Medicare Disproportionate Share Payments (better known as DSH) are a critical component of overall Medicare inpatient payments, and help offset the costs of care hospitals incur treating indigent patients.  The Affordable Care Act imposed substantial reductions in DSH payments over time, under the assumption that as ACA achieves its goal of increasing the number of Americans with health care coverage, hospitals would experience a corresponding decrease in their uncompensated care costs.  In addition, ACA fundamentally changed the way hospital DSH payments are defined and determined. 

In FY14, CMS implemented the DSH cuts and payment reforms mandated by Congress.  While the FAH regrets the cuts to vital DSH payments, we generally supports the methodologies adopted by CMS to distribute DSH funds.  The FAH believes these changes are responsive to hospital concerns and consistent with Congressional intent.  Going forward, FAH will continue to closely monitor CMS implementation of DSH policy, work to ensure any future cuts are minimized, and work to ensure DSH funds support the mission of community hospitals to provide access to care for everyone who needs it -- regardless of ability to pay.