Case-mix indexes: do they adversely affect some hospitals?
The use of 1981 case mix indexes in setting the hospital-specific payment amounts under PPS appears to treat a number of hospitals arbitrarily. Due to random variation, data errors, and changes in services, the use of these indexes will sometimes produce clearly unreasonable results. Therefore, hospitals should review the effect of the indexes, and if adversely affected, they should properly note their objection to their use to preserve appeal rights when filing PPS cost reports.
D014487:Centers for Medicare and Medicaid Services, U.S.; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups; D005376:Financial Management; D005377:Financial Management, Hospital; D006278:Medicare; D011445:Prospective Payment System; D012051:Reimbursement Mechanisms; D014481:United States