Physicians in health care management: 4. Case Mix Groups and Resource Intensity Weights: physicians and hospital funding.

In the second of two articles on Case Mix Groups (CMGs) and Resource Intensity Weights (RIWs) the authors describe how these measures are used to adjust the funding of hospitals in Ontario. Because CMGs and RIWs are based on medical chart information concerning diagnoses, concurrent illnesses and main procedures the role of physicians in recording this information is important to the outcome for hospital funding. CMGs and RIWs provide the basis for the calculations of the average cost per weighted case for hospitals and for groups of comparable hospitals. The Ontario Ministry of Health originally gave equity adjustment payments to hospitals with low average costs per weighted case to raise their funding toward norms of comparable hospitals. However, it is now proposed that hospitals with high average costs per weighted case be targeted for budget cuts. In the face of greater case-mix-based hospital funding in the future physician recording of information will be ever more critical.