Significant Payors

12 Months Ended

Dec. 31, 2022

13. Significant Payors

For 2022, 2021 and 2020, the Company’s revenue by payor type was as follows:


	Personal Care
	For the Years Ended December 31,
	2022					2021					2020
	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	$	348,234		49.3	%	$	338,325		49.3	%	$	324,670		50.2	%
Managed care organizations		326,778		46.3			311,801		45.5			287,032		44.3
Private pay		18,301		2.6			19,991		2.9			20,398		3.2
Commercial insurance		7,689		1.1			9,820		1.4			9,991		1.5
Other		5,505		0.7			5,917		0.9			5,142		0.8
Total personal care segment net service revenues	$	706,507		100.0	%	$	685,854		100.0	%	$	647,233		100.0	%


	Hospice
	For the Years Ended December 31,
	2022					2021					2020
	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	$	183,407		90.9	%	$	142,086		93.3	%	$	94,068		92.9	%
Managed care organizations		7,353		3.6			5,664		3.7			4,931		4.9
Other		11,012		5.5			4,503		3.0			2,298		2.2
Total hospice segment net service revenues	$	201,772		100.0	%	$	152,253		100.0	%	$	101,297		100.0	%


	Home Health
	For the Years Ended December 31,
	2022					2021					2020
	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	$	31,505		73.5	%	$	20,700		78.4	%	$	12,765		78.6	%
Managed care organizations		8,698		20.3			4,457		16.9			3,188		19.6
Other		2,638		6.2			1,235		4.7			292		1.8
Total home health segment net service revenues	$	42,841		100.0	%	$	26,392		100.0	%	$	16,245		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 for 2022, 2021 and 2020 were as follows:


	Personal Care
	For the Years Ended December 31,
	2022					2021					2020
	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	$	360,778		51.1	%	$	328,619		47.9	%	$	288,326		44.6	%
New York		86,592		12.3			99,732		14.5			115,510		17.8
New Mexico		105,315		14.9			97,784		14.3			86,618		13.4
All other states		153,822		21.7			159,719		23.3			156,779		24.2
Total personal care segment net service revenues	$	706,507		100.0	%	$	685,854		100.0	%	$	647,233		100.0	%


	Hospice
	For the Years Ended December 31,
	2022					2021					2020
	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	$	70,503		35.0	%	$	61,415		40.3	%	$	—		—	%
New Mexico		30,722		15.2			36,063		23.7			42,648		42.1
Illinois		47,181		23.4			—		—			—		—
All other states		53,366		26.4			54,775		36.0			58,649		57.9
Total hospice segment net service revenues	$	201,772		100.0	%	$	152,253		100.0	%	$	101,297		100.0	%

With the acquisition of Queen City Hospice in late 2020, the Company expanded its hospice services in the state of Ohio, and with the JourneyCare acquisition in 2022, the Company also expanded its hospice services in the state of Illinois.


	Home Health
	For the Years Ended December 31,
	2022					2021					2020
	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	$	34,111		79.6	%	$	24,735		93.7	%	$	16,245		100.0	%
Illinois		8,730		20.4			1,657		6.3			—		—
Total home health segment net service revenues	$	42,841		100.0	%	$	26,392		100.0	%	$	16,245		100.0	%

With the acquisition of Summit in 2021, the Company expanded its home health services in the state of Illinois.

A substantial portion of the Company’s revenue and accounts receivable are derived from services performed for state and local governmental agencies. We derive a significant amount of our net service revenues in Illinois, which represented 43.8%, 38.2% and 37.7% of our net service revenues for the years ended December 31, 2022, 2021 and 2020, respectively. The Illinois Department on Aging, the largest payor program for the Company’s Illinois personal care operations, accounted for 20.7%, 21.4% and 23.0% of the Company’s net service revenues for 2022, 2021 and 2020, respectively.

The related receivables due from the Illinois Department on Aging represented 18.0% and 16.1% of the Company’s net accounts receivable at December 31, 2022 and 2021, respectively.

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, amends the current 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 submits 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. Under this provision, the Company is allowed to continue to contract with all of its current payors for CDPAP services, as of the contract award date, which is anticipated to be April 1, 2023. The Company continues to assess the future of its participation in this program. Given the current profitability of the program, the Company has suspended materially all of its new fee-for-service patient admissions through County Social Service Departments in the CDPAP program.

The Company recognized approximately $39.2 million from the program for the year ended December 31, 2022.