Oklahoma Medicaid inpatient rates adjusted for 2014

Posted On: 12/11/2013

Some critical access hospitals will see increases of 23 percent in their Medicaid inpatient payment rates for 2014, according to new information published by the Oklahoma Health Care Authority (OHCA).

Oklahoma Medicaid uses a diagnosis related group (DRG) payment method for inpatient hospital services. Inpatient base rates are calculated each year for “peer groups” of hospitals with similar cost characteristics. Hospital payments are calculated by multiplying the hospital’s base rate by a DRG weight, where the DRG weight reflects the relative cost of care for patients in that DRG.  

The base rates are:

 Base Rate
Peer Group  2013   2014
 1 $ 4,073.24 $ 4,146.55
 2 4,250.04  4,378.21
 3 4,638.71  4,743.04
 4 5,431.25    5,713.85

A hospital’s peer group assignment may change from year to year.  Some hospitals will see a base rate reduction of 2.4 percent in 2014 as a result of their classification to a lower-paying peer group. The base rate for the states’ largest hospitals, classified both years in Peer Group 1, will increase 1.8 percent.

A listing of all hospitals’ base rates for 2014 is available on the OHCA Acute General Hospital Inpatient Reimbursement page (click “Active DRG Facilities”).  See “Annual DRG Update Process” on that same page for more information on the peer grouping and base rate calculation methodology.  (Rick Snyder)

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