Most hospital finance teams are focused on maintaining or improving revenue capture quarter to quarter. It is also helpful to know how your program is trending long term.
My colleagues at Health Data Analytics Institute have trended the 100 US hospitals that had the best revenue capture performance in the first half of 2026. We quantify revenue cycle performance by calculating observed to expected case mix index, or OE CMI. This number reflects a given hospital’s results compared with others where case mix index is adjusted for patient severity.
Below are the top 100 Hospitals in 2026 CMI (through June) with greater than 5,724 annual Medicare fee for service discharges in 2025. These hospitals represent the largest ~300 hospitals in the country. If you would like to see your hospital’s performance, please contact us for your personalized data.
Each hospital is assigned to one of four segments—Consistent Excellence, Navigating Turbulence, Rising Stars, and Cooling Off—based on their trends in CMI vs. expected since 2022.
The graph below highlights the 12 hospitals in the Cooling Off segment, with their weighed average performance represented by the thick red line.
Observed to Expected Case Mix Index, Top 100 US Hospitals
2022 – H1 2026
It is possible that leaders in the Cooling Off segment feel pretty good about their revenue cycle performance. Hospitals in this group had a median OE CMI 1.7% higher than an average US hospital.
But they are capable of better. In 2022 these same hospitals had an OE CMI of 1.032. in other words, despite strong relative performance, OE CMI for these hospitals dropped 1.5 percentage points in five years. For a hospital with 5,000 FFS beneficiaries generating revenue of $15,000 per admission, this could translate to $1.1 million per year. Scaling the same pattern to Medicare Advantage and commercial patients, the total impact could easily reach $2 – $3 million. That is an impressive figure for a hospital already in the top 100.
The key is expanding leadership focus from quarter-on –quarter to year-on-year performance. Taking the long view highlights opportunities, even for hospitals starting with a strong baseline.
My colleagues have built a tool that allows hospitals to access and analyze their own revenue capture performance, including specific DRGs and service lines that represent potentially poor diagnostic capture.
Please sign up for a demo and my colleagues and we would be happy to share those findings with you.
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