XML 31 R20.htm IDEA: XBRL DOCUMENT v3.23.2
Revenue
6 Months Ended
Jun. 30, 2023
Revenue from Contract with Customer [Abstract]  
Revenue

(12) Revenue

We recognize revenue when we transfer promised goods or services to customers in an amount that reflects the consideration to which we expect to be entitled in exchange for those goods or services. Our estimate for amounts not expected to be collected based on historical experience will continue to be recognized as a reduction to net revenue. However, subsequent changes in estimate of collectability due to a change in the financial status of a payer, for example a bankruptcy, will be recognized as bad debt expense in operating charges.

The performance obligation is separately identifiable from other promises in the customer contract. As the performance obligations are met (i.e.: room, board, ancillary services, level of care), revenue is recognized based upon allocated transaction price. The transaction price is allocated to separate performance obligations based upon the relative standalone selling price. In instances where we determine there are multiple performance obligations across multiple months, the transaction price will be allocated by applying an estimated implicit and explicit rate to gross charges based on the separate performance obligations.

In assessing collectability, we have elected the portfolio approach. This portfolio approach is being used as we have large volume of similar contracts with similar classes of customers. We reasonably expect that the effect of applying a portfolio approach to a group of contracts would not differ materially from considering each contract separately. Management’s judgment to group the contracts by portfolio is based on the payment behavior expected in each portfolio category. As a result, aggregating all of the contracts (which are at the patient level) by the particular payer or group of payers, will result in the recognition of the same amount of revenue as applying the analysis at the individual patient level.

We group our revenues into categories based on payment behaviors. Each component has its own reimbursement structure which allows us to disaggregate the revenue into categories that share the nature and timing of payments. The other patient revenue consists primarily of self-pay, government-funded non-Medicaid, and other.

The following table disaggregates our revenue by major source for the three and six-month periods ended June 30, 2023 and 2022 (in thousands):

 

 

For the three months ended June 30, 2023

 

 

Acute Care

 

 

Behavioral Health

 

 

Other

 

 

Total

 

Medicare

$

334,073

 

 

17

%

 

$

75,697

 

 

5

%

 

 

 

 

$

409,770

 

 

12

%

Managed Medicare

 

344,975

 

 

17

%

 

 

85,611

 

 

6

%

 

 

 

 

 

430,586

 

 

12

%

Medicaid

 

134,521

 

 

7

%

 

 

215,329

 

 

14

%

 

 

 

 

 

349,850

 

 

10

%

Managed Medicaid

 

171,824

 

 

9

%

 

 

397,389

 

 

26

%

 

 

 

 

 

569,213

 

 

16

%

Managed Care (HMO and PPOs)

 

702,499

 

 

35

%

 

 

386,377

 

 

25

%

 

 

 

 

 

1,088,876

 

 

31

%

UK Revenue

 

0

 

 

0

%

 

 

190,114

 

 

12

%

 

 

 

 

 

190,114

 

 

5

%

Other patient revenue and adjustments, net

 

74,290

 

 

4

%

 

 

136,158

 

 

9

%

 

 

 

 

 

210,448

 

 

6

%

Other non-patient revenue

 

240,897

 

 

12

%

 

 

55,519

 

 

4

%

 

 

2,865

 

 

 

299,281

 

 

8

%

Total Net Revenue

$

2,003,079

 

 

100

%

 

$

1,542,194

 

 

100

%

 

$

2,865

 

 

 

3,548,138

 

 

100

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For the six months ended June 30, 2023

 

 

Acute Care

 

 

Behavioral Health

 

 

Other

 

 

Total

 

Medicare

$

663,519

 

 

17

%

 

$

152,241

 

 

5

%

 

 

 

 

$

815,760

 

 

12

%

Managed Medicare

 

689,007

 

 

17

%

 

 

160,688

 

 

5

%

 

 

 

 

 

849,695

 

 

12

%

Medicaid

 

244,530

 

 

6

%

 

 

421,802

 

 

14

%

 

 

 

 

 

666,332

 

 

9

%

Managed Medicaid

 

364,122

 

 

