TITLE:  Physician Workload and Hospital Reimbursement: Overworked Servers Generate Lower Income

SPEAKER:  Sergei Savin

ABSTRACT:

We study the impact of physician workload on hospital reimbursement utilizing a detailed data set from the trauma department of a major urban hospital. We find that the proportion of patients assigned a  "high-severity'' status for reimbursement purposes, which maps, on average, to a 27.8% higher payment for the hospital, is substantially reduced as the workload of the discharging physician increases. This effect persists after we control for a number of systematic differences in patient characteristics, condition and time of discharge. Furthermore, we show  that it is not caused by selection bias or endogeneity in either discharge timing or allocation of discharges to physicians. Finally, we find that the impact of workload on the probability that a patient is assigned the high-severity designation is moderated by the department's past experience in handling certain patient conditions. We attribute this phenomenon to a workload-induced reduction in diligence of paperwork execution. We estimate the associated monetary loss to be approximately 0.9% (with a 95% confidence interval of 0.3% and 1.5%) of the department's annual revenue.