What is Case Mix Index? We explain in the video below.
Certified coding professionals perform a confidential and in-depth analysis of a Customer’s Case Mix Index (CMI). This analysis is primarily designed to identify opportunities to:
- Compare the Health System’s CMI to the statewide CMI;
- Identify the top 10 MS-DRGs for a fiscal year;
- Compare the geometric mean length of stay (GMLOS) to the Health System’s actual length of stay (LOS) for the top 10 MS-DRGs;
- Compare national MS-DRG relative weights from the prior fiscal year to the current fiscal year identifying realized reimbursement for the Health System’s top 10 MS-DRGs;
- Identify potential “at risk” MS-DRGs targeted by the MAC, RA, OIG, CERT and other payer investigators;
- Track trends in patient mix (total cases, medical/surgical cases); and
- Identify One-Day-Admission trends with LOS concerns.
Since coding is just one factor that effects the CMI, we will assess other factors that may be impacting outcomes such as physician documentation, intensity of services provided and strategic business development.
The primary benefits are potential CMI improvement and support of on-going compliance processes.