What does case mix index mean to you?
What does the calculated CMI tell you about the facility?
A hospital’s CMI represents the average diagnosis-related group (DRG) relative weight for that hospital. It is calculated by summing the DRG weights for all Medicare discharges and dividing by the number of discharges. CMIs are calculated using both transfer-adjusted cases and unadjusted cases.
What is the primary use of the case mix index?
The Case Mix Index has historically been used to calculate adjusted average cost per patient (or day) for a given hospital relative to the adjusted average cost for other hospitals by dividing the average cost per patient (or day) by the hospital’s calculated CMI.
What is the highest case mix index?
Top 25 hospitals with highest case mix index
| Rank | Definitive ID | Case Mix Index |
|---|---|---|
| 1 | 1561 | 5.69 |
| 2 | 2148 | 5.60 |
| 3 | 552489 | 5.24 |
| 4 | 4164 | 4.51 |
What is average case mix index?
The Case Mix Index (CMI) is the average relative DRG weight of a hospital’s inpatient discharges, calculated by summing the Medicare Severity-Diagnosis Related Group (MS-DRG) weight for each discharge and dividing the total by the number of discharges.
How does case mix index affect reimbursement?
A higher CMI means more reimbursement dollars for providing care because it indicates that a hospital is treating a sicker patient population. Increasing the CMI hinges on having clinical documentation that accurately reflects the severity level of patients’ conditions.
What is case mix adjustment?
Case-mix adjustment uses statistical models to predict what each hospital’s ratings would have been for a standard patient or population, thereby removing from comparisons the predictable effects of differences in patient characteristics that are consistent across hospitals.
Why is Case Mix important in evaluating different health care providers?
HCFA’s most urgent research need in case-mix classification is to determine whether the DRG system is fair to classes of beneficiaries, to individual hospitals, and to classes of hospitals. Resolving this question is important because any problems which exist should be promptly identified and corrected.
How do I increase my hospital CMI?
When physicians accurately portray the acuity of their patients, it equates to CMI and more reimbursement for the hospital. The most effective way to improve CMI is thorough documentation training and consistent follow-through as it relates to ongoing documentation review and education.
In which situation could the use of a case mix information be helpful?
A tool that can be used to predict income, summarize patient populations, explain the cost of treating those populations, and even suggest what kind of services are most viable for that population.
What does CMI mean in medical terms?
Case mix index
Case mix index (CMI) within health care and medicine, is a relative value assigned to a diagnosis-related group of patients in a medical care environment. The CMI value is used in determining the allocation of resources to care for and/or treat the patients in the group.
What affects CMI?
However, CMI may be affected by the accuracy of physician documentation and the skill and experience of the coder who abstracts data from the medical record and assigns ICD-9-CM codes.
How does the CMI affects a facility?
A higher CMI corresponds to increased consumption of resources and increased cost of patient care, resulting in increased reimbursement to the facility from government and private payers, like CMS.
How do you increase case mix index?
Five Ways to Improve Case-Mix Index For Your Community
- Hold CMI Review Meetings. …
- Communicate with Therapy. …
- Capture the Complete Clinical Picture. …
- Accurately Code Activities of Daily Living. …
- Complete Interviews Timely and Accurately. …
- For More Information.