America’s Essential Hospitals has urged the Medicare Payments Advisory Commission (MedPAC) to consider alternatives mechanisms to the commission’s proposed Medicare Safety-Net Index (MSNI) when recommending changes to disproportionate share hospital (DSH) and uncompensated care payments.
In a Jan. 15 comment letter, the association shared its concerns with the commission’s draft recommendations, in which the commission considered increasing DSH and uncompensated care payments by $4 billion while calculating distributions using the MSNI formula.
The association urges MedPAC to consider instead using the designation criteria proposed in the 118th Congress’ Reinforcing Essential Health Systems for Communities Act (H.R. 7397) as an alternative to the MSNI.
MedPAC first recommended the MSNI, which seeks to identify hospitals that are key sources of care for low-income Medicare beneficiaries and target resources towards these hospitals, in 2023. MedPAC’s own analysis, however, found the MSNI redistributed funding from larger, urban, and/or teaching hospitals as smaller, more rural hospitals benefited most.
While thanking the commission for their interest in increasing federal funding for and recognizing “the inadequacy of current Medicare payments to safety net hospitals,” the association noted the MSNI’s failure to account for “all types of low-income patients,” and urges policymakers to “supplement rather than redistribute” existing DSH and uncompensated care payments.
Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.
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