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Accounts Receivable and Net Revenue | 12 Months Ended
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Dec. 31, 2019
Text Block [Abstract] |
Accounts Receivable and Net Revenue |
4. | Accounts Receivable and Net Revenue:
Accounts receivable, net consists of the following (in thousands):
|  | December 31, |
|  | 2019 |  |  | 2018 |
Gross accounts receivable |  | $ | 1,943,664 |  |  | $ | 1,993,395 |
Allowance for contractual adjustments and uncollectibles |  |  | (1,444,795 | ) |  |  | (1,486,672 | )
|  | $ | 498,869 |  |  | $ | 506,723 |
Net revenue consists of the following (in thousands):
|  | Years Ended December 31, |
|  | 2019 |  |  | 2018 |  |  | 2017 |
Net patient service revenue |  | $ | 3,091,987 |  |  | $ | 3,067,784 |  |  | $ | 2,915,648 |
Hospital contract administrative fees |  |  | 396,814 |  |  |  | 363,368 |  |  |  | 315,778 |
Other revenue |  |  | 24,741 |  |  |  | 23,658 |  |  |  | 21,965 |
|  | $ | 3,513,542 |  |  | $ | 3,454,810 |  |  | $ | 3,253,391 |
The following is a summary of our payor mix, expressed as a percentage of net revenue, exclusive of administrative fees and revenue related to management services and other, for the periods indicated:
|  | Years Ended December 31, |
|  | 2019 |  |  | 2018 |  |  | 2017 |
Contracted managed care |  |  | 69 | % |  |  | 69 | % |  |  | 70 | %
Government |  |  | 24 | % |  |  | 24 | % |  |  | 23 | %
Other third-parties |  |  | 5 | % |  |  | 5 | % |  |  | 5 | %
Private-pay patients |  |  | 2 | % |  |  | 2 | % |  |  | 2 | %
|  |  | 100 | % |  |  | 100 | % |  |  | 100 | %
Accounts receivable consist primarily of amounts due from GHC Programs and third-party insurance payors for services provided by the Company’s affiliated physicians. Net revenue consists primarily of gross billed charges for services provided by the Company’s affiliated physicians less an estimated allowance for contractual adjustments and uncollectibles to properly account for the anticipated differences between gross billed charge amounts and expected reimbursement amounts. The Company’s contractual adjustments and uncollectibles as a percentage of gross patient service revenue vary slightly each year depending on several factors, including improved managed care contracting, changes in reimbursement from state Medicaid programs and other GHC Programs, shifts in the percentage of patient services being reimbursed under GHC Programs and annual price increases. The Company’s annual price increases typically increase contractual adjustments as a percentage of gross patient service revenue. This increase is primarily due to Medicaid, Medicare and other GHC Programs that generally provide for reimbursements on a fee-schedule basis rather than on a gross charge basis. When the Company bills these programs, like other payors, on a gross-charge basis, it also increases its provision for contractual adjustments and uncollectibles by the amount of any price increase, resulting in a higher contractual adjustment percentage. Some of the Company’s hospital agreements require hospitals to pay the Company administrative fees. Some agreements provide for fees if the hospital does not generate sufficient patient volume in order to guarantee that the Company receives a specified minimum revenue level. The Company also receives fees from hospitals for administrative services performed by its affiliated physicians providing medical director or other services at the hospital.

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