 FY 2014 IPPS Final Rule Correction Notice and Interim Final Rule with Comment : Supplemental Information on the Medicare DSH Estimates and  Factor 1 in Support of Implementation of Section 3133 of the Affordable Care Act                                                           (September 2013)																
As calculated by the CMS Office of the Actuary																
																
2010 Medicare DSH Payments as reported on March 2013 Update of the Medicare Hospital Cost Report and supplemental data provided by Indian Health Service Hospitals (in millions)																
"$10,353"																
																
"Amount includes Medicare DSH payments for Maryland hospitals, Sole Community Hospitals and  hospitals in the Rural Community Hospital Demonstration"																
																
Increases from 2010																
FY	Update	Discharge	Case mix	Other	Total	Medicare DSH (in millions)										
																
2011	0.9945	1.0088	1	1.0616	1.065051899	"$11,026"										
2012	0.999	0.9892	1.007	1.045	1.039909048	"$11,467"										
2013	1.028	1.004	1.005	0.9934	1.030426561	"$11,815"										
2014	1.009	1.0177	1.005	1.049	1.082561283	"$12,791"										
																
"""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	Market Basket Update	Reductions under Affordable Care Act	Productivity Adjustment	Documentation & Coding Adjustment	Total											
																
2011	2.6	0.25		-2.9	-0.55											
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											
																
All numbers based on Midsession Review of FY 2014 Budget projections.																
