Table 4. Medicaid Skilled Nursing Facility Use of Case-Mix Methods: 1978-89.

State	1978	1979	1980	1981	1982	1983	1984	1985	1986	1987	1988	1989
Alabama	No	No	No	No	No	No	No	No	No	No	No	No
Alaska	No	No	No	No	No	No	No	No	No	No	No	No
Arizona	—	—	—	—	—	—	—	—	—	—	—	No
Arkansas	No	No	No	No	No	No	No	No	No	No	No	No
California	No	No	No	No	No	No	No	No	No	No	No	No
Colorado	No	No	No	No	No	No	No	No	No	No	No	No
Connecticut	No	No	No	No	No	No	No	No	No	No	No	No
District of Columbia	No	No	No	No	No	No	No	No	No	No	No	No
Delaware1	No	No	No	No	No	No	No	No	No	No	No	Yes
Florida	No	No	No	No	No	No	No	No	No	No	No	No
Georgia	No	No	No	No	No	No	No	No	No	No	No	No
Hawaii	No	No	No	No	No	No	No	No	No	No	No	No
Idaho	No	No	No	No	No	No	No	No	No	No	No	No
Illinois	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Indiana	No	No	No	No	No	No	No	No	No	No	No	No
Iowa	No	No	No	No	No	No	No	No	No	No	No	No
Kansas2	No	No	No	No	No	No	No	No	No	No	No	No
Kentucky3	No	No	No	No	No	No	No	No	No	No	No	No
Louisiana	No	No	No	No	No	No	No	No	No	No	No	No
Maine2	No	No	No	No	No	No	No	No	No	No	No	No
Maryland	No	No	No	No	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Massachusetts4	No	No	No	No	No	No	No	No	No	No	No	No
Michigan	No	No	No	No	No	No	No	No	No	No	No	No
Minnesota	No	No	No	No	No	No	No	No	Yes	Yes	Yes	Yes
Mississippi2	No	No	No	No	No	No	No	No	No	No	No	No
Missouri	No	No	No	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Montana	No	No	No	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Nebraska	No	No	No	No	No	No	No	No	Yes	Yes	Yes	Yes
Nevada	No	No	No	No	No	No	No	No	No	No	No	No
New Hampshire	No	No	No	No	No	No	No	No	No	No	No	No
New Jersey	No	No	No	No	No	No	No	No	No	No	No	No
New Mexico	No	No	No	No	No	No	No	No	No	No	No	No
New York	No	No	No	No	No	No	No	No	Yes	Yes	Yes	Yes
North Carolina	No	No	No	No	No	No	No	No	No	No	No	No
North Dakota3	No	No	No	No	No	No	No	No	No	No	No	No
Ohio	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Oklahoma	No	No	No	No	No	No	No	No	No	No	No	No
Oregon	No	No	No	No	No	No	No	No	No	No	No	No
Pennsylvania	No	No	No	No	No	No	No	No	No	No	No	No
Rhode Island	No	No	No	No	No	No	No	No	No	No	No	No
South Carolina	No	No	No	No	No	No	No	No	No	Yes	Yes	Yes
South Dakota2	No	No	No	No	No	No	No	No	No	No	No	No
Tennessee	No	No	No	No	No	No	No	No	No	No	No	No
Texas1	No	No	No	No	No	No	No	No	No	No	No	Yes
Utah	No	No	No	No	No	No	No	No	No	No	No	No
Vermont	No	No	No	No	No	No	No	No	No	No	No	No
Virginia	No	No	No	No	No	No	No	No	No	No	No	No
Washington5	No	No	No	No	No	No	No	No	No	No	No	No
West Virginia	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Wisconsin	No	No	No	No	No	No	No	No	No	No	No	No
Wyoming	No	No	No	No	No	No	No	No	No	No	No	No
Number of States with Case Mix	4	4	4	4	6	7	7	7	10	11	11	13

¹Case mix considered in setting class rates, but individual facility does not have rates altered by Its own case mix.

²Demonstration case-mix program reported.

³Demonstration case-mix program through 1989, full case-mix system implemented in February 1990.

⁴Case-mix system implemented in fiscal year 1991.

⁵Higher reimbursement on a patient-by-patient basis under exceptional care program, but applies to a very small portion of patients (perhaps 10 percent of facilities and well under 1 percent of patients).

SOURCE: Institute for Health and Aging and National Governors' Association: State Medicaid Reimbursement Survey, San Francisco, 1989.