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HOSPITALS: How many DSH hospitals are there?

Hospitals that serve a higher proportion of low-income patients are eligible to receive disproportionate share payments from state Medicaid programs.

DSH hospital: A hospital that receives disproportionate share hospital (DSH) payments and meets the minimum statutory requirements to be eligible for DSH payments: a Medicaid inpatient utilization rate of at least 1 percent and at least two obstetricians with staff privileges that treat Medicaid enrollees (with certain exceptions” (page 57)

In this report from the Medicaid and CHIP Payment and Access Commission (MACPAC), there is a table that quantifies the number of disproportionate share hospitals (DSH) in the United States as of 2012.

DSH Hospitals: Counts by Type of Hospital

  • 1,865 (55 percent) of Short-term acute care hospitals
  •    565 (42 percent) of Critical access hospitals
  •    129 (26 percent) of Psychiatric hospitals
  •      47 (58 percent) of Children’s hospitals
  •      32 (  7 percent) of Long-term hospitals
  •      32 (13 percent) of Rehabilitation hospitals

Counts by Location

  • 1,681 (40 percent) of urban hospitals
  •    989 (54 percent) of rural hospitals

Counts by Teaching Status

  • 1,921 (39 percent) of non-teaching hospitals
  •    392 (59 percent) of “low-teaching” hospitals
  •    357 (79 percent) of “high-teaching” hospitals

Source: Medicaid and CHIP Payment and Access Commission. (2017, March). Report to Congress on Medicaid and CHIP (pp. 57, 59). Washington, D.C.: MACPAC.  Click here for access: https://www.macpac.gov/wp-content/uploads/2017/03/March-2017-Report-to-Congress-on-Medicaid-and-CHIP.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

What helps a safety net hospital succeed?

Nine safety net hospitals were studied to see what factors might contribute to higher versus lower performance. Safety net hospitals are those with a mission to care for vulnerable populations and typically have a higher percentage of Medicaid patients and uncompensated care.  They are often public hospitals and may struggle to survive.  The authors found that higher-performing safety net hospitals tended to:

  • Develop an efficient process to coordinate patient flow among different providers and levels of care
  • Work on partnerships with other providers
  • Right-size the scope of services offered
  • Invest in the development of staff

Source: Clark, J., and others.  From striving to thriving: systems thinking, strategy, and the performance of safety net hospitals.  Health Care Management Review;38(3):211-223, July-Sept. 2013.

Click here for access to publisher’s website:  http://journals.lww.com/hcmrjournal/Abstract/2013/07000/From_striving_to_thriving__Systems_thinking,.4.aspx  Posted by AHA Resource Center (312) 422-2050, rc@aha.org