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 | $291,243,168 | 35.74% | 16.76% | $161,162,975 | 27.82% | 15.93% | 55.34% |
| 2a. | Medicaid Managed Care (capitated) | $241,833,943 | 29.68% | 13.92% | $246,145,940 | 42.50% | 24.32% | 101.78% |
| 2b. | Medicaid Managed Care (fee-for-service) | $281,796,520 | 34.58% | 16.22% | $171,917,660 | 29.68% | 16.99% | 61.01% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $814,873,631 | 100.00% | 46.90% | $579,226,575 | 100.00% | 57.24% | 71.08% |
| 4. | Medicare Non-Managed Care | $172,139,899 | 57.95% | 9.91% | $80,666,933 | 50.85% | 7.97% | 46.86% |
| 5a. | Medicare Managed Care (capitated) | $28,241,512 | 9.51% | 1.63% | $26,214,089 | 16.53% | 2.59% | 92.82% |
| 5b. | Medicare Managed Care (fee-for-service) | $96,647,561 | 32.54% | 5.56% | $51,749,417 | 32.62% | 5.11% | 53.54% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $297,028,972 | 100.00% | 17.09% | $158,630,439 | 100.00% | 15.67% | 53.41% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $55,979,573 | 97.72% | 3.22% | $28,828,252 | 97.88% | 2.85% | 51.50% |
| 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) | $1,308,748 | 2.28% | 0.08% | $625,154 | 2.12% | 0.06% | 47.77% |
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b) | $57,288,321 | 100.00% | 3.30% | $29,453,406 | 100.00% | 2.91% | 51.41% |
| 10. | Private Non-Managed Care | $228,461,083 | 64.17% | 13.15% | $134,302,122 | 62.40% | 13.27% | 58.79% |
| 11a. | Private Managed Care (capitated) | $2,215,300 | 0.62% | 0.13% | $1,504,243 | 0.70% | 0.15% | 67.90% |
| 11b. | Private Managed Care (fee-for-service) | $125,335,485 | 35.21% | 7.21% | $79,420,227 | 36.90% | 7.85% | 63.37% |
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $356,011,868 | 100.00% | 20.49% | $215,226,592 | 100.00% | 21.27% | 60.45% |
| 13. | Self-Pay | $212,327,762 | 100.00% | 12.22% | $29,468,211 | 100.00% | 2.91% | 13.88% |
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $1,737,530,554 | 100.00% | $1,012,005,223 | 100.00% | 58.24% | ||
| 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 | $2,100,537 | $2,484,197 | $1,025,010 | $0 | $5,609,744 | 1.93% | $106,546,204 | 36.58% |
| 2a. | Medicaid Managed Care (capitated) | $1,856,736 | $1,115,494 | $4,302,621 | $0 | $7,274,851 | 3.01% | $6,887,871 | 2.85% |
| 2b. | Medicaid Managed Care (fee-for-service) | $8,027,072 | $3,947,911 | $3,055,714 | $0 | $15,030,697 | 5.33% | $108,395,891 | 38.47% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $11,984,345 | $7,547,602 | $8,383,345 | $0 | $27,915,292 | 3.43% | $221,829,966 | 27.22% |
| 4. | Medicare Non-Managed Care | $926,301 | $194,521 | $687,750 | $0 | $1,808,572 | 1.05% | $66,966,573 | 38.90% |
| 5a. | Medicare Managed Care (capitated) | $0 | $0 | $0 | $250,505 | ($250,505.00) | -0.89% | $3,005,833 | 10.64% |
| 5b. | Medicare Managed Care (fee-for-service) | $15,365 | $28,035 | $98,800 | $0 | $142,200 | 0.15% | $32,322,289 | 33.44% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $941,666 | $222,556 | $786,550 | $250,505 | $1,700,267 | 0.57% | $102,294,695 | 34.44% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $166,307 | $7,657 | $0 | $0 | $173,964 | 0.31% | $22,021,831 | 39.34% |
| 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) | $0 | $0 | $8,955 | $0 | $8,955 | 0.68% | $258,313 | 19.74% |
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b) | $166,307 | $7,657 | $8,955 | $0 | $182,919 | 0.32% | $22,280,144 | 38.89% |
| 10. | Private Non-Managed Care | $39,009 | $0 | $39,009 | 0.02% | $96,398,550 | 42.19% | ||
| 11a. | Private Managed Care (capitated) | $0 | $0 | $0 | 0.00% | $978,397 | 44.17% | ||
| 11b. | Private Managed Care (fee-for-service) | $79,769 | $0 | $79,769 | 0.06% | $34,281,252 | 27.35% | ||
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $118,778 | $0 | $118,778 | 0.03% | $131,658,199 | 36.98% | ||
| 13. | Self-Pay | ||||||||
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $13,092,318 | $7,777,815 | $9,297,628 | $250,505 | $29,917,256 | 1.72% | $478,063,004 | 27.51% |
| Line | Sliding Fee Discounts (e) $ |
Bad Debt Write-Off (f) $ |
|
|---|---|---|---|
| 13. | Self-Pay | $115,297,739 | $15,065,490 |
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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