Table 9D: Patient Related Revenue
National Data
1,370 Awardees
| 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 | $7,835,283,258 | 37.16% | 18.20% | $6,462,758,273 | 36.32% | 22.74% | 82.48% |
| 2a. | Medicaid Managed Care (capitated) | $4,657,130,612 | 22.09% | 10.82% | $4,525,175,205 | 25.43% | 15.93% | 97.17% |
| 2b. | Medicaid Managed Care (fee-for-service) | $8,590,795,056 | 40.75% | 19.95% | $6,807,977,617 | 38.26% | 23.96% | 79.25% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $21,083,208,926 | 100.00% | 48.97% | $17,795,911,095 | 100.00% | 62.63% | 84.41% |
| 4. | Medicare Non-Managed Care | $4,673,741,905 | 74.26% | 10.86% | $2,782,126,295 | 73.00% | 9.79% | 59.53% |
| 5a. | Medicare Managed Care (capitated) | $362,203,712 | 5.75% | 0.84% | $323,554,787 | 8.49% | 1.14% | 89.33% |
| 5b. | Medicare Managed Care (fee-for-service) | $1,257,813,542 | 19.99% | 2.92% | $705,707,019 | 18.52% | 2.48% | 56.11% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $6,293,759,159 | 100.00% | 14.62% | $3,811,388,101 | 100.00% | 13.41% | 60.56% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $433,477,719 | 68.24% | 1.01% | $284,976,021 | 70.62% | 1.00% | 65.74% |
| 8a. | Other Public, including Non-Medicaid CHIP, Managed Care (capitated) | $28,973,301 | 4.56% | 0.07% | $14,286,129 | 3.54% | 0.05% | 49.31% |
| 8b. | Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) | $93,673,704 | 14.75% | 0.22% | $51,640,325 | 12.80% | 0.18% | 55.13% |
| 8c. | Other Public, including COVID-19 Uninsured Program | $79,076,726 | 12.45% | 0.18% | $52,620,937 | 13.04% | 0.19% | 66.54% |
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b + 8c) | $635,201,450 | 100.00% | 1.48% | $403,523,412 | 100.00% | 1.42% | 63.53% |
| 10. | Private Non-Managed Care | $7,319,006,110 | 84.78% | 17.00% | $4,328,417,499 | 85.83% | 15.23% | 59.14% |
| 11a. | Private Managed Care (capitated) | $223,812,092 | 2.59% | 0.52% | $84,186,822 | 1.67% | 0.30% | 37.61% |
| 11b. | Private Managed Care (fee-for-service) | $1,089,770,340 | 12.62% | 2.53% | $630,554,866 | 12.50% | 2.22% | 57.86% |
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $8,632,588,542 | 100.00% | 20.05% | $5,043,159,187 | 100.00% | 17.75% | 58.42% |
| 13. | Self-Pay | $6,410,634,862 | 100.00% | 14.89% | $1,361,308,618 | 100.00% | 4.79% | 21.24% |
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $43,055,392,939 | 100.00% | $28,415,290,413 | 100.00% | 66.00% | ||
| Line | Payer Category | Retroactive Settlements, Receipts, and Paybacks(c) | Adjustments | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Collection of Reconciliation /Wraparound Current Year(c1) $ |
Collection of Reconciliation /Wraparound Previous Years(c2) $ |
Collection of Other Payments: P4P, Risk Pools, etc.(c3) $ |
Penalty/ Payback (c4) $ |
Net Retros $ |
Net Retros % of Charges | Adjustments (d) $ |
Adjustments % of Charges | ||
| 1. | Medicaid Non-Managed Care | $664,156,938 | $282,145,293 | $106,037,833 | $57,167,648 | $995,172,416 | 12.70% | $1,449,607,642 | 18.50% |
| 2a. | Medicaid Managed Care (capitated) | $1,777,887,884 | $314,829,793 | $320,662,950 | $94,563,595 | $2,318,817,032 | 49.79% | $197,367,521 | 4.24% |
| 2b. | Medicaid Managed Care (fee-for-service) | $1,425,188,976 | $316,807,031 | $323,411,990 | $18,856,760 | $2,046,551,237 | 23.82% | $2,081,328,833 | 24.23% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $3,867,233,798 | $913,782,117 | $750,112,773 | $170,588,003 | $5,360,540,685 | 25.43% | $3,728,303,996 | 17.68% |
| 4. | Medicare Non-Managed Care | $26,613,739 | $27,260,930 | $31,542,562 | $871,554 | $84,545,677 | 1.81% | $1,755,403,016 | 37.56% |
| 5a. | Medicare Managed Care (capitated) | $5,881,518 | $1,962,302 | $14,264,200 | $3,223 | $22,104,797 | 6.10% | $41,499,117 | 11.46% |
| 5b. | Medicare Managed Care (fee-for-service) | $11,282,999 | $4,202,564 | $14,823,245 | $116,925 | $30,191,883 | 2.40% | $492,136,317 | 39.13% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $43,778,256 | $33,425,796 | $60,630,007 | $991,702 | $136,842,357 | 2.17% | $2,289,038,450 | 36.37% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $748,382 | $1,003,130 | $1,184,571 | $32,466 | $2,903,617 | 0.67% | $131,112,422 | 30.25% |
| 8a. | Other Public, including Non-Medicaid CHIP, Managed Care (capitated) | $1,283,344 | $2,352,153 | $74,627 | $182 | $3,709,942 | 12.80% | $14,478,515 | 49.97% |
| 8b. | Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) | $1,795,210 | $1,213,518 | $203,055 | $22,578 | $3,189,205 | 3.40% | $32,065,102 | 34.23% |
| 8c. | Other Public, including COVID-19 Uninsured Program | $127,601 | $16,894 | $110,707 | 0.14% | $39,840,090 | 50.38% | ||
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b + 8c) | $3,826,936 | $4,568,801 | $1,589,854 | $72,120 | $9,913,471 | 1.56% | $217,496,129 | 34.24% |
| 10. | Private Non-Managed Care | $35,730,384 | $254,344 | $35,476,040 | 0.48% | $2,543,302,229 | 34.75% | ||
| 11a. | Private Managed Care (capitated) | $4,504,029 | $196 | $4,503,833 | 2.01% | $141,263,476 | 63.12% | ||
| 11b. | Private Managed Care (fee-for-service) | $5,157,217 | $41,413 | $5,115,804 | 0.47% | $430,198,238 | 39.48% | ||
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $45,391,630 | $295,953 | $45,095,677 | 0.52% | $3,114,763,943 | 36.08% | ||
| 13. | Self-Pay | ||||||||
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $3,914,838,990 | $951,776,714 | $857,724,264 | $171,947,778 | $5,552,392,190 | 12.90% | $9,349,602,518 | 21.72% |
| Line | Sliding Fee Discounts (e) $ |
Bad Debt Write-Off (f) $ |
|
|---|---|---|---|
| 13. | Self-Pay | $3,944,501,257 | $622,262,239 |
Footnotes
'-' Data cannot be calculated or has been suppressed for confidentiality purposes.
Cells that are shaded blue represent data that was not reported or null values.
View Detailed UDS Footnotes
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