Case Mix Index (CMI) is the average of DRG weights of all inpatients. It indicates the complexity of the cases dealt by the hospital.
- CMI is directly impacted by specificity of DRGs
- Higher weighted DRGs (DRGs with CC or MCC) can be assigned by coders only if supported by physician documentation
- A low or reduced CMI reflects low specificity diagnoses assignment, poor documentation quality, no or inefficient CDI program
- The reimbursement received by a hospital is based on the multiplication of the DRG weight for each inpatient case and the blended rate agreed upon between the hospital and the Payers/CMS
- CMI therefore directly impacts the reimbursement received by the hospital
- Inability to monitor your CMI in real-time?
- Not aware of what factors cause fluctuations in your CMI?
- Do you feel that your CMI does not reflect the true picture of your hospital’s patient population and care?
- NLP based AGS solutions deploy cutting edge technologies which helps improve CMI in the
following manner:- Automated suggestion of specific codes instead of generic codes
- Improved CC/MCC capture rate
- Improves DRGs by built-in DRG analysis tool
- Real-time dashboards which help in providing improving opportunities in real-time
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