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case mix

   Also found in: Wikipedia 0.04 sec.
case mix
Managed care The characteristics–age, gender and health status–of the population served by a health system or physician's office in a given period of time, which are classified by disease, diagnostic or therapeutic procedures performed, method of payment, duration of hospitalization, and intensity and type of services provided; in the US, a hospital's CM is based on the diagnosis-related groups. See Demographics, DRGs.


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Figure 4 shows the change in revenue (RUG-53 compared with 2005 RUG-44 rates) on the vertical axis using the case mix for more than 1,000 long-term care providers plotted against each provider's percentage of Medicare assessments in the 9 new groups.
The senior leadership in a hospital wants to increase reimbursement and hires a consulting firm to assist with improving its diagnosis related group (DRG) case mix.
Nationally, approximately 48 percent of all nursing home residents experience urinary incontinence and the number can be as high as 70 percent, depending upon a facility's case mix.
 
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