Chapter 1 contains MACPAC’s annual analysis of 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 previous years, the Commission continues to find little meaningful relationship between states’ DSH allotments and indicators of their need for DSH funds. This year’s analysis finds that two of these indicators—the number of uninsured individuals and the amount of uncompensated care—are increasing nationally just as hospitals face a statutorily required DSH allotment reduction.
The analysis also takes a deeper look at the extent to which DSH hospitals provide obstetric services, one of the 10 types of hospital services included in the Commission’s definition of essential community services. It concludes with an update on California’s Global Payment Program, a Section 1115 demonstration that tests whether distributing DSH funding as a global payment will encourage hospitals to reduce avoidable hospital use for patients who are uninsured.
From: March 2020 Report to Congress on Medicaid and CHIP