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How much change in the case mix index is DRG creep? / Grace M. Carter, Joseph P. Newhouse, Daniel A. Relles.
- Format:
- Book
- Government document
- Author/Creator:
- Carter, Grace M.
- Language:
- English
- Subjects (All):
- Diagnosis related groups--United States.
- Diagnosis related groups.
- Hospital patients--United States--Classification.
- Hospital patients.
- Physical Description:
- 1 online resource (xiv, 43 pages) : illustrations
- Place of Publication:
- Santa Monica, CA : RAND Corporation, 1990.
- Summary:
- The authors reabstracted a nationally representative sample of 7,887 Medicare charts to determine how much of the change in Medicare's Case Mix Index between 1986 and 1987 was due to upcoding or DRG (diagnosis-related group) creep. About two-thirds of the actual change is true. Most of the remaining third is attributable to a general change in the completeness of coding; some is attributable to changes in the Grouper program that assigns DRGs to cases using diagnostic and procedural information. Thus, most of the additional $1 billion that Medicare paid to hospitals because of the change in the Case Mix Index appears justified by the additional complexity of the cases of the patients being hospitalized.
- Notes:
- "April 1990."
- "RAND/UCLA/Harvard Center for Health Care Financing Policy Research."
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