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
|
MS-DRG
|
Description
|
# of Pts.
|
CMS Relative Weight
|
|
037
|
Extracranial Procedures w/MCC
|
35
|
3.0845
|
|
653
|
Major Bladder Procedures
|
29
|
5.9249
|
|
652
|
Kidney Transplant
|
27
|
3.0507
|
|
736
|
Uterine/Adnexal Procedures for Malignancy w/ MCC
|
25
|
4.5276
|
|
095
|
Bacterial/Tuberculosis Infections of the Nervous. System w/cc
|
23
|
2.3762
|
a. 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.
b. 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.
c. Prepare a short report (1 pages) 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.