The Centers for Medicare and Medicaid Services (CMS) published the Supplemental Security Income (SSI) percentages for fiscal year 2023. This ratio will apply to cost report years beginning on or after Oct. 1, 2022, and prior to Oct. 1, 2023. Nationally, the overall FFY23 SSI ratio decreased 0.12% from the FFY22 SSI ratio. However, we’ve observed significant fluctuations on a hospital-by-hospital basis.
As a key component of the Medicare Disproportionate Share Hospital (DSH) calculation, these ratios are crucial for hospitals aiming to qualify for various financial assistance programs, including empirically justified DSH payments, the uncompensated care program (UCC), and potential cost savings through the 340B Drug Pricing Program.
The SSI percentage has played a significant role in 340B qualification. Providers need to be sure and consider what has happened to inpatient payor mix since the last SSI release. Many providers have experienced declines in Medicaid days due to redetermination. Others have had patient mix shifts due to staffing constraints and changes within the community. Given these dynamics and tight hospital margins, it’s more important than ever to understand the full impact the latest SSI release will have on your organization.
What should you do with this information?
- Review the FFY23 SSI ratio compared to the previous years to estimate the impact on Medicare DSH reimbursement. Identify any significant changes that could affect financial planning and budgeting.
- Determine if the latest ratio changes your hospital’s ability to qualify for the 340B program. By leveraging the latest SSI data, you can better assess your hospital’s eligibility for, or potential loss of340B savings.
- Investigate whether realigning your hospital’s SSI data reporting or patient categorization could optimize your DSH adjustment.
Take a closer look at how the SSI data directly affects your inpatient prospective payment system or rehabilitation facilities:
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