Abstract
Objective: The Center for Medicare and Medicaid Services (CMS) Case Mix Index (CMI) is a relative value assigned to a diagnosis-related group (DRG) of patients to determine allocation of resources for care. A higher CMI indicates more resource-intensive cases. CMI depends on accurate coding of pre-existing morbidity and is correlated to an expected postoperative severe morbidity index (SMI) (Clavien-Dindo complication grade 3-4) and mortality index (MI) (Clavien-Dindo complication grade 5). The observed over expected (O/E) ratio is a metric used by CMS to determine payment; if this ratio is greater than 1, the observed morbidity or mortality is higher than the expected.
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