Skip to content

HRSA Health Resources & Services Administration

Table 9D: Patient Related Revenue

Massachusetts Data

38 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 $271,906,702 45.83% 20.36% $144,514,605 41.96% 20.70% 53.15%
2a. Medicaid Managed Care (capitated) $1,664,082 0.28% 0.12% $1,964,342 0.57% 0.28% 118.04%
2b. Medicaid Managed Care (fee-for-service) $319,738,893 53.89% 23.95% $197,954,964 57.47% 28.36% 61.91%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $593,309,677 100.00% 44.44% $344,433,911 100.00% 49.34% 58.05%
4. Medicare Non-Managed Care $135,469,997 73.11% 10.15% $86,920,385 75.26% 12.45% 64.16%
5a. Medicare Managed Care (capitated) $4,238,960 2.29% 0.32% $3,358,846 2.91% 0.48% 79.24%
5b. Medicare Managed Care (fee-for-service) $45,581,640 24.60% 3.41% $25,208,221 21.83% 3.61% 55.30%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $185,290,597 100.00% 13.88% $115,487,452 100.00% 16.54% 62.33%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $29,469,289 87.11% 2.21% $14,420,457 85.30% 2.07% 48.93%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $85,910 0.25% 0.01% $32,949 0.19% 0.00% 38.35%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $4,274,599 12.64% 0.32% $2,452,407 14.51% 0.35% 57.37%
9. Total Other Public (Sum of Lines 7 + 8a + 8b) $33,829,798 100.00% 2.53% $16,905,813 100.00% 2.42% 49.97%
10. Private Non-Managed Care $137,130,809 44.26% 10.27% $80,368,340 42.89% 11.51% 58.61%
11a. Private Managed Care (capitated) $81,746 0.03% 0.01% $21,943 0.01% 0.00% 26.84%
11b. Private Managed Care (fee-for-service) $172,606,240 55.71% 12.93% $106,988,900 57.10% 15.33% 61.98%
12. Total Private (Sum of Lines 10 + 11a + 11b) $309,818,795 100.00% 23.20% $187,379,183 100.00% 26.84% 60.48%
13. Self-pay $212,941,854 100.00% 15.95% $33,851,941 100.00% 4.85% 15.90%
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $1,335,190,721 100.00% $698,058,300 100.00% 52.28%

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 $0 $0 $62,668 $16,410 $46,258 0.02% $110,963,748 40.81%
2a. Medicaid Managed Care (capitated) $0 $0 $0 $0 $0 0.00% ($300,260.00) -18.04%
2b. Medicaid Managed Care (fee-for-service) $0 $0 $120,584 $27,981 $92,603 0.03% $117,700,961 36.81%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $0 $0 $183,252 $44,391 $138,861 0.02% $228,364,449 38.49%
4. Medicare Non-Managed Care $32,764 $343,465 $237,708 $904 $613,033 0.45% $45,846,726 33.84%
5a. Medicare Managed Care (capitated) $0 $0 $0 $0 $0 0.00% $880,114 20.76%
5b. Medicare Managed Care (fee-for-service) $0 $0 $151,594 $521 $151,073 0.33% $19,389,569 42.54%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $32,764 $343,465 $389,302 $1,425 $764,106 0.41% $66,116,409 35.68%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $0 $0 $24,633 $20,883 $3,750 0.01% $12,780,119 43.37%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $0 $0 $0 $0 $0 0.00% $52,961 61.65%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $0 $0 $0 $0 $0 0.00% $1,543,694 36.11%
9. Total Other Public (Sum of Lines 7 + 8a + 8b) $0 $0 $24,633 $20,883 $3,750 0.01% $14,376,774 42.50%
10. Private Non-Managed Care $67,776 $0 $67,776 0.05% $55,065,509 40.16%
11a. Private Managed Care (capitated) $1,417 $0 $1,417 1.73% $59,803 73.16%
11b. Private Managed Care (fee-for-service) $585,207 $15,842 $569,365 0.33% $55,432,624 32.12%
12. Total Private (Sum of Lines 10 + 11a + 11b) $654,400 $15,842 $638,558 0.21% $110,557,936 35.68%
13. Self-pay
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $32,764 $343,465 $1,251,587 $82,541 $1,545,275 0.12% $419,415,568 31.41%
Line Sliding Fee Discounts (e)
$
Bad Debt Write Off (f)
$
13. Self-pay $152,097,642 $23,456,827

Footnotes

Percentages may not equal 100% due to rounding.