Table 9D: Patient Related Revenue
National Look-Alikes Data
72 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 | $151,783,582 | 39.23% | 19.11% | $106,136,782 | 38.25% | 21.05% | 69.93% |
| 2a. | Medicaid Managed Care (capitated) | $99,288,585 | 25.66% | 12.50% | $85,098,039 | 30.67% | 16.88% | 85.71% |
| 2b. | Medicaid Managed Care (fee-for-service) | $135,863,768 | 35.11% | 17.11% | $86,228,364 | 31.08% | 17.10% | 63.47% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $386,935,935 | 100.00% | 48.72% | $277,463,185 | 100.00% | 55.03% | 71.71% |
| 4. | Medicare Non-Managed Care | $109,342,508 | 82.53% | 13.77% | $68,221,232 | 86.82% | 13.53% | 62.39% |
| 5a. | Medicare Managed Care (capitated) | $3,034,259 | 2.29% | 0.38% | $2,335,984 | 2.97% | 0.46% | 76.99% |
| 5b. | Medicare Managed Care (fee-for-service) | $20,105,100 | 15.18% | 2.53% | $8,020,637 | 10.21% | 1.59% | 39.89% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $132,481,867 | 100.00% | 16.68% | $78,577,853 | 100.00% | 15.59% | 59.31% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $19,512,018 | 91.33% | 2.46% | $11,523,217 | 94.33% | 2.29% | 59.06% |
| 8a. | Other Public, including Non-Medicaid CHIP, Managed Care (capitated) | $765,606 | 3.58% | 0.10% | $162,262 | 1.33% | 0.03% | 21.19% |
| 8b. | Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) | $1,085,921 | 5.08% | 0.14% | $530,327 | 4.34% | 0.11% | 48.84% |
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b) | $21,363,545 | 100.00% | 2.69% | $12,215,806 | 100.00% | 2.42% | 57.18% |
| 10. | Private Non-Managed Care | $150,568,855 | 85.98% | 18.96% | $96,245,049 | 87.00% | 19.09% | 63.92% |
| 11a. | Private Managed Care (capitated) | $3,827,751 | 2.19% | 0.48% | $1,390,608 | 1.26% | 0.28% | 36.33% |
| 11b. | Private Managed Care (fee-for-service) | $20,721,751 | 11.83% | 2.61% | $12,988,568 | 11.74% | 2.58% | 62.68% |
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $175,118,357 | 100.00% | 22.05% | $110,624,225 | 100.00% | 21.94% | 63.17% |
| 13. | Self-pay | $78,276,085 | 100.00% | 9.86% | $25,283,514 | 100.00% | 5.01% | 32.30% |
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $794,175,789 | 100.00% | $504,164,583 | 100.00% | 63.48% | ||
Percentages 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 | $5,060,374 | $4,039,671 | $391,831 | $956,271 | $8,535,605 | 5.62% | $50,266,962 | 33.12% |
| 2a. | Medicaid Managed Care (capitated) | $46,701,483 | $1,314,614 | $4,294,386 | $4,141,841 | $48,168,642 | 48.51% | $14,172,798 | 14.27% |
| 2b. | Medicaid Managed Care (fee-for-service) | $10,386,869 | $4,526,675 | $2,676,161 | $585 | $17,589,120 | 12.95% | $37,635,604 | 27.70% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $62,148,726 | $9,880,960 | $7,362,378 | $5,098,697 | $74,293,367 | 19.20% | $102,075,364 | 26.38% |
| 4. | Medicare Non-Managed Care | $960,725 | $606,653 | $72,946 | $866 | $1,639,458 | 1.50% | $36,399,983 | 33.29% |
| 5a. | Medicare Managed Care (capitated) | $0 | $0 | $19,232 | $0 | $19,232 | 0.63% | $702,440 | 23.15% |
| 5b. | Medicare Managed Care (fee-for-service) | $1,060,054 | $18,659 | $135,407 | $0 | $1,214,120 | 6.04% | $10,762,191 | 53.53% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $2,020,779 | $625,312 | $227,585 | $866 | $2,872,810 | 2.17% | $47,864,614 | 36.13% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $0 | $1,383 | $0 | $0 | $1,383 | 0.01% | $5,595,358 | 28.68% |
| 8a. | Other Public, including Non-Medicaid CHIP, Managed Care (capitated) | $32,646 | $0 | $0 | $0 | $32,646 | 4.26% | $603,227 | 78.79% |
| 8b. | Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) | $92,915 | $61,614 | $40,697 | $0 | $195,226 | 17.98% | $447,170 | 41.18% |
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b) | $125,561 | $62,997 | $40,697 | $0 | $229,255 | 1.07% | $6,645,755 | 31.11% |
| 10. | Private Non-Managed Care | $876,726 | $0 | $876,726 | 0.58% | $48,603,932 | 32.28% | ||
| 11a. | Private Managed Care (capitated) | $41,910 | $0 | $41,910 | 1.09% | $2,402,754 | 62.77% | ||
| 11b. | Private Managed Care (fee-for-service) | $196,249 | $0 | $196,249 | 0.95% | $4,762,049 | 22.98% | ||
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $1,114,885 | $0 | $1,114,885 | 0.64% | $55,768,735 | 31.85% | ||
| 13. | Self-pay | ||||||||
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $64,295,066 | $10,569,269 | $8,745,545 | $5,099,563 | $78,510,317 | 9.89% | $212,354,468 | 26.74% |
| Line | Sliding Fee Discounts (e) $ |
Bad Debt Write Off (f) $ |
|
|---|---|---|---|
| 13. | Self-pay | $32,377,821 | $9,060,345 |
Footnotes
Percentages may not equal 100% due to rounding.