Ku L, Coughlin T A
Urban Institute, Washington, DC 20037, USA.
Health Care Financ Rev. 1995 Spring;16(3):27-54.
Medicaid disproportionate share hospital (DSH) and related programs, such as provider-specific taxes or intergovernmental transfers (IGTs), help support uncompensated care and effectively reduce State Medicaid expenditures by increasing Federal matching funds. We analyze the uses of these funds, based on a survey completed by 39 States and case studies of 6 States. We find that only a small share of these funds were available to cover the costs of uncompensated care. One method to ensure that funds are used for health care would be to reprogram funds into health insurance subsidies. An alternative to improve equity of funding across the Nation would be to create a substitute Federal grant program to directly support uncompensated care.
医疗补助计划中的高比例分担医院（DSH）及相关项目，如针对特定医疗服务提供者的税收或政府间转移支付（IGTs），有助于支持无偿医疗服务，并通过增加联邦配套资金有效降低州医疗补助计划的支出。我们基于39个州完成的一项调查以及6个州的案例研究，分析了这些资金的用途。我们发现，这些资金中只有一小部分可用于支付无偿医疗服务的费用。确保资金用于医疗保健的一种方法是将资金重新规划为医疗保险补贴。另一种改善全国资金公平性的方法是创建一个替代的联邦拨款计划，以直接支持无偿医疗服务。
