Table 9D: Patient Related Revenue
West Virginia Data
28 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 | $138,950,997 | 60.17% | 17.40% | $116,500,242 | 52.19% | 22.31% | 83.84% |
| 2a. | Medicaid Managed Care (capitated) | $656,554 | 0.28% | 0.08% | $525,243 | 0.24% | 0.10% | 80.00% |
| 2b. | Medicaid Managed Care (fee-for-service) | $91,310,297 | 39.54% | 11.43% | $106,200,408 | 47.58% | 20.34% | 116.31% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $230,917,848 | 100.00% | 28.92% | $223,225,893 | 100.00% | 42.75% | 96.67% |
| 4. | Medicare Non-Managed Care | $135,431,739 | 86.18% | 16.96% | $79,746,749 | 82.81% | 15.27% | 58.88% |
| 5a. | Medicare Managed Care (capitated) | $0 | 0.00% | 0.00% | $0 | 0.00% | 0.00% | |
| 5b. | Medicare Managed Care (fee-for-service) | $21,709,007 | 13.82% | 2.72% | $16,556,654 | 17.19% | 3.17% | 76.27% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $157,140,746 | 100.00% | 19.68% | $96,303,403 | 100.00% | 18.44% | 61.28% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $4,046,815 | 100.00% | 0.51% | $2,390,096 | 100.00% | 0.46% | 59.06% |
| 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) | $4,046,815 | 100.00% | 0.51% | $2,390,096 | 100.00% | 0.46% | 59.06% |
| 10. | Private Non-Managed Care | $269,094,986 | 94.46% | 33.70% | $149,091,729 | 94.67% | 28.55% | 55.40% |
| 11a. | Private Managed Care (capitated) | $5,547,915 | 1.95% | 0.69% | $3,045,917 | 1.93% | 0.58% | 54.90% |
| 11b. | Private Managed Care (fee-for-service) | $10,222,706 | 3.59% | 1.28% | $5,355,483 | 3.40% | 1.03% | 52.39% |
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $284,865,607 | 100.00% | 35.67% | $157,493,129 | 100.00% | 30.16% | 55.29% |
| 13. | Self-Pay | $121,610,465 | 100.00% | 15.23% | $42,768,762 | 100.00% | 8.19% | 35.17% |
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $798,581,481 | 100.00% | $522,181,283 | 100.00% | 65.39% | ||
| 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 | $776,620 | $4,327,932 | $624,799 | $1,226 | $5,728,125 | 4.12% | $25,394,781 | 18.28% |
| 2a. | Medicaid Managed Care (capitated) | $0 | $0 | $0 | $0 | $0 | 0.00% | $131,311 | 20.00% |
| 2b. | Medicaid Managed Care (fee-for-service) | $825,457 | $15,475,247 | $662,825 | $0 | $16,963,529 | 18.58% | ($1,194,367.00) | -1.31% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $1,602,077 | $19,803,179 | $1,287,624 | $1,226 | $22,691,654 | 9.83% | $24,331,725 | 10.54% |
| 4. | Medicare Non-Managed Care | $1,074,198 | $954,171 | $468,219 | $299 | $2,496,289 | 1.84% | $47,782,516 | 35.28% |
| 5a. | Medicare Managed Care (capitated) | $0 | $0 | $0 | $0 | $0 | $0 | ||
| 5b. | Medicare Managed Care (fee-for-service) | $0 | $7,682 | $236,114 | $0 | $243,796 | 1.12% | $4,307,314 | 19.84% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $1,074,198 | $961,853 | $704,333 | $299 | $2,740,085 | 1.74% | $52,089,830 | 33.15% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $0 | $28,344 | $145 | $0 | $28,489 | 0.70% | $1,226,263 | 30.30% |
| 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 | ||
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b) | $0 | $28,344 | $145 | $0 | $28,489 | 0.70% | $1,226,263 | 30.30% |
| 10. | Private Non-Managed Care | $3,111,507 | $1,450 | $3,110,057 | 1.16% | $89,848,723 | 33.39% | ||
| 11a. | Private Managed Care (capitated) | $0 | $0 | $0 | 0.00% | $2,366,001 | 42.65% | ||
| 11b. | Private Managed Care (fee-for-service) | $74,885 | $0 | $74,885 | 0.73% | $4,576,085 | 44.76% | ||
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $3,186,392 | $1,450 | $3,184,942 | 1.12% | $96,790,809 | 33.98% | ||
| 13. | Self-Pay | ||||||||
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $2,676,275 | $20,793,376 | $5,178,494 | $2,975 | $28,645,170 | 3.59% | $174,438,627 | 21.84% |
| Line | Sliding Fee Discounts (e) $ |
Bad Debt Write-Off (f) $ |
|
|---|---|---|---|
| 13. | Self-Pay | $58,185,289 | $6,707,655 |
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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