Accounts Receivable and Net Revenue

12 Months Ended

Dec. 31, 2020

5.	Accounts Receivable and Net Revenue:

Accounts receivable, net consists of the following (in thousands):


	December 31,
	2020			2019
Gross accounts receivable	$	1,106,394		$	1,750,264
Allowance for contractual adjustments and uncollectibles		(864,463	)		(1,315,998	)

	$	241,931		$	434,266

Net revenue consists of the following (in thousands):


	Years Ended December 31,
	2020		2019		2018
Net patient service revenue	$	1,481,331	$	1,567,624	$	1,529,561
Hospital contract administrative fees		218,495		197,340		181,050
Other revenue		34,125		14,795		12,496

	$	1,733,951	$	1,779,759	$	1,723,107

The following is a summary of

the Company’s

payor mix, expressed as a percentage of net revenue, exclusive of administrative fees and other miscellaneous revenue, for the periods indicated:


	Years Ended December 31,
	2020			2019			2018
Contracted managed care		68	%		68	%		67	%
Government		27	%		26	%		26	%
Other third-parties		4	%		5	%		6	%
Private-pay patients		1	%		1	%		1	%

		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.