital Productivity , 2012 .

[10]  Steffie Woolhandler,et al.  Hospital computing and the costs and quality of care: a national study. , 2010, The American journal of medicine.

[11]  Catherine E. Tucker,et al.  Can Health Care Information Technology Save Babies? , 2011, Journal of Political Economy.

[12]  D. Dranove,et al.  How Do Hospitals Respond to Negative Financial Shocks? The Impact of the 2008 Stock Market Crash , 2013 .

[13]  Stephen L. Parente,et al.  Health Information Technology and Patient Outcomes: The Role of Organizational and Informational Complementarities , 2013 .

[14]  S. Peltzman The Effect of Government Subsidies-in-Kind on Private Expenditures: The Case of Higher Education , 1973, Journal of Political Economy.

[15]  Shane Heitzman,et al.  A Review of Tax Research , 2010 .

[16]  D. Blumenthal,et al.  The benefits of health information technology: a review of the recent literature shows predominantly positive results. , 2011, Health affairs.

[17]  D. Blumenthal,et al.  The "meaningful use" regulation for electronic health records. , 2010, The New England journal of medicine.

[18]  Saul Lach,et al.  Do R&D Subsidies Stimulate or Displace Private R&D? Evidence from Israel , 2000 .

[19]  A Review of Tax Research , 2010 .

[20]  Robin C. Meili,et al.  Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. , 2005, Health affairs.

[21]  Sara Rosenbaum,et al.  Electronic health records' limited successes suggest more targeted uses. , 2010, Health affairs.

[22]  Kamal Saggi,et al.  Is there a case for industrial policy? A critical survey , 2006 .

[23]  S. Wallsten The Effects of Government-Industry R&D Programs on Private R&D: The Case of the Small Business Innovation Research Program , 2000 .

[24]  Avi Goldfarb,et al.  The Trillion Dollar Conundrum: Complementarities and Health Information Technology , 2012 .

[25]  Catherine Tucker,et al.  Privacy Protection and Technology Diffusion: The Case of Electronic Medical Records , 2009, Manag. Sci..