Project your reimbursement impact based on the implementation of the Affordable Care Act, stated CMS intentions and IPPS rules. Under the ACA, the Medicare DSH formula will begin to evolve in FY2014. Hospitals will still receive 25% of their “empirically justified” DSH reimbursement under the traditional formula. The remaining 75% will be redistributed nationally to qualifying hospitals based on their percentage of Low-Income days.

In FY2014, CMS will distribute the 75% uncompensated care pool based on a factor of the hospitals low-income days (SSI + Medicaid days). CMS has stated their desire to eventually apply the uncompensated care model using data from cost report worksheet S-10.

SCA prepares situational analysis for hospitals by modeling the impact of a combination of variables:
  • Factor 1: Total DSH estimate
  • Factor 2: Change in the uninsured population
  • Factor 3: Low – income days (SSI + Medicaid days)
  • Factor 3: CMS switch to Uncompensated Care (S-10)
  • Latest published cost report data (HCRIS)
  • Latest published cost reporting periods
Contact our office to learn about changes under the ACA and how they will impact your facility.