Estimating PPD Under Proposed RCS

Included in the CMS proposal to scrap RUGS-IV and move to a new system called RCS-1 was a table that showed the estimated percent change in certain RUGs. Using that table and the current 2017 rates, we can (roughly) estimate reimbursement based on current caseload. Keep in mind that this is only an estimate! RCS is bound to change at least some. Also keep in mind that:

  1. RCS was designed using 2014 data because that's what was available.
  2. You should probably be using an average of several months to get a better idea. (You don't have to average. Just add several months to the boxes below.)

RUGS-IV
RCS-I
Difference

Select RUGs

Rehab + Extensive
Rehab
Extensive Services
Special Care High
Special Care Low
Clinically Complex
Behavioral
Reduced Physical Function
RUX RUC ES3 HE2 LE2 CE2 BB2 PE2
RUL RUB ES2 HE1 LE1 CE1 BB1 PE1
RVX RUA ES1 HD2 LD2 CD2 BA2 PD2
RVL RVC   HD1 LD1 CD1 BA1 PD1
RHX RVB   HC2 LC2 CC2   PC2
RHL RVA   HC1 LC1 CC1   PC1
RMX RHC   HB2 LB2 CB2   PB2
RML RHB   HB1 LB1 CB1   PB1
RLX RHA       CA2   PA2
  RMC       CA1   PA1
  RMB            
  RMA            
  RLB            
  RLA