Physician Advisor's Corner: What is (and isn’t) in your control regarding your facility CMI

by Trey La Charité, MD, FACP, CCDS
Your CDI program successfully obtained consistent results over the last few years, and all is right within the CDI world. Then, the facility case-mix index (CMI) unexpectedly drops. Provided it rebounds, one or two months below its usual average is probably not cause for a great deal of concern. But what happens when the CMI shows an overall downward trend for six months, or a year, or two years? To be blunt, making an initial positive impact with  your new CDI program is the easy part. Maintaining that momentum over the long haul, year after year, is a more difficult task. After reviewing the CMI trends seen at my facility and investigating the causes of those trends, I have some insight to share if your facility, too, is experiencing this problem.