RT Journal
A1 Neuhausen K, Katz MH
T1 Patient satisfaction and safety-net hospitals: Carrots, not sticks, are a better approach
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2012
FD September 10
VO 172
IS 16
SP 1202
OP 1203
DO 10.1001/archinternmed.2012.3175
UL http://dx.doi.org/10.1001/archinternmed.2012.3175
AB 
Under the Patient Protection and Affordable Care Act (ACA),2 many uninsured patients will gain coverage. This increase in coverage will help SNHs because they will likely have more paying patients. However, another provision of the ACA, a reduction in the Medicaid and Medicare Disproportionate Share Hospital (DSH) programs, may result in SNHs losing more money than they gain through the insurance expansion. The DSH programs provide supplemental payments to hospitals that deliver a disproportionate volume of care to uninsured patients and Medicaid recipients. The ACA requires a $14 billion cut in Medicaid DSH and a $22 billion reduction in Medicare DSH payments from 2014 through 2019.3 These cuts could have a devastating effect on the already precarious finances of SNHs, especially if they are unable to attract or retain newly insured patients.