Is DSH the same as 340B?
Christopher Pierce
Updated on March 02, 2026
Disproportionate share hospitals (DSH) are eligible to participate in 340B if their DSH adjustment–a measure that identifies hospitals that treat a disproportionate share of low income Medicare or Medicaid patients–is above 11.75%.
What is the Disproportionate Share Hospital program?
The Disproportionate Share Hospital (DSH) Program is a Medi-Cal supplemental payment program. It was established to reimburse hospitals for some of the uncompensated care costs associated with furnishing inpatient hospital services to Medi-Cal beneficiaries and uninsured individuals.
What does DSH mean in healthcare?
Medicaid disproportionate share hospital (DSH) payments are statutorily required payments intended to offset hospitals’ uncompensated care costs to improve access for Medicaid and uninsured patients as well as the financial stability of safety-net hospitals.
How many hospitals does Massachusetts have?
Massachusetts has 102 hospitals. Eleven meet high U.S. News standards and are ranked in the state. U.S. News also ranked hospitals in the Boston, Springfield, Providence (which encompasses some hospitals in Massachusetts) and Worcester metro areas.
How do you qualify for DSH?
To qualify for DSH funds, a hospital must meet one of two criteria: (1) its number of Medi-Cal inpatient days must be at least one standard deviation above the statewide mean; or (2) its revenues from low- income utilization (including Medi-Cal and uncompensated care) must account for 25% or more of its total revenues.
What is the biggest hospital in Massachusetts?
Massachusetts General Hospital
Total Inpatient Discharges (Jan to Dec 2018) = 302,018
| Rank | Hospital Name | Total Medicare Inpatient Discharges With Criteria (Jan to Dec 2018) |
|---|---|---|
| 1 | Massachusetts General Hospital | 16,220 |
| 2 | Baystate Medical Center | 13,246 |
| 3 | Brigham and Women’s Hospital | 12,547 |
| 4 | South Shore Hospital | 11,831 |
How is operating DSH calculated?
Because Hospital A is located in an urban area, has less than 100 beds, and has a DSH patient percentage of more than 20.2%, the formula for determining the Medicare DSH adjustment is: 5.88% + [. 825 x (DSH % – 20.2%)]. Urban hospitals with less than 100 beds are subject to a maximum DSH adjustment of 12%.
Which hospitals are eligible for a DSH payment adjustment?
Hospitals whose DSH patient percentage exceeds 15 percent are eligible for a DSH payment adjustment based on another statutory formula. The formula varies for urban hospitals with 100 or more beds and rural hospitals with 500 or more beds, hospital that qualify as rural referral centers or sole community hospitals, and other hospitals.
What is the uncompensated care payment for Medicare DSH hospitals?
Each Medicare DSH hospital will receive an uncompensated care payment based on its share of insured low income days (that is, the sum of Medicaid days and Medicare SSI days) reported by Medicare DSH hospitals. Each hospital’s uncompensated care payment is the product of three factors. These three factors are:
How is the DSH patient percentage calculated?
The DSH patient percentage is equal to the sum of the percentage of Medicare inpatient days attributable to patients eligible for both Medicare Part A and Supplemental Security Income (SSI), and the percentage of total inpatient days attributable to patients eligible for Medicaid by not Medicare Part A. The DSH patient percentage is defined as:
When did the Medicare DSH adjustment become effective?
The Medicare DSH Adjustment (42 CFR 412.106) The Medicare DSH adjustment provision under section 1886 (d) (5) (F) of the Act was enacted by section 9105 of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 and became effective for discharges occurring on or after May 1, 1986.
