Estimating PPD Under Proposed RCS

The CMS proposal to scrap RUGS-IV and move to a new system called Resident Classification System Version 1 included in it some estimates on the impact to PPD. I blogged about the new system as a whole yesterday. You can read that here. Today I am going to focus just on reimbursement. 

The technical report that was released with the proposal included a lot of good information, but there was still a lot of information missing. (CMS: If you're reading this please release the same anonymized data set that Accumen used to devise this system. I can't be the only one who would like to do some analysis.)

Here is Accumen's estimate of the effect this change would have on RUG reimbursement:

This table shows common RUG levels, the percentage of patients in those levels and the estimated percentage reduction in payment for those RUGs. You can see that if you run a lot of ultra high patients you should expect to see a 9% drop in reimbursement. (Use caution since the actual payment will depend on the reason the patient had a qualifying stay AND the length of stay.)

This is table really shows how these particular patients (from 2014) would have paid in the new system. It isn't a guarantee a new set of patients wouldn't look completely different.

With the caveats out of the way, I have created a calculator you can use to see how your current caseload would look using RCS-I. You can find that tool here.