Annual Analysis of Disproportionate Share Hospital Allotments to States

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March 2019

Chapter 3 of the March Report to Congress on Medicaid and CHIP contains MACPAC’s annual statutorily required DSH analyses. The analyses in this chapter underscore MACPAC’s prior findings that DSH allotments have little meaningful relationship to measures of uncompensated care at the state level. Much of the variation in state DSH allotments reflects their basis on historic patterns of spending. We also find that CMS’s methodology for implementing DSH allotment reductions would preserve most of this historical variation.

Publication Type: Reports to Congress

From: March 2019 Report to Congress on Medicaid and CHIP

Tags: disproportionate share hospital (DSH) payment, hospitals, Medicaid expansion, payment, supplemental payments, uncompensated care, uninsured