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HRSA Health Resources & Services Administration

Table 9D: Patient Related Revenue

National Data

1,375 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 $6,035,352,913 36.74% 17.59% $4,991,414,238 36.60% 22.51% 82.70%
2a. Medicaid Managed Care (capitated) $3,610,674,319 21.98% 10.52% $3,356,921,268 24.62% 15.14% 92.97%
2b. Medicaid Managed Care (fee-for-service) $6,778,948,852 41.27% 19.75% $5,287,902,280 38.78% 23.84% 78.00%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $16,424,976,084 100.00% 47.86% $13,636,237,786 100.00% 61.49% 83.02%
4. Medicare Non-Managed Care $3,710,921,197 78.04% 10.81% $2,197,720,174 78.26% 9.91% 59.22%
5a. Medicare Managed Care (capitated) $207,815,307 4.37% 0.61% $172,913,876 6.16% 0.78% 83.21%
5b. Medicare Managed Care (fee-for-service) $836,435,218 17.59% 2.44% $437,642,842 15.58% 1.97% 52.32%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $4,755,171,722 100.00% 13.86% $2,808,276,892 100.00% 12.66% 59.06%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $400,973,013 56.17% 1.17% $283,927,514 67.76% 1.28% 70.81%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $37,526,017 5.26% 0.11% $19,436,712 4.64% 0.09% 51.80%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $107,479,093 15.06% 0.31% $65,662,052 15.67% 0.30% 61.09%
8c. Other Public, including COVID-19 Uninsured Program $167,890,989 23.52% 0.49% $49,981,834 11.93% 0.23% 29.77%
9. Total Other Public (Sum of Lines 7 + 8a + 8b + 8c) $713,869,112 100.00% 2.08% $419,008,112 100.00% 1.89% 58.70%
10. Private Non-Managed Care $5,856,008,756 84.21% 17.06% $3,500,468,027 86.01% 15.78% 59.78%
11a. Private Managed Care (capitated) $177,016,308 2.55% 0.52% $82,157,021 2.02% 0.37% 46.41%
11b. Private Managed Care (fee-for-service) $920,863,474 13.24% 2.68% $487,349,344 11.97% 2.20% 52.92%
12. Total Private (Sum of Lines 10 + 11a + 11b) $6,953,888,538 100.00% 20.26% $4,069,974,392 100.00% 18.35% 58.53%
13. Self-Pay $5,472,074,452 100.00% 15.94% $1,242,672,576 100.00% 5.60% 22.71%
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $34,319,979,908 100.00% $22,176,169,758 100.00% 64.62%
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 $488,525,424 $191,113,092 $73,940,729 $31,720,040 $721,859,205 11.96% $1,108,678,556 18.37%
2a. Medicaid Managed Care (capitated) $1,404,403,493 $166,524,752 $209,507,705 $48,944,218 $1,731,491,732 47.95% $262,921,288 7.28%
2b. Medicaid Managed Care (fee-for-service) $1,116,417,146 $269,882,759 $195,592,067 $14,536,559 $1,567,355,413 23.12% $1,509,607,165 22.27%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $3,009,346,063 $627,520,603 $479,040,501 $95,200,817 $4,020,706,350 24.48% $2,881,207,009 17.54%
4. Medicare Non-Managed Care $21,543,710 $19,439,722 $13,343,580 $1,753,251 $52,573,761 1.42% $1,364,124,998 36.76%
5a. Medicare Managed Care (capitated) $2,732,208 $507,154 $4,368,176 $1,312 $7,606,226 3.66% $34,227,016 16.47%
5b. Medicare Managed Care (fee-for-service) $8,614,245 $3,594,359 $11,750,732 $346,520 $23,612,816 2.82% $359,546,442 42.99%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $32,890,163 $23,541,235 $29,462,488 $2,101,083 $83,792,803 1.76% $1,757,898,456 36.97%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $763,080 $342,326 $1,728,382 $6,263 $2,827,525 0.71% $116,417,941 29.03%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $2,182,367 $4,166,353 $269,873 $19,405 $6,599,188 17.59% $18,046,559 48.09%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $2,519,893 $1,596,988 $112,902 $39,313 $4,190,470 3.90% $34,955,560 32.52%
8c. Other Public, including COVID-19 Uninsured Program $32,382 $637 $31,745 0.02% $41,374,660 24.64%
9. Total Other Public (Sum of Lines 7 + 8a + 8b + 8c) $5,465,340 $6,105,667 $2,143,539 $65,618 $13,648,928 1.91% $210,794,720 29.53%
10. Private Non-Managed Care $22,775,062 $501,323 $22,273,739 0.38% $2,104,872,866 35.94%
11a. Private Managed Care (capitated) $5,585,365 $13,568 $5,571,797 3.15% $92,885,955 52.47%
11b. Private Managed Care (fee-for-service) $5,046,400 $75,405 $4,970,995 0.54% $386,082,667 41.93%
12. Total Private (Sum of Lines 10 + 11a + 11b) $33,406,827 $590,296 $32,816,531 0.47% $2,583,841,488 37.16%
13. Self-Pay
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $3,047,701,566 $657,167,505 $544,053,355 $97,957,814 $4,150,964,612 12.09% $7,433,741,673 21.66%
Line Sliding Fee Discounts (e)
$
Bad Debt Write-Off (f)
$
13. Self-Pay $3,411,493,568 $571,483,500

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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