Table 9D: Patient Related Revenue
Massachusetts Data
37 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 | $295,342,463 | 38.87% | 18.64% | $164,974,274 | 34.16% | 19.37% | 55.86% |
| 2a. | Medicaid Managed Care (capitated) | $16,251,940 | 2.14% | 1.03% | $14,826,117 | 3.07% | 1.74% | 91.23% |
| 2b. | Medicaid Managed Care (fee-for-service) | $448,156,848 | 58.99% | 28.28% | $303,126,836 | 62.77% | 35.59% | 67.64% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $759,751,251 | 100.00% | 47.94% | $482,927,227 | 100.00% | 56.71% | 63.56% |
| 4. | Medicare Non-Managed Care | $140,761,947 | 60.00% | 8.88% | $67,633,428 | 51.13% | 7.94% | 48.05% |
| 5a. | Medicare Managed Care (capitated) | $20,911,977 | 8.91% | 1.32% | $19,355,305 | 14.63% | 2.27% | 92.56% |
| 5b. | Medicare Managed Care (fee-for-service) | $72,930,006 | 31.09% | 4.60% | $45,292,416 | 34.24% | 5.32% | 62.10% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $234,603,930 | 100.00% | 14.80% | $132,281,149 | 100.00% | 15.53% | 56.38% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $35,915,584 | 88.21% | 2.27% | $15,493,891 | 87.75% | 1.82% | 43.14% |
| 8a. | Other Public, including Non-Medicaid CHIP, Managed Care (capitated) | $0 | 0.00% | 0.00% | $0 | 0.00% | 0.00% | |
| 8b. | Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) | $2,541,139 | 6.24% | 0.16% | $1,269,712 | 7.19% | 0.15% | 49.97% |
| 8c. | Other Public, including COVID-19 Uninsured Program | $2,258,592 | 5.55% | 0.14% | $893,903 | 5.06% | 0.10% | 39.58% |
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b + 8c) | $40,715,315 | 100.00% | 2.57% | $17,657,506 | 100.00% | 2.07% | 43.37% |
| 10. | Private Non-Managed Care | $206,300,493 | 59.10% | 13.02% | $104,581,436 | 54.42% | 12.28% | 50.69% |
| 11a. | Private Managed Care (capitated) | $98,396 | 0.03% | 0.01% | $55,567 | 0.03% | 0.01% | 56.47% |
| 11b. | Private Managed Care (fee-for-service) | $142,671,233 | 40.87% | 9.00% | $87,543,787 | 45.55% | 10.28% | 61.36% |
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $349,070,122 | 100.00% | 22.03% | $192,180,790 | 100.00% | 22.57% | 55.06% |
| 13. | Self-Pay | $200,696,259 | 100.00% | 12.66% | $26,600,459 | 100.00% | 3.12% | 13.25% |
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $1,584,836,877 | 100.00% | $851,647,131 | 100.00% | 53.74% | ||
| 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 | $1,009,415 | $1,597,092 | $359,868 | $0 | $2,966,375 | 1.00% | $115,530,626 | 39.12% |
| 2a. | Medicaid Managed Care (capitated) | $0 | $0 | $449,496 | $0 | $449,496 | 2.77% | $1,353,037 | 8.33% |
| 2b. | Medicaid Managed Care (fee-for-service) | $6,774,550 | $139,160 | $1,863,604 | $0 | $8,777,314 | 1.96% | $138,718,001 | 30.95% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $7,783,965 | $1,736,252 | $2,672,968 | $0 | $12,193,185 | 1.60% | $255,601,664 | 33.64% |
| 4. | Medicare Non-Managed Care | $98,045 | $414,989 | $246,082 | $0 | $759,116 | 0.54% | $61,160,701 | 43.45% |
| 5a. | Medicare Managed Care (capitated) | $0 | $0 | $0 | $0 | $0 | 0.00% | $2,295,036 | 10.97% |
| 5b. | Medicare Managed Care (fee-for-service) | $0 | $0 | $31,944 | $0 | $31,944 | 0.04% | $24,974,795 | 34.24% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $98,045 | $414,989 | $278,026 | $0 | $791,060 | 0.34% | $88,430,532 | 37.69% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $0 | $0 | $0 | $0 | $0 | 0.00% | $12,966,002 | 36.10% |
| 8a. | Other Public, including Non-Medicaid CHIP, Managed Care (capitated) | $0 | $0 | $0 | $0 | $0 | $0 | ||
| 8b. | Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) | $2,192 | $0 | $0 | $0 | $2,192 | 0.09% | $1,136,338 | 44.72% |
| 8c. | Other Public, including COVID-19 Uninsured Program | $0 | $0 | $0 | 0.00% | $1,524,704 | 67.51% | ||
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b + 8c) | $2,192 | $0 | $0 | $0 | $2,192 | 0.01% | $15,627,044 | 38.38% |
| 10. | Private Non-Managed Care | $36,780 | $41,938 | ($5,158.00) | 0.00% | $95,347,160 | 46.22% | ||
| 11a. | Private Managed Care (capitated) | $0 | $0 | $0 | 0.00% | $42,454 | 43.15% | ||
| 11b. | Private Managed Care (fee-for-service) | $112,348 | $0 | $112,348 | 0.08% | $46,274,073 | 32.43% | ||
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $149,128 | $41,938 | $107,190 | 0.03% | $141,663,687 | 40.58% | ||
| 13. | Self-Pay | ||||||||
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $7,884,202 | $2,151,241 | $3,100,122 | $41,938 | $13,093,627 | 0.83% | $501,322,927 | 31.63% |
| Line | Sliding Fee Discounts (e) $ |
Bad Debt Write-Off (f) $ |
|
|---|---|---|---|
| 13. | Self-Pay | $131,028,247 | $18,898,607 |
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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