 FY 2015 IPPS Proposed Rule : Supplemental Information on the Medicare DSH Estimates and  Factor 1 in Support of Implementation of Section 3133 of the Affordable Care Act									
As calculated by the CMS Office of the Actuary									
									
2011 Medicare DSH Payments as reported on December 2013 Update of the Medicare Hospital Cost Report and supplemental data submitted by Indian Health Service Hospital (in billions)									
"$11,498"									
									
"Amount includes Medicare DSH payments for Maryland hospitals, Sole Community Hospitals and  hospitals in the Rural Community Hospital Demonstration"									
									
Increases from 2011									
									
FY	Update	Discharge	Case mix	Other	Total	DSH			
									
2012	0.999	0.9701	1.007	1.0445	1.019341974	11720			
2013	1.028	0.9952	1.01	1.0156	1.049415678	12300			
2014	1.009	1.0172	1.005	1.0328	1.065319334	13103			
2015	1.012	1.0357	1.005	1.0292	1.084127418	14205			
"""Discharge"" column reflects assumptions for all inpatient hospitals, not limited to IPPS hospitals."									
"""Other"" column includes impact of only IPPS discharges and  impact of DSH payments increasing or decreasing at a different rate than other IPPS payments."									
									
									
									
Update column is determined as follows:									
									
FY	MB	ACA cut	Prod	D&C	Total				
									
2012	3	0.1	1	-2	-0.1				
2013	2.6	0.1	0.7	1	2.8				
2014	2.5	0.3	0.5	-0.8	0.9				
2015	2.7	0.2	0.5	-0.8	1.2				
									
All numbers based on FY 2015 Budget projections.									
