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Risk adjustment initiatives in the West

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.
Washington

3M™ APR DRGs
3M™ Enhanced APGs
3M™ Potentially Preventable Readmissions (PPRs)

Read more.
Oregon

No current initiatives

Read more.
Montana

3M™ APR DRGs
 

Read more.
Idaho

No current initiatives

Wyoming

3M™ APR DRGs
 

Read more.
Colorado

3M™ Enhanced APGs
3M™ APR DRGs
3M™ Clinical Risk Groups
 

Read more.
Utah

3M™ APR DRGs
3M™ Clinical Risk Groups (CRGs)
 

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Nevada

3M™ Potentially Preventable Readmissions (PPRs)
 

Read more.
California

3M™ APR DRGs
 

Read more.
Arizona

3M™ APR DRGs
 

Read more.
Alaska

No current initiatives

New Mexico

No current initiatives

Hawaii

3M Potentially Preventable Readmissions (PPRs)
 

Read more.
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
 

Read more.
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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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  • Colorado

    Colorado

    • Initiative: 3M™ Enhanced APGs for Medicaid Department of Health Care Policy and Financing
      Type: Payment
      Implemented: October 2016
    • Initiative: 3M™ APR DRGs for Medicaid Department of Health Care Policy and Financing
      Type: Payment
      Implemented: January 2014
    • Initiative: 3M™ Clinical Risk Groups for Medicaid Department of Health Care Policy and Financing
      Type: Payment Adjustment
      Implemented: September 2012
    • Interested in licensing these methodologies? Let our team help.

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  • Nevada

    Nevada

    • Initiative: 3M™ Potentially Preventable Readmissions (PPRs) for Center for Health Information Analysis
      Type: Reporting
      Implemented: December 2012
    • Initiative: 3M™ APR DRGs for Center for Health Information Analysis
      Type: Reporting
      Implemented: October 2011
    • Interested in licensing these methodologies? Let our team help.

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  • Washington

    Washington

    • Initiative: 3M™ Potentially Preventable Readmissions (PPRs) for Medicaid Health Authority (FFS)
      Type: Reporting
      Implemented: January 2018
    • Initiative: 3M™ APR DRGs for Medicaid Health Authority
      Type: Payment
      Implemented: July 2014
    • Initiative: 3M™ Enhanced APGs for Medicaid Health Authority
      Type: Payment
      Implemented: July 2014
    • Initiative: 3M™ APR DRGs for Department of Labor and Industries
      Type: Payment
      Implemented: October 2012
    • Interested in licensing these methodologies? Let our team help.

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