Modeled Disproportionate Share Hospital Payments for FY 2018 under Full S-10 Implementation as Compared to FY 2017 by Hospital Type: Model DSH $ (in millions)							
(0)	(1)	(2)	(3)	(4)	(5)		
Hospital Type	"Number of Estimated DSHs
(FY 2018) "	FY 2017 Final Rule Estimated DSH $ (in millions)	FY 2018 Modeled Estimated DSH $ (in millions)	Dollar Difference: FY 2017 - FY 2018 (in millions)	Percent Change**		
Total	"2,418"	"$9,553"	"$10,931"	"$1,378"	14.4%		
By Geographic Location							
Urban Hospitals	"1,921"	"$9,113"	"$10,195"	"$1,082"	11.9%		
Large Urban Areas	"1,037"	"$5,717"	"$6,478"	$761	13.3%		
Other Urban Areas	884	"$3,396"	"$3,717"	$321	9.5%		
Rural Hospitals	497	$439	$736	$296	67.4%		
Bed Size (Urban)							
0 to 99 Beds	331	$185	$308	$124	67.1%		
100 to 249 Beds	841	"$2,154"	"$2,456"	$302	14.0%		
250+ Beds	749	"$6,775"	"$7,431"	$656	9.7%		
Bed Size (Rural)							
0 to 99 Beds	370	$190	$436	$246	129.3%		
100 to 249 Beds	114	$193	$243	$49	25.5%		
250+ Beds	13	$56	$57	$1	1.9%		
Urban by Region							
New England	92	$387	$404	$17	4.4%		
Middle Atlantic	237	"$1,570"	"$1,398"	-$172	-11.0%		
South Atlantic	314	"$1,724"	"$2,327"	$604	35.0%		
East North Central	324	"$1,252"	"$1,377"	$125	10.0%		
East South Central	128	$566	$586	$20	3.5%		
West North Central	101	$439	$495	$55	12.6%		
West South Central	253	"$1,165"	"$1,810"	$645	55.3%		
Mountain	120	$448	$508	$60	13.5%		
Pacific	311	"$1,448"	"$1,147"	-$301	-20.8%		
Puerto Rico	41	$116	$144	$28	24.5%		
Rural by Region							
New England	12	$16	$26	$10	64.0%		
Middle Atlantic	27	$33	$29	-$5	-13.6%		
South Atlantic	84	$92	$150	$58	63.5%		
East North Central	66	$44	$73	$29	64.5%		
East South Central	136	$141	$146	$5	3.6%		
West North Central	28	$19	$27	$8	43.2%		
West South Central	112	$72	$254	$182	252.7%		
Mountain	27	$15	$25	$10	61.6%		
Pacific	5	$7	$6	-$1	-13.1%		
By Payment Classification							
Urban Hospitals	"1,912"	"$9,106"	"$10,186"	"$1,080"	11.9%		
Large Urban Areas	"1,037"	"$5,717"	"$6,478"	$761	13.3%		
Other Urban Areas	875	"$3,389"	"$3,708"	$319	9.4%		
Rural Hospitals	506	$447	$745	$298	66.8%		
Teaching Status							
Nonteaching	"1,510"	"$2,955"	"$3,526"	$571	19.3%		
Fewer than 100 residents	665	"$3,213"	"$3,391"	$178	5.5%		
100 or more residents	243	"$3,384"	"$4,014"	$630	18.6%		
Type of Ownership							
Voluntary	"1,420"	"$5,971"	"$6,438"	$467	7.8%		
Proprietary	550	"$1,650"	"$1,400"	-$250	-15.2%		
Government	448	"$1,932"	"$3,093"	"$1,162"	60.1%		
Medicare Utilization Percent							
Missing or Unknown	4	$1	$2	$2	246.0%		
0 to 25	424	"$2,972"	"$3,506"	$535	18.0%		
25 to 50	"1,635"	"$6,218"	"$6,946"	$729	11.7%		
50 to 65	309	$352	$459	$107	30.5%		
Greater than 65	46	$11	$17	$6	56.2%		
Source: Dobson | DaVanzo analysis of 2014 Hospital Cost Reports							
"* Dollar DSH calculated by [0.25 * estimated section 1886(d)(5)(F) payments] + [0.75 * estimated section 1886(d)(5)(F) payments * Factor 2 * Factor 3]. When summed across all hospitals projected to receive Medicare DSH payments, Medicare DSH payments are estimated to be $9,553 million in FY 2017 and $10,930 million in FY 2018."							
** Percentage change is determined as the difference between Medicare DSH payments modeled to show the effects of full implementation of Worksheet S-10 in FY 2018 (column 3) and Medicare DSH payments modeled for the FY 2017 IPPS/LTCH PPS final rule (column 2) divided by Medicare DSH payments modeled for the FY 2017 final rule (column 2) times 100 percent.							
