Payment Reimbursement and Managed Care

Ask the Experts: SSI percentage and eligibility

May 14, 2019 3:29 pm

Our Supplemental Security Income (SSI) percentage has fluctuated significantly over the past few years. How does your facility track its SSI percentage? Do you rely on the annual publication of SSI percentages issued by the Centers for Medicare & Medicaid Services (CMS)? Does anyone know of a database we can access against which we could bump up our patient data to see if the patient is SSI eligible?

Answer: This is definitely an issue as the SSI ratio bounces around quite a bit. In previous roles, I’ve used a five-year rolling average of the SSI ratio for disproportionate share hospital reserve account models. It’s not perfect by any means but provides a little more stability than the year-to-year volatility. 

This question was answered byChad Mulvany, director, Healthcare Financial Practices Perspectives and Analysis, HFMA.

The information provided through the Forum’s Ask the Expert service does not constitute legal advice, even when the advice is provided by lawyers. You need to obtain your own legal counsel for legal advice and consider the laws and regulations that govern your state. The content and opinions expressed are those of the Forum experts, and not that of their employers or of HFMA. HFMA does not endorse the material or warrant or guarantee its accuracy. The responses are based only on the specific facts or circumstances provided. Forum experts cannot be held liable for outcomes related to any information provided.

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