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Case Mix Index (CMI) is used by the Centers for Medicare and Medicaid Services (CMS) to determine funding allocation for Medicare and Medicaid beneficiaries in hospitals and other care facilities. Patients are classified into diagnosis-related groups (DRGs) depending on condition, case complexity, and medical needs. CMS is able to evaluate the resources required to treat patients in each DRG compared to other DRGs and to patients outside a DRG.

Case mix is used to find and adjust the average care cost per patient at a hospital or other care facility based on the patient population demographics. This can have an impact on quality ratings and reimbursement rates, as the weight of each DRG is determined by CMS. As an example, if a hospital’s average cost per patient is $1,000 and its annual CMI is 0.80, the adjusted cost per patient would be $1,250. CMI is a vital indicator of hospital performance because of the way it impacts finances.

The following tables list the top 50 hospitals with the largest case mix index. The average CMI of all 50 hospitals is 3.15, though CMIs range from 2.75 to 4.88. CMI does not appear to correlate to the number of annual discharges, with discharges from the top 10 hospitals ranging from 5,531 to 87 annually.

Many of the hospitals with the highest CMI are located in Louisiana (14 percent), Oklahoma (12 percent), and Texas (28 percent). This is likely due to barriers to care access in rural parts of these states, and high concentrations of patients with chronic illnesses that require patients to seek insurance through Medicare and Medicaid.

Top 50 Hospitals by Case Mix Index

  Hospital Name Case Mix Index Net Patient Revenue Number of Discharges

1.

Nebraska Spine Hospital (NE)

4.88

$51,593,052

963

2.

Doctors Hospital LLC (KS)

4.56

$20,681,633

87

3.

Oklahoma Spine Hospital (OK)

4.25

$64,275,054

1,917

4.

Northwest Surgical Hospital (OK)

4.03

$14,168,955

119

5.

Baylor Scott & White the Heart Hospital Baylor - Plano (TX)

3.72

$318,881,623

5,531

6.

Northwest Hills Surgical Hospital (TX)

3.64

$28,779,627

376

7.

CHI Health Nebraska Heart (NE)

3.56

N/A

3,113

8.

Tulsa Spine & Specialty Hospital (OK)

3.53

$63,317,906

1,167

9.

The Spine Hospital of Louisiana at the NeuroMedical Center (LA)

3.5

$44,073,332

1,407

10.

Dana Farber Cancer Institute (MA)

3.44

$1,130,077,403

1,304

11.

Unity Medical and Surgical Hospital (IN)

3.41

$37,393,196

440

12.

Miracle Mile Medical Center (CA)

3.34

$7,707,668

195

13.

Premier Surgical Institute (KS)

3.33

$27,351,083

1,269

14.

Michigan Surgical Hospital (MI)

3.3

$17,896,547

132

15.

Arkansas Childrens Hospital (AR)

3.26

$548,140,349

10,244

16.

Cypress Pointe Hospital (LA)

3.2

$32,944,433

531

17.

St Vincent Heart Center of Indiana - Carmel (IN)

3.19

$155,677,816

4,360

18.

Sterling Surgical Hospital (LA)

3.14

$13,222,248

181

19.

Methodist Hospital for Surgery (TX)

3.12

$171,984,343

2,614

20.

Saint Thomas Hospital for Specialty Surgery (TN)

3.12

$68,663,695

1,977

21.

Avala Hospital (LA)

3.1

$28,104,843

553

22.

Baylor Jack and Jane Hamilton Heart and Vascular Hospital at Dallas (TX)

3.09

$195,611,708

2,548

23.

Texas Health Center for Diagnostics &

Surgery Plano (TX)

3.02

$91,354,187

695

24.

Specialists Hospital Shreveport (LA)

2.98

$57,979,294

1,348

25.

South Texas Spine & Surgical Hospital (TX)

2.95

$44,747,974

1,429

26.

Surgical Specialty Center of Baton Rouge (LA)

2.94

$46,351,431

407

27.

Keck Medical Center of USC (CA)

2.94

$1,047,720,526

11,725

28.

Avera Heart Hospital (SD)

2.93

$108,294,123

2,079

29.

Saint Camillus Medical Center (TX)

2.93

$15,884,357

244

30.

The Heart Hospital at Deaconess Gateway (IN)

2.92

$57,276,023

1,516

31.

The Heart Hospital Baylor - Denton (TX)

2.91

$47,915,247

676

32.

Lafayette Surgical Specialty Hospital (LA)

2.91

$38,033,732

858

33.

Gillette Childrens Specialty Health (MN)

2.91

$225,030,165

2,153

34.

Kansas Spine & Specialty Hospital (KA)

2.86

$51,983,217

2,153

35.

Wise Health Surgical Hospital - Parkway (TX)

2.85

$152,461,400

380

36.

Swedish Medical Center - Cherry Hill Campus (WA)

2.85

$450,992,770

9,147

37.

Akron Childrens Hospital (OH)

2.85

$789,469,178

10,233

38.

One Core Health (OK)

2.84

$14,727,054

196

39.

Summit Medical Center (OK)

2.84

$54,497,189

266

40.

University of Maryland Medical Center (MD)

2.82

$1,460,597,672

27,599

41.

Baylor Scott & White Surgical Hospital -

Fort Worth (TX)

2.82

$118,317,565

1,930

42.

Seattle Cancer Care Alliance (WA)

2.8

$602,949,271

531

43.

Baylor Surgical Hospital at Las Colinas (TX)

2.8

$65,528,373

806

44.

CHI St Lukes Health - Baylor St Lukes

Medical Center (TX)

2.79

$901,806,987

22,802

45.

Treasure Valley Hospital (ID)

2.79

$65,176,810

641

46.

Surgery Specialty Hospitals of America (TX)

2.79

$19,494,588

121

47.

OrthoColorado Hospital (CO)

2.79

$90,729,530

3,060

48.

Foundation Surgical Hospital of El Paso (TX)

2.78

$42,461,942

718

49.

Oklahoma Heart Hospital South Campus (OK)

2.75

$141,090,773

3,846

50.

Banner Heart Hospital (AZ)

2.75

$148,900,785

4,664

Fig 1. Data from Definitive Healthcare based on annual fiscal reports released through CMS.