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Table 9D: Patient Service Revenue

Pennsylvania Data

X

40 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 $175,884,689 25.81% 12.53% $127,831,158 23.56% 14.03% 72.68%
2a. Medicaid Managed Care (capitated) $562 0.00% 0.00% $397 0.00% 0.00% 70.64%
2b. Medicaid Managed Care (fee-for-service) $505,453,691 74.19% 36.01% $414,738,945 76.44% 45.51% 82.05%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $681,338,942 100.00% 48.54% $542,570,500 100.00% 59.54% 79.63%
4. Medicare Non-Managed Care $173,907,922 66.87% 12.39% $108,494,494 69.68% 11.91% 62.39%
5a. Medicare Managed Care (capitated) $485,565 0.19% 0.03% $206,447 0.13% 0.02% 42.52%
5b. Medicare Managed Care (fee-for-service) $85,658,115 32.94% 6.10% $47,007,375 30.19% 5.16% 54.88%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $260,051,602 100.00% 18.52% $155,708,316 100.00% 17.09% 59.88%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $7,762,811 50.94% 0.55% $6,731,517 60.30% 0.74% 86.71%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $305 0.00% 0.00% $305 0.00% 0.00% 100.00%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $7,475,557 49.06% 0.53% $4,431,882 39.70% 0.49% 59.28%
9. Total Other Public (specify _______) (Sum of Lines 7 + 8a + 8b) $15,238,673 100.00% 1.09% $11,163,704 100.00% 1.23% 73.26%
10. Private Non-Managed Care $244,110,881 77.11% 17.39% $130,960,508 77.54% 14.37% 53.65%
11a. Private Managed Care (capitated) $13,199,255 4.17% 0.94% $4,896,602 2.90% 0.54% 37.10%
11b. Private Managed Care (fee-for-service) $59,252,811 18.72% 4.22% $33,029,248 19.56% 3.62% 55.74%
12. Total Private (Sum of Lines 10 + 11a + 11b) $316,562,947 100.00% 22.55% $168,886,358 100.00% 18.53% 53.35%
13. Self-Pay $130,604,636 100.00% 9.30% $32,985,892 100.00% 3.62% 25.26%
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $1,403,796,800 100.00% $911,314,770 100.00% 64.92%
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 $396,395 $1,140,232 $129,008 $410,996 $1,254,639 0.71% $42,781,988 24.32%
2a. Medicaid Managed Care (capitated) $0 $0 $0 $0 $0 0.00% $0 0.00%
2b. Medicaid Managed Care (fee-for-service) $0 $20,453,287 $8,503,529 $413,092 $28,543,724 5.65% $102,350,330 20.25%
3. Total Medicaid (Sum of Lines 1 + 2a + 2b) $396,395 $21,593,519 $8,632,537 $824,088 $29,798,363 4.37% $145,132,318 21.30%
4. Medicare Non-Managed Care $24,724 $1,075,320 $2,189,505 $45,077 $3,244,472 1.87% $60,884,322 35.01%
5a. Medicare Managed Care (capitated) $0 $0 $17,655 $0 $17,655 3.64% $279,118 57.48%
5b. Medicare Managed Care (fee-for-service) $361,175 $205,978 $1,124,987 $97,887 $1,594,253 1.86% $33,363,055 38.95%
6. Total Medicare (Sum of Lines 4 + 5a + 5b) $385,899 $1,281,298 $3,332,147 $142,964 $4,856,380 1.87% $94,526,495 36.35%
7. Other Public, including Non-Medicaid CHIP, Non-Managed Care $0 $0 $0 $0 $0 0.00% $562,316 7.24%
8a. Other Public, including Non-Medicaid CHIP, Managed Care (capitated) $0 $0 $0 $0 $0 0.00% $0 0.00%
8b. Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) $0 $0 $30,613 $0 $30,613 0.41% $3,029,268 40.52%
9. Total Other Public (specify _______) (Sum of Lines 7 + 8a + 8b) $0 $0 $30,613 $0 $30,613 0.20% $3,591,584 23.57%
10. Private Non-Managed Care $6,026,392 $2,699 $6,023,693 2.47% $105,717,512 43.31%
11a. Private Managed Care (capitated) $0 $0 $0 0.00% $8,370,166 63.41%
11b. Private Managed Care (fee-for-service) $332,105 $0 $332,105 0.56% $18,443,361 31.13%
12. Total Private (Sum of Lines 10 + 11a + 11b) $6,358,497 $2,699 $6,355,798 2.01% $132,531,039 41.87%
13. Self-Pay
14. TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) $782,294 $22,874,817 $18,353,794 $969,751 $41,041,154 2.92% $375,781,436 26.77%
Line Sliding Fee Discounts (e)
$
Bad Debt Write-Off (f)
$
13. Self-Pay $69,244,879 $20,097,990

Footnotes

'-' Data cannot be calculated or has been suppressed for confidentiality purposes.

'**' Patient Support Services are listed as Enabling Services in the 2025 UDS Manual.

Cells that are shaded blue represent data that was not reported or null values.

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