Ten issues to consider when evaluating case-mix reimbursement

Peter W Butler, J. D. Bentley

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


In a previous article available case-mix measures and their present reimbursement applications were summarized. This article complements that one by describing ten major policy issues faced by payers and hospitals interested in evaluating case-mix reimbursement: choosing the case-mix measure; tying the case-mix measure to reimbursement; determining which costs are case-mix related; allocating costs to diagnostic groups; identifying, collecting and processing the data; defining atypical patients; examining historical trends; deciding which third parties will participate; meeting the needs of different types of hospitals, and designing an exceptions process.

Original languageEnglish (US)
Pages (from-to)34-42
Number of pages9
JournalHospital Financial Management
Issue number6
StatePublished - Dec 1 1980

ASJC Scopus subject areas

  • Medicine(all)


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