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HRSA Health Resources & Services Administration

Table 9D: Patient Related Revenue

National Look-Alikes Data

108 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 $248,400,704 37.88% 18.39% $194,070,746 37.52% 20.21% 78.13%
2a. Medicaid Managed Care (capitated) $118,829,896 18.12% 8.80% $114,418,233 22.12% 11.91% 96.29%
2b. Medicaid Managed Care (fee-for-service) $288,609,696 44.01% 21.37% $208,690,469 40.35% 21.73% 72.31%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $655,840,296 100.00% 48.56% $517,179,448 100.00% 53.85% 78.86%
4. Medicare Non-Managed Care $145,346,142 69.53% 10.76% $97,865,709 68.02% 10.19% 67.33%
5a. Medicare Managed Care (capitated) $5,681,406 2.72% 0.42% $5,093,317 3.54% 0.53% 89.65%
5b. Medicare Managed Care (fee-for-service) $58,012,841 27.75% 4.30% $40,908,756 28.43% 4.26% 70.52%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $209,040,389 100.00% 15.48% $143,867,782 100.00% 14.98% 68.82%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $8,305,700 18.05% 0.61% $5,919,993 14.86% 0.62% 71.28%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $472,062 1.03% 0.03% $259,826 0.65% 0.03% 55.04%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $25,680,564 55.82% 1.90% $24,864,155 62.42% 2.59% 96.82%
8c. Other Public, including COVID-19 Uninsured Program $11,550,548 25.11% 0.86% $8,787,712 22.06% 0.91% 76.08%
9. Total Other Public (Sum of Lines 7 + 8a + 8b + 8c) $46,008,874 100.00% 3.41% $39,831,686 100.00% 4.15% 86.57%
10. Private Non-Managed Care $265,219,565 74.01% 19.64% $166,961,115 70.90% 17.38% 62.95%
11a. Private Managed Care (capitated) $5,355,323 1.49% 0.40% $2,680,729 1.14% 0.28% 50.06%
11b. Private Managed Care (fee-for-service) $87,764,617 24.49% 6.50% $65,848,636 27.96% 6.86% 75.03%
12. Total Private (Sum of Lines 10 + 11a + 11b) $358,339,505 100.00% 26.53% $235,490,480 100.00% 24.52% 65.72%
13. Self-Pay $81,427,612 100.00% 6.03% $24,047,629 100.00% 2.50% 29.53%
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $1,350,656,676 100.00% $960,417,025 100.00% 71.11%
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 $10,391,244 $4,235,847 $456,855 $403,103 $14,680,843 5.91% $48,838,863 19.66%
2a. Medicaid Managed Care (capitated) $46,326,217 $4,397,735 $3,346,325 $8,133,529 $45,936,748 38.66% $2,780,544 2.34%
2b. Medicaid Managed Care (fee-for-service) $24,582,358 $2,529,632 $1,758,207 $1,250,495 $27,619,702 9.57% $74,189,600 25.71%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $81,299,819 $11,163,214 $5,561,387 $9,787,127 $88,237,293 13.45% $125,809,007 19.18%
4. Medicare Non-Managed Care $1,193,780 $158,106 $311,607 $86,249 $1,577,244 1.09% $38,335,018 26.37%
5a. Medicare Managed Care (capitated) $478,334 $23,320 $42,193 $0 $543,847 9.57% $564,072 9.93%
5b. Medicare Managed Care (fee-for-service) $869,483 $40,560 $237,782 $13,300 $1,134,525 1.96% $15,731,581 27.12%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $2,541,597 $221,986 $591,582 $99,549 $3,255,616 1.56% $54,630,671 26.13%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $280,083 $4,752 $0 $739 $284,096 3.42% $1,674,220 20.16%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $68,176 $21,623 $0 $0 $89,799 19.02% $194,631 41.23%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $338,527 $83,824 $0 $0 $422,351 1.64% $629,710 2.45%
8c. Other Public, including COVID-19 Uninsured Program $0 $0 $0 0.00% $2,898,561 25.09%
9. Total Other Public (Sum of Lines 7 + 8a + 8b + 8c) $686,786 $110,199 $0 $739 $796,246 1.73% $5,397,122 11.73%
10. Private Non-Managed Care $1,122,295 $2,120 $1,120,175 0.42% $82,142,404 30.97%
11a. Private Managed Care (capitated) $30,005 $0 $30,005 0.56% $2,755,379 51.45%
11b. Private Managed Care (fee-for-service) $263,280 $321,506 ($58,226.00) -0.07% $18,208,902 20.75%
12. Total Private (Sum of Lines 10 + 11a + 11b) $1,415,580 $323,626 $1,091,954 0.30% $103,106,685 28.77%
13. Self-Pay
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $84,528,202 $11,495,399 $7,568,549 $10,211,041 $93,381,109 6.91% $288,943,485 21.39%
Line Sliding Fee Discounts (e)
$
Bad Debt Write-Off (f)
$
13. Self-Pay $25,091,739 $14,506,666

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.

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