The number of Medicare-Dependent Hospitals declined 28% from fiscal years 2011 through 2017 to 138 as hospitals became ineligible, merged, closed or other changes, according to a report released today by the Government Accountability Office. Under the program, enacted by Congress in 1989, hospitals that serve a high proportion of Medicare patients, have 100 or fewer beds and are generally located in a rural area can qualify for additional payments. The number of MDHs that received an additional payment declined by about 15% from 2011 through 2017, GAO said. Over the period, MDHs also experienced a 6-percentage-point decline in Medicare profit margins and almost a 2-percentage point decline in total facility margins, so that both were negative in 2017, the agency said. The Bipartisan Budget Act of 2018 extended the MDH program through 2022 and required GAO to review the program. 

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