HCA updating grouper versions - July 2022

Washington State Health Care Authority sent this bulletin at 04/20/2022 03:00 PM PDT

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Updated grouper versions - July 2022

The Washington State Health Care Authority (HCA) is updating its grouper versions effective July 1, 2022.

The specific version changes are as follows:

The All Patients Refined Diagnosis Related Groups (APR-DRG) will be updated from V33 to V38.
The Enhanced Ambulatory Patient Groups (EAPG) will be updated from V3.11 to V3.16.

With these updates, both the inpatient and outpatient weights have been updated using the national weights scaled for Washington’s case mix. The new weights will be posted on the HCA website no later than June 1, 2022.

The APR-DRG grouper settings have not been changed, however the EAPG settings have been updated.

Be sure to work with your software representative to ensure you are using the correct grouper settings.

Questions

If you have any questions regarding this transition please contact Sarah Cook, HCA hospital rates unit manager.

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.