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Assignment Lesson 5

Assignment Lesson 5

Q Evaluating the Impact of Clinical Documentation on Case Mix Index Instructions: Assume that you are responsible for calculating the Case Mix Index (CMI) for your hospital’s inpatient stays at the end of each month. You report the data to the hospital’s administration and they utilize this information for financial forecasting related to resource intensity and patient acuity. Fluctuations in the CMI resulted in the implementation of a clinical documentation improvement (CDI) project. The purpose of this project was to improve the documentation in order to obtain an accurate understanding of the patient’s being treated by your facility and resource need. The hospital's administration opted to measure the value of the CDI project by assessing CMI. They were hoping to find an increase in the CMI with improvements to documentation. In 3-4 paragraphs, summarize the following: • Importance of CMI on hospital finances • Relationship between quality documentation and CMI • Limitations with using CMI for assessing documentation improvement efforts • Recommendations for alternative measures for assessing CDI impact PreviousNext

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Case Mix Index is a measure used by the Centers for Medicare and Medicaid Services (CMS) to determine hospital rate of reimbursements for Medicare and Medicaid. This means that hospitals that perform complex operations need to be reimbursed well. It is very important in hospital finance as it indicates the performance of a given hospital. Case Mix Index can also be used to find and adjust the average cost per patient based on the patient population. This has an overall effect on the quality ratings ad reimbursement rates. Hospital performance is also determined by the CMI. Quality documentation relates to CMI since high quality documentation highly determines appropriate reimbursements and quality of care provided to patients since all information is contained and organized well thus better informed medical decisions are made.