Table 9D: Patient Related Revenue
National Data
1,373 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 | $6,977,983,435 | 36.42% | 17.54% | $5,633,918,550 | 36.06% | 22.23% | 80.74% |
| 2a. | Medicaid Managed Care (capitated) | $4,234,587,609 | 22.10% | 10.64% | $3,899,448,476 | 24.96% | 15.39% | 92.09% |
| 2b. | Medicaid Managed Care (fee-for-service) | $7,944,705,578 | 41.47% | 19.97% | $6,089,271,372 | 38.98% | 24.03% | 76.65% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $19,157,276,622 | 100.00% | 48.14% | $15,622,638,398 | 100.00% | 61.64% | 81.55% |
| 4. | Medicare Non-Managed Care | $4,280,681,628 | 76.49% | 10.76% | $2,519,814,430 | 76.75% | 9.94% | 58.86% |
| 5a. | Medicare Managed Care (capitated) | $285,703,886 | 5.10% | 0.72% | $224,130,025 | 6.83% | 0.88% | 78.45% |
| 5b. | Medicare Managed Care (fee-for-service) | $1,030,196,472 | 18.41% | 2.59% | $539,298,649 | 16.43% | 2.13% | 52.35% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $5,596,581,986 | 100.00% | 14.06% | $3,283,243,104 | 100.00% | 12.95% | 58.67% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $479,661,075 | 50.16% | 1.21% | $330,017,234 | 58.44% | 1.30% | 68.80% |
| 8a. | Other Public, including Non-Medicaid CHIP, Managed Care (capitated) | $39,674,593 | 4.15% | 0.10% | $19,050,984 | 3.37% | 0.08% | 48.02% |
| 8b. | Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) | $105,088,649 | 10.99% | 0.26% | $55,511,182 | 9.83% | 0.22% | 52.82% |
| 8c. | Other Public, including COVID-19 Uninsured Program | $331,759,003 | 34.70% | 0.83% | $160,171,896 | 28.36% | 0.63% | 48.28% |
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b + 8c) | $956,183,320 | 100.00% | 2.40% | $564,751,296 | 100.00% | 2.23% | 59.06% |
| 10. | Private Non-Managed Care | $6,672,726,005 | 84.04% | 16.77% | $3,891,505,513 | 85.50% | 15.35% | 58.32% |
| 11a. | Private Managed Care (capitated) | $218,482,766 | 2.75% | 0.55% | $87,404,943 | 1.92% | 0.34% | 40.01% |
| 11b. | Private Managed Care (fee-for-service) | $1,048,493,371 | 13.21% | 2.63% | $572,301,154 | 12.57% | 2.26% | 54.58% |
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $7,939,702,142 | 100.00% | 19.95% | $4,551,211,610 | 100.00% | 17.96% | 57.32% |
| 13. | Self-Pay | $6,143,412,567 | 100.00% | 15.44% | $1,323,494,161 | 100.00% | 5.22% | 21.54% |
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $39,793,156,637 | 100.00% | $25,345,338,569 | 100.00% | 63.69% | ||
| 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 | $562,239,772 | $186,901,271 | $92,499,329 | $23,325,869 | $818,314,503 | 11.73% | $1,358,786,487 | 19.47% |
| 2a. | Medicaid Managed Care (capitated) | $1,615,398,037 | $169,563,065 | $236,589,653 | $89,036,198 | $1,932,514,557 | 45.64% | $396,976,808 | 9.37% |
| 2b. | Medicaid Managed Care (fee-for-service) | $1,302,092,410 | $286,354,896 | $228,203,324 | $17,580,854 | $1,799,069,776 | 22.64% | $1,896,650,007 | 23.87% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $3,479,730,219 | $642,819,232 | $557,292,306 | $129,942,921 | $4,549,898,836 | 23.75% | $3,652,413,302 | 19.07% |
| 4. | Medicare Non-Managed Care | $23,152,940 | $20,759,284 | $19,628,046 | $1,112,403 | $62,427,867 | 1.46% | $1,562,400,756 | 36.50% |
| 5a. | Medicare Managed Care (capitated) | $4,452,799 | $459,097 | $5,308,681 | $15,091 | $10,205,486 | 3.57% | $63,398,829 | 22.19% |
| 5b. | Medicare Managed Care (fee-for-service) | $12,190,790 | $4,436,236 | $15,446,546 | $178,955 | $31,894,617 | 3.10% | $445,452,009 | 43.24% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $39,796,529 | $25,654,617 | $40,383,273 | $1,306,449 | $104,527,970 | 1.87% | $2,071,251,594 | 37.01% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $1,076,303 | $1,138,027 | $1,270,782 | $13,646 | $3,471,466 | 0.72% | $136,656,295 | 28.49% |
| 8a. | Other Public, including Non-Medicaid CHIP, Managed Care (capitated) | $3,256,632 | $3,472,190 | $180,514 | $86 | $6,909,250 | 17.41% | $19,199,307 | 48.39% |
| 8b. | Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) | $2,756,647 | $1,259,668 | $105,147 | $25,458 | $4,096,004 | 3.90% | $42,164,108 | 40.12% |
| 8c. | Other Public, including COVID-19 Uninsured Program | $3,008,689 | $2,706 | $3,005,983 | 0.91% | $180,692,228 | 54.46% | ||
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b + 8c) | $7,089,582 | $5,869,885 | $4,565,132 | $41,896 | $17,482,703 | 1.83% | $378,711,938 | 39.61% |
| 10. | Private Non-Managed Care | $29,099,032 | $363,053 | $28,735,979 | 0.43% | $2,332,415,810 | 34.95% | ||
| 11a. | Private Managed Care (capitated) | $6,629,103 | $1,402 | $6,627,701 | 3.03% | $130,623,362 | 59.79% | ||
| 11b. | Private Managed Care (fee-for-service) | $5,031,119 | $14,692 | $5,016,427 | 0.48% | $428,791,086 | 40.90% | ||
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $40,759,254 | $379,147 | $40,380,107 | 0.51% | $2,891,830,258 | 36.42% | ||
| 13. | Self-Pay | ||||||||
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $3,526,616,330 | $674,343,734 | $642,999,965 | $131,670,413 | $4,712,289,616 | 11.84% | $8,994,207,092 | 22.60% |
| Line | Sliding Fee Discounts (e) $ |
Bad Debt Write-Off (f) $ |
|
|---|---|---|---|
| 13. | Self-Pay | $3,829,567,774 | $588,716,706 |
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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