Improving Data as the First Step to a More Targeted Disproportionate Share Hospital Policy

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March 2016

Chapter 3 of the March 2016 Report to Congress on Medicaid and CHIP discusses the limited availability of data and the rationale behind MACPAC’s recommendation for greater transparency in hospital payment. In the Commission’s view, disproportionate share hospital (DSH) allotments and payments should be better targeted, consistent with their original statutory intent. The scheduled reduction in Medicaid DSH allotments of 16 percent in FY 2018, rising to 55 percent in FY 2025, makes such targeting particularly important.

Greater transparency, which will lead to a more thorough understanding of total Medicaid payments at an institutional level, is critical to developing new approaches to targeting DSH payments. To fill existing data gaps, MACPAC recommends that the Secretary of Health and Human Services collect and report hospital-specific data on all types of Medicaid payments for all hospitals that receive them. In addition, the Secretary should collect and report data on the sources of non-federal share necessary to determine net Medicaid payment at the provider level. Chapter 3 of the March report was originally published online in February 2016 as part of the freestanding Report to Congress on Medicaid Disproportionate Share Hospital Payments.

Publication Type: Reports to Congress

From: March 2016 Report to Congress on Medicaid and CHIP

Tags: Affordable Care Act, data, disproportionate share hospital (DSH) payment, financing, hospitals, payment, safety net providers, supplemental payments, uninsured