Table 9D - Patient Related Revenue

National Data

:
Tables 3A through 9E

1367 Grantees


Payor Category Charges Collections
Full Charges
This Period
(a)
% of payer % of Total Amount Collected
This Period
(b)
% of payer % of Total % of Charges
1. Medicaid Non-Managed Care 5,363,673,738  41.9%  21.9%  4,180,470,786  40.6%  27.0%  77.9% 
2a. Medicaid Managed Care (capitated) 2,621,734,701  20.5%  10.7%  2,494,444,030  24.2%  16.1%  95.1% 
2b. Medicaid Managed Care (fee-for-service) 4,803,265,803  37.6%  19.6%  3,613,877,086  35.1%  23.4%  75.2% 
3. Total Medicaid (Sum lines 1+2a+2b)  12,788,674,242  100.0%  52.2%  10,288,791,902  100.0%  66.5%  80.5% 
4. Medicare Non-Managed Care 2,487,951,162  82.8%  10.2%  1,421,574,536  84.0%  9.2%  57.1% 
5a. Medicare Managed Care (capitated) 123,330,377  4.1%  0.5%  77,203,595  4.6%  0.5%  62.6% 
5b. Medicare Managed Care (fee-for-service) 392,162,710  13.1%  1.6%  193,269,584  11.4%  1.2%  49.3% 
6. Total Medicare (Sum lines 4+5a+5b)  3,003,444,249  100.0%  12.3%  1,692,047,715  100.0%  10.9%  56.3% 
7. Other Public including Non-Medicaid CHIP (Non Managed Care) 348,199,460  75.1%  1.4%  189,483,834  74.0%  1.2%  54.4% 
8a. Other Public including Non-Medicaid CHIP (Managed Care Capitated) 26,898,742  5.8%  0.1%  17,727,264  6.9%  0.1%  65.9% 
8b. Other Public including Non-Medicaid CHIP (Managed Care fee-for-service) 88,674,331  19.1%  0.4%  48,943,516  19.1%  0.3%  55.2% 
9. Total Other Public (Sum lines 7+8a+8b)  463,772,533  100.0%  1.9%  256,154,614  100.0%  1.7%  55.2% 
10. Private Non-Managed Care 3,275,404,553  82.6%  13.4%  1,873,284,669  84.1%  12.1%  57.2% 
11a. Private Managed Care (Capitated) 137,710,280  3.5%  0.6%  88,524,482  4.0%  0.6%  64.3% 
11b. Private Managed Care (fee-for-service) 552,744,112  13.9%  2.3%  266,171,262  11.9%  1.7%  48.2% 
12. Total Private (Sum lines 10+11a+11b)  3,965,858,945  100.0%  16.2%  2,227,980,413  100.0%  14.4%  56.2% 
13. Self Pay 4,277,291,435  100.0%  17.5%  1,004,791,680  100.0%  6.5%  23.5% 
14. Total (Sum lines 3+6+9+12+13)  24,499,041,404    100.0%  15,469,766,324    100.0%  63.1% 

payer Category Retroactive Settlements, Receipts, and Paybacks (c) Allowances
Collection of
recon./wrap
around Current
Year
(c1)
Collection of
recon./wrap
around
Previous Years
(c2)
Collection of
other
retroactive
payments
(c3)
Penalty/
Payback
(c4)
Net Retros Net Retros
% of
Charges
Allowances
(d)
Allowances
% of
Charges
1. Medicaid Non-Managed Care 410,426,889  114,172,841  41,681,567  29,652,900  536,628,397  10.0%  1,224,571,397  22.8% 
2a. Medicaid Managed Care (capitated) 995,754,359  148,608,599  215,614,312  14,172,719  1,345,804,551  51.3%  130,232,531  5.0% 
2b. Medicaid Managed Care (fee-for-service) 743,959,945  186,457,965  104,508,317  5,858,729  1,029,067,498  21.4%  1,176,925,335  24.5% 
3. Total Medicaid (Sum lines 1+2a+2b)  2,150,141,193  449,239,405  361,804,196  49,684,348  2,911,500,446  22.8%  2,531,729,263  19.8% 
4. Medicare Non-Managed Care 17,064,057  14,011,984  4,625,368  910,948  34,790,461  1.4%  950,095,358  38.2% 
5a. Medicare Managed Care (capitated) 2,644,800  340,252  1,741,668  24,411 4,702,309  3.8%  45,468,539  36.9% 
5b. Medicare Managed Care (fee-for-service) 5,574,716  2,076,859  3,579,650  77,794  11,153,431  2.8%  175,051,974  44.6% 
6. Total Medicare (Sum lines 4+5a+5b)  25,283,573  16,429,095  9,946,686  1,013,153  50,646,201  1.7%  1,170,615,871  39.0% 
7. Other Public including Non-Medicaid CHIP (Non Managed Care) 198,141  187,686  175,620  12,339  549,108  0.2%  143,483,054  41.2% 
8a. Other Public including Non-Medicaid CHIP (Managed Care Capitated) 2,386,687  1,825,433  848,037  284  5,059,873  18.8%  9,148,376  34.0% 
8b. Other Public including Non-Medicaid CHIP (Managed Care fee-for-service) 1,522,547  1,588,041  37,791  79,718  3,068,661  3.5%  34,891,178  39.3% 
9. Total Other Public (Sum lines 7+8a+8b)  4,107,375  3,601,160  1,061,448  92,341  8,677,642  1.9%  187,522,608  40.4% 
10. Private Non-Managed Care     7,987,701  359,029  7,628,672  0.2%  1,220,092,445  37.3% 
11a. Private Managed Care (Capitated)     2,828,462  2,828,462  2.1%  48,354,602  35.1% 
11b. Private Managed Care (fee-for-service)     4,475,561  13,349  4,462,212  0.8%  259,891,870  47.0% 
12. Total Private (Sum lines 10+11a+11b)      15,291,724  372,378  14,919,346  0.4%  1,528,338,917  38.5% 
13. Self Pay                
14. Total (Sum lines 3+6+9+12+13)  2,179,532,141  469,269,660  388,104,054  51,162,220  2,985,743,635  12.2%  5,418,206,659  22.1% 

13. Self Pay Sliding Discounts (e) Bad Debt Write Off (f)
2,670,166,301  410,833,632 

Percents may not equal 100% due to rounding

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