What is the case mix index in nursing homes?
Case Mix Index CMI Weight or numeric score assigned to each RUG-III group that reflects the relative resources predicted to provide care to a resident. The higher the case mix weight, the greater the resource requirements for the resident.
What does CMI stand for in long term care?
Case mix index
Case mix index (CMI) is the metric by which the relative cost of treating residents covered by Medicaid is measured. It also sheds light on the type of residents being treated and the burden of care required.
How do you calculate the case mix index?
Case mix index is calculated by adding up the relative Medicare Severity Diagnosis Related Group (MS-DRG) weight for each discharge, and dividing that by the total number of Medicare and Medicaid discharges in a given month and year.
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 |
Is a higher case mix index better?
Case Mix Index, CMI, is a metric used to measure the relative cost needed to treat a hospital’s patients. A higher case mix reflects a sicker patient population.
How do hospitals determine CMI?
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 impact does case mix index have on 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.