 FY 2015 IPPS Final 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 March 2014 Update of the Medicare Hospital Cost Report (from HCRIS) and data submitted by Indian Health Service Hospital (in billions)									
"$11,499"									
									
"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	1.0447	1.019537157	11724			
2013	1.028	0.9799	1.014	1.0132	1.034922928	12133			
2014	1.009	0.9855	1.005	1.0355	1.034817965	12556			
2015	1.014	1.0116	1.005	1.034	1.065941513	13383			
"""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. It also includes adjustments not reflected in the other columns, such as the increase in rates for the Cape Cod litigation and the reduction in rates for the two midnight policy. In addition, the ""Other"" column includes a factor for the Medicaid expansion due to the Affordable Care Act"									
									
									
									
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	2.9	0.2	0.5	-0.8	1.4				
									
All numbers based on Mid-Session Review of FY 2015 Budget projections.									
									
									
									
Completion Factors Applied to Inpatient Hospital Claims Data 									
									
	Discharges	Reimbursement							
6 months after period	0.9947	0.9735							
18 months after period	0.9964	0.9887							
30 months after period	0.9989	0.9973							
									
"To complete the claims data to estimate inpatient discharges and Medicare reimbursement , these are the factors which were used."									
"For instance, 6 months after the end of a year, that year's discharge data should be multiplied by 0.9947 to get to the final estimate of discharges."									
