Under the Affordable Care Act, Medicare disproportionate share hospitals (DSH) will be paid under an uncompensated care (UC) model. The amount of uncompensated care reimbursement received by a qualifying DSH is determined by 3 factors.
Facts:
Factor 1 establishes the uncompensated care pool. CMS will estimate the total amount of Medicare DSH reimbursement for all qualifying hospitals (under the pre-ACA/traditional DSH formula) in a given federal fiscal year. That estimate is reduced by 25%, which represents the empirically justified Medicare DSH reimbursement that is payable directly to a qualifying DSH ultimately through the settlement of the cost report. The net result is Factor 1.