What is needed to determine a facility's CMI?
A. The relative weight, sum of all discharges, and hospital base rate
B. The hospital base rate and DRG relative weight
C. The relative weight of a specific DRG and total discharges for that DRG
D. The sum total of all DRG weights and sum of all discharges
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To determine a facility's Case Mix Index (CMI), you need to consider several factors. CMI is a measure of the average severity of a facility's patient population and is calculated based on the relative weight of diagnosis-related groups (DRGs) and the number of discharges for each DRG.
Option A: The relative weight, sum of all discharges, and hospital base rate - This option is incorrect. While it includes the relative weight and sum of all discharges, it is missing the hospital base rate, which is necessary to calculate the CMI accurately.
Option B: The hospital base rate and DRG relative weight - This option is partially correct. The hospital base rate is required to calculate the CMI accurately. However, only considering the DRG relative weight is not sufficient, as you need the total discharges for each DRG as well.
Option C: The relative weight of a specific DRG and total discharges for that DRG - This option is partially correct. While it considers the relative weight and total discharges for a specific DRG, the CMI requires the same information for all DRGs in order to calculate the average severity across all patients.
Option D: The sum total of all DRG weights and sum of all discharges - This option is incorrect. While it considers the sum of all DRG weights and the sum of all discharges, it does not account for the individual relative weights for each DRG.
Therefore, the correct answer is B. To determine a facility's CMI, you need both the hospital base rate and the relative weight for each DRG, as well as the total discharges for each DRG. These factors are used in a mathematical formula to calculate the CMI accurately.
To determine a facility's Case Mix Index (CMI), the following is needed:
C. The relative weight of a specific DRG and total discharges for that DRG.
The CMI is calculated by multiplying the relative weight of each Diagnosis-Related Group (DRG) by the number of discharges for that specific DRG and then summing these values. Therefore, the relative weight of a specific DRG and the total discharges for that DRG are needed to determine the facility's CMI.