 FY 2016 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									
									
2012 Medicare DSH Payments as reported on March 2014 Update of the Medicare Hospital Cost Report (from HCRIS) and data submitted by Indian Health Service Hospital (in billions)									
"$11,632"									
									
"Amount includes Medicare DSH payments for Maryland hospitals, hospitals in the Indian Health Service, Sole Community Hospitals and  hospitals in the Rural Community Hospital Demonstration"									
									
Increases from 2012									
									
FY	Update	Discharge	Case mix	Other	Total	DSH			
									
2013	1.028	0.9844	1.014	1.0139	1.040393901	12102			
2014	1.009	0.9595	1.015	0.9993	0.981969672	11884			
2015	1.014	0.9885	1.005	1.0485	1.056207204	12552			
2016	1.011	1.0012	1.005	1.0446	1.062644698	13338			
"""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 at a different rate than other IPPS payments."									
									
									
									
Update column is determined as follows:									
									
FY	MB	ACA cut	Prod	D&C	Total				
									
2013	2.6	0.1	0.7	1	2.8				
2014	2.5	0.3	0.5	-0.8	0.9				
2015	2.9	0.2	0.5	-0.8	1.4				
2016	2.7	0.2	0.6	-0.8	1.1				
									
All numbers based on FY 2016 President's Budget projections.									
