What is a CMI score?

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.

What is a good case mix score?

The average CMI of all 25 hospitals is 3.48, though CMIs range from 3.02 to 5.26. This is a shift up from the last reporting period, which ranged from 2.75 to 4.88. CMI does not appear to correlate to the number of annual discharges, with discharges from the top 10 hospitals ranging from 5,531 to 87 annually.

How do you calculate case mix?

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 case mix index used for?

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 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.

What is Case Mix in long term care?

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.

Is a high CMI good or bad?

If the CMI is high, DRG payments are larger. It indicates a lower average cost per patient. So, in theory, you get more money to spend. The inverse, however, is not good.

What is a case-mix?

The term case-mix refers to the type or mix of patients treated by a hospital or unit. The term is often used to describe the billing system of the hospital or unit, since the “cost per item” of health care is based on the case-mix.

What is a case mix?

How many case mix groups are there?

For each of the case- mix adjusted components, there are a number of groups to which a resident may be assigned, based on the relevant MDS 3.0 data for that component. There are 16 PT groups, 16 OT groups, 12 SLP groups, 6 NTA groups, and 25 nursing groups.

What is case-mix adjustment?

Abstract. We review case-mix adjustment, which is the process of adjusting for differences in the cases treated in different hospitals so that their costs or outcomes can be compared.

What is case mix variables?

A case mix variable may be any variable that is predictive of improvement on the outcome measure. The intake score on the outcome questionnaire is almost always the strongest predictor of the final score and by extension the change score on the same questionnaire.

What is the meaning of case mix index?

Case mix index (CMI) is a relative value assigned to a diagnosis-related group of patients in a medical care environment.

What should be included in a case mix?

On a wider level; it is possible to compare the case mix of hospitals, regions, and even countries. Whilst a case mix will often include a condition or diagnosis, as well as any treatment received; it can also include demographics, such as gender or age, and a specific time range.

What does M1850 stand for in case mix?

not present M1850 (Transferring) = 2 or more OR M1 19 Primary or Other Diagnosis = Ortho 1 – L 8 7 20 Primary or Other Diagnosis = Ortho 1 – L 3 . 3 21 Primary or Other Diagnosis = Psych 1 – A . . .

How are patients grouped in a case mix?

The practice of coding, essentially groups patients using statistical codes. The coded data can be grouped further into Diagnosis-Related Groups (DRGs), which are used in the billing process by hospitals and practices; as the “cost per item” of healthcare is based on the casemix.