NYS Institutional Cost Report, audited, 2021

Net patient revenue by payor

Net = gross charges minus contractual allowances, bad debt, and financial-aid discounts. Exhibit 46, Total All Services column. What each payor actually paid hospitals.

Statewide, 169 hospitals$80.1B
NYC Health + Hospitals, 12$5.0B
All other, 157$75.1B

Statewide net revenue, $ billions

0 5 10 15 20 HMO/PHSP Other HMO/PHSP Other: 17.4 $B 17.4 Medicare Medicare: 16.1 $B 16.1 HMO/Medicare HMO/Medicare: 11.8 $B 11.8 HMO/PHSP Medicaid HMO/PHSP Medicaid: 10.8 $B 10.8 Non-Profit Indemnity Ins Non-Profit Indemnity Ins: 9.7 $B 9.7 Commercial Indemnity Ins Commercial Indemnity Ins: 7.7 $B 7.7 Medicaid FFS Medicaid FFS: 3.2 $B 3.2 Free Charity Free Charity: 1.0 $B 1.0 Essential Plan 1-2 inferred Essential Plan 1-2 inferred: 0.9 $B 0.9 Government Government: 0.8 $B 0.8 Essential Plan 3-4 inferred Essential Plan 3-4 inferred: 0.5 $B 0.5 No-Fault No-Fault: 0.5 $B 0.5 Workers Comp Workers Comp: 0.4 $B 0.4 Courtesy Courtesy: 0.4 $B 0.4 Self Insured Self Insured: 0.2 $B 0.2 HFAL insured any payor HFAL insured any payor: -0.3 $B -0.3 Other bad debt Other bad debt: -0.5 $B -0.5 Uninsured/Self-Pay Uninsured/Self-Pay: -0.6 $B -0.6

Share of net revenue: NYC H+H vs all other hospitals

Each group's payor mix as percent of its own net revenue. "All other" includes non-H+H public hospitals (SUNY, county), not only private.

NYC H+HAll other
0% 5% 10% 15% 20% 25% 30% HMO/PHSP Other NYC H+H, HMO/PHSP Other: 9.5% of net revenue 9.5 All other, HMO/PHSP Other: 22.6% of net revenue 22.6 Medicare NYC H+H, Medicare: 19.4% of net revenue 19.4 All other, Medicare: 20.2% of net revenue 20.2 HMO/Medicare NYC H+H, HMO/Medicare: 16.5% of net revenue 16.5 All other, HMO/Medicare: 14.7% of net revenue 14.7 HMO/PHSP Medicaid NYC H+H, HMO/PHSP Medicaid: 25.6% of net revenue 25.6 All other, HMO/PHSP Medicaid: 12.7% of net revenue 12.7 Non-Profit Indemnity Ins NYC H+H, Non-Profit Indemnity Ins: 0.0% of net revenue 0.0 All other, Non-Profit Indemnity Ins: 12.9% of net revenue 12.9 Commercial Indemnity Ins NYC H+H, Commercial Indemnity Ins: -1.0% of net revenue -1.0 All other, Commercial Indemnity Ins: 10.4% of net revenue 10.4 Medicaid FFS NYC H+H, Medicaid FFS: 18.4% of net revenue 18.4 All other, Medicaid FFS: 3.1% of net revenue 3.1 Free Charity NYC H+H, Free Charity: 1.4% of net revenue 1.4 All other, Free Charity: 1.2% of net revenue 1.2 Essential Plan 1-2 inferred NYC H+H, Essential Plan 1-2 inferred: 1.5% of net revenue 1.5 All other, Essential Plan 1-2 inferred: 1.1% of net revenue 1.1 Government NYC H+H, Government: 5.1% of net revenue 5.1 All other, Government: 0.8% of net revenue 0.8 Essential Plan 3-4 inferred NYC H+H, Essential Plan 3-4 inferred: 2.1% of net revenue 2.1 All other, Essential Plan 3-4 inferred: 0.6% of net revenue 0.6 No-Fault NYC H+H, No-Fault: 0.9% of net revenue 0.9 All other, No-Fault: 0.6% of net revenue 0.6 Workers Comp NYC H+H, Workers Comp: 0.3% of net revenue 0.3 All other, Workers Comp: 0.5% of net revenue 0.5 Courtesy NYC H+H, Courtesy: 0.0% of net revenue 0.0 All other, Courtesy: 0.5% of net revenue 0.5 Self Insured NYC H+H, Self Insured: 0.0% of net revenue 0.0 All other, Self Insured: 0.2% of net revenue 0.2 HFAL insured any payor NYC H+H, HFAL insured any payor: 0.0% of net revenue 0.0 All other, HFAL insured any payor: -0.4% of net revenue -0.4 Other bad debt NYC H+H, Other bad debt: -0.5% of net revenue -0.5 All other, Other bad debt: -0.7% of net revenue -0.7 Uninsured/Self-Pay NYC H+H, Uninsured/Self-Pay: 0.8% of net revenue 0.8 All other, Uninsured/Self-Pay: -0.8% of net revenue -0.8
Table view
PayorStatewide $BNYC H+H $BAll other $BH+H %Other %
HMO/PHSP Other17.430.4816.959.522.6
Medicare16.150.9715.1819.420.2
HMO/Medicare11.840.8211.0116.514.7
HMO/PHSP Medicaid10.831.289.5625.612.7
Non-Profit Indemnity Ins9.650.009.650.012.9
Commercial Indemnity Ins7.74-0.057.78-1.010.4
Medicaid FFS3.230.922.3118.43.1
Free Charity0.970.070.901.41.2
Essential Plan 1-2 inferred0.870.070.801.51.1
Government0.840.250.595.10.8
Essential Plan 3-4 inferred0.530.100.432.10.6
No-Fault0.460.040.420.90.6
Workers Comp0.400.010.390.30.5
Courtesy0.370.000.370.00.5
Self Insured0.160.000.160.00.2
HFAL insured any payor-0.320.00-0.320.0-0.4
Other bad debt-0.51-0.02-0.49-0.5-0.7
Uninsured/Self-Pay-0.560.04-0.600.8-0.8

Source: health.data.ny.gov, Hospital Cost Report Audited Data 2021 (3ngu-ihm3). Method: methods/PAYOR.md, 01_payor.py, 02_groups.py. "Essential Plan" line labels inferred from instructions. Charity net counts unpaid charges; HFAL and bad debt rows are pure deductions.