Study Finds Racial Health Disparities Negatively Impacted by Medicaid and Medicare DSH Payment Model

November 11, 2022

A recently published article in JAMA Network Open found that structural problems in Medicaid and Medicare DSH payment programs hurt the marginalized, low-income populations they are meant to benefit. Data was gathered from DSH programs in largely majority Black counties in all US states except Massachusetts. The results showed that payment models based on healthcare utilization underpay majority Black counties due to barriers of access to care.

According to Victoria Bailey, “Disproportionately Black counties that received the same level of DSH payments as other counties had higher rates of uncompensated care and worse population health, the study found. For example, when keeping Medicare DSH payments per resident constant, uncompensated hospital care rates were 2 percentage points higher in disproportionately Black counties than other counties. Additionally, the share of uninsured residents was 2.5 percentage points higher, there were 75.8 more deaths per 100,000 residents, and the share of residents reporting poor or fair health was 3.6 percentage points higher.”

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(Source: Revcycle Intelligence, November 8th, 2022)

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