Annual Analysis of Disproportionate Share Hospital Allotments to States

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March 2018 | Provider Payment

Chapter 3 contains MACPAC’s statutorily required annual analysis of disproportionate share hospital (DSH) payment policy. In this year’s analysis, we continue to find no meaningful relationship between states’ DSH allotments and the three factors that Congress has asked the Commission to study:

  • the number of uninsured individuals;
  • the amounts and sources of hospitals’ uncompensated care costs; and
  • the number of hospitals with high levels of uncompensated care that also provide essential community services for low-income, uninsured, and vulnerable populations.

The analysis finds that since implementation of coverage expansions under the Patient Protection and Affordable Care Act, total hospital charity care continues to fall, with the largest declines occurring in states that expanded Medicaid. Medicaid shortfall, however, increased due to increased Medicaid enrollment.

For more information about MACPAC’s prior DSH reports and ongoing DSH analyses, click here.

Publication Type: Reports to Congress

From: March 2018 Report to Congress on Medicaid and CHIP

Tags: disproportionate share hospital (DSH) payment, financing, hospitals, inpatient hospital services, Medicaid expansion, payment, safety net providers