1 edition of The Medicare case mix index increase found in the catalog.
The Medicare case mix index increase
Grace M. Carter
|Statement||Grace M. Carter, Paul B. Ginsburg|
|Series||Rand publication series -- R-3292-HCFA., R (Rand Corporation) -- R-3292-HCFA.|
|Contributions||Ginsburg, Paul B., United States. Health Care Financing Administration, Rand/UCLA Center for Health Care Financing Policy Research|
|LC Classifications||RA412.3 .C37 1985|
|The Physical Object|
|Pagination||xi, 49 p. :|
|Number of Pages||49|
Sum of all total weights divided by the sum of total patient discharges equals the case-mix index What relating the case-mix index to the costs incurred for inpatient care does Allows the hospital to make administrative decisions about services to be offered to its patient population. This study estimated the degree to which the increase in the CMI from reflected medical practice changes, the aging of the Medicare inpatient population, changes in coding practices of physicians and hospitals, and changes in the way that the Health Care Financing Administration collects the data on case-mix.
There is good news and bad tucked away in the details of the proposed Inpatient Prospective Payment System (IPPS) Final Rule released last week by the Centers for Medicare & Medicaid Services (CMS).Some acute-care hospitals could see a decrease in their case mix index (CMI), as a number of. medicare case mix index chart. PDF download: (FY) Inpatient Prospective Payment System (IPPS) – Oct 3, 1A-C and Table 1D, respectively, of the FY IPPS/LTCH PPS Final .. data, such as bed count, number of discharges, or case-mix index, Home Health Prospective Payment System (HH PPS) Rate – CMS.
The case mix index for a healthcare facility reflects costs incurred to provide services and treatments that inpatients require. In general, the higher the CMI is, the sicker its patients, and the more resources patients required during treatment. Title: The Medicare Case Mix Index Increase: Medical Practice Changes, Aging, and DRG Creep Author: Grace M. Carter, Paul B. Ginsburg Subject: In , the Medicare program paid hospitals a higher amount per patient discharge than had been projected, because of a substantial shift in the mix of cases toward those with higher payment rates.
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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 practice changes, the aging of the Medicare.
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 (CMI) reflects the costliness of a hospital's Medicare patient mix.
The costs are based on the diagnosis-related group (DRG) in which each patient is classified and the weight that Medicare has applied to each DRG to reflect patients' relative by: 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/ The Medicare case-mix index (CMI) reflects the costliness of a hospital's Medicare patient mix. The costs are based on the diagnosis-related group (DRG) in which each patient is classified and the weight that Medicare has applied to each DRG to reflect patients' relative Size: KB.
This file contains hospitals case mix indexes (CMI) for discharges. A hospital's CMI represents the average diagnosis-related group (DRG) relative weight for that hospital.
It is calculated by summing the DRG weights for all Medicare discharges and dividing by the number of discharges. These changes have been attributed, in the absence of appropriate data and analyses, to the incentives of the Medicare prospective payment system (PPS).
Using data for from hospitals, we estimate the effect on the Medicare case-mix index of a series of variables that reflect medical treatments and coding by: In talking with our hospital customers, case mix index (CMI) often comes up as a source of confusion and misunderstanding by clinical staff.
CMI is widely Support: Sales: In JulyCMS finalized a new case-mix classification model, the Patient Driven Payment Model (PDPM), that, effective beginning October 1,will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for classifying SNF patients in a covered Part A stay.
Focusing solely on revenue capture or improving case mix index (CMI) has been discussed, but caution is recommended when considering such a singular goal.
1–5 Hicks and Gentleman described a clinical documentation management program utilizing nurses trained as clinical documentation consultants that resulted in improved clinical documentation. 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 t Source URI: will increase the CY day and day base payment rates by the appropriate rural add-on percentage prior to applying any case-mix and wage index adjustments, as required by Section (b) of the Medicare Prescription Drug, Improvement, and Modernization Act of (MMA), as amended by Section (a) of the BBA of File Size: KB.
The case-mix index for newborns increased percent, which increased the total Medicaid hospital expenditure percent. Outlier payments increased total expenditure further.
DRG distribution change among newborns has a large impact on spending because newborn complication DRGs have high by: 4. Additional Physical Format: Online version: Carter, Grace M. Medicare case-mix index increase. [Washington, D.C.?: Health Care Financing Administration, ]. The Medicare case mix index increase: medical practice changes, aging, and DRG Creep.
Health Care Financ Rev. Summer;7(4) Medicare case-mix index increase. Ginsburg PB, Carter GM. 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 Cited by: To find out more about analyzing Case Mix Index and the impact of CDI programs, please contact: REFERENCES Ginsburg, Paul B.
and Grace M. Carter. “Medicare case-mix index increase.” Health Care Finance. Rev. Summer; 7(4): 51– Mendez, Carmen M., Darrell W. Harrington, Peter Christenson, and Brad Size: KB.
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).
Two databases were used to investigate the causes of the Case Mix Index (CMI) increase: Medicare bills from calendar year and fiscal yearand discharge abstract data from the Commission on Hospital and Professional Activities for January through September Cited by:. Case Mix Index (CMI) is used by the Centers for Medicare and Medicaid Services (CMS) to determine funding allocation for Medicare and Medicaid beneficiaries in hospitals and other care facilities.
Patients are classified into diagnosis-related groups (DRGs) depending on condition, case .Start studying Healthcare Reimbursement Chapter 6. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The increase in Medicare expenditures for inpatient hospital care jeopardizing Medicare ability to fund other health programs.
for what is the case-mix index a proxy? Consumption of resources.If a hospital's Medicare case mix index shifts from towhat impact will that shift have on the Medicare inpatient revenue projection for that hospital (assume volume does not change)?
Increase Decrease No change Need more information to answer.