The Role of Overbilling in Hospitals’ Earnings Management Decisions
European Accounting Review (Forthcoming)
Harvard Business School Accounting & Management Unit Working Paper No. 18-026
45 Pages Posted: 20 Sep 2017
Date Written: September 19, 2017
Abstract
This paper examines the role of overbilling in hospitals’ earnings management choices. Overbilling by hospitals is a form of revenue manipulation that involves misclassifying a patient into a diagnosis-related group that yields higher reimbursement. As overbilling allows hospitals to increase revenues without altering operations, affecting costs, or having to reverse such behavior in the future, I propose and find that overbilling reduces hospitals’ use of managing accruals or cutting discretionary expenditures. Next, I find that hospital managers prefer overbilling to managing accruals (cutting discretionary expenditures) when cutting discretionary expenditures (managing accruals) is constrained, and vice versa. Collectively, my findings suggest that overbilling is an important alternative manipulation tool in hospitals.
Keywords: Overbilling, accrual-based earnings management, real activities manipulation, for-profit hospitals
JEL Classification: I11, I18, M41, M48
Suggested Citation: Suggested Citation