Tip: Look for more than CMI improvement from your program metrics
CDI Strategies, April 1, 2010
Want to receive articles like this one in your inbox? Subscribe to CDI Strategies!
by Robert S. Gold, MD
Too many organizations measure the effectiveness of their CDI program solely by an increase in Medicare case-mix index (CMI). This perspective is faulty for many reasons, but primarily because CMS frowns upon it. CMS views this practice as a strategy to increase payments for Medicare patients only—which will certainly grab the attention of the Office of Inspector General.
CMI is a measure of who walks through the door, and, on a daily, weekly, or monthly basis, physicians in your hospital treat a different mix of patients. For example, if your heart surgeon takes a vacation, your CMI will drop. If a physician performs three tracheostomies one month and not the next, your overall CMI will fall.
The best way to evaluate your CDI program’s statistical success is through a true severity-adjusted system—one in which analysis of the ICD-9-CM codes and patient risk demographics factor into the determination of severity of illness or risk of mortality.
Editor’s Note: This article was excerpted from “Avoid the CMI trap: Measure your CDI program using severity-adjusted data” published in the December 2009 issue of the CDI Journal. Dr. Gold is founder of DCBA, Inc., in Atlanta, a consulting firm that provides physician-to-physician programs in CDI. Contact him at 770/216-9691 or by e-mail at DCBAInc@cs.com.
Want to receive articles like this one in your inbox? Subscribe to CDI Strategies!
Related Products
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- HIPAA Q&A: Level of encryption needed for email
- Topic: CMS, OESS post new security compliance review information, checklist
- Capturing all necessary codes for IUD insertion and removal can be challenging
- What does case-mix index mean to you?
- QA:Coding multiple initial infusions
- OB services: Coding inside and outside of the package
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- HIPAA Q&A: Level of encryption needed for email
- Q&A: Follow CMS' coding guidelines when using modifier -25
- What does case-mix index mean to you?
- Catch up on what's new with injections and infusions
- CMS has reformulated payments for some bilateral procedures
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- ED-to-inpatient transfers are flawed with safety gaps
- Searched