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Editorial |

Medicaid and Children’s Hospitals—A Vital but Strained Double Helix for Children’s Health Care ONLINE FIRST

Matthew M. Davis, MD, MAPP1; Kristin Kan, MD, MPH, MSc2
[+] Author Affiliations
1Ann & Robert H. Lurie Children’s Hospital of Chicago, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
2Robert Wood Johnson Foundation Clinical Scholars, University of Michigan, Ann Arbor
JAMA Pediatr. Published online September 12, 2016. doi:10.1001/jamapediatrics.2016.2328
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Together, state Medicaid programs and children’s hospitals disproportionately contribute to care for children whose health is most vulnerable. Children’s hospitals look to Medicaid to provide coverage for an age group that does not enjoy an entitlement as broad as Medicare for seniors. Medicaid relies on children’s hospitals to provide age-specific, subspecialty-focused, technology-enriched care that is not as readily available in other health care institutions.

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Calculations of Age-Adjusted Disproportionate Share Hospital (A2DSH) Payments in Medicaid

Values for the children’s hospitals and non–children’s hospitals regarding Medicaid Disproportionate Share Hospital (DSH) payments and proportion of patients 18 years or younger are hypothetical illustrations based on the data by Colvin et al.3 Calculations of A2DSH are derived from the mean values of Medicaid DSH, indexed to the mean proportions of discharges for youth in fiscal years (FY) 2015-2017.

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