Healthcare Insights
Hospitals with the highest case mix index
A hospital’s case mix index (CMI) reflects the complexity of its patient population and the associated resources for their care.
What does a high CMI mean?
Many factors influence hospital case mix index such as a patient’s condition or overall health prior to their hospital stay, their diagnoses, and any procedures they may need during the course of their care.
Patients are classified into Medicare severity diagnosis-related groups (MS-DRGs) depending on case complexity and medical needs. The Definitive Healthcare HospitalView product uses the average of MS-DRG weights across inpatient claims to calculate a CMI.
Higher CMIs often result in higher reimbursement rates for hospitals. The Centers for Medicare and Medicaid Services (CMS) uses their own CMI calculations based on MS-DRGs and DRGs to determine reimbursement for Medicare and Medicaid beneficiaries.
For example, many of the top 25 hospitals on the list above specialize in spinal surgery, general or orthopedic surgery, or the heart, which can involve complicated patient procedures. Because they treat the most complex cases with potentially higher risk, the hospital may be reimbursed at a higher rate.
The following table lists the 25 highest case mix index hospitals. Results in this analysis are sourced from the Medicare Cost Report (MCR) and reflect the most recent 12-month interval tracked in our database.
Top 25 hospitals by highest case mix index
Rank | Definitive ID | Hospital name | Location | Case mix index | Explore dataset |
---|---|---|---|---|---|
1 | 552489 | Nebraska Spine Hospital | Omaha, NE | 5.35 | Explore |
2 | 1561 | Ascentist Hospital (AKA Doctors Hospital LLC) | Leawood, KS | 5.29 | Explore |
3 | 3321 | Oklahoma Spine Hospital | Oklahoma City, OK | 4.55 | Explore |
4 | 4164 | Northwest Hills Surgical Hospital (AKA Austin Surgery Center) | Austin, TX | 4.39 | Explore |
5 | 1738 | Specialists Hospital Shreveport | Shreveport, LA | 4.38 | Explore |
6 | 776981 | Mercy Specialty Hospital - Southeast Kansas (AKA Premier Surgical Institute) | Galena, KS | 4.21 | Explore |
7 | 3332 | HPI Northwest Surgical Hospital | Oklahoma City, OK | 4.17 | Explore |
8 | 1756 | The Spine Hospital of Louisiana at the NeuroMedical Center (FKA the Neuromedical Center Surgical Hospital) | Baton Rouge, LA | 4.03 | Explore |
9 | 3744 | Ascension Saint Thomas Hospital for Specialty Surgery (FKA the Hospital for Spinal Surgery) | Nashville, TN | 3.98 | Explore |
10 | 274123 | OrthoColorado Hospital | Lakewood, CO | 3.94 | Explore |
11 | 3901 | Baylor Scott & White the Heart Hospital Baylor - Plano | Plano, TX | 3.85 | Explore |
12 | 3364 | Tulsa Spine & Specialty Hospital | Tulsa, OK | 3.81 | Explore |
13 | 1287 | Parkview Ortho Hospital | Fort Wayne, IN | 3.79 | Explore |
14 | 1317 | St Vincent Heart Center of Indiana | Indianapolis, IN | 3.79 | Explore |
15 | 1826 | Physicians Medical Center | Houma, LA | 3.75 | Explore |
16 | 1100 | Northwest Specialty Hospital | Post Falls, ID | 3.71 | Explore |
17 | 764511 | Baylor Scott & White the Heart Hospital Baylor - Denton | Denton, TX | 3.69 | Explore |
18 | 1818 | Avala Hospital (FKA Fairway Medical Center) | Covington, LA | 3.68 | Explore |
19 | 975307 | Townsen Memorial Hospital | Humble, TX | 3.6 | Explore |
20 | 1090 | Treasure Valley Hospital | Boise, ID | 3.6 | Explore |
21 | 5692 | Fred Hutchinson Cancer Center (FKA Seattle Cancer Care Alliance) | Seattle, WA | 3.56 | Explore |
22 | 329 | Fresno Surgical Hospital | Fresno, CA | 3.54 | Explore |
23 | 2548 | CHI Health Nebraska Heart (FKA Nebraska Heart Hospital) | Lincoln, NE | 3.43 | Explore |
24 | 552269 | Cypress Pointe Surgical Hospital | Hammond, LA | 3.41 | Explore |
25 | 4095 | CHI St Luke's Health - Lakeside Hospital | The Woodlands, TX | 3.37 | Explore |
Fig. 1. Data is from the Definitive Healthcare HospitalView product and sourced from the Medicare Cost Report. Accessed July 2023.
Which hospitals have the highest case mix index?
Nebraska Spine Hospital in Omaha and Doctors Hospital in Leawood, Kansas each have CMIs more than 5.25, the highest among U.S. hospitals. Both hospitals specialize in spine surgery, which can be a highly complex procedure and likely contributes to their CMIs.
What is the national average case mix index for hospitals?
Definitive Healthcare calculates a case mix index value for more than 5,800 hospitals in our HospitalView product. The average CMI is 1.50, with a range of values from 0.42 to 5.35.
CMI for the top 25 hospitals on the list above ranges from 3.37 to 5.35, with an average CMI of 3.95.
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