9.5 Healthy Kids Children's Hospital recently implemented a pediatric hospitalist program that increased the hospital's ability to provide more acute services. However, this led to an increase in the overall acuity level of patients and caused a shift in the existing staffing patterns and budget projections. The program administrator is exploring moving beds and staffing numbers in its general pediatrics services, pediatrics step-down program, and pediatric intensive care units to better allocate resources and track productivity numbers. Under the current cost center model, general services and step-down program are grouped in the same pediatrics cost center, with weights of 0.85 and 0.15, respectively, while intensive care is its own cost center (a weight of 1). Direct patient care hours are 5.33 for general pediatrics, 8.o for the step-down program, and 12.0 for intensive care, so that average of direct care hours is 8.44. 1. Calculate the case mix indexes for the two cost centers under the current state. 2. The program administrator has proposed moving the step-down program into the intensive care unit cost center, leaving the general pediatrics unit as its own cost center. Calculate the case mix indexes for the two cost centers under the proposal, assuming the weights for the step-down program and intensive care unit would be 0.55 and 0.45, respectively. 3. Compare the case mix indexes under the current state and proposed change. Would you recommend moving forward with the proposed change? If so, why? 1 EX 9.5 3 a. Case Mix - Current Case Mix Index - PICU Direct Care 4. Patient Class Hours 5 General 6 Step down 7 PICU 8 Average Weight (DC hrs/Avg DC Peds Case Mix PICU hrs) Distribution Index - Peds Distribution 5.33 0.63 0.85 0.54 8 0.95 0.15 0.14 1.42 8.44 12 1.42 10 b. Case Mix - Proposed Direct Care 11 Patient Class Hours 12 General 13 Step down 14 PICU 15 Average Weight (DC hrs/Avg DC Peds Case Mix PICU Case Mix hrs) Distribution Index - Peds Distribution Index - PICU 5.33 0.63 0.63 8 0.95 0.55 0.55 12 1.42 0.45 0.64 8.44 17 c. Recommendation 18