Table 9D: Patient Related Revenue
Missouri Data
27 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 | $468,519,218 | 87.73% | 46.21% | $384,980,845 | 87.28% | 57.81% | 82.17% |
| 2a. | Medicaid Managed Care (capitated) | $0 | 0.00% | 0.00% | $0 | 0.00% | 0.00% | |
| 2b. | Medicaid Managed Care (fee-for-service) | $65,541,594 | 12.27% | 6.46% | $56,129,152 | 12.72% | 8.43% | 85.64% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $534,060,812 | 100.00% | 52.68% | $441,109,997 | 100.00% | 66.24% | 82.60% |
| 4. | Medicare Non-Managed Care | $92,144,009 | 86.80% | 9.09% | $48,552,813 | 91.94% | 7.29% | 52.69% |
| 5a. | Medicare Managed Care (capitated) | $0 | 0.00% | 0.00% | $0 | 0.00% | 0.00% | |
| 5b. | Medicare Managed Care (fee-for-service) | $14,009,318 | 13.20% | 1.38% | $4,257,399 | 8.06% | 0.64% | 30.39% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $106,153,327 | 100.00% | 10.47% | $52,810,212 | 100.00% | 7.93% | 49.75% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $22,316,636 | 98.34% | 2.20% | $21,119,184 | 99.53% | 3.17% | 94.63% |
| 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) | $376,515 | 1.66% | 0.04% | $100,000 | 0.47% | 0.02% | 26.56% |
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b) | $22,693,151 | 100.00% | 2.24% | $21,219,184 | 100.00% | 3.19% | 93.50% |
| 10. | Private Non-Managed Care | $229,190,348 | 100.00% | 22.61% | $122,928,536 | 100.00% | 18.46% | 53.64% |
| 11a. | Private Managed Care (capitated) | $0 | 0.00% | 0.00% | $0 | 0.00% | 0.00% | |
| 11b. | Private Managed Care (fee-for-service) | $823 | 0.00% | 0.00% | $142 | 0.00% | 0.00% | 17.25% |
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $229,191,171 | 100.00% | 22.61% | $122,928,678 | 100.00% | 18.46% | 53.64% |
| 13. | Self-Pay | $121,738,951 | 100.00% | 12.01% | $27,884,077 | 100.00% | 4.19% | 22.90% |
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $1,013,837,412 | 100.00% | $665,952,148 | 100.00% | 65.69% | ||
| 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 | $62,498,867 | $27,321,113 | $5,914,552 | $927,064 | $94,807,468 | 20.24% | $96,759,111 | 20.65% |
| 2a. | Medicaid Managed Care (capitated) | $0 | $0 | $0 | $0 | $0 | $0 | ||
| 2b. | Medicaid Managed Care (fee-for-service) | $21,183,851 | $6,746,233 | $1,242,971 | $818,536 | $28,354,519 | 43.26% | $17,026,171 | 25.98% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $83,682,718 | $34,067,346 | $7,157,523 | $1,745,600 | $123,161,987 | 23.06% | $113,785,282 | 21.31% |
| 4. | Medicare Non-Managed Care | $68,198 | $321,605 | $644,949 | $237 | $1,034,515 | 1.12% | $40,712,463 | 44.18% |
| 5a. | Medicare Managed Care (capitated) | $0 | $0 | $0 | $0 | $0 | $0 | ||
| 5b. | Medicare Managed Care (fee-for-service) | $0 | $0 | $0 | $518 | ($518.00) | 0.00% | $7,797,556 | 55.66% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $68,198 | $321,605 | $644,949 | $755 | $1,033,997 | 0.97% | $48,510,019 | 45.70% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $0 | $0 | $815,229 | $0 | $815,229 | 3.65% | $271,254 | 1.22% |
| 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 | $0 | $0 | $0 | 0.00% | $0 | 0.00% |
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b) | $0 | $0 | $815,229 | $0 | $815,229 | 3.59% | $271,254 | 1.20% |
| 10. | Private Non-Managed Care | $935,028 | $15,386 | $919,642 | 0.40% | $99,269,104 | 43.31% | ||
| 11a. | Private Managed Care (capitated) | $0 | $0 | $0 | $0 | ||||
| 11b. | Private Managed Care (fee-for-service) | $0 | $0 | $0 | 0.00% | ($300.00) | -36.45% | ||
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $935,028 | $15,386 | $919,642 | 0.40% | $99,268,804 | 43.31% | ||
| 13. | Self-Pay | ||||||||
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $83,750,916 | $34,388,951 | $9,552,729 | $1,761,741 | $125,930,855 | 12.42% | $261,835,359 | 25.83% |
| Line | Sliding Fee Discounts (e) $ |
Bad Debt Write-Off (f) $ |
|
|---|---|---|---|
| 13. | Self-Pay | $53,854,687 | $33,331,048 |
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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