DSH payment under the ACA. Steps to receiving your fair share.

Area of Science:

• Healthcare finance
• Health policy
• Hospital administration

Background:

• Hospitals require specific payment levels for disproportionate share and uncompensated care (UC) under the Affordable Care Act.
• Current methods may not fully capture eligible patient populations or accurately distribute funds.

Purpose of the Study:

• To outline actionable steps for hospitals to obtain appropriate disproportionate share and uncompensated care (UC) payments.
• To guide healthcare providers in optimizing financial reimbursements under federal healthcare legislation.

Main Methods:

• Shift from episodic to continuous patient eligibility management for Medicaid.
• Implement automated systems for tracking patient eligibility for government assistance programs.
• Utilize Worksheet S-10 as the primary basis for UC payment distribution.

Main Results:

• Continuous management enhances the capture of eligible Medicaid days.
• Automated tracking improves accuracy in identifying patients eligible for various aid sources.
• Standardized use of Worksheet S-10 ensures equitable UC payment distribution.

Conclusions:

• Hospitals can secure optimal funding by adopting proactive patient financial management strategies.
• Streamlined processes for eligibility tracking and payment distribution are crucial for financial health.
• Adherence to recommended practices maximizes benefits under the Affordable Care Act.