Note 6.

Net Revenues and Accounts Receivable

Net Revenues

Net revenues in the Home Health and Hospice segments were derived from all major payer classes and were as follows (in thousands):


	Year
	2011		2010		2009
Medicare:
Home Health	$	799.2	$	822.7	$	782.5
Hospice		729.1		326.2		68.8

Total Medicare		1,528.3		1,148.9		851.3
Medicaid and Local Government		83.1		74.0		83.9
Commercial Insurance and Other:
Paid at episodic rates		77.7		86.4		79.3
Other		109.7		105.2		104.3

Total Commercial Insurance and Other		187.4		191.6		183.6

Total net revenues	$	1,798.8	$	1,414.5	$	1,118.8

For 2011 and 2010, the Company recorded hospice Medicare cap expense of $4.3 million and $3.0 million, respectively, which is reflected in net revenues in the Company's consolidated statements of operations. The payment cap, which is calculated for each provider by the Medicare fiscal intermediary at the end of the hospice cap period, is determined by multiplying the number of first time patient admissions during the cap period by the Medicare cap amount, subject to certain adjustments. Medicare revenue paid to a provider during a twelve month period cannot exceed the aggregate Medicare payment cap. As of December 31, 2011 and 2010, the Company had Medicare cap liabilities of $15.6 million and $15.4 million, respectively, which were reflected in Medicare liabilities in the Company's consolidated balance sheets.

Accounts Receivable

Net revenues in the Home Health and Hospice segments were derived from all major payer classes. Accounts receivable attributable to major payer sources of reimbursement are as follows:


	December 31, 2011			December 31, 2010
Medicare	$	217,028		$	186,747
Medicaid and Local Government		46,553			35,872
Commercial Insurance and Other		38,570			44,623

Gross Accounts Receivable		302,151			267,242
Less: Allowance for doubtful accounts		(11,562	)		(7,654	)

Net Accounts Receivable	$	290,589		$	259,588

The Commercial Insurance and Other payer group included self-pay accounts receivable relating to patient co-payments of $2.1 million and $2.6 million as of December 31, 2011 and 2010, respectively.

The Company's only financing receivable is the note receivable from CareCentrix, Inc. The Company measures impairment based on the present value of expected cash flows after considering assumptions relating to risk factors and economic conditions. On an ongoing basis, the Company assesses the credit quality based on the Company's review of CareCentrix, Inc.'s financial position and receipt of interest payments when due. Based on the Company's analysis, as of December 31, 2011 and 2010, the Company had no allowances for credit losses.