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Risk adjustment initiatives in the South

Many risk adjustment initiatives are happening across your region. Some apply to payment, some to reporting and still others to quality. Find out what initiatives are impacting you.

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  • To see the current initiatives affecting your organization, click your state.
National

3M™ APR DRGs Cost Weights and Trims
CMS Inpatient Prospective Payment System
CMS Long Term Care
CMS Inpatient Psychiatric Facilities
TRICARE Inpatient Prospective Payment System
 

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Florida

3M™ Enhanced APGs
3M™ Potentially Preventable Events
3M™ All Patient Refined DRGs
3M™ Potentially Preventable Readmissions
 

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Mississippi

3M™ All Patient Refined DRGs
 

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Oklahoma

3M™ Potentially Preventable Readmissions
 

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South Carolina

3M™ All Patient Refined DRGs
 

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Texas

3M™ Potentially Preventable Complications
3M™ Potentially Preventable Events
3M™ Potentially Preventable Readmissions
3M™ All Patient Refined DRGs
 

Read more.
Arkansas

No current initiatives

Louisiana

No current initiatives

Tennessee

No current initiatives

Alabama

No current initiatives

Georgia

No current initiatives

North Carolina

No current initiatives

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  • The 3M clinical grouping solutions calculate expected reimbursement using predefined logic and a custom rate schedule. You can define the parameters—hospital values, statistics files, and other reimbursement variables—governing payment processing of your patient claims. Look below to find out what is available in your state.


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  • National grouping soutions

    National

    • 3M software also allows hospitals and other interested parties to model grouping and pricing software used by national payers. The software considers regional and hospital-specific factors such as wage areas and graduate medical education payments.
    • The Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System – CMS DRGs and Medicare Severity Diagnosis Related Groups (MS-DRGs) – were developed for classifying claims for Medicare patients in acute care hospitals, long-term care hospitals (LTCHs) and inpatient psychiatric facilities.
    • The Centers for Medicare & Medicaid Services (CMS) Outpatient Prospective Payment System – CMS Ambulatory Payment Classifications (APCs).
    • The TRICARE Inpatient and Outpatient Prospective Payment System -- Developed and maintained by 3M for the Department of Defense (DoD), this system includes additional DRGs not related to the Medicare population and is used by the Department of Veterans Affairs and DoD facilities.
    • Interested in licensing these methodologies? Let our team help.

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  • Florida

    Florida

    • Initiative: 3M™ Enhanced APGs for Agency for Healthcare Administration (AHCA)
      Type: Payment
      Implemented: July 2017
    • Initiative: 3M™ Potentially Preventable Events (PPE) Software for Agency for Healthcare Administration (AHCA)
      Type: Reporting
      Implemented: July 2017
    • Initiative: 3M™ APR DRGs for Agency for Healthcare Administration (AHCA)
      Type: Payment
      Implemented: July 2013
    • Initiative: 3M™ Potentially Preventable Readmissions (PPRs) for Agency for Healthcare Administration (AHCA)
      Type: Reporting
      Implemented: July 2008
    • Interested in licensing these methodologies? Let our team help.

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  • Texas

    Texas

    • Initiative: 3M™ Potentially Preventable Events (PPEs) for Medicaid Managed Care
      Type: Payment adjustment
      Implemented: January 2018
    • Initiative: 3M™ Potentially Preventable Events (PPEs) for Medicaid Managed Long Term Care
      Type: Payment adjustment
      Implemented: January 2018
    • Initiative: Initiative: 3M™ Potentially Preventable Complications (PPCs) for Medicaid (HHSC)
      Type: Payment adjustment
      Implemented: November 2013
    • Initiative: 3M™ Potentially Preventable Readmissions (PPRs) for Medicaid (HHSC)
      Type: Payment adjustment
      Implemented: May 2013
    • Initiative: 3M™ APR DRGs for Medicaid (HHSC)
      Type: Payment
      Implemented: September 2012
    • Initiative: 3M™ Potentially Preventable Events (PPEs) for Medicaid MCP
      Type: Reporting
      Implemented: May 2012
    • Initiative: 3M™ Potentially Preventable Events (PPEs) for Regional Healthcare Partnerships
      Type: Payment Adjustment
      Implemented: September 2013
    • Interested in licensing these methodologies? Let our team help.

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