Table 9D - Patient Related Revenue (Scope of Project Only)

National Data

:
Tables 3A through 9E

1373 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 5,974,870,264  41.09%  21.55%  4,744,878,588  41.34%  27.25%  79.41% 
2a. Medicaid Managed Care (capitated) 2,811,826,192  19.34%  10.14%  2,528,833,928  22.03%  14.52%  89.94% 
2b. Medicaid Managed Care (fee-for-service) 5,753,387,431  39.57%  20.75%  4,204,157,798  36.63%  24.15%  73.07% 
3. Total Medicaid (Lines 1+2a+2b)  14,540,083,887  100.00%  52.44%  11,477,870,314  100.00%  65.92%  78.94% 
4. Medicare Non-Managed Care 2,773,789,670  81.57%  10.00%  1,640,240,164  83.09%  9.42%  59.13% 
5a. Medicare Managed Care (capitated) 138,056,609  4.06%  0.50%  98,025,476  4.97%  0.56%  71.00% 
5b. Medicare Managed Care (fee-for-service) 488,772,418  14.37%  1.76%  235,830,290  11.95%  1.35%  48.25% 
6. Total Medicare (Lines 4+5a+5b)  3,400,618,697  100.00%  12.26%  1,974,095,930  100.00%  11.34%  58.05% 
7. Other Public including Non-Medicaid CHIP (Non Managed Care) 360,377,851  73.07%  1.30%  198,491,335  70.70%  1.14%  55.08% 
8a. Other Public, including NonMedicaid CHIP (Managed Care Capitated) 23,197,499  4.70%  0.08%  15,703,333  5.59%  0.09%  67.69% 
8b. Other Public including Non-Medicaid CHIP (Managed Care fee-for-service) 109,588,792  22.22%  0.40%  66,545,930  23.70%  0.38%  60.72% 
9. Total Other Public (Lines 7+8a+8b)  493,164,142  100.00%  1.78%  280,740,598  100.00%  1.61%  56.93% 
10. Private Non-Managed Care 3,893,074,621  84.40%  14.04%  2,228,021,166  86.74%  12.80%  57.23% 
11a. Private Managed Care (capitated) 138,802,509  3.01%  0.50%  73,650,099  2.87%  0.42%  53.06% 
11b. Private Managed Care (fee-for-service) 580,651,142  12.59%  2.09%  267,000,940  10.39%  1.53%  45.98% 
12. Total Private (Lines 10+11a+11b)  4,612,528,272  100.00%  16.64%  2,568,672,205  100.00%  14.75%  55.69% 
13. Self-pay 4,680,727,210  100.00%  16.88%  1,109,443,349  100.00%  6.37%  23.70% 
14. Total (Lines 3+6+9+12+13)  27,727,122,208    100.00%  17,410,822,396    100.00%  62.79% 

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 Payments: P4P, Risk Pools, Withholds, etc.
(c3)
Penalty/
Payback
(c4)
Net Retros Net Retros
% of
Charges
Allowances
(d)
Allowances
% of
Charges
1. Medicaid Non-Managed Care 447,527,973  160,401,527  44,515,465  30,151,163  622,293,802  10.42%  1,302,025,644  21.79% 
2a. Medicaid Managed Care (capitated) 1,016,545,795  120,280,104  206,879,368  28,733,564  1,314,971,703  46.77%  281,866,104  10.02% 
2b. Medicaid Managed Care (fee-for-service) 803,070,666  191,098,514  124,994,798  7,941,672  1,111,222,306  19.31%  1,534,349,655  26.67% 
3. Total Medicaid (Lines 1+2a+2b)  2,267,144,434  471,780,145  376,389,631  66,826,399  3,048,487,811  20.97%  3,118,241,403  21.45% 
4. Medicare Non-Managed Care 21,813,386  17,477,336  8,180,402  2,110,168  45,360,956  1.64%  1,025,515,904  36.97% 
5a. Medicare Managed Care (capitated) 2,103,114  626,045  1,497,914  0 4,227,073  3.06%  39,596,619  28.68% 
5b. Medicare Managed Care (fee-for-service) 4,796,077  2,624,811  3,585,767  254,426  10,752,229  2.20%  226,655,687  46.37% 
6. Total Medicare (Lines 4+5a+5b)  28,712,577  20,728,192  13,264,083  2,364,594  60,340,258  1.77%  1,291,768,210  37.99% 
7. Other Public including Non-Medicaid CHIP (Non Managed Care) 154,719  703,622  157,801  56,127  960,015  0.27%  142,106,359  39.43% 
8a. Other Public including Non-Medicaid CHIP (Managed Care capitated) 1,823,960  4,221,045  810,129  3,056  6,852,078  29.54%  7,453,727  32.13% 
8b. Other Public including Non-Medicaid CHIP (Managed Care fee-for-service) 1,441,770  3,211,329  285,045  102,612  4,835,532  4.41%  38,875,619  35.47% 
9. Total Other Public (Lines 7+8a+8b)  3,420,449  8,135,996  1,252,975  161,795  12,647,625  2.56%  188,435,705  38.21% 
10. Private Non-Managed Care     10,884,550  341,740  10,542,810  0.27%  1,465,575,792  37.65% 
11a. Private Managed Care (capitated)     5,045,567  5,045,567  3.64%  66,419,564  47.85% 
11b. Private Managed Care (fee-for-service)     6,313,085  20,893  6,292,192  1.08%  280,576,155  48.32% 
12. Total Private (Lines 10+11a+11b)      22,243,202  362,633  21,880,569  0.47%  1,812,571,511  39.30% 
13. Self-pay                
14. Total (Lines 3+6+9+12+13)  2,299,277,460  500,644,333  413,149,891  69,715,421  3,143,356,263  11.34%  6,411,016,829  23.12% 

Sliding Discounts
(e)
Bad Debt Write Off
(f)
13. Self-pay 2,892,681,676  455,310,777 

Percents may not equal 100% due to rounding.

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