Evaluating and improving the measurement

This issue of Health Care Financing Review is devoted entirely to the accuracy of hospital case-mix measurement systems for reimbursing hospitals. We have brought together eight articles by active workers in this field, representing the most promising efforts to improve case-mix measurement. Although severity of illness is an organizing theme for these articles, their scope is much broader. The purpose of this paper is to give the reader four perspectives for reading these articles: • An understanding of what casecmix measurement is and of the major approaches which are now being explored. • An understanding of the importance of case-mix measurement to the Health Care Financing Admin­ istration (HCFA). • An analytic framework which can be used to describe and compare different approaches to case­ mix measurement. • An outline of the research directions which appear likely, at this time, to be most useful to HCFA over the next five to ten years.