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Revenue
6 Months Ended
Jun. 30, 2020
Revenue From Contract With Customer [Abstract]  
Revenue

(12) Revenue

The company recognizes revenue when it transfers promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. Or estimate for amounts not expected to be collected based on historical experience will continue to be recognized as a reduction to net revenue. However, subsequent changes in estimate of collectability due to a change in the financial status of a payer, for example a bankruptcy, will be recognized as bad debt expense in operating charges.

The performance obligation is separately identifiable from other promises in the customer contract. As the performance obligations are met (i.e.: room, board, ancillary services, level of care), revenue is recognized based upon allocated transaction price. The transaction

price is allocated to separate performance obligations based upon the relative standalone selling price. In instances where we determine there are multiple performance obligations across multiple months, the transaction price will be allocated by applying an estimated implicit and explicit rate to gross charges based on the separate performance obligations.

In assessing collectability, we have elected the portfolio approach.  This portfolio approach is being used as we have large volume of similar contracts with similar classes of customers. We reasonably expect that the effect of applying a portfolio approach to a group of contracts would not differ materially from considering each contract separately.  Management’s judgment to group the contracts by portfolio is based on the payment behavior expected in each portfolio category.  As a result, aggregating all of the contracts (which are at the patient level) by the particular payer or group of payers, will result in the recognition of the same amount of revenue as applying the analysis at the individual patient level.

We group our revenues into categories based on payment behaviors.  Each component has its own reimbursement structure which allows us to disaggregate the revenue into categories that share the nature and timing of payments.  The other patient revenue consists primarily of self-pay, government-funded non-Medicaid, and other.

 

The following table disaggregates our revenue by major source for the three and six month periods ended June 30, 2020 and 2019 (in thousands):

 

 

For the three months ended June 30, 2020

 

 

Acute Care

 

 

Behavioral Health

 

 

Other

 

 

Total

 

Medicare

$

264,310

 

 

18

%

 

$

106,571

 

 

8

%

 

 

 

 

 

$

370,881

 

 

14

%

Managed Medicare

 

182,771

 

 

12

%

 

 

59,979

 

 

5

%

 

 

 

 

 

 

242,750

 

 

9

%

Medicaid

 

131,452

 

 

9

%

 

 

154,090

 

 

12

%

 

 

 

 

 

 

285,542

 

 

10

%

Managed Medicaid

 

108,336

 

 

7

%

 

 

280,865

 

 

22

%

 

 

 

 

 

 

389,201

 

 

14

%

Managed Care (HMO and PPOs)

 

432,695

 

 

29

%

 

 

293,124

 

 

23

%

 

 

 

 

 

 

725,819

 

 

27

%

UK Revenue

 

0

 

 

0

%

 

 

136,622

 

 

11

%

 

 

 

 

 

 

136,622

 

 

5

%

Other patient revenue and adjustments, net

 

78,196

 

 

5

%

 

 

121,135

 

 

10

%

 

 

 

 

 

 

199,331

 

 

7

%

Other non-patient revenue (a)

 

269,746

 

 

18

%

 

 

106,737

 

 

8

%

 

 

3,125

 

 

 

379,608

 

 

14

%

Total Net Revenue

$

1,467,506

 

 

100

%

 

$

1,259,123

 

 

100

%

 

$

3,125

 

 

 

2,729,754

 

 

100

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For the six months ended June 30, 2020

 

 

Acute Care

 

 

Behavioral Health

 

 

Other

 

 

Total

 

Medicare

$

590,335

 

 

20

%

 

$

226,188

 

 

9

%

 

 

 

 

 

$

816,523

 

 

15

%

Managed Medicare

 

404,762

 

 

14

%

 

 

119,217

 

 

5

%

 

 

 

 

 

 

523,979

 

 

9

%

Medicaid

 

259,411

 

 

9

%

 

 

329,108

 

 

13

%

 

 

 

 

 

 

588,519

 

 

11

%

Managed Medicaid

 

231,791

 

 

8

%

 

 

583,422

 

 

23

%

 

 

 

 

 

 

815,213

 

 

15

%

Managed Care (HMO and PPOs)

 

973,432

 

