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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.