Financial impact of CMI increase

aliciasmail@twc.comaliciasmail@twc.com
in CDI Management

I was asked by a Senior Leader what the average fiscal impact is in a .01 increase in case mix index.  I recognize it varies based on the volumes, case types (DRGs) etc. however I believe I had heard someone list a “general” number before. 

Any insight you have is appreciated!

Thank you,

Alicia Mitchell

Director Clinical Documentation at Nortonhealthcare

Comments

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited December 2020

    Ask your finance team to provide to you the Medicare Blended Rate for each site that has a Medicare ID.

    Compute the impact by multiplying the unique facility blended base rate X .01, your stated change in the CMI.

    Formula will vary if payor is not Medicare. The Federal Blended Rate changes and you need to ensure you are using the correct time period for your calculations.


    There is no general Blended Base Rate, rather it is unique to each facility, determined by a number of factors, such as prevailing wages, teaching status, and so. The Best Source, again, would be Finance but your HIM Manager should also have this value.


    P. Evans, RHIA, CCDS

  • aliciasmail@twc.comaliciasmail@twc.com

    Thanks Paul! We did as you suggested to multiply the blended rate X.01 however the number seemed minimal - not as high as I expected. At least I know we are on the right track.

    Thanks again

    Alicia

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org

    You are on the correct track. Most welcome. If you are working in small, rural site, your blended rate may be much lower when compared to where I work, Bay Area of California. If I issue 10 impactful queries at a hospital with a Blended Rate of $10,000, my financial impact would double for someone with the same impactful queries at a site with a Blended Rate of, say, $5,000 dollars. Same DRG impact, but different Blended Rates


    Something to keep in mind as the Blended Rate is a factor none of us control.


    Best, Paul

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