Chapter 5 of the March 2021 report fulfills MACPAC’s annual, statutorily mandated obligation to report on Medicaid disproportionate share hospital (DSH) allotments to states for payments to hospitals that serve a high proportion of Medicaid beneficiaries and other low-income patients.
As in prior years, the Commission continues to find little meaningful relationship between state DSH allotments and 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 chapter includes a discussion of planned reductions in DSH allotments and the substantial effect of the COVID-19 pandemic on hospital finances due to the increased costs of treating patients with COVID-19 and disruptions in care. Safety-net providers are particularly vulnerable to financial pressures because they typically have low operating margins. However, data are not yet available to examine the full effects of COVID-19 on hospital finances.
From: March 2021 Report to Congress on Medicaid and CHIP