Business Commons^™

Upcoding Medicare: Is Healthcare Fraud And Abuse Increasing?, Alberto Coustasse, Whitney Layton, Laikyn Nelson, Victoria Walker

Management Faculty Research

Medicare fraud has been the cause of up to $60 billion in overpaid claims in 2015 alone. Upcoding occurs when a healthcare provider has submitted codes for more severe conditions than diagnosed for the patient to receive higher reimbursement. The purpose of this study was to assess the impact of Medicare and Medicaid fraud to determine the magnitude of upcoding inpatient and outpatient claims throughout reimbursements.

The methodology for this study utilized a literature review. The literature review analyzed physician upcoding throughout present on admission infections, diagnostic related group upcoding, emergency department, and clinic upcoding. It was found that upcoding …

Potential Savings From Consumer-Driven Health Plans, William Ferguson, Brittany Smith, Jessica Mcnair, Sarah Miller, Bojing Wang, Alberto Coustasse

Management Faculty Research

Consumer Driven Health Plans (CDHPs) have been identified as a high-deductible insurance option that has increased consumer responsibility while healthcare expenditures have decreased. There has been an increasing need of these plans because they can help to control healthcare costs, and the increasing healthcare utilization. As the use of these plans have expanded, educated consumers have become more engaged in their healthcare services and have increased demands for transparency of healthcare costs. The methodology for this study was a literature review using 36 sources. The purpose of this study was to determine if CDHPs have created financial savings by increasing …

Law Helps Ensure Safety Of The Supply Chain, Kenneth Maxik, Craig Kimble, Alberto Coustasse

Management Faculty Research

The Drug Quality and Security Act was signed into law on November 27, 2013, and included the Title 2 Drug Supply Chain and Security Act (DSCSA). This legislation was introduced to enact a federal prescription drug safety standard to decrease contamination, counterfeiting, diversion, and otherwise harmful illicit activities. It also improves the detection and elimination of potentially unsafe drugs from the drug supply chain to protect US consumers.

Black Swan To Phoenix: The Role Of Dynamic Capabilities, Ambidexterity And Corporate Insight, Marc D. Sollosy

Management Faculty Research

The paper presents the position that in times of Black Swan or other unforeseen or unprecedented events the path to survival is not the sole function of the company’s strategy. While much has been written about the need for companies to alter or adapt their strategies in face of such events, doing so is easier said than done. In fact, strategy is foundational and a function of and subject to the capabilities of the company. That there is no real strategy or strategy altering approach for preparing for a Black Swan like event.

The paper provides insights and alternative view …

Accounting Conservatism Or Earnings Management: A Study Of The Allowance For Doubtful Accounts, Timothy G. Bryan

Faculty Submissions

This paper empirically examines the relationship between conservatism and earnings management in chemical and allied products manufacturers via an analysis of the allowance for doubtful accounts and bad debt expense. Data used in the study included total accounts receivable, the total allowance for uncollectible accounts, total assets, and other firm-level data from the COMPUSTAT database of North American firms for companies with the standardized industry code (SIC) of 28 which represents chemical and allied products manufacturers. Chemical and allied products manufacturers were deemed an ideal target for the study because the industry typically has large balances in accounts receivable and …

Macra And Accountable Care Organizations: Is It Working?, Bukola Abodunde, Chelsea Slater, Alberto Coustasse

Management Faculty Research

The purpose of this study was to examine how the Medicare Access and CHIP Reauthorization Act (MACRA) has improved health care delivery and to determine its impact on Accountable Care Organization (ACO) goals. ACOs have provided quality care through the reduction in readmission rates, coordinated care, and cost savings. With the passage of the MACRA, it has been estimated that it would further decrease Medicare spending on physician and hospital services. Also, ACOs have had a positive impact on improving health care delivery and have played a significant role in providing exceptional quality of care while also managing to increase …

Charge Masters And The Effects On Hospitals, Whitney Layton, Katie Lemmon, Alberto Coustasse

Management Faculty Research

The hospital chargemaster has been the heart of the healthcare revenue cycle, as it has served as the hospitals’ starting point for billing patients and payers. The CDM was made as an extensive breakdown of the cost of the care provided and in order for a hospital to correctly bill a patient for care received as every chargeable item in the hospital must be included in the master. The methodology for this study utilized a literature review. It consisted of academic sources, electronic databases, academic journals, and government websites. Thirty-eight sources were referenced for this literature review. The literature review …

Unfaithful Representation: Understating Accounts Receivable In The Name Of Conservatism, Timothy G. Bryan

Faculty Submissions

This research empirically examines the relationship between conservatism in accounting and the allowance for doubtful accounts. A sample of companies’ financial data related to the allowance for doubtful accounts and bad debt expense in the chemical and allied products manufacturers industry, SIC 28, for the period from 2005 through 2017 was obtained. The results of analysis of this data indicate that the allowance for doubtful accounts is overstated in these firms and has become more overstated since 2004. This research is important as few have researched the allowance for doubtful accounts, and that research has not considered the allowance for …

Incorporating Experiential Learning Into The Accounting Curriculum: Best Practices And Lessons Learned From A Recently Implemented Curriculum, Timothy G. Bryan

Faculty Submissions

This paper offers best practices for implementing an experiential learning component into an accounting curriculum in order to provide multiple experiential learning opportunities that are “for credit.” Sometimes employers may not be able to provide internship opportunities to students, or students may not be able to dedicate the required amount of time to obtain an internship in accounting. Recognizing this reality, we recommend implementing an on-campus alternative that would provide students the experiential learning opportunity they need through the Volunteer Income Tax Assistance Program (VITA) for course credit. For students transitioning into the job market, this experiential learning opportunity provides …