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Significant Payors
3 Months Ended
Mar. 31, 2023
Significant Payors [Abstract]  
Significant Payors

11. Significant Payors

The Company’s revenue by payor type was as follows:

 

 

 

 

 

 

 

 

 

 

 

 

Personal Care Segment

 

For the Three Months Ended March 31,

 

 

 

2023

 

 

2022

 

 

 

Amount
(in Thousands)

 

% of Segment
Net Service
Revenues

 

 

Amount
(in Thousands)

 

% of Segment
Net Service
Revenues

 

State, local and other governmental programs

 

$95,320

 

50.1

%

 

$83,908

 

49.5

%

Managed care organizations

 

87,901

 

46.3

 

 

77,390

 

45.6

 

Private pay

 

4,226

 

2.2

 

 

4,626

 

2.7

 

Commercial insurance

 

1,669

 

0.9

 

 

2,024

 

1.2

 

Other

 

916

 

0.5

 

 

1,684

 

1.0

 

Total personal care segment net service revenues

 

$190,032

 

100.0

%

 

$169,632

 

100.0

%

 

 

 

 

 

 

 

 

 

 

 

 

Hospice Segment

 

For the Three Months Ended March 31,

 

 

 

2023

 

 

2022

 

 

 

Amount
 (in Thousands)

 

% of Segment
Net Service
Revenues

 

 

Amount
 (in Thousands)

 

% of Segment
Net Service
Revenues

 

Medicare

 

$44,556

 

90.7

%

 

$43,485

 

91.1

%

Commercial insurance

 

2,547

 

5.2

 

 

2,244

 

4.7

 

Managed care organizations

 

1,647

 

3.4

 

 

1,715

 

3.6

 

Other

 

332

 

0.7

 

 

283

 

0.6

 

Total hospice segment net service revenues

 

$49,082

 

100.0

%

 

$47,727

 

100.0

%

 

 

 

 

 

 

 

 

 

 

 

 

Home Health Segment

 

For the Three Months Ended March 31,

 

 

 

2023

 

 

2022

 

 

 

Amount
 (in Thousands)

 

% of Segment
Net Service
Revenues

 

 

Amount
 (in Thousands)

 

% of Segment
Net Service
Revenues

 

Medicare

 

$9,270

 

74.2

%

 

$6,812

 

73.5

%

Managed care organizations

 

2,539

 

20.3

 

 

1,904

 

20.5

 

Other

 

676

 

5.5

 

 

559

 

6.0

 

Total home health segment net service revenues

 

$12,485

 

100.0

%

 

$9,275

 

100.0

%

 

The Company derives a significant amount of its revenue from its operations in Illinois, New Mexico and New York. The percentages of segment revenue for each of these significant states were as follows:

 

 

 

 

 

 

 

 

 

 

 

 

Personal Care Segment

 

For the Three Months Ended March 31,

 

 

 

2023

 

 

2022

 

 

 

Amount
 (in Thousands)

 

% of Segment
Net Service
Revenues

 

 

Amount
 (in Thousands)

 

% of Segment
Net Service
Revenues

 

Illinois

 

$98,414

 

51.8

%

 

$84,693

 

49.9

%

New Mexico

 

28,474

 

15.0

 

 

25,440

 

15.0

 

New York (1)

 

21,885

 

11.5

 

 

21,385

 

12.6

 

All other states

 

41,259

 

21.7

 

 

38,114

 

22.5

 

Total personal care segment net service revenues

 

$190,032

 

100.0

%

 

$169,632

 

100.0

%

 

(1)
In 2019, New York initiated a new Request For Offer (“RFO”) process to competitively procure CDPAP fiscal intermediaries. The Company was not selected in the initial RFO process. We submitted a formal protest in response to the selection process, which was filed and accepted in March 2021. The New York fiscal year 2023 state budget, passed in April 2022, amends the current Fiscal Intermediary RFO process to authorize all fiscal intermediaries that submitted an RFO application and served at least 200 clients in New York City or 50 clients in other counties between January 1, 2020 and March 31, 2020 to contract with the New York State Department of Health and continue to operate in all counties contained in their application, if the fiscal intermediary submits an attestation and supporting information to the New York State Department of Health no later than November 29, 2022. The Company submitted an attestation on November 22, 2022. Under this provision, the Company is allowed to continue to contract with all of its current payors for CDPAP services, as of the contract award date, which was anticipated to be April 1, 2023. However, the New York State Department of Health has not yet awarded these contracts. The Company continues to assess the future of its participation in this program. Given the current profitability of the program, the Company has suspended materially all of its new fee-for-service patient admissions through County Social Service Departments in the CDPAP program.

 

 

 

 

 

 

 

 

 

 

 

 

Hospice Segment

 

For the Three Months Ended March 31,

 

 

 

2023

 

 

2022

 

 

 

Amount
(in Thousands)

 

% of Segment
Net Service
Revenues

 

 

Amount
(in Thousands)

 

% of Segment
Net Service
Revenues

 

Ohio

 

$18,451

 

37.6

%

 

$16,328

 

34.2

%

Illinois

 

11,480

 

23.4

 

 

9,541

 

20.0

 

New Mexico

 

6,486

 

13.2

 

 

8,233

 

17.3

 

All other states

 

12,665

 

25.8

 

 

13,625

 

28.5

 

Total hospice segment net service revenues

 

$49,082

 

100.0

%

 

$47,727

 

100.0

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Home Health Segment

 

For the Three Months Ended March 31,

 

 

 

2023

 

 

2022

 

 

 

Amount
(in Thousands)

 

% of Segment
Net Service
Revenues

 

 

Amount
(in Thousands)

 

% of Segment
Net Service
Revenues

 

New Mexico

 

$9,116

 

73.0

%

 

$7,509

 

81.0

%

Illinois

 

3,369

 

27.0

 

 

1,766

 

19

 

Total home health segment net service revenues

 

$12,485

 

100.0

%

 

$9,275

 

100.0

%

 

 

A substantial portion of the Company’s revenue and accounts receivable are derived from services performed for federal, state and local governmental agencies. We derive a significant amount of our net service revenues in Illinois, which represented 39.1% and 37.4% of our net service revenues for the three months ended March 31, 2023 and 2022, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 21.5% and 20.7% of the Company’s net service revenues for the three months ended March 31, 2023 and 2022, respectively.

The related receivables due from the Illinois Department on Aging represented 20.7% and 18.0% of the Company’s net accounts receivable at March 31, 2023 and December 31, 2022, respectively.