Idaho: Moving to 3M APR DRGs for inpatient reimbursement

The Idaho Department of Health and Welfare (DHW) intends to implement 3M™ All Patient Refined DRG (APR DRG) as the payment method for inpatient hospitals stays for the Medicaid program on July 1, 2021. The 3M APR DRG methodology classifies hospital inpatient stays according to the reason for admission, severity of illness and risk of mortality. By using 3M APR DRG Idaho DHW will have a better understanding of the clinical complexity of the patient population to base accurate value-based reimbursement. Medicaid agencies, commercial payers and Medicaid managed care organizations nationwide use 3M APR DRGs for risk adjustment, claims payment and as the basis for hospital quality measurement.  More information is located on the DHW website here.

Publication Date: May 2021

Read Article

Source: Idaho Department of Health and Welfare