HRSI works with hospitals who are eligible for the Disproportionate Share Hospital (DSH) program, which allocates federal funding to healthcare facilities that provide services to low-income, self-pay patients.
Most healthcare providers are familiar with the Disproportionate Share Hospital (DSH) program and its supplemental funding to hospitals. What they may not realize is that they’re meeting the DSH eligibility requirements, but failing to receive their rightful share of the appropriations.
Funded by the United States government, the DSH program was designed to assist hospitals that care for a high proportion of low-income, self-pay patients. In 2017, a total of 3,109 hospitals received over $12 billion in DSH funding.
Top 10 States Receiving DSH Funding in 2017.
New York $1,763,093,901
New Jersey $706,609,619
South Carolina $359,479,068
There are two methods to becoming eligible for DSH funding programs and they’re both dizzying. The primary method is based on a complex statutory formula that produces the Medicare DSH patient percentage. The alternate “special exception” method is for urban hospitals with more than 100 hospital beds. They must show evidence that more than 30 percent of their total net inpatient care revenues, other than Medicare or Medicaid, come from state and local government sources for indigent care.
Both methods are complicated and time-consuming, which underscores why many healthcare facilities fail to receive supplemental funding despite being eligible. Who has the internal resources, time, and expertise to extract and analyze the necessary data to prove they’re eligible for funding?
Many facilities outsource the work to vendors who specialize in identifying providers who meet the requirements. They hire them to 1) determine if their facility is eligible; and 2) annually collect and present the necessary data to verify their DSH funding should continue. HRSI is a healthcare receivables specialist located in Philadelphia with over 25 years of experience in uncompensated healthcare reimbursement. They have been a funding champion to hospitals in the Commonwealth of Pennsylvania for nearly three decades.
The 4-Step Process at HRSI
- Request a file from the healthcare provider that includes all Medicare and self-pay patients
- Run the data through HRSI’s cutting-edge batching software to provide results in 72 hours
- Produce results identifying all patients with Medicaid primary or secondary behind Medicare
- Enable healthcare providers to gain or maintain their DSH status