 

33

%

 

 

633,811

 

 

25

%

 

 

 

 

 

 

1,607,243

 

 

29

%

UK Revenue

 

0

 

 

0

%

 

 

273,472

 

 

11

%

 

 

 

 

 

 

273,472

 

 

5

%

Other patient revenue and adjustments, net

 

142,795

 

 

5

%

 

 

244,195

 

 

10

%

 

 

 

 

 

 

386,990

 

 

7

%

Other non-patient revenue (a)

 

386,029

 

 

13

%

 

 

155,819

 

 

6

%

 

 

5,634

 

 

 

547,482

 

 

10

%

Total Net Revenue

$

2,988,555

 

 

100

%

 

$

2,565,232

 

 

100

%

 

$

5,634

 

 

 

5,559,421

 

 

100

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For the three months ended June 30, 2019

 

 

Acute Care

 

 

Behavioral Health

 

 

Other

 

 

Total

 

Medicare

$

319,060

 

 

21

%

 

$

139,248

 

 

11

%

 

 

 

 

 

$

458,308

 

 

16

%

Managed Medicare

 

211,660

 

 

14

%

 

 

54,152

 

 

4

%

 

 

 

 

 

 

265,812

 

 

9

%

Medicaid

 

138,682

 

 

9

%

 

 

183,563

 

 

14

%

 

 

 

 

 

 

322,245

 

 

11

%

Managed Medicaid

 

145,970

 

 

10

%

 

 

275,252

 

 

21

%

 

 

 

 

 

 

421,222

 

 

15

%

Managed Care (HMO and PPOs)

 

566,165

 

 

37

%

 

 

346,717

 

 

26

%

 

 

 

 

 

 

912,882

 

 

32

%

UK Revenue

 

0

 

 

0

%

 

 

143,800

 

 

11

%

 

 

 

 

 

 

143,800

 

 

5

%

Other patient revenue and adjustments, net

 

36,161

 

 

2

%

 

 

126,903

 

 

10

%

 

 

 

 

 

 

163,064

 

 

6

%

Other non-patient revenue

 

114,011

 

 

7

%

 

 

50,606

 

 

4

%

 

 

3,218

 

 

 

167,835

 

 

6

%

Total Net Revenue

$

1,531,709

 

 

100

%

 

$

1,320,241

 

 

100

%

 

$

3,218

 

 

 

2,855,168

 

 

100

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For the six months ended June 30, 2019

 

 

Acute Care

 

 

Behavioral Health

 

 

Other

 

 

Total

 

Medicare

$

654,969

 

 

21

%

 

$

276,704

 

 

11

%

 

 

 

 

 

$

931,673

 

 

16

%

Managed Medicare

 

420,763

 

 

14

%

 

 

106,411

 

 

4

%

 

 

 

 

 

 

527,174

 

 

9

%

Medicaid

 

243,192

 

 

8

%

 

 

356,479

 

 

14

%

 

 

 

 

 

 

599,671

 

 

11

%

Managed Medicaid

 

279,701

 

 

9

%

 

 

542,525

 

 

21

%

 

 

 

 

 

 

822,226

 

 

15

%

Managed Care (HMO and PPOs)

 

1,136,548

 

 

37

%

 

 

694,599

 

 

27

%

 

 

 

 

 

 

1,831,147

 

 

32

%

UK Revenue

 

0

 

 

0

%

 

 

280,502

 

 

11

%

 

 

 

 

 

 

280,502

 

 

5

%

Other patient revenue and adjustments, net

 

88,044

 

 

3

%

 

 

250,381

 

 

10

%

 

 

 

 

 

 

338,425

 

 

6

%

Other non-patient revenue

 

223,336

 

 

7

%

 

 

99,023

 

 

4

%

 

 

6,382

 

 

 

328,741

 

 

6

%

Total Net Revenue

$

3,046,553

 

 

100

%

 

$

2,606,624

 

 

100

%

 

$

6,382

 

 

 

5,659,559

 

 

100

%

 

 

(a) Includes $157 million in Acute Care and $61 million in Behavioral Health of governmental stimulus program revenues in each of the three and six-months periods ended June 30, 2020.