9

%

 

 

796,340

 

 

26

%

 

 

 

 

 

1,160,462

 

 

17

%

Managed Care (HMO and PPOs)

 

1,357,294

 

 

34

%

 

 

777,674

 

 

26

%

 

 

 

 

 

2,134,968

 

 

30

%

UK Revenue

 

0

 

 

0

%

 

 

357,903

 

 

12

%

 

 

 

 

 

357,903

 

 

5

%

Other patient revenue and adjustments, net

 

195,247

 

 

5

%

 

 

257,835

 

 

9

%

 

 

 

 

 

453,082

 

 

6

%

Other non-patient revenue

 

462,892

 

 

12

%

 

 

108,200

 

 

4

%

 

 

6,362

 

 

 

577,454

 

 

8

%

Total Net Revenue

$

3,976,611

 

 

100

%

 

$

3,032,683

 

 

100

%

 

$

6,362

 

 

$

7,015,656

 

 

100

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For the three months ended June 30, 2022

 

 

Acute Care

 

 

Behavioral Health

 

 

Other

 

 

Total

 

Medicare

$

318,166

 

 

17

%

 

$

83,350

 

 

6

%

 

 

 

 

$

401,516

 

 

12

%

Managed Medicare

 

306,585

 

 

16

%

 

 

70,877

 

 

5

%

 

 

 

 

 

377,462

 

 

11

%

Medicaid

 

184,098

 

 

10

%

 

 

183,911

 

 

13

%

 

 

 

 

 

368,009

 

 

11

%

Managed Medicaid

 

162,092

 

 

9

%

 

 

364,171

 

 

25

%

 

 

 

 

 

526,263

 

 

16

%

Managed Care (HMO and PPOs)

 

627,475

 

 

33

%

 

 

376,011

 

 

26

%

 

 

 

 

 

1,003,486

 

 

30

%

UK Revenue

 

0

 

 

0

%

 

 

173,231

 

 

12

%

 

 

 

 

 

173,231

 

 

5

%

Other patient revenue and adjustments, net

 

74,123

 

 

4

%

 

 

125,995

 

 

9

%

 

 

 

 

 

200,118

 

 

6

%

Other non-patient revenue

 

202,977

 

 

11

%

 

 

56,374

 

 

4

%

 

 

13,971

 

 

 

273,322

 

 

8

%

Total Net Revenue

$

1,875,516

 

 

100

%

 

$

1,433,920

 

 

100

%

 

$

13,971

 

 

$

3,323,407

 

 

100

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For the six months ended June 30, 2022

 

 

Acute Care

 

 

Behavioral Health

 

 

Other

 

 

Total

 

Medicare

$

655,275

 

 

17

%

 

$

162,862

 

 

6

%

 

 

 

 

$

818,137

 

 

12

%

Managed Medicare

 

638,833

 

 

17

%

 

 

134,727

 

 

5

%

 

 

 

 

 

773,560

 

 

12

%

Medicaid

 

339,934

 

 

9

%

 

 

359,314

 

 

13

%

 

 

 

 

 

699,248

 

 

11

%

Managed Medicaid

 

333,729

 

 

9

%

 

 

698,336

 

 

25

%

 

 

 

 

 

1,032,065

 

 

16

%

Managed Care (HMO and PPOs)

 

1,266,370

 

 

33

%

 

 

741,216

 

 

26

%

 

 

 

 

 

2,007,586

 

 

30

%

UK Revenue

 

0

 

 

0

%

 

 

349,323

 

 

12

%

 

 

 

 

 

349,323

 

 

5

%

Other patient revenue and adjustments, net

 

166,233

 

 

4

%

 

 

246,728

 

 

9

%

 

 

 

 

 

412,961

 

 

6

%

Other non-patient revenue

 

387,458

 

 

10

%

 

 

107,881

 

 

4

%

 

 

28,144

 

 

 

523,483

 

 

8

%

Total Net Revenue

$

3,787,832

 

 

100

%

 

$

2,800,387

 

 

100

%

 

$

28,144

 

 

$

6,616,363

 

 

100

%