|Statement||by Grace M. Carter and Paul B. Ginsburg|
|Contributions||Ginsburg, Paul B, United States. Health Care Financing Administration|
|The Physical Object|
|Pagination||p. 51-65 :|
|Number of Pages||65|
Medicare paid hospitals a higher amount per admission in than had been planned because the case-mix index (CMI), which reflects the proportion of patients in high-weighted DRG's versus low-weighted ones, increased more than had been projected. This study estimated the degree to which the increase in the CMI from reflected medical Cited by: The Case Mix Index (CMI) is the average relative DRG weight of a hospital’s inpatient discharges, calculated by summing the Medicare Severity-Diagnosis Related Group (MS-DRG) weight for each discharge and dividing the total by the number of discharges. The CMI reflects the diversity, clinical complexity, and resource needs of all the patients Harvest Source URI: Get this from a library! The Medicare case mix index increase: medical practice changes, aging, and DRG Creep. [Grace M Carter; Paul B Ginsburg; Rand Corporation.; United States. Health Care . Two databases were used to investigate the causes of the Case Mix Index (CMI) increase: Medicare bills from calendar year and fiscal year , and discharge abstract data from the Commission on Hospital and Professional Activities for January through September Cited by:
The financial department monitors case-mix index (CMI), and in an ideal world, the hospital’s CMI would be as high as possible. A high CMI means the hospital performs big-ticket services and therefore receives more money per patient. To calculate CMI, choose a time period (e.g., one month) to examine. Within that time, take all the DRGs your hospital billed and add up the relative weights (RW). The percent case-mix increase for newborns implies a percent increase in total Medicaid hospital payments, even if there were no DRG jump among other Medicaid patients. Suppose all Medicaid hospitalizations other than newborns had a case-mix increase of percent, which was our finding for deliveries, conservatively excluding all of Cited by: 4. The Medicare Case Mix Index Increase Medical Practice Changes, Aging, and Drg Creep (Rand Report, RHcfa) by Grace M. Carter, Paul B. Ginsburg Published June by Rand Corp. The Medicare case mix index increase: medical practice changes, aging, and DRG creep by Carter, Grace M; Ginsburg, Paul B; United States. Health Care Financing Administration; Rand/UCLA Center for Health Care Financing Policy ResearchPages:
The Medicare Case Mix Index Increase Medical Practice Changes, Aging, and DRG Creep Grace M. Carter, Paul B. Ginsburg The research described in this report was supported by the Health Care Financing Administration, U.S. Department of Health and Human Services, under Cooperative Agreement No. C/ Background. —Hospital reimbursement by Medicare's prospective payment system depends on accurate identification and coding of inpatients' diagnoses and procedures using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICDCM).A previous study showed that %±% (mean±SE) of hospital bills for contained errors that changed their Cited by: This article describes an attempt to estimate the relative importance of a variety of influences on the Medicare case-mix index over the period Real and coding changes between the years and each account for about one-half of the change in the Medicare case-mix index for HCUP hospitals. database which is a nationally representative sample of hospital discharges. Case‐mix was estimated from measures of disease indicators based on the CCS system (Figure 2). 3. An alternative measure of in‐hospital case‐mix in the Medicare population has been steadily increasing from ‐File Size: KB.