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HRSA Health Resources & Services Administration

Table 9D: Patient Related Revenue

National Data

1,385 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 $6,911,950,330 39.32% 19.56% $5,426,288,944 39.86% 24.96% 78.51%
2a. Medicaid Managed Care (capitated) $3,499,748,034 19.91% 9.90% $3,004,171,920 22.07% 13.82% 85.84%
2b. Medicaid Managed Care (fee-for-service) $7,166,556,316 40.77% 20.28% $5,182,119,698 38.07% 23.84% 72.31%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $17,578,254,680 100.00% 49.74% $13,612,580,562 100.00% 62.62% 77.44%
4. Medicare Non-Managed Care $3,581,005,289 78.15% 10.13% $2,111,938,118 79.26% 9.71% 58.98%
5a. Medicare Managed Care (capitated) $192,696,183 4.21% 0.55% $157,079,330 5.90% 0.72% 81.52%
5b. Medicare Managed Care (fee-for-service) $808,503,860 17.64% 2.29% $395,487,770 14.84% 1.82% 48.92%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $4,582,205,332 100.00% 12.97% $2,664,505,218 100.00% 12.26% 58.15%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $457,052,703 73.98% 1.29% $279,195,263 76.31% 1.28% 61.09%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $50,794,071 8.22% 0.14% $20,843,767 5.70% 0.10% 41.04%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $109,959,516 17.80% 0.31% $65,846,374 18.00% 0.30% 59.88%
9. Total Other Public (Sum of Lines 7 + 8a + 8b) $617,806,290 100.00% 1.75% $365,885,404 100.00% 1.68% 59.22%
10. Private Non-Managed Care $5,485,479,150 84.08% 15.52% $3,213,756,148 86.50% 14.78% 58.59%
11a. Private Managed Care (capitated) $199,409,099 3.06% 0.56% $85,316,329 2.30% 0.39% 42.78%
11b. Private Managed Care (fee-for-service) $839,058,753 12.86% 2.37% $416,077,360 11.20% 1.91% 49.59%
12. Total Private (Sum of Lines 10 + 11a + 11b) $6,523,947,002 100.00% 18.46% $3,715,149,837 100.00% 17.09% 56.95%
13. Self-pay $6,036,024,790 100.00% 17.08% $1,381,335,323 100.00% 6.35% 22.88%
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $35,338,238,094 100.00% $21,739,456,344 100.00% 61.52%

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 $522,840,559 $240,910,152 $59,642,551 $30,641,419 $792,751,843 11.47% $1,636,997,676 23.68%
2a. Medicaid Managed Care (capitated) $1,312,516,267 $112,342,243 $211,921,437 $84,667,223 $1,552,112,724 44.35% $524,039,599 14.97%
2b. Medicaid Managed Care (fee-for-service) $998,556,436 $230,646,772 $186,655,801 $15,336,617 $1,400,522,392 19.54% $1,973,386,854 27.54%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $2,833,913,262 $583,899,167 $458,219,789 $130,645,259 $3,745,386,959 21.31% $4,134,424,129 23.52%
4. Medicare Non-Managed Care $24,363,280 $19,791,740 $9,779,941 $761,057 $53,173,904 1.48% $1,342,571,519 37.49%
5a. Medicare Managed Care (capitated) $3,027,867 $175,310 $6,360,488 $9,514 $9,554,151 4.96% $36,511,952 18.95%
5b. Medicare Managed Care (fee-for-service) $8,780,664 $6,308,321 $8,064,052 $113,940 $23,039,097 2.85% $352,262,757 43.57%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $36,171,811 $26,275,371 $24,204,481 $884,511 $85,767,152 1.87% $1,731,346,228 37.78%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $476,404 $315,997 $846,173 $46,473 $1,592,101 0.35% $161,890,909 35.42%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $2,568,601 $4,389,942 $223,073 $0 $7,181,616 14.14% $27,753,339 54.64%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $2,405,740 $2,292,478 $487,310 $19,210 $5,166,318 4.70% $36,611,543 33.30%
9. Total Other Public (Sum of Lines 7 + 8a + 8b) $5,450,745 $6,998,417 $1,556,556 $65,683 $13,940,035 2.26% $226,255,791 36.62%
10. Private Non-Managed Care $23,686,873 $1,312,014 $22,374,859 0.41% $2,003,589,129 36.53%
11a. Private Managed Care (capitated) $9,429,394 $107 $9,429,287 4.73% $113,640,136 56.99%
11b. Private Managed Care (fee-for-service) $3,668,006 $25,751 $3,642,255 0.43% $354,820,114 42.29%
12. Total Private (Sum of Lines 10 + 11a + 11b) $36,784,273 $1,337,872 $35,446,401 0.54% $2,472,049,379 37.89%
13. Self-pay
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $2,875,535,818 $617,172,955 $520,765,099 $132,933,325 $3,880,540,547 10.98% $8,564,075,527 24.23%
Line Sliding Fee Discounts (e)
$
Bad Debt Write Off (f)
$
13. Self-pay $3,765,129,217 $581,006,913

Footnotes

Percentages may not equal 100% due to rounding.