The Medicare Disproportionate Share Hospital (DSH) payment adjustment is intended to compensate those hospitals serving a disproportionate number of low-income patients. Begun in 1986, the program was amended by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to impose a 12% cap on the payment, with exception for large hospitals and Rural Referral Centers. This policy brief from the RUPRI Center for Rural Health Policy Analysis describes the number and location of urban and rural hospitals affected by that cap. Read more here.
