Significant Payors

9 Months Ended

Sep. 30, 2023

12. Significant Payors

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


Personal Care Segment		For the Three Months Ended September 30,								For the Nine Months Ended September 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	$	101,821	50.4	%	$	88,448	49.4	%	$	297,541	50.4	%	$	257,817	49.4	%
Managed care organizations		93,583	46.4			83,199	46.4			272,758	46.2			241,164	46.1
Private pay		3,990	2.0			4,521	2.6			12,354	2.1			13,758	2.6
Commercial insurance		1,631	0.8			1,870	1.0			4,937	0.8			5,988	1.1
Other		856	0.4			1,142	0.6			2,637	0.5			4,415	0.8
Total personal care segment net service revenues	$	201,882	100.0	%	$	179,180	100.0	%	$	590,227	100.0	%	$	523,142	100.0	%


Hospice Segment		For the Three Months Ended September 30,								For the Nine Months Ended September 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	$	47,313	89.1	%	$	46,537	90.6	%	$	137,432	90.2	%	$	137,174	90.8	%
Commercial insurance		3,640	6.8			2,772	5.4			8,916	5.8			7,742	5.1
Managed care organizations		1,808	3.4			1,815	3.5			5,022	3.3			5,498	3.6
Other		360	0.7			235	0.5			1,044	0.7			746	0.5
Total hospice segment net service revenues	$	53,121	100.0	%	$	51,359	100.0	%	$	152,414	100.0	%	$	151,160	100.0	%


Home Health Segment		For the Three Months Ended September 30,								For the Nine Months Ended September 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	$	11,325	72.1	%	$	7,320	73.5	%	$	29,306	73.9	%	$	21,727	73.0	%
Managed care organizations		3,445	21.9			1,998	20.1			8,239	20.8			6,160	20.7
Other		948	6.0			638	6.4			2,114	5.3			1,881	6.3
Total home health segment net service revenues	$	15,718	100.0	%	$	9,956	100.0	%	$	39,659	100.0	%	$	29,768	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 September 30,								For the Nine Months Ended September 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	$	105,206	52.1	%	$	92,804	51.8	%	$	306,711	52.0	%	$	266,284	50.9	%
New Mexico		28,347	14.0			26,912	15.0			84,969	14.3			78,825	15.1
New York (1)		22,989	11.4			20,997	11.7			68,910	11.7			63,510	12.1
All other states		45,340	22.5			38,467	21.5			129,637	22.0			114,523	21.9
Total personal care segment net service revenues	$	201,882	100.0	%	$	179,180	100.0	%	$	590,227	100.0	%	$	523,142	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, amended the 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 submitted 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, which allowed the Company to continue its CDPAP fiscal intermediary operations. However, the Company decided at that time to suspend materially all of its new fee-for-service patient admissions in the CDPAP program through County Social Service Departments. On June 6, 2023, the New York State Department of Health notified the Company that it had received a contract award. Under this contract, the Company is providing services to all current payors and has resumed new fee-for-service patient admissions through County Social Service Departments in the CDPAP program.


Hospice Segment		For the Three Months Ended September 30,								For the Nine Months Ended September 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	$	18,916	35.6	%	$	18,139	35.3	%	$	55,363	36.3	%	$	51,714	34.2	%
Illinois		12,477	23.5			12,188	23.7			34,750	22.8			35,290	23.3
New Mexico		7,619	14.3			7,789	15.2			23,688	15.5			23,867	15.8
All other states		14,109	26.6			13,243	25.8			38,612	25.4			40,289	26.7
Total hospice segment net service revenues	$	53,121	100.0	%	$	51,359	100.0	%	$	152,414	100.0	%	$	151,160	100.0	%


Home Health Segment		For the Three Months Ended September 30,								For the Nine Months Ended September 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	$	8,040	51.2	%	$	8,375	84.1	%	$	25,277	63.7	%	$	24,954	83.8	%
Illinois		2,909	18.5			1,581	15.9			9,539	24.1			4,814	16.2
Tennessee		4,769	30.3			—	—			4,843	12.2			—	—
Total home health segment net service revenues	$	15,718	100.0	%	$	9,956	100.0	%	$	39,659	100.0	%	$	29,768	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 44.5% and 44.3% of our net service revenues for the three months ended September 30, 2023, and 2022, respectively, and accounted for 44.9% and 43.5% of our net service revenues for the nine months ended September 30, 2023 and 2022, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 20.5% and 21.0% of the Company’s net service revenues for the three months ended September 30, 2023 and 2022, respectively, and accounted for 21.2% and 20.8% of the Company’s net service revenues for the nine months ended September 30, 2023 and 2022, respectively.

The related receivables due from the Illinois Department on Aging represented 20.5% and 18.0% of the Company’s net accounts receivable at September 30, 2023 and December 31, 2022, respectively.