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Table 9D: Patient Related Revenue

New Hampshire Data

X

9 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 $9,479,446 28.86% 6.99% $6,363,498 19.07% 7.01% 67.13%
2a. Medicaid Managed Care (capitated) $0 0.00% 0.00% $0 0.00% 0.00%
2b. Medicaid Managed Care (fee-for-service) $23,365,014 71.14% 17.23% $26,999,966 80.93% 29.76% 115.56%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $32,844,460 100.00% 24.23% $33,363,464 100.00% 36.77% 101.58%
4. Medicare Non-Managed Care $26,801,789 95.25% 19.77% $17,561,415 93.40% 19.36% 65.52%
5a. Medicare Managed Care (capitated) $0 0.00% 0.00% $0 0.00% 0.00%
5b. Medicare Managed Care (fee-for-service) $1,337,204 4.75% 0.99% $1,241,037 6.60% 1.37% 92.81%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $28,138,993 100.00% 20.76% $18,802,452 100.00% 20.72% 66.82%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $648,620 100.00% 0.48% $344,788 100.00% 0.38% 53.16%
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) $648,620 100.00% 0.48% $344,788 100.00% 0.38% 53.16%
10. Private Non-Managed Care $55,153,999 100.00% 40.68% $32,611,412 100.00% 35.94% 59.13%
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) $55,153,999 100.00% 40.68% $32,611,412 100.00% 35.94% 59.13%
13. Self-Pay $18,786,564 100.00% 13.86% $5,609,628 100.00% 6.18% 29.86%
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $135,572,636 100.00% $90,731,744 100.00% 66.92%
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% $1,817,527 19.17%
2a. Medicaid Managed Care (capitated) $0 $0 $0 $0 $0 $0
2b. Medicaid Managed Care (fee-for-service) $0 $0 $87,973 $0 $87,973 0.38% ($1,699,660.00) -7.27%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $0 $0 $87,973 $0 $87,973 0.27% $117,867 0.36%
4. Medicare Non-Managed Care $24,126 $40,555 $622,072 $0 $686,753 2.56% $9,165,726 34.20%
5a. Medicare Managed Care (capitated) $0 $0 $0 $0 $0 $0
5b. Medicare Managed Care (fee-for-service) $0 $0 $23,917 $0 $23,917 1.79% $91,107 6.81%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $24,126 $40,555 $645,989 $0 $710,670 2.53% $9,256,833 32.90%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $0 $0 $0 $0 $0 0.00% $262,594 40.49%
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 0.00% $262,594 40.49%
10. Private Non-Managed Care $756,655 $0 $756,655 1.37% $15,825,313 28.69%
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) $756,655 $0 $756,655 1.37% $15,825,313 28.69%
13. Self-Pay
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $24,126 $40,555 $1,490,617 $0 $1,555,298 1.15% $25,462,607 18.78%
Line Sliding Fee Discounts (e)
$
Bad Debt Write-Off (f)
$
13. Self-Pay $10,178,592 $2,715,214

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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