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Significant Payors | 3 Months Ended
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Mar. 31, 2024
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, |
|  | 2024 |  |  | 2023 |
|  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |
State, local and other governmental programs |  | $107,754 |  | 51.8 | % |  | $95,320 |  | 50.1 | %
Managed care organizations |  | 94,276 |  | 45.3 |  |  | 87,901 |  | 46.3 |
Private pay |  | 3,906 |  | 1.9 |  |  | 4,226 |  | 2.2 |
Commercial insurance |  | 1,486 |  | 0.7 |  |  | 1,669 |  | 0.9 |
Other |  | 581 |  | 0.3 |  |  | 916 |  | 0.5 |
Total personal care segment net service revenues |  | $208,003 |  | 100.0 | % |  | $190,032 |  | 100.0 | %
Hospice Segment |  | For the Three Months Ended March 31, |
|  | 2024 |  |  | 2023 |
|  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |
Medicare |  | $50,652 |  | 90.7 | % |  | $44,556 |  | 90.7 | %
Commercial insurance |  | 3,134 |  | 5.6 |  |  | 2,547 |  | 5.2 |
Managed care organizations |  | 1,817 |  | 3.3 |  |  | 1,647 |  | 3.4 |
Other |  | 260 |  | 0.4 |  |  | 332 |  | 0.7 |
Total hospice segment net service revenues |  | $55,863 |  | 100.0 | % |  | $49,082 |  | 100.0 | %
Home Health Segment |  | For the Three Months Ended March 31, |
|  | 2024 |  |  | 2023 |
|  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |
Medicare |  | $11,663 |  | 69.1 | % |  | $9,270 |  | 74.2 | %
Managed care organizations |  | 4,400 |  | 26.1 |  |  | 2,539 |  | 20.3 |
Other |  | 817 |  | 4.8 |  |  | 676 |  | 5.5 |
Total home health segment net service revenues |  | $16,880 |  | 100.0 | % |  | $12,485 |  | 100.0 | %
The Company derives a significant amount of its revenue from its operations in Illinois, New Mexico, New York and Ohio. The percentages of segment revenue for each of these significant states were as follows:
Personal Care Segment |  | For the Three Months Ended March 31, |
|  | 2024 |  |  | 2023 |
|  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |
Illinois |  | $107,575 |  | 51.8 | % |  | $98,414 |  | 51.8 | %
New Mexico |  | 28,967 |  | 13.9 |  |  | 28,474 |  | 15.0 |
New York(1) |  | 23,534 |  | 11.3 |  |  | 21,885 |  | 11.5 |
All other states |  | 47,927 |  | 23.0 |  |  | 41,259 |  | 21.7 |
Total personal care segment net service revenues |  | $208,003 |  | 100.0 | % |  | $190,032 |  | 100.0 | %
(1) In 2019, New York initiated a new Request For Offer (“RFO”) process to competitively procure Consumer Directed Personal Assistance Program (“CDPAP”) fiscal intermediaries. The Company was not one of the entities selected to enter into contracts as a Lead Fiscal Intermediary through the initial RFO process. However, the New York legislature intervened in 2022, authorizing fiscal intermediary applicants who satisfied certain criteria to continue operating in all counties contained in their RFO application. Although the Company was permitted to continue its CDPAP fiscal intermediary operations, the Company decided in November 2022 to suspend materially all of its new fee-for-service patient admissions through County Social Service Departments in the CDPAP. On June 6, 2023, the New York State Department of Health (“NYSDOH”) 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. The CDPAP continues to be a focus for changes by New York governmental authorities. For example, the New York fiscal year 2025 budget will replace the CDPAP fiscal intermediaries with a single statewide fiscal intermediary with a stated deadline of April 1, 2025. The statewide fiscal intermediary, which will be selected by the NYSDOH, will be able to subcontract with several entities to facilitate the delivery of fiscal intermediary services. All service providers seeking to offer services under CDPAP will be required to contract with the statewide fiscal intermediary or its contractors in order to offer services. The Company does not currently believe it is likely to be selected as the single statewide fiscal intermediary and it is not possible at this time to assess the likelihood of becoming a subcontractor or the financial terms of any such arrangement. At this time, it is difficult to predict the details of the implementation of these modifications and their final timeline and, thus, their impact on the Company’s business and operations. However, we expect this could have a negative impact on our New York CDPAP business, though it would not be material to our business as a whole.
Hospice Segment |  | For the Three Months Ended March 31, |
|  | 2024 |  |  | 2023 |
|  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |
Ohio |  | $20,236 |  | 36.2 | % |  | $18,451 |  | 37.6 | %
Illinois |  | 12,252 |  | 21.9 |  |  | 11,480 |  | 23.4 |
New Mexico |  | 7,515 |  | 13.5 |  |  | 6,486 |  | 13.2 |
All other states |  | 15,860 |  | 28.4 |  |  | 12,665 |  | 25.8 |
Total hospice segment net service revenues |  | $55,863 |  | 100.0 | % |  | $49,082 |  | 100.0 | %
Home Health Segment |  | For the Three Months Ended March 31, |
|  | 2024 |  |  | 2023 |
|  | Amount (in Thousands) |  | % of Segment Net Service Revenues |  |  | Amount (in Thousands) |  | % of Segment Net Service Revenues |
New Mexico |  | $7,777 |  | 46.1 | % |  | $9,116 |  | 73.0 | %
Illinois |  | 2,942 |  | 17.4 |  |  | 3,369 |  | 27.0 |
Tennessee |  | 6,161 |  | 36.5 |  |  | — |  | — |
Total home health segment net service revenues |  | $16,880 |  | 100.0 | % |  | $12,485 |  | 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. The personal care segment derives a significant amount of its net service revenues in Illinois, which represented 38.3% and 39.1% of our net service revenues for the three months ended March 31, 2024 and 2023, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 20.8% and 21.5% of the Company’s net service revenues for the three months ended March 31, 2024 and 2023, respectively. The related receivables due from the Illinois Department on Aging represented 18.0% and 20.7% of the Company’s net accounts receivable at March 31, 2024 and December 31, 2023, respectively.

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