- Title
- Medicaid prospective payment: case-mix increase.
- First Author
- Baker, Samuel L
- Date of Pub
- 1990 Fall
- Pages
- 63-70
- Volume
- 12
- Issue
- 1
- Other Authors
- Kronenfeld, Jennie J
- Abstract
- South Carolina Medicaid implemented prospective payment by diagnosis-related group (DRG) for inpatient care. The rate of complications among newborns and deliveries doubled immediately. The case-mix index for newborns increased 66.6 percent, which increased the total Medicaid hospital expenditure 5.5 percent. Outlier payments increased total expenditure further. DRG distribution change among newborns has a large impact on spending because newborn complication DRGs have high weights. States adopting a DRG-based payment system for Medicaid should anticipate a greater increase in case mix than Medicare experienced.
- Abstract Continued
- N/A
- MeSH
- Abstracting and Indexing : Cesarean Section/utilization : Comorbidity : Diagnosis-Related Groups/trends : Female : Hospitalization/statistics & numerical data : Human : Infant, Newborn : Medicaid/utilization : Outliers, DRG : Pregnancy : Prospective Payment System/statistics & numerical data : South Carolina : State Health Plans : United States
- NTIS Number
- PB91-176255
