First of all, medical insurance RW is a relative weight, which is the weight given to each DRG or disease combination according to its resource consumption. RW reflects the degree of resource consumption of DRG or disease relative to other diseases and is the benchmark of medical insurance payment. According to the ratio of the average hospitalization expenses of each DRG or disease group to the average hospitalization expenses of all cases. The higher the value, the higher the resource consumption of the disease group or the disease group. RW is mainly used to evaluate the resource consumption of different diseases or treatments, and provide a basis for medical insurance payment.

CMI, namely case combination index, is an index used to evaluate the diagnosis and treatment ability of medical institutions. By analyzing the severity of patients' illness, the difficulty of treatment and the cost of treatment, the patients were divided into groups, and then the average cost of treatment in each group was calculated. The higher the CMI value, the stronger the diagnosis and treatment ability of medical institutions. CMI is mainly used to evaluate the comprehensive diagnosis and treatment ability of medical institutions, and to help medical institutions understand their own service level and advantages, as well as the gap with other institutions.

Attention should be paid to the use of medical insurance cards:

1. Cash withdrawal is prohibited.

No unit or individual may violate the scope and requirements of the medical insurance card, and it is strictly forbidden to take cash.

2. Some provincial and municipal medical insurance cards can be used by the whole family.

In some provinces and cities, such as Zhejiang Province and Guangzhou City, the surplus funds of individual medical insurance accounts over the years can be used to pay the medical insurance expenses of employees' spouses, children, parents and other close relatives who participate in basic medical insurance, so as to realize mutual assistance among family members.

3. The following medical insurance will not be paid.

Seeing a doctor in a non-designated medical institution or buying medicine in a non-designated retail pharmacy (except emergency): self-injury caused by personal fighting, drug abuse or other illegal acts; Treatment for alcoholism, suicide and self-mutilation; Injuries caused by traffic accidents, medical accidents or other liability accidents; And the situation that the state or local regulations should be paid by individuals.

To sum up, there are significant differences between medical insurance RW and CMI in definition, calculation method and application. RW pays more attention to evaluating the resource consumption of disease or treatment, and provides the basis for medical insurance payment; CMI, on the other hand, pays more attention to evaluating the diagnosis and treatment ability of medical institutions and helping them improve service quality and efficiency.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 12

The basic medical insurance premium is levied on a monthly basis, and the employer and employees shall pay the basic medical insurance premium to the tax collection authority within the prescribed time limit. The part that individual employees should pay shall be withheld and remitted by the employer from their wages.