Disproportionate Share Hospitals (DHS) which once served as a safety net to the uninsured and underinsured is under threat to provide the population it was designed to help. Drastic budget cuts to this vital lifeline of the health care system could affect the health care needs of this vulnerable population. At the same time, there must be increased restrain to rein in the costs.
We cannot talk about DSH, without first discussing the role of safety net hospital play in the healthcare system. Per Bailit at el, ...” National data from 2012 reflect that low-income communities experienced 29 percent higher rates of hospitalization, longer average length of stay, and 9 percent lower average hospital costs compared to higher-income communities. Safety …show more content…
First, most notable is Section 3133 of the Affordable Care Act. It limits hospitals to only 25 percent of the amount they previously would have received under the current statutory formula for Medicare DSH. With such a drastic cut in the budget that fee of service care that is being provided becomes non-viable for most safety net hospitals. Another rule that is threatening DSH is the RIN 0938-AS92 Medicaid Program. The main rule is DSH limit is based only on uncompensated care costs. “..The hospital-specific limit prevents hospitals from receiving DSH payments above the level of any net uncompensated cost incurred in the treatment of Medicaid eligibility or uninsured individuals.” It will lead to gaps in reimbursement in the care provided, in turn, will lead hospitals to avoid taking on patients that are uninsured. Third, Medicare has reduced the length of stay that will be covered under DSH. This has led to Medicare and mixed payer patients to be discharged at a higher rate and for a shorter treatment. This has the greatest impact on the Medicare insured children who under the ACA provisions will see a higher discharge rate, when compared to non-Medicare patients. This might also force community hospitals, which serve as safety net hospitals, to close. This will evidently increase the distance that a person must go to find health care.(Colvin et al., 2016; "Disproportionate Share Hospital (DSH)," 2016; Mulvany, 2016; Nikpay, Buchmueller, & Levy,
We cannot talk about DSH, without first discussing the role of safety net hospital play in the healthcare system. Per Bailit at el, ...” National data from 2012 reflect that low-income communities experienced 29 percent higher rates of hospitalization, longer average length of stay, and 9 percent lower average hospital costs compared to higher-income communities. Safety …show more content…
First, most notable is Section 3133 of the Affordable Care Act. It limits hospitals to only 25 percent of the amount they previously would have received under the current statutory formula for Medicare DSH. With such a drastic cut in the budget that fee of service care that is being provided becomes non-viable for most safety net hospitals. Another rule that is threatening DSH is the RIN 0938-AS92 Medicaid Program. The main rule is DSH limit is based only on uncompensated care costs. “..The hospital-specific limit prevents hospitals from receiving DSH payments above the level of any net uncompensated cost incurred in the treatment of Medicaid eligibility or uninsured individuals.” It will lead to gaps in reimbursement in the care provided, in turn, will lead hospitals to avoid taking on patients that are uninsured. Third, Medicare has reduced the length of stay that will be covered under DSH. This has led to Medicare and mixed payer patients to be discharged at a higher rate and for a shorter treatment. This has the greatest impact on the Medicare insured children who under the ACA provisions will see a higher discharge rate, when compared to non-Medicare patients. This might also force community hospitals, which serve as safety net hospitals, to close. This will evidently increase the distance that a person must go to find health care.(Colvin et al., 2016; "Disproportionate Share Hospital (DSH)," 2016; Mulvany, 2016; Nikpay, Buchmueller, & Levy,