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Table 9D: Patient Related Revenue

National Look-Alikes Data

X

153 Look-Alikes

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 $536,726,941 43.04% 19.55% $413,494,503 41.68% 22.01% 77.04%
2a. Medicaid Managed Care (capitated) $185,949,383 14.91% 6.77% $178,128,123 17.96% 9.48% 95.79%
2b. Medicaid Managed Care (fee-for-service) $524,416,783 42.05% 19.10% $400,383,059 40.36% 21.31% 76.35%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $1,247,093,107 100.00% 45.42% $992,005,685 100.00% 52.80% 79.55%
4. Medicare Non-Managed Care $367,774,185 70.89% 13.39% $226,793,753 70.18% 12.07% 61.67%
5a. Medicare Managed Care (capitated) $9,555,588 1.84% 0.35% $7,777,178 2.41% 0.41% 81.39%
5b. Medicare Managed Care (fee-for-service) $141,490,186 27.27% 5.15% $88,601,623 27.42% 4.72% 62.62%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $518,819,959 100.00% 18.90% $323,172,554 100.00% 17.20% 62.29%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $24,989,267 80.07% 0.91% $12,898,730 73.37% 0.69% 51.62%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $732,981 2.35% 0.03% $731,006 4.16% 0.04% 99.73%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $5,486,433 17.58% 0.20% $3,950,706 22.47% 0.21% 72.01%
9. Total Other Public (Sum of Lines 7 + 8a + 8b) $31,208,681 100.00% 1.14% $17,580,442 100.00% 0.94% 56.33%
10. Private Non-Managed Care $620,300,500 77.11% 22.59% $402,733,567 81.29% 21.44% 64.93%
11a. Private Managed Care (capitated) $13,541,005 1.68% 0.49% $6,101,031 1.23% 0.32% 45.06%
11b. Private Managed Care (fee-for-service) $170,575,016 21.20% 6.21% $86,565,793 17.47% 4.61% 50.75%
12. Total Private (Sum of Lines 10 + 11a + 11b) $804,416,521 100.00% 29.30% $495,400,391 100.00% 26.37% 61.59%
13. Self-Pay $144,105,377 100.00% 5.25% $50,492,406 100.00% 2.69% 35.04%
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $2,745,643,645 100.00% $1,878,651,478 100.00% 68.42%
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 $32,038,015 $7,271,797 $2,701,330 $475,520 $41,535,622 7.74% $122,978,169 22.91%
2a. Medicaid Managed Care (capitated) $71,564,601 $4,206,141 $8,723,626 $10,587,950 $73,906,418 39.75% $8,347,419 4.49%
2b. Medicaid Managed Care (fee-for-service) $98,184,815 $16,007,360 $7,939,205 $2,501,403 $119,629,977 22.81% $145,349,766 27.72%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $201,787,431 $27,485,298 $19,364,161 $13,564,873 $235,072,017 18.85% $276,675,354 22.19%
4. Medicare Non-Managed Care $3,366,751 $260,045 $271,728 $18,634 $3,879,890 1.05% $118,777,033 32.30%
5a. Medicare Managed Care (capitated) $134,414 $2,209 $82,277 $0 $218,900 2.29% $1,513,911 15.84%
5b. Medicare Managed Care (fee-for-service) $2,202,084 $328,277 $625,743 $26,762 $3,129,342 2.21% $44,428,314 31.40%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $5,703,249 $590,531 $979,748 $45,396 $7,228,132 1.39% $164,719,258 31.75%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $49,993 $12,447 $0 $1,241 $61,199 0.24% $11,266,155 45.08%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $190,879 $207,998 $0 $0 $398,877 54.42% $1,975 0.27%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $1,339,062 $1,150,359 $0 $0 $2,489,421 45.37% $3,709,876 67.62%
9. Total Other Public (Sum of Lines 7 + 8a + 8b) $1,579,934 $1,370,804 $0 $1,241 $2,949,497 9.45% $14,978,006 47.99%
10. Private Non-Managed Care $1,716,059 $31,355 $1,684,704 0.27% $180,214,861 29.05%
11a. Private Managed Care (capitated) $85,476 $0 $85,476 0.63% $6,403,366 47.29%
11b. Private Managed Care (fee-for-service) $208,490 $168,107 $40,383 0.02% $74,684,230 43.78%
12. Total Private (Sum of Lines 10 + 11a + 11b) $2,010,025 $199,462 $1,810,563 0.23% $261,302,457 32.48%
13. Self-Pay
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $209,070,614 $29,446,633 $22,353,934 $13,810,972 $247,060,209 9.00% $717,675,075 26.14%
Line Sliding Fee Discounts (e)
$
Bad Debt Write-Off (f)
$
13. Self-Pay $59,801,329 $26,593,379

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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