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Decision tool · included

How exposed is this DSH payment?

Medicare disproportionate share and uncompensated-care payments hinge on one percentage staying above a threshold. See where a hospital stands, how it has moved, and what a policy change would do to it.

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Trend & cliffThreshold 15%
FilingDSH %vs 15%Status
FYE 202127.4%+12.4 ptsAbove threshold
FYE 202221.9%+6.9 ptsAbove threshold
FYE 202316.2%+1.2 ptsClose to threshold
FYE 202414.1%−0.9 ptsBelow threshold
DSH analysis · fictional example, not real figures

How it works

From a filing to a plan of action.

  1. 01

    Hospital & filings

    Pick a hospital and see every cost report it has filed, with the Medicare/SSI and Medicaid fractions, the resulting DSH percentage, and the worksheet and line each value was read from.

  2. 02

    Trend & cliff

    Plot the percentage across filed years against the 15% threshold. A hospital that falls below it generally loses the DSH payment and, with it, the uncompensated-care payment that depends on it.

  3. 03

    Scenarios

    Change the Medicaid days and see what happens to the percentage and the payments. The default scenario models the H.R. 1 Medicaid community-engagement requirement from its effective year.

  4. 04

    Report & actions

    A written summary of where the hospital stands and what to do about it, which you can save and return to.

Read the guide: how the 15% threshold works

Where the numbers come from

Filed values, traced to the line.

The model shows what a hospital filed and what the rules produce from it. It does not predict CMS's final figures, and scenario outputs are estimates.

Cost reports
HCRIS Worksheet E Part A and Worksheet S-10, read at the worksheet, line, and column level for every filed year.
CMS published figures
The SSI ratio and the uncompensated-care Factor 3 from CMS's published DSH files, stored by federal fiscal year.
Rules
42 CFR 412.106 for the two fractions, the 15% threshold, and the payment adjustment, held as data so a rule change is a data change.
Checks
The percentage is compared to what CMS and the hospital's own filing show, and any mismatch is flagged instead of smoothed over.

Included

Part of the portal subscription.

No separate price. If the question is bigger than the model, our analysts can work it with you.

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