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.
From: March 2018 Report to Congress on Medicaid and CHIP