This background paper describes the history and political evolution of Medicaid’s disproportionate share hospital (DSH) program and examines DSH as it exists today. It highlights the importance of DSH payments for the viability of safety net hospitals and considers the consequences of states’ creative financing strategies for maximizing federal Medicaid matching funds. Finally, this paper reviews several options for improving the structure and effectiveness of the DSH program.
Mechanic, Robert E., "Medicaid's Disproportionate Share Hospital Program: Complex Structure, Critical Payments" (2004). National Health Policy Forum. Paper 144.