While data show that Medicare hospital inpatient margins remain relatively healthy, more hospitals had negative margins in 1998 than 1996. Thus, MedPAC recommends an increase in the hospital inpatient update over current law in 2001. As noted above, rural hospitals are, in general, disproportionately affected by Medicare payment reductions. However, other payment increases appear to be warranted to help the long-term viability of rural hospitals. Disproportionate share payments.
Hospitals are often the last resort for people without health insurance.
Some uninsured use hospital emergency rooms for primary care while others delay care until their problems become more severe and costly. This coincides with reductions in payments from private payers which traditionally has helped fund uncompensated care. Puerto Rico hospitals. The BBA improved payments to Puerto Rico hospitals by increasing the proportion of the payment that is based on national rates from 25 to 50 percent. Replace the BBA s Medicaid DSH reductions for 2001 with a one-year freeze, so that the Federal share DSH limits for FY 2000 would also apply in 2001.