Uncompensated care for uninsured patients remains a major challenge for health systems in the United States. Disproportionate Share Hospital (DSH) payments have historically been used to subsidize hospitals treating large numbers of uninsured individuals, yet evidence suggests that the current mechanism generates inefficiencies and uneven resource allocation. Recent policy initiatives, including the Global Payment Program (GPP), emphasize preventive primary care as a strategy to reduce emergency room utilization among uninsured populations. This paper develops a policy framework for jointly financing emergency and primary care services for uninsured patients. Using hospital-level financial data and a stylized health economics model, we analyze how different reimbursement rules affect welfare, hospital incentives, and patient access to care. The findings suggest that integrating direct compensation for emergency services with targeted subsidies for preventive primary care can significantly reduce avoidable emergency visits while improving the efficiency of public health spending. The results provide evidence-based guidance for policymakers designing reimbursement systems that balance hospital sustainability with improved health outcomes for vulnerable populations.
