Readers ask: What is CMI adjusted length of stay?

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Written By Thurman Schinner

Thurman Schinner graduated from Cambridge University with a bachelor’s degree and has specialized in technical writing.

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.
How is CMI-adjusted patient days calculated?
Adjusted hospital days were calculated based on the following formula: [1 + (outpatient gross charges/inpatient gross charges)] * patient days. CMI-adjusted discharges and CMI-adjusted hospital days were calculated by multiplying CMI by discharges and adjusted hospital days, respectively.
How is CMI calculated?
The Case Mix Index (CMI) is the average relative DRG weight of a hospital?s inpatient discharges, calculated by summing the Medicare Severity-Diagnosis Related Group (MS-DRG) weight for each discharge and dividing the total by the number of discharges.
Is it better to have a high or low CMI?
The financial department monitors case-mix index (CMI), and in an ideal world, the hospital?s CMI would be as high as possible. A high CMI means the hospital performs big-ticket services and therefore receives more money per patient.

How is CMI calculated example?
Total all of the relative weights and divide that number by the total number of individual DRGs. The result is your hospital?s CMI for the calculation period. For example, if your hospital billed 35 DRGs for a one-month period and relative weights totaled 40, the CMI for one month is 0.875, or 35 divided by 40.
What is an adjusted discharge?
?Adjusted discharge? is the number of discharges multiplied by the ratio of total gross revenue to inpatient gross revenue and multiplied by the case-mix index and the wage index.
How does CMI affect reimbursement?
A higher CMI means more reimbursement dollars for providing care because it indicates that a hospital is treating a sicker patient population. Increasing the CMI hinges on having clinical documentation that accurately reflects the severity level of patients? conditions.
What is CMI in long term care?
CMI is a relative value assigned to individual patients in an SNF facility. That value in aggregate, in turn, is used to determine the allocation of resources to care for and/or treat patients in the facility. Essentially, case mix reimbursement was designed to tailor payment amounts to acuity in a facility.

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What is a good CMI?
The average CMI of all 25 hospitals is 3.48, though CMIs range from 3.02 to 5.26. This is a shift up from the last reporting period, which ranged 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.
How CMI affects a facility?
Increased CMI results in higher reimbursement and lower adjusted cost per patient per day, which equates to a significant revenue enhancement for hospitals. Not only that, it also positively impacts Observed Over Expected (O/E) ratios for quality scores, including mortality and expected complications.
What is the length of stay theory?
Length of stay is the number of nights spent in the unit, including home leave of up to 3 nights plus Saturday and Sunday. Count the number of nights according to whether the patient was occupying a bed at midnight. However, if a patient dies on the day of admission, a length of stay of 1 day can be recorded.
Is High CMI good or bad?
The CMI is used to adjust the hospital?s average cost per patient (or per day). If the CMI is high, DRG payments are larger. It indicates a lower average cost per patient.
How does CMI affect Hppd?
Case Mix Index was significantly associated with HPPD (? =0.33, p <. 001); Model 5 explained 57.4 percent of the variance in HPPD. Finally, both unit level CMI (? =?0.29, p <. 01) and inadequate number of assistive personnel (?=0.30, p =. What does the calculated CMI tell you about a facility? 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. The adjusted average cost per patient would reflect the charges reported for the types of cases treated in that year. What is a CMI score? Case mix index (CMI) is a relative value assigned to a diagnosis-related group of patients in a medical care environment. The CMI value is used in determining the allocation of resources to care for and/or treat the patients in the group. Why would we want to monitor CMI? CMI is an important performance indicator for your hospital not because it tells a big story in and of itself, but because of how it impacts your hospital?s finances. CMI is a measure of the average severity level of a hospital?s procedures. While the logic may be debatable, the revenue impact on hospitals is not.

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