Significant Payors

6 Months Ended

Jun. 30, 2022

12. Significant Payors

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

Personal Care Segment	For the Three Months Ended June 30,										For the Six Months Ended June 30,
	2022					2021					2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
State, local and other governmental programs	$	85,462		49.0	%	$	88,382		50.2	%	$	169,370		49.2	%	$	169,231		49.6	%
Managed care organizations		80,577		46.2			78,865		44.7			157,967		45.9			154,321		45.2
Private pay		4,610		2.7			5,046		2.9			9,236		2.7			9,949		2.9
Commercial insurance		2,093		1.2			2,676		1.5			4,117		1.2			5,022		1.5
Other		1,588		0.9			1,298		0.7			3,272		1.0			2,612		0.8
Total personal care segment net service revenues	$	174,330		100.0	%	$	176,267		100.0	%	$	343,962		100.0	%	$	341,135		100.0	%

Hospice Segment	For the Three Months Ended June 30,										For the Six Months Ended June 30,
	2022					2021					2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	47,152		90.5	%	$	34,452		93.3	%	$	90,637		90.8	%	$	68,437		93.8	%
Commercial insurance		2,726		5.2			959		2.6			4,970		5.0			1,492		2.0
Managed care organizations		1,968		3.8			1,395		3.8			3,683		3.7			2,882		3.9
Other		228		0.5			103		0.3			511		0.5			192		0.3
Total hospice segment net service revenues	$	52,074		100.0	%	$	36,909		100.0	%	$	99,801		100.0	%	$	73,003		100.0	%

Home Health Segment	For the Three Months Ended June 30,										For the Six Months Ended June 30,
	2022					2021					2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Medicare	$	7,592		72.1	%	$	3,825		81.1	%	$	14,404		72.7	%	$	7,327		80.9	%
Managed care organizations		2,262		21.5			822		17.4			4,166		21.0			1,620		17.9
Other		682		6.4			70		1.5			1,241		6.3			110		1.2
Total home health segment net service revenues	$	10,536		100.0	%	$	4,717		100.0	%	$	19,811		100.0	%	$	9,057		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 for the three and six months ended June 30, 2022 and 2021 were as follows:

Personal Care Segment	For the Three Months Ended June 30,										For the Six Months Ended June 30,
	2022					2021					2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Illinois	$	88,797		50.9	%	$	84,788		48.0	%	$	173,480		50.4	%	$	158,172		46.3	%
New Mexico		26,473		15.2			25,484		14.5			51,912		15.1			49,077		14.4
New York ⁽¹⁾		21,127		12.1			25,535		14.5			42,513		12.4			53,110		15.6
All other states		37,933		21.8			40,460		23.0			76,057		22.1			80,776		23.7
Total personal care segment net service revenues	$	174,330		100.0	%	$	176,267		100.0	%	$	343,962		100.0	%	$	341,135		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, but we have not received a response to the formal protest. The Company continues to consider other arrangements and to pursue our protest of the award. 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. Under this provision, the Company is allowed to continue to contract with all of its current payors for CDPAP services. The Company continues to assess the future of its participation in this program. Given the status of the program, the Company has suspended materially all of its new patient admissions under the New York CDPAP program.

Hospice Segment	For the Three Months Ended June 30,										For the Six Months Ended June 30,
	2022					2021					2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
Ohio	$	17,245		33.1	%	$	14,694		39.8	%	$	33,574		33.7	%	$	28,808		39.4	%
Illinois ⁽²⁾		13,561		26.0			—		—			16,078		16.1			—		—
New Mexico		7,846		15.1			8,717		23.6			23,102		23.1			17,948		24.6
All other states		13,422		25.8			13,498		36.6			27,047		27.1			26,247		36.0
Total hospice segment net service revenues	$	52,074		100.0	%	$	36,909		100.0	%	$	99,801		100.0	%	$	73,003		100.0	%

(2)

With the JourneyCare acquisition, the Company expanded its hospice services in the state of Illinois.

Home Health Segment	For the Three Months Ended June 30,										For the Six Months Ended June 30,
	2022					2021					2022					2021
	Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues			Amount (in Thousands)		% of Segment Net Service Revenues
New Mexico	$	9,070		86.1	%	$	4,717		100.0	%	$	16,579		83.7	%	$	9,057		100.0	%
Illinois ⁽³⁾		1,466		13.9			—		—			3,232		16.3			—		—
Total home health segment net service revenues	$	10,536		100.0	%	$	4,717		100.0	%	$	19,811		100.0	%	$	9,057		100.0	%

(3)

With the acquisition of Summit Home Health, LLC (“Summit”) on October 1, 2021, the Company expanded its home health services in the state of Illinois.

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 43.8%, and 38.9% of our net service revenues for the three months ended June 30, 2022, and 2021, respectively, and accounted for 41.6% and 37.4% of our net service revenues for the six months ended June 30, 2022 and 2021, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 20.7% and 22.6% of the Company’s net service revenues for the three months ended June 30, 2022 and 2021, respectively, and accounted for 20.7% and 21.5% of the Company’s net service revenues for the six months ended June 30, 2022 and 2021, respectively.

The related receivables due from the Illinois Department on Aging represented 18.3% and 16.1% of the Company’s net accounts receivable at June 30, 2022 and December 31, 2021, respectively.