Has DRG Creep Crept Up?

Decomposing the Case Mix Index Change Between 1987 and 1988

by Grace M. Carter, Joseph P. Newhouse, Daniel A. Relles


Download eBook for Free

FormatFile SizeNotes
PDF file 1.8 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.


Purchase Print Copy

 FormatList Price Price
Add to Cart Paperback55 pages $20.00 $16.00 20% Web Discount

Between 1987 and 1988, the Medicare program's case mix index (CMI), which is an average of the diagnosis-related group weights of hospital patients, increased by about 3.3 percent, resulting in a $1.5 billion increase in the amount the Health Care Financing Administration paid to hospitals. This report describes results of a study to determine how much of the 1987-1988 CMI increase was caused by an increase in the real resource needs of Medicare patients and how much was caused by changes in coding and administrative practices. The results indicate that true change was responsible for 50 percent of the total CMI increase. The analysis showed that hospitals changed their coding behavior relative to a consistent coding standard.

This report is part of the RAND Corporation Report series. The report was a product of the RAND Corporation from 1948 to 1993 that represented the principal publication documenting and transmitting RAND's major research findings and final research.

Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.