Case Mix Index (CMI) Spotlight

Spot your Missing Documentation

Our data-driven approach ensures your clinical documentation tells the full story—accurately reflecting patient complexity and the quality of care provided. This not only supports appropriate reimbursement but also boosts your performance on key quality metrics.

By tapping into extensive external datasets, we analyze Case Mix Index (CMI) and MCC/CC capture rates at a granular, code-level view. The result? Actionable insights that reveal your greatest ICD-10 coding opportunities.

We help you focus where it counts—enhancing your existing Clinical Documentation Integrity (CDI) program, increasing provider engagement, and driving sustainable, long-term results.

What We Do

We combine advanced data insights with focused interventions to elevate your CDI program—driving meaningful, measurable, and sustainable results.

Our Approach

1. Data-Driven Assessment

We begin with a deep dive into your performance using regional and highly detailed peer data to uncover key opportunities:

  • Identify DRG groupings where your Case Mix Index (CMI) falls below expectations

  • Pinpoint specific ICD-10 codes that are frequently missed within those DRGs

  • Highlight physicians whose documentation patterns differ significantly from regional peers

  • Surface coding gaps within those physicians’ patient populations

  • Compare your performance across all DRGs to peers with a similar patient mix

This targeted insight tells you exactly where to focus for the biggest clinical and financial impact.

2. Focused Interventions that Deliver

We don’t reinvent the wheel; we strengthen what’s already working. Our approach is designed to complement your current tools and team, not compete with them.

  • CDI Resource Prioritization: Direct CDI nurse efforts where they will drive the most value

  • Tailored Tools: Provide concurrent and retrospective tools to identify missed opportunities and track code use

  • Physician Engagement: Peer-to-peer, brief, and impactful education that resonates with providers

3. Lasting Results & Long-Term Sustainability

To ensure the improvements stick, we help build a management system that supports ongoing performance monitoring and continuous process refinement.

We also mentor CDI and physician leaders, empowering them to:

  • Review documentation performance regularly

  • Tackle new challenges as they arise

  • Celebrate wins and maintain momentum

With the right insights, targeted actions, and a structure for long-term success, your documentation can consistently reflect the true complexity of care and drive the results you deserve.