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Review of Draft March Report Chapter: Analyzing Disproportionate Share Hospital Allotments to States

Congress requires MACPAC to report annually on the relationship between federal disproportionate share hospital (DSH) allotments to states and three indicators of the need for DSH funds: (1) the number of uninsured individuals; (2) the amount of hospital uncompensated care; and, (3) the number of hospitals with high levels of uncompensated care that also provide essential community services.

This slide set reviews a draft chapter on DSH payment planned for the March 2018 report finding, among other issues, that:

  • there continues to be little meaningful relationship between DSH allotments and the factors that Congress asked MACPAC to consider, even after DSH allotment reductions;
  • 18 states have fiscal year (FY) 2018 DSH allotment reductions that are greater than the decline in uncompensated care between 2013 and 2015; and
  • FY 2018 DSH allotments exceed the total amount of uncompensated care in 2015 in 11 states.