We Helped a Medical Center Identify $730K in Additional Medicare DSH Reimbursement

Situation

A medium-sized medical center serving a high Medicare disproportionate share hospital (DSH) population wanted to uncover additional net revenue opportunities tied to prior cost report years. The organization needed an efficient, low-risk approach that could identify potential reimbursement without creating a significant burden for internal teams.

Solution

We reviewed retrospective Medicare DSH days and performed Supplemental Security Income Redetermination (SSIRD) across 24 cost report years. The engagement required no internal hospital data, minimizing lift for the organization, and we completed the work on a no-risk basis. SSIRD reopenings were settled quickly, typically within 180 days.

Outcome

We identified an additional $730,000 in Medicare DSH reimbursement across nine hospital fiscal years. Based on the results, we were engaged to expand services to an additional system facility and has delivered $4.65 million in reimbursement across 13 hospital fiscal years for DSH and SSIRD, ultimately displacing the original vendor.