Reg's Blog

Senior and Post-Acute Healthcare News and Topics

Medicaid Case-Mix States: A Reader Question

Recently, a reader asked me a question regarding which states still use RUGs III for their Medicaid case-mix payments. At the time, I honestly didn’t know the answer completely. Based on a little research, I’ve outlined the RUGs status as I currently know it, across the states that utilize Medicaid case-mix. Note: Not all states use a case-mix reimbursement methodology for their Medicaid SNF payments (eighteen don’t). Any readers that know more specifics about any of the states and their status as listed below, are free to comment with additional information.

RUGs IV

  1. Washington
  2. Minnesota

Transitioning to RUGs IV (either upcoming, very recent or at this point in time)

  1. Vermont
  2. Wisconsin
  3. Illinois
  4. Maryland (last cost based state in the country, transition in July of 2014)
  5. Indiana (2015)

RUGs III (some may be in the process of developing a transition)

  1. Montana
  2. Idaho
  3. Nevada
  4. Utah
  5. Colorado
  6. North Dakota
  7. South Dakota
  8. Nebraska
  9. Kansas
  10. Texas
  11. Iowa
  12. Louisiana
  13. Mississippi
  14. Kentucky
  15. Ohio
  16. Maine
  17. New Hampshire
  18. New York
  19. Pennsylvania
  20. West Virginia
  21. Virginia
  22. North Carolina
  23. Georgia

Again, if anyone knows more specifics about any of the above mentioned states, please feel free to comment to this post.

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April 7, 2014 - Posted by | Skilled Nursing | , , , , , , ,

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