Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota.
Hennepin Healthcare Research Institute, Minneapolis, Minnesota.
JAMA Netw Open. 2019 Aug 2;2(8):e198562. doi: 10.1001/jamanetworkopen.2019.8562.
Safety-net hospitals (SNHs) in the United States provide care for individuals and families regardless of their ability to pay. Since 1986, SNHs have received supplemental federal compensation through Medicare Disproportionate Share Hospital (DSH) payments. These payments have historically been calculated based on the proportion of hospital days accounted for by Medicare Supplemental Security Income plus Medicaid, non-Medicare inpatient days. The Affordable Care Act (ACA) modified this definition and reduced DSH payments to offset a growing insured, low-income population.
美国的安全网医院（SNH）为无论支付能力如何的个人和家庭提供医疗服务。自 1986 年以来，SNH 通过医疗保险的差额拨款医院（DSH）支付获得了联邦政府的额外补偿。这些支付款项的计算历史上是基于 Medicare 补充保障收入和医疗补助占医院住院天数的比例，以及非 Medicare 住院天数。平价医疗法案（ACA）修改了这一定义，并减少了 DSH 支付，以抵消不断增长的参保低收入人群。
