Hospital Case-Mix Change: Sicker Patients Or Drg Creep?

Prologue: Medicare's prospective payment system (PPS) has for the past five and a half years attempted to constrain the rising payments to hospitals for care of the nations elderly. Early on, the new system appeared to reward hospitals with double-digit Medicare profit margins. Later reports predicted that over half the hospitals would show a negative margin if annual update factors were not increased. Debate over the level of increase in the...