Decrease in CMI and How to Analyze/Explain

We had a slight decrease in CMI from FY 2018 to FY 2019 so I’m analyzing why…How would  I go about explaining the decrease in CMI when I  know it could be attributed to many factors. WE have printed a list of MDs with their CMIs  in FY 2018 vs. 2019.   If there was a large # of MCCs that changed to CCs, how would I attribute this to the change in CMI?  Or the weights of DRGs that may have changed from year to year? 

Does CMS have a mathematical factor they publish each year when the DRG weights are published to be used for budgeting purposes when there is a change in DRG weights are a decrease in MCCs to CCs and CCs to non-cc diagnoses?

Suzonne Bourque

 

Comments

  • 1. Yes, the relative weights for a DRG often change from one Fiscal year to another.

    .  Suggest you review your top 15 or so DRGs by volume and examine any difference in R.W.

    Keep in mind the Federal Fiscal year ‘starts’ with discharges on/after Oct 1.  

    2.  Have you reviewed the % of Surgical/Medical year to year?  Surgical DRGs have higher weights...is your volume of surgical cases changing?

    Pe
  • Thanks Paul
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