Significant Payors

6 Months Ended

Jun. 30, 2023

11. 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,
	2023					2022				2023				2022
	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	$	100,399	50.6	%	$	85,462	49.0	%	$	195,721	50.4	%	$	169,370	49.2	%
Managed care organizations		91,276	46.0			80,577	46.2			179,176	46.1			157,967	45.9
Private pay		4,137	2.2			4,610	2.7			8,363	2.2			9,236	2.7
Commercial insurance		1,637	0.8			2,093	1.2			3,306	0.9			4,117	1.2
Other		865	0.4			1,588	0.9			1,781	0.4			3,272	1.0
Total personal care segment net service revenues	$	198,314	100.0	%	$	174,330	100.0	%	$	388,346	100.0	%	$	343,962	100.0	%


Hospice Segment		For the Three Months Ended June 30,								For the Six Months Ended June 30,
	2023					2022				2023				2022
	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	$	45,566	90.7	%	$	47,152	90.5	%	$	90,122	90.8	%	$	90,637	90.8	%
Commercial insurance		2,726	5.4			2,726	5.2			5,273	5.3			4,970	5.0
Managed care organizations		1,567	3.1			1,968	3.8			3,214	3.2			3,683	3.7
Other		352	0.8			228	0.5			684	0.7			511	0.5
Total hospice segment net service revenues	$	50,210	100.0	%	$	52,074	100.0	%	$	99,293	100.0	%	$	99,801	100.0	%


Home Health Segment		For the Three Months Ended June 30,								For the Six Months Ended June 30,
	2023					2022				2023				2022
	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	$	8,716	76.1	%	$	7,592	72.1	%	$	17,988	75.1	%	$	14,404	72.7	%
Managed care organizations		2,251	19.6			2,262	21.5			4,789	20.0			4,166	21.0
Other		489	4.3			682	6.4			1,164	4.9			1,241	6.3
Total home health segment net service revenues	$	11,456	100.0	%	$	10,536	100.0	%	$	23,941	100.0	%	$	19,811	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 June 30,								For the Six Months Ended June 30,
		2023				2022				2023				2022
	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	$	103,864	52.4	%	$	88,797	50.9	%	$	202,279	52.1	%	$	173,480	50.4	%
New Mexico		27,907	14.1			26,473	15.2			56,381	14.5			51,912	15.1
New York (1)		23,841	12.0			21,127	12.1			45,727	11.8			42,513	12.4
All other states		42,702	21.5			37,933	21.8			83,959	21.6			76,057	22.1
Total personal care segment net service revenues	$	198,314	100.0	%	$	174,330	100.0	%	$	388,346	100.0	%	$	343,962	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 anticipated contract award date of April 1, 2023. On June 6, 2023, the New York State Department of Health notified the Company of a contract award. The Company has resumed services under this contract to all current payors.


Hospice Segment		For the Three Months Ended June 30,								For the Six Months Ended June 30,
	2023					2022				2023				2022
	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	$	19,332	38.5	%	$	17,245	33.1	%	$	37,783	38.1	%	$	33,574	33.7	%
Illinois		11,606	23.1			13,561	26.0			23,087	23.3			16,078	16.1
New Mexico		6,540	13.0			7,846	15.1			13,026	13.1			23,102	23.1
All other states		12,732	25.4			13,422	25.8			25,397	25.5			27,047	27.1
Total hospice segment net service revenues	$	50,210	100.0	%	$	52,074	100.0	%	$	99,293	100.0	%	$	99,801	100.0	%


Home Health Segment		For the Three Months Ended June 30,								For the Six Months Ended June 30,
	2023					2022				2023				2022
	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	$	8,093	70.6	%	$	9,070	86.1	%	$	17,209	71.9	%	$	16,579	83.7	%
Illinois		3,363	29.4			1,466	13.9			6,732	28.1			3,232	16.3
Total home health segment net service revenues	$	11,456	100.0	%	$	10,536	100.0	%	$	23,941	100.0	%	$	19,811	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 45.7%, and 43.8% of our net service revenues for the three months ended June 30, 2023, and 2022, respectively, and accounted for 45.4% and 41.6% of our net service revenues for the six months ended June 30, 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 June 30, 2023 and 2022, respectively, and accounted for 21.5% and 20.7% of the Company’s net service revenues for the six months ended June 30, 2023 and 2022, respectively.

The related receivables due from the Illinois Department on Aging represented 13.0% and 18.0% of the Company’s net accounts receivable at June 30, 2023 and December 31, 2022, respectively.