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% | ||
| 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
'-' 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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