RUG Refinement Model

The aim of the "RUG Refinement" is to improve the ability of the existing RUG-III classification system to explain non-therapy ancillary (NTA) costs. The Urban Institute re-examined prior efforts by Abt Associates (2000) and Dr. Brant Fries (2003) using data from our 2001 analysis files and replicated and validated the research. Under this approach, the existing RUG-III classification system continues to be used while adding categories that account for beneficiaries who receive both extensive medical services and rehabilitation, i.e. the medically complex. See download section below for the final report by the Urban Institute, Options for Improving Medicare Payment for SNFs (March 2007), which discusses the refinement analyses. The download section below also contains tables showing the updated RUG-53 unadjusted case-mix indices and the updated 2001 distribution of days for the RUG-44 and RUG-53 models.