Case mix index analysis | Human Resource Management homework help

 

Content Link: MS-DRGs and CMI

Objectives:

  1. Calculate the Case Mix Index for a selected group of cases.
  2. Analyze Case Mix Indices for different facilities.
  3. Evaluate the impact of utilization patterns on a facility’s Case Mix.

Introduction

The case mix of a patient population is a description of that  population based on any number of the following characteristics such as  age, gender, treatments received or resources used. Case Mix Analysis is  used to determine reimbursement, to describe a population being served  and to identify differences in practice patterns or coding complexity.

The case mix index is the average of the relative weights of all  cases treated at a given facility. The theoretical average CMI is 1.000.  CMI’s over 1.000 signify more complex cases and CMI’s less than 1.000  signify less complex cases. Factors that influence a facility’s case mix  index include:

  • Changes made in relative weight values
  • Changes in the type of services offered or provided by the facility
  • Accuracy of documentation and coding in MS-DRG or APC assignment

Case Mix Analysis begins with the calculation of the Case Mix Index.  The Case-Mix Index is the average of the relative weights of all cases  treated at a given facility or by a given physician. The formula for  calculating the Case Mix Index is:

The total number of CMS Relative Weights for all of the cases divided by the total number of patients served.

Example: Commonwealth Hospital – Top 5 MS DRGs


 The total CMS Relative Weight is 213.0332

  The total number of patients served is 78

The Case Mix Index is 213.0332 / 78 = 2.7311

  Part I Written Assignment

  Scenario:

  You are the HIM Director for PrimeCare Medical Center and you are  charged with the task of analyzing your facility’s case mix and  comparing your Case Mix Index with comparable facilities in your area.  The top 5 procedures performed in your facility are listed below:

PrimeCare – Top 5 MS DRGs

  1. Calculate the Case Mix Index for the top 5 MS DRGs for your  facility. Report all calculations to four places after the decimal point  for the most accurate CMI. 
  2. The Transplant Surgery Department has predicted a 20% increase in  kidney cases for the next fiscal year and the Urology department has  predicted a 10% decrease in major bladder procedures. Recalculate the  CMI to account for these predictions. Report all calculations to four  places behind the decimal point for the most accurate CMI.
  3. Prepare a short report (1 page) to the Finance Department that  analyzes the impact of the projected changes in utilization practices.  In your report include the new projected CMI. The purpose of the report  would not be to give actual facts and figures just to identify areas  that would be impacted by the projected changes.

Part II Written Assignment

Review the Case Mix Index figures in the table below.

Overall Case Mix Index FY 20xx
   Facility                Year 1      Year 2      Year 3
   Hospital A            1.7694      1.9052      1.9689
   Hospital B            1.5925      1.5554      1.7715
   Hospital C            1.6443      1.7073      1.9003
   Hospital D            1.5053      1.9471      1.8945
   State Average       1.6667      1.7712      1.9085

a. Prepare a graphic representation that compares each of the hospital figures to the state average for each year.
  b. Evaluate the data contained in the table. What types of conclusions  can be drawn from this information about each hospital and the state  average for each year? Prepare a short report (1 page) that evaluates  the possible explanations as for why each facility’s overall CMIs were  higher or lower that the state average for each year.

Calculate the price of your order

275 words
We'll send you the first draft for approval before your deadline so that you can go through it in time.
Total price:
$15
The price is based on these factors:
Academic level
Number of pages
Urgency
Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism guarantee

Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.

Read more

Free-revision policy

Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.

Read more

Privacy policy

Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.

Read more

Fair-cooperation guarantee

By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.

Read more
Open chat
Need help? Talk to us
Hello, Welcome to Essay Writing Help. place an order or talk to us for enquiries