Massachusetts categorizes certain acute hospitals as disproportionate share hospitals (DSH) for purpose of setting MassHealth rates.
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 (CHIA) 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.
It should be noted that Centers for Medicare and Medicaid Services (CMS) determines a hospital’s DSH status according to different criteria.