Harmony Healthcare Blog

Increase your Medicaid Case Mix Index Tip #4

Posted by The Harmony Team on Mon, Jun 07, 2010


Edited by Kris Mastrangelo

Increase your Medicaid CASE MIX INDEX TIP #4

Cold and Flu Season:  During the case mix window it is more important than ever to have a heightened awareness on patients with cold and flu symptoms.  Patients frequently require additional physician visits, may have additional physician orders, may have a fever and vomiting and may require oxygen.  Patients will often have a diagnosis of pneumonia with fever or weight loss with a fever during these illnesses. 

These above symptoms all are triggers for a higher RUG CMI.

MD Visits/Orders:                   Clinically Complex

Fever and Vomiting:                 Special Care

Oxygen:                                    Clinically Complex

Pneumonia:                               Clinically Complex

Fever and Weight Loss:           Special Care

Pneumonia and Fever:              Special Care

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ARD management is essential in order to effectively obtain the higher RUG level.

Tags: Case Mix, Medicaid Reimbursement

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