30 Statistics on Payor Mix as a Percent of Gross Charges

Here are 30 statistics on payor mix as a percent of gross charges, based on data from the VMG Health Multi-Specialty ASC Intellimarker 2010.

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Aggregate statistical analysis:

1. Medicare represented 25 percent of gross charges.
2. Medicaid represented 5 percent of gross charges.
3. Commercial payors represented 59 percent of gross charges.
4. Workers’ compensation represented 6 percent of gross charges.
5. Self-pay represented 5 percent of gross charges.

Based on number of operating rooms:

Medicare:

1. Medicare represented 20 percent of gross charges in ASCs in the western United States.
2. Medicare represented 19 percent of gross charges in ASCs in the Southwest.
3. Medicare represented 21 percent of gross charges in ASCs in the Midwest.
4. Medicare represented 30 percent of gross charges in ASCs in the Southeast.
5. Medicare represented 21 percent of gross charges in ASCs in the Northeast.

Medicaid:

6. Medicaid represented 4 percent of gross charges in ASCs in the western United States.
7. Medicaid represented 2 percent of gross charges in ASCs in the Southwest.
8. Medicaid represented 2 percent of gross charges in ASCs in the Midwest.
9. Medicaid represented 2 percent of gross charges in ASCs in the Southeast.
10. Medicaid represented 2 percent of gross charges in ASCs in the Northeast.

Commercial payors:

11. Commercial payors represented 58 percent of gross charges in ASCs in the western United States.
12. Commercial payors represented 61 percent of gross charges in ASCs in the Southwest.
13. Commercial payors represented 63 percent of gross charges in ASCs in the Midwest.
14. Commercial payors represented 54 percent of gross charges in ASCs in the Southeast.
15. Commercial payors represented 68 percent of gross charges in ASCs in the Northeast.

Workers’ compensation:

16. Workers’ comp represented 6 percent of gross charges in ASCs in the western United States.
17. Workers’ comp represented 3 percent of gross charges in ASCs in the Southwest.
18. Workers’ comp represented 4 percent of gross charges in ASCs in the Midwest.
19. Workers’ comp represented 3 percent of gross charges in ASCs in the Southeast.
20. Workers’ comp represented 3 percent of gross charges in ASCs in the Northeast.

Self pay:

21. Self-pay represented 2 percent of gross charges in ASCs in the western United States.
22. Self-pay represented 3 percent of gross charges in ASCs in the Southwest.
23. Self-pay represented 2 percent of gross charges in ASCs in the Midwest.
24. Self-pay represented 3 percent of gross charges in ASCS in the Southeast.
25. Self-pay represented 2 percent of gross charges in ASCs in the Northeast.

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