How are CMI adjusted discharges calculated?

Publish date: 2023-01-13
A hospital's CMI represents the average diagnosis-related group (DRG) relative weight for that hospital. It is calculated by summing the DRG weights for all Medicare discharges and dividing by the number of discharges. CMIs are calculated using both transfer-adjusted cases and unadjusted cases.

Also to know is, how is adjusted discharge calculated?

The IP/OP Adjustment Factor is derived by taking Total Gross Patient Revenue divided by Total Gross Inpatient Revenue for all the business units supported, Adjusted Discharges Supported is derived by taking the sum of the Total Facility Discharges multiplied by the IP/OP Adjustment Factor.

Subsequently, question is, what does the calculated CMI tell you about the facility? The Case Mix Index (CMI) is the average of the DRG values of all the hospital admissions in a year. A higher CMI would indicate that the hospital takes care of more complex patients. Although a hospital can calculate its CMI based on all inpatients, that number usually isn't publicized.

One may also ask, what is CMI adjusted length of stay?

We encourage hospitals to use a modified measure as a baseline for efficiency: CMI-adjusted length of stay. It is defined as the ratio of the number of days of hospital care that were utilized to care for patients adjusted for the documented severity of the illnesses.

What adjusted patient days?

Adjusted patient days means inpatient days divided by the percentage of inpatient revenues to total patient revenues.

What is an adjusted discharge?

Adjusted Discharges = Inpatient Discharges + [(Gross Outpatient Revenue/Gross Inpatient Revenue) X Inpatient Discharges] The case mix adjusted discharge metric is determined by multiplying the result of this formula by the inpatient case mix index.

How do you calculate adjusted occupied beds?

Calculate adjusted occupied beds by dividing the total dollar amount of revenue generated by the hospital's patients (this includes the revenue generated by both inpatients and outpatients) by the dollar amount of revenue generated by the hospital's inpatients.

How do you calculate discharge days?

example of actual data for an acute care general hospital demonstrates this:
  • METHOD 1: (DISCHARGE DAYS 48,579) / (DISCHARGES 6,246) = 7.8 DAYS.
  • METHOD 2: (INPATIENT DAYS OF CARE 48,090) / (ADMISSIONS 6,206) = 7.7 DAYS.
  • METHOD 1: (DISCHARGE DAYS 393,552) / (DISCHARGES 534) = 737.0 DAYS.
  • What is cost per discharge?

    Average Cost per Discharge Cost per discharge is a dynamic measure that can be adjusted for a hospital's case mix and other patient population demographics.

    How do you calculate payer mix?

    The percentage is calculated by taking the total payments for the financial class, provider, service location, and/or payer and dividing it by the total amount of payments for the entire search results (total at the bottom of the total payments column).

    How do you calculate average age of a plant?

    The average age of plant is a simple ratio to calculate. Just divide your accumulated depreciation from your balance sheet at year-end by your annual depreciation expense. The result is an estimate of your facilities' average age.

    What is considered a high CMI?

    A high CMI means the hospital performs big-ticket services and therefore receives more money per patient. Finance departments consider CMI when determining the hospital's budget. If the hospital's actual CMI is less than what the finance department predicted, the hospital may experience a loss in revenue.

    What is a good CMI?

    “…the CMI is a good tool to compare area hospital performance at a similar acuity level for medical and surgical care. The DRG for a patient admission that does not meet medical necessity, indicates the patient's care could have been provided on an outpatient basis. It could also have a critical impact on the CMI.”

    What affects CMI?

    However, CMI may be affected by the accuracy of physician documentation and the skill and experience of the coder who abstracts data from the medical record and assigns ICD-9-CM codes.

    How does Medicare calculate length of stay?

    The percentage staying 14 days or fewer is calculated by dividing the number of individuals with LOS 14 days or fewer by the total number of admissions from a hospital that did not have a prior stay in a SNF within the 100 days of admission (see denominator definition).

    How is geometric length calculated?

    Medicare generally tracks and reports length of stay as a “Geometric Mean Length of Stay” or GMLOS. This is calculated by multiplying all of the lengths of stay and then taking the nth root of that number (where n=number of patients).

    What contributes to a hospital's CMI?

    The CMI value is used in determining the allocation of resources necessary to provide care for and/or treat the patients in an identified group. The CMI of a facility reflects the diversity and clinical complexity of the patients and the associated resources utilized in the care of those patients.

    How is average daily census calculated in a hospital?

    Average Daily Census (ADC) Average number of patients in the hospital at a given time per day. This is the ratio of the total number of in-patient days (Excluding new born) to total number of days in the same period. ADC= Total Patient Days ÷ Number of calendar days in a period.

    Which has more influence on the CMI RW or volume?

    Because surgical MS-DRGs are higher weighted than medical MS-DRGs (because the cost of the surgery is typically higher and therefore represented in higher RW) an increase in the volume of surgical cases can increase the overall CMI.

    What is needed to determine a facility CMI?

    A hospital's CMI represents the average diagnosis-related group (DRG) relative weight for that hospital. It is calculated by summing the DRG weights for all Medicare discharges and dividing by the number of discharges. CMIs are calculated using both transfer-adjusted cases and unadjusted cases.

    What does CMI stand for?

    Chartered Management Institute

    What is the national average CMI for hospitals?

    The average CMI of all 50 hospitals is 3.15, though CMIs range 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.

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