Massachusetts categorizes certain acute hospitals as disproportionate share (DSH) hospitals for a variety of purposes, such as determining provider reimbursement rates for MassHealth and Health Safety Net programs.
A “disproportionate share hospital” is defined in M.G.L. c. 6D sec. 1 as “any acute hospital that exhibits a payer mix where a minimum of 63% of the acute hospital’s gross patient service revenue is attributable to Title XVIII and Title XIX of the Federal Social Security Act, other government payers, and free care.”
A hospital’s DSH status is calculated using the gross patient service revenue payer categories reported to the Center for Health Information and Analysis in the hospital’s cost report (403 Cost Report). A hospital qualifies for DSH status if it has 63% or more of gross patient service revenue attributed to Medicare, Medicaid, and other government payers, including Commonwealth Care and the Health Safety Net.
According to FY2012 403 Cost Report data, thirty-one hospitals qualify as DSH hospitals. The attached spreadsheet lists each DSH hospital for the periods FY2008 – FY2012. The number of DSH designations increased from 36% of Massachusetts acute hospitals in FY2008 to 48% of acute hospitals in FY2012.
It should be noted that Centers for Medicare and Medicaid Services (CMS) determines a hospital’s DSH status according to different criteria.