Engelberg Center for Health Care Reform, Brookings Institution, Washington, DC, USA.
Health Aff (Millwood). 2009 Sep-Oct;28(5):w926-36. doi: 10.1377/hlthaff.28.5.w926. Epub 2009 Aug 18.
Congress and the Obama administration are considering redirecting federal spending on the Medicaid disproportionate-share hospital (DSH) program to help pay for health reform. In this paper, we propose linking federal Medicaid DSH funding to state-level Medicaid enrollment or uninsured populations, or both. This approach could produce as much as $44 billion in federal savings over time without exposing hospitals to uncertain or across-the-board spending cuts. It could also gradually address state variations in Medicaid DSH funding. We also offer ideas to ensure that DSH spending is more directly connected than it is now to improvements in care for vulnerable populations.
国会和奥巴马政府正在考虑重新分配联邦医疗补助计划（Medicaid）中不成比例份额医院（DSH）项目的支出，以帮助支付医改费用。在本文中，我们提议将联邦医疗补助 DSH 资金与州级医疗补助参保人数或未参保人口挂钩，或两者兼而有之。这种方法可以在不使医院面临不确定或全面削减开支的情况下，在一段时间内节省多达 440 亿美元的联邦资金。它还可以逐步解决各州在医疗补助 DSH 资金方面的差异。我们还提供了一些想法，以确保 DSH 支出与弱势群体的护理改善更直接相关。
