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The case mix index (CMI) can be defined as the average relative weight of all cases treated at a given facility or by a given physician. The CMI will reflect the resource intensity or clinical severity of a specific group in relation to other groups in the classification system.
Facilities will use the CMI to compare their CMI to others statewide. It can also be utilized to identify â€œat-riskâ€ MS-DRGs that are targeted by multiple payer investigators such as OIG, RAC auditors and so forth. It can also be used to track trends in patient mix (total cases, medical/surgical cases).
Review the attached PowerPoint Slides that demonstrate how to calculate CMI. The attached Worksheet has identified the top 10 MS-DRGs for UNOH Hospital located in Lima, Ohio that you will be determining CMI. Also attached is the FY 2016 Proposed Rule Tables that include the MS-DRG, its description, weights, as well as Geometric and Arithmetic mean lengths of stay. Fill the table out to its entirety.
Utilizing the attached resources:
Â· Determine the CMI for UNOH Hospital
Â· Explain how the CMI might raise or lower dependent on the number of discharges per MS-DRG
Â· Explain how the information collected in this table could be used to support the new addition of a floor devoted to rehabilitation of joint replacement patients