Tip: Use your case-mix index to help measure the effectiveness of your CDI program
HIM-HIPAA Insider, August 17, 2010
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Calculating a hospital’s case-mix index (CMI) is one way to gauge a CDI program’s success. CMI refers to the average of a hospital’s DRG relative weights, and it reflects overall patient severity of illness, says Fran Jurcak, RN, MSN, CCDS, manager at Wellspring+Stockamp, a division of Huron Healthcare in Chicago. Most hospitals monitor their CMI monthly. However, looking for trends over longer periods of time is equally important, she adds.
An increase in CMI could indicate that a CDI program is working well and yielding better documentation. However, hospitals can’t assume a positive correlation between the two, says Jurcak. An increase in CMI could simply be reflective of additional service lines with higher-weighted DRGs, she says. Likewise, a decrease in CMI could be due to a decrease in the number of surgical DRGs, a decreased census, poor documentation, or a poor response rate to queries.
Editor’s note: This tip was adapted from an article in the August issue of Briefings on Coding Compliance Strategies. Subscribers have access to the full article in the August issue of the newsletter.
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