The Medicaid program subsidizes indigent care through payments to disproportionate share hospitals (DSHs). The Preamble Hospital is a DSH. As a DSH, Preamble most likely:
A) Receives financial assistance from the federal government but not a state government.
B) Is at a higher risk of operating at a loss than are most other hospitals.
C) Receives no payments directly from Medicaid for services rendered but rather receives a portion of the capitation payment that Medicaid makes to the health plans with which Preamble contracts.
D) Is eligible for capitation rates that are significantly higher than the FFS average for all covered Medicaid services.

Question

Quizplus · Accepted Answer

Disproportionate share hospitals (DSHs) are hospitals that serve a high percentage of low-income and uninsured patients, and as a result, they are at a higher risk of operating at a loss than are most other hospitals. Medicaid provides financial assistance to DSHs to help offset their uncompensated care costs. Preamble Hospital is a DSH, so it is likely that it serves a high percentage of low-income and uninsured patients, which puts it at a higher risk of operating at a loss. Choice A is incorrect because DSHs may receive financial assistance from both the federal and state governments. Choice C is incorrect because DSHs receive payments directly from Medicaid for services rendered, in addition to the payments they receive from Medicaid as a DSH. Choice D is incorrect because DSHs are not eligible for capitation rates that are significantly higher than the FFS average for all covered Medicaid services.

The Medicaid Program Subsidizes Indigent Care Through Payments to Disproportionate