AHCCCS APR-DRG REBASE 2021

10/01/2021 Update


On October 1st, 2014, AHCCCS launched a new inpatient hospital reimbursement methodology utilizing All Patient Refined, Diagnosis-Related Groups or APR-DRGs. The APR-DRG payment methodology is better aligned with the agency’s focus on improved patient care and health outcomes for its members, and incentivizes quality of care. This payment methodology was first rebased in 2017.

AHCCCS is partnering with Guidehouse Consulting to conduct a 2021 rebase of the APR-DRG reimbursement methodology. Currently, AHCCCS is on Version 34 of 3M's DRG software, and is looking to move to Version 38 of the software. The rebase process is underway, with an expected completion of April 30th, 2021.

Timeline

DRG analysis 02/10/2017-04/14/2017
First Workgroup Meeting 03/18/2021
Tribal Consultation 03/24/2021
Second Workgroup Meeting 04/22/2021
Notice of Proposed Rulemaking 06/18/2021
Comment Period 06/18/2021 - 08/09/2021
Notice of Final Rulemaking to GRRC 08/24/2021
Implementation of New Version DRG 10/01/2021

Public Presentations