case-mix reimbursement

A system in which government or third-party organizations pay an institution, such as a nursing home or hospital, for its expected services to a group over a specified period. Typically, the amount paid to the institution depends not on the individual's specific health care requirements but on the variety of services likely to be required for the group for which care is provided. The system of diagnosis-related groups (DRGs) is one form of case-mix reimbursement.