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HRSA Health Resources & Services Administration

Table 9D: Patient Related Revenue

Rhode Island Data

X

8 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 $36,368,410 22.91% 13.36% $32,495,454 17.82% 12.70% 89.35%
2a. Medicaid Managed Care (capitated) $22,620,194 14.25% 8.31% $33,595,520 18.43% 13.13% 148.52%
2b. Medicaid Managed Care (fee-for-service) $99,758,415 62.84% 36.65% $116,218,672 63.75% 45.41% 116.50%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $158,747,019 100.00% 58.32% $182,309,646 100.00% 71.23% 114.84%
4. Medicare Non-Managed Care $25,011,871 75.02% 9.19% $18,698,721 72.92% 7.31% 74.76%
5a. Medicare Managed Care (capitated) $574,514 1.72% 0.21% $421,619 1.64% 0.16% 73.39%
5b. Medicare Managed Care (fee-for-service) $7,754,311 23.26% 2.85% $6,520,880 25.43% 2.55% 84.09%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $33,340,696 100.00% 12.25% $25,641,220 100.00% 10.02% 76.91%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $245,442 100.00% 0.09% $160,225 100.00% 0.06% 65.28%
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) $0 0.00% 0.00% $0 0.00% 0.00%
9. Total Other Public (Sum of Lines 7 + 8a + 8b) $245,442 100.00% 0.09% $160,225 100.00% 0.06% 65.28%
10. Private Non-Managed Care $56,822,651 94.28% 20.87% $38,849,150 93.37% 15.18% 68.37%
11a. Private Managed Care (capitated) $513,379 0.85% 0.19% $856,015 2.06% 0.33% 166.74%
11b. Private Managed Care (fee-for-service) $2,933,112 4.87% 1.08% $1,901,834 4.57% 0.74% 64.84%
12. Total Private (Sum of Lines 10 + 11a + 11b) $60,269,142 100.00% 22.14% $41,606,999 100.00% 16.26% 69.04%
13. Self-Pay $19,609,088 100.00% 7.20% $6,210,320 100.00% 2.43% 31.67%
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $272,211,387 100.00% $255,928,410 100.00% 94.02%
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 $1,600,592 $653,033 $1,176,740 $36,333 $3,394,032 9.33% $544,816 1.50%
2a. Medicaid Managed Care (capitated) $11,991,823 $944,154 $5,917,239 $3,464 $18,849,752 83.33% ($10,975,326.00) -48.52%
2b. Medicaid Managed Care (fee-for-service) $40,680,229 $3,076,865 $14,604,250 $232,253 $58,129,091 58.27% ($26,579,236.00) -26.64%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $54,272,644 $4,674,052 $21,698,229 $272,050 $80,372,875 50.63% ($37,009,746.00) -23.31%
4. Medicare Non-Managed Care $0 $61,324 $381,446 $1,140 $441,630 1.77% $5,333,266 21.32%
5a. Medicare Managed Care (capitated) $0 $0 $0 $0 $0 0.00% $152,895 26.61%
5b. Medicare Managed Care (fee-for-service) $0 $0 $41,310 $43,223 ($1,913.00) -0.02% $1,228,976 15.85%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $0 $61,324 $422,756 $44,363 $439,717 1.32% $6,715,137 20.14%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $0 $0 $0 $0 $0 0.00% $57,344 23.36%
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 $40 ($40.00) $0
9. Total Other Public (Sum of Lines 7 + 8a + 8b) $0 $0 $0 $40 ($40.00) -0.02% $57,344 23.36%
10. Private Non-Managed Care $975,722 $35,888 $939,834 1.65% $17,626,786 31.02%
11a. Private Managed Care (capitated) $0 $0 $0 0.00% ($342,636.00) -66.74%
11b. Private Managed Care (fee-for-service) $0 $11,293 ($11,293.00) -0.39% $1,013,273 34.55%
12. Total Private (Sum of Lines 10 + 11a + 11b) $975,722 $47,181 $928,541 1.54% $18,297,423 30.36%
13. Self-Pay
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $54,272,644 $4,735,376 $23,096,707 $363,634 $81,741,093 30.03% ($11,939,842.00) -4.39%
Line Sliding Fee Discounts (e)
$
Bad Debt Write-Off (f)
$
13. Self-Pay $7,553,226 $3,718,173

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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