Puerto Rico Data
21 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 | $4,263,409 | 0.99% | 0.70% | $1,562,204 | 0.39% | 0.30% | 36.64% |
| 2a. | Medicaid Managed Care (capitated) | $224,730,107 | 52.07% | 36.67% | $259,055,332 | 64.57% | 50.21% | 115.27% |
| 2b. | Medicaid Managed Care (fee-for-service) | $202,566,102 | 46.94% | 33.06% | $140,570,066 | 35.04% | 27.24% | 69.39% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $431,559,618 | 100.00% | 70.43% | $401,187,602 | 100.00% | 77.75% | 92.96% |
| 4. | Medicare Non-Managed Care | $7,657,099 | 7.41% | 1.25% | $4,239,380 | 5.52% | 0.82% | 55.37% |
| 5a. | Medicare Managed Care (capitated) | $28,024,864 | 27.11% | 4.57% | $22,349,336 | 29.10% | 4.33% | 79.75% |
| 5b. | Medicare Managed Care (fee-for-service) | $67,693,361 | 65.48% | 11.05% | $50,206,412 | 65.38% | 9.73% | 74.17% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $103,375,324 | 100.00% | 16.87% | $76,795,128 | 100.00% | 14.88% | 74.29% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $0 | 0.00% | $0 | 0.00% | |||
| 8a. | Other Public, including Non-Medicaid CHIP, Managed Care (capitated) | $0 | 0.00% | $0 | 0.00% | |||
| 8b. | Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) | $0 | 0.00% | $0 | 0.00% | |||
| 9. | Total Other Public (Sum of Lines 7 + 8a + 8b) | $0 | 0.00% | $0 | 0.00% | |||
| 10. | Private Non-Managed Care | $43,466,833 | 100.00% | 7.09% | $21,911,646 | 100.00% | 4.25% | 50.41% |
| 11a. | Private Managed Care (capitated) | $0 | 0.00% | 0.00% | $0 | 0.00% | 0.00% | |
| 11b. | Private Managed Care (fee-for-service) | $0 | 0.00% | 0.00% | $0 | 0.00% | 0.00% | |
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $43,466,833 | 100.00% | 7.09% | $21,911,646 | 100.00% | 4.25% | 50.41% |
| 13. | Self-Pay | $34,366,951 | 100.00% | 5.61% | $16,096,378 | 100.00% | 3.12% | 46.84% |
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $612,768,726 | 100.00% | $515,990,754 | 100.00% | 84.21% | ||
| 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 | $0 | $0 | $0 | $0 | $0 | 0.00% | $2,231,505 | 52.34% |
| 2a. | Medicaid Managed Care (capitated) | $87,089,873 | $56,044,928 | $3,247,825 | $30,810 | $146,351,816 | 65.12% | ($34,433,287.00) | -15.32% |
| 2b. | Medicaid Managed Care (fee-for-service) | $3,317,996 | $3,059,711 | $230,069 | $0 | $6,607,776 | 3.26% | $44,126,556 | 21.78% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $90,407,869 | $59,104,639 | $3,477,894 | $30,810 | $152,959,592 | 35.44% | $11,924,774 | 2.76% |
| 4. | Medicare Non-Managed Care | $0 | $0 | $0 | $0 | $0 | 0.00% | $2,277,535 | 29.74% |
| 5a. | Medicare Managed Care (capitated) | $0 | $373,733 | $209,072 | $0 | $582,805 | 2.08% | $5,668,552 | 20.23% |
| 5b. | Medicare Managed Care (fee-for-service) | $0 | $0 | $25,922 | $0 | $25,922 | 0.04% | $11,061,991 | 16.34% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $0 | $373,733 | $234,994 | $0 | $608,727 | 0.59% | $19,008,078 | 18.39% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $0 | $0 | $0 | $0 | $0 | $0 | ||
| 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 | $0 | $0 | $0 | $0 | $0 | ||
| 10. | Private Non-Managed Care | $0 | $0 | $0 | 0.00% | $11,686,452 | 26.89% | ||
| 11a. | Private Managed Care (capitated) | $0 | $0 | $0 | $0 | ||||
| 11b. | Private Managed Care (fee-for-service) | $0 | $0 | $0 | $0 | ||||
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $0 | $0 | $0 | 0.00% | $11,686,452 | 26.89% | ||
| 13. | Self-Pay | ||||||||
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $90,407,869 | $59,478,372 | $3,712,888 | $30,810 | $153,568,319 | 25.06% | $42,619,304 | 6.96% |
| Line | Sliding Fee Discounts (e) $ |
Bad Debt Write-Off (f) $ |
|
|---|---|---|---|
| 13. | Self-Pay | $9,360,938 | $1,374,173 |
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.
View Detailed UDS Footnotes
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