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HRSA Health Resources & Services Administration

Table 9D: Patient Related Revenue

National Data

1,363 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 $8,879,130,846 37.89% 18.43% $7,349,137,307 37.03% 22.98% 82.77%
2a. Medicaid Managed Care (capitated) $5,341,352,677 22.79% 11.09% $5,249,368,724 26.45% 16.42% 98.28%
2b. Medicaid Managed Care (fee-for-service) $9,214,344,395 39.32% 19.13% $7,245,644,275 36.51% 22.66% 78.63%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $23,434,827,918 100.00% 48.65% $19,844,150,306 100.00% 62.06% 84.68%
4. Medicare Non-Managed Care $5,454,147,617 73.19% 11.32% $3,285,304,840 71.71% 10.27% 60.23%
5a. Medicare Managed Care (capitated) $360,482,505 4.84% 0.75% $432,982,270 9.45% 1.35% 120.11%
5b. Medicare Managed Care (fee-for-service) $1,637,728,379 21.98% 3.40% $863,041,235 18.84% 2.70% 52.70%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $7,452,358,501 100.00% 15.47% $4,581,328,345 100.00% 14.33% 61.47%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $484,066,957 76.82% 1.00% $295,171,813 78.54% 0.92% 60.98%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $27,884,032 4.43% 0.06% $13,872,325 3.69% 0.04% 49.75%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $118,192,085 18.76% 0.25% $66,784,464 17.77% 0.21% 56.51%
9. Total Other Public (Sum of Lines 7 + 8a + 8b) $630,143,074 100.00% 1.31% $375,828,602 100.00% 1.18% 59.64%
10. Private Non-Managed Care $8,651,850,652 86.57% 17.96% $5,137,074,696 88.44% 16.07% 59.38%
11a. Private Managed Care (capitated) $221,536,256 2.22% 0.46% $89,493,952 1.54% 0.28% 40.40%
11b. Private Managed Care (fee-for-service) $1,120,123,397 11.21% 2.33% $581,858,342 10.02% 1.82% 51.95%
12. Total Private (Sum of Lines 10 + 11a + 11b) $9,993,510,305 100.00% 20.75% $5,808,426,990 100.00% 18.17% 58.12%
13. Self-Pay $6,655,117,401 100.00% 13.82% $1,365,135,115 100.00% 4.27% 20.51%
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $48,165,957,199 100.00% $31,974,869,358 100.00% 66.38%
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 $679,898,377 $239,391,744 $131,696,280 $31,373,935 $1,019,612,466 11.48% $1,637,704,953 18.44%
2a. Medicaid Managed Care (capitated) $2,070,787,637 $325,964,548 $382,106,713 $80,705,036 $2,698,153,862 50.51% $143,793,136 2.69%
2b. Medicaid Managed Care (fee-for-service) $1,564,163,130 $335,752,824 $352,131,863 $29,392,075 $2,222,655,742 24.12% $2,089,132,485 22.67%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $4,314,849,144 $901,109,116 $865,934,856 $141,471,046 $5,940,422,070 25.35% $3,870,630,574 16.52%
4. Medicare Non-Managed Care $39,013,183 $25,107,883 $30,344,702 $2,348,031 $92,117,737 1.69% $1,987,197,864 36.43%
5a. Medicare Managed Care (capitated) $8,640,927 $1,513,055 $13,268,749 $350,359 $23,072,372 6.40% ($70,435,351.00) -19.54%
5b. Medicare Managed Care (fee-for-service) $26,008,049 $4,708,713 $22,895,216 $107,746 $53,504,232 3.27% $670,114,261 40.92%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $73,662,159 $31,329,651 $66,508,667 $2,806,136 $168,694,341 2.26% $2,586,876,774 34.71%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $772,802 $341,735 $884,804 $58,119 $1,941,222 0.40% $148,041,712 30.58%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $1,460,180 $3,328,400 $177,933 $0 $4,966,513 17.81% $14,413,769 51.69%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $1,843,697 $1,674,461 $141,413 $3,711 $3,655,860 3.09% $36,198,105 30.63%
9. Total Other Public (Sum of Lines 7 + 8a + 8b) $4,076,679 $5,344,596 $1,204,150 $61,830 $10,563,595 1.68% $198,653,586 31.53%
10. Private Non-Managed Care $43,235,728 $1,248,777 $41,986,951 0.49% $3,093,313,271 35.75%
11a. Private Managed Care (capitated) $8,340,507 $13,369 $8,327,138 3.76% $132,137,516 59.65%
11b. Private Managed Care (fee-for-service) $6,791,306 $179,409 $6,611,897 0.59% $449,078,723 40.09%
12. Total Private (Sum of Lines 10 + 11a + 11b) $58,367,541 $1,441,555 $56,925,986 0.57% $3,674,529,510 36.77%
13. Self-Pay
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $4,392,587,982 $937,783,363 $992,015,214 $145,780,567 $6,176,605,992 12.82% $10,330,690,444 21.45%
Line Sliding Fee Discounts (e)
$
Bad Debt Write-Off (f)
$
13. Self-Pay $4,182,410,616 $671,260,823

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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