Table 9D: Patient Related Revenue
National Data
1362 Grantees
| Line | Payer 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 | 6,407,249,129 | 39.89% | 20.53% | 5,052,460,891 | 40.01% | 25.89% | 78.86% |
| 2a. | Medicaid Managed Care (capitated) | 3,262,786,504 | 20.31% | 10.45% | 2,849,882,490 | 22.57% | 14.60% | 87.35% |
| 2b. | Medicaid Managed Care (fee-for-service) | 6,392,920,083 | 39.80% | 20.48% | 4,725,829,844 | 37.42% | 24.21% | 73.92% |
| 3. | Total Medicaid (Lines 1+2a+2b) | 16,062,955,716 | 100.00% | 51.47% | 12,628,173,225 | 100.00% | 64.71% | 78.62% |
| 4. | Medicare Non-Managed Care | 3,134,242,023 | 80.92% | 10.04% | 1,853,837,744 | 82.02% | 9.50% | 59.15% |
| 5a. | Medicare Managed Care (capitated) | 152,687,044 | 3.94% | 0.49% | 111,725,320 | 4.94% | 0.57% | 73.17% |
| 5b. | Medicare Managed Care (fee-for-service) | 586,193,174 | 15.13% | 1.88% | 294,684,917 | 13.04% | 1.51% | 50.27% |
| 6. | Total Medicare (Lines 4+5a+5b) | 3,873,122,241 | 100.00% | 12.41% | 2,260,247,981 | 100.00% | 11.58% | 58.36% |
| 7. | Other Public including Non-Medicaid CHIP (Non-Managed Care) | 385,290,667 | 72.43% | 1.23% | 246,406,603 | 74.54% | 1.26% | 63.95% |
| 8a. | Other Public, including NonMedicaid CHIP (Managed Care Capitated) | 43,181,427 | 8.12% | 0.14% | 24,659,202 | 7.46% | 0.13% | 57.11% |
| 8b. | Other Public including Non-Medicaid CHIP (Managed Care fee-for-service) | 103,443,275 | 19.45% | 0.33% | 59,504,427 | 18.00% | 0.30% | 57.52% |
| 9. | Total Other Public (Lines 7+8a+8b) | 531,915,369 | 100.00% | 1.70% | 330,570,232 | 100.00% | 1.69% | 62.15% |
| 10. | Private Non-Managed Care | 4,548,595,181 | 83.62% | 14.57% | 2,614,088,263 | 85.75% | 13.39% | 57.47% |
| 11a. | Private Managed Care (capitated) | 189,036,555 | 3.48% | 0.61% | 78,348,523 | 2.57% | 0.40% | 41.45% |
| 11b. | Private Managed Care (fee-for-service) | 702,207,269 | 12.91% | 2.25% | 356,075,620 | 11.68% | 1.82% | 50.71% |
| 12. | Total Private (Lines 10+11a+11b) | 5,439,839,005 | 100.00% | 17.43% | 3,048,512,406 | 100.00% | 15.62% | 56.04% |
| 13. | Self-pay | 5,300,482,277 | 100.00% | 16.98% | 1,248,741,884 | 100.00% | 6.40% | 23.56% |
| 14. | Total (Lines 3+6+9+12+13) | 31,208,314,608 | 100.00% | 19,516,245,728 | 100.00% | 62.54% | ||
% may not equal 100% due to rounding.
| Line | 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 | 476,172,574 | 143,114,365 | 60,755,076 | 20,582,575 | 659,459,440 | 10.29% | 1,509,955,435 | 23.57% |
| 2a. | Medicaid Managed Care (capitated) | 1,182,869,318 | 130,520,540 | 263,501,104 | 70,544,998 | 1,506,345,964 | 46.17% | 445,523,633 | 13.65% |
| 2b. | Medicaid Managed Care (fee-for-service) | 921,145,408 | 261,528,002 | 201,365,587 | 12,427,363 | 1,371,611,634 | 21.46% | 1,688,864,744 | 26.42% |
| 3. | Total Medicaid (Lines 1+2a+2b) | 2,580,187,300 | 535,162,907 | 525,621,767 | 103,554,936 | 3,537,417,038 | 22.02% | 3,644,343,812 | 22.69% |
| 4. | Medicare Non-Managed Care | 20,601,534 | 21,616,051 | 6,364,254 | 1,891,203 | 46,690,636 | 1.49% | 1,143,225,103 | 36.48% |
| 5a. | Medicare Managed Care (capitated) | 2,370,906 | 382,388 | 3,033,029 | 2,691 | 5,783,632 | 3.79% | 41,102,107 | 26.92% |
| 5b. | Medicare Managed Care (fee-for-service) | 6,853,664 | 2,695,311 | 7,124,667 | 449,995 | 16,223,647 | 2.77% | 273,779,352 | 46.70% |
| 6. | Total Medicare (Lines 4+5a+5b) | 29,826,104 | 24,693,750 | 16,521,950 | 2,343,889 | 68,697,915 | 1.77% | 1,458,106,562 | 37.65% |
| 7. | Other Public including Non-Medicaid CHIP (Non-Managed Care) | 478,989 | 1,081,789 | 1,056,844 | 40,782 | 2,576,840 | 0.67% | 122,594,635 | 31.82% |
| 8a. | Other Public including Non-Medicaid CHIP (Managed Care capitated) | 2,738,429 | 4,809,970 | 1,488,175 | 0 | 9,036,574 | 20.93% | 24,486,912 | 56.71% |
| 8b. | Other Public including Non-Medicaid CHIP (Managed Care fee-for-service) | 2,430,138 | 2,575,592 | 105,303 | 105,390 | 5,005,643 | 4.84% | 36,650,826 | 35.43% |
| 9. | Total Other Public (Lines 7+8a+8b) | 5,647,556 | 8,467,351 | 2,650,322 | 146,172 | 16,619,057 | 3.12% | 183,732,373 | 34.54% |
| 10. | Private Non-Managed Care | 13,461,535 | 658,188 | 12,803,347 | 0.28% | 1,693,221,373 | 37.23% | ||
| 11a. | Private Managed Care (capitated) | 6,484,862 | 65 | 6,484,797 | 3.43% | 110,403,744 | 58.40% | ||
| 11b. | Private Managed Care (fee-for-service) | 5,345,481 | 218,391 | 5,127,090 | 0.73% | 305,795,301 | 43.55% | ||
| 12. | Total Private (Lines 10+11a+11b) | 25,291,878 | 876,644 | 24,415,234 | 0.45% | 2,109,420,418 | 38.78% | ||
| 13. | Self-pay | ||||||||
| 14. | Total (Lines 3+6+9+12+13) | 2,615,660,960 | 568,324,008 | 570,085,917 | 106,921,641 | 3,647,149,244 | 11.69% | 7,395,603,165 | 23.70% |
| Line | Sliding Fee Discounts (e) |
Bad Debt Write Off (f) |
|
|---|---|---|---|
| 13. | Self-pay | 3,269,059,549 | 515,172,633 |
Percents may not equal 100% due to rounding.