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.
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