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HRSA Health Resources & Services Administration

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.