Table 9D: Patient Related Revenue

National Data

:
Tables 3A through 9E

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  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.

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