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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