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On Telemedicine Reimbursements and Hospital Adoption: A Policy Analysis Using Causal Inference Methods

Journal of Operations Management · Kang Bok Lee, Andrew Hildebrandt, Nitish Patidar, Shashank Rao

methodmethod/causal-inferenceoperationsoperations/service-operationsdigital

摘要

本研究利用因果推断方法,分析了2014年至2019年美国各州分阶段实施的远程医疗报销政策对医院采纳远程医疗的影响。结果表明,报销政策推动了远程医疗服务的采纳,但主要限于住院服务而非门诊服务。研究基于制度同构理论,揭示了政策驱动下医院采纳行为的局限性,为相关政策设计提供了管理启示。

ABSTRACT

There continue to be substantial differences in the quality and access to healthcare available to communities across the United States. Researchers have called this the healthcare divide. Telemedicine, a technology-mediated intervention that promises to bridge this healthcare divide, has been discussed by some as the great leveler. Policymakers, therefore, continue creating legislation that may drive hospitals to adopt telemedicine. Yet, how (or whether) such legislation achieves the goal of telemedicine adoption (and relatedly, healthcare divide reduction) is unclear. In the current study, we investigate a phased introduction of telemedicine reimbursement policies across various states in the United States between 2014 and 2019 to explore the causal effects of such policies on hospital adoption of telemedicine. Results suggest that while reimbursement policies drove the adoption of telemedicine services, this adoption was restricted to inpatient services rather than outpatient ones. We ground our investigation on extant theoretical insights from institutional isomorphism and highlight the limitations in our understanding of the adoption of telemedicine by hospitals in the country.

On Telemedicine Reimbursements and Hospital Adoption: A Policy Analysis Using Causal Inference Methods