America's Payor Mix by Region

The following data, from the National Hospital Discharge Survey, reflects the expected hospital payment source in different regions of the United States. Expected payment source is the type of program or insurance that, upon admission to the hospital, was expected to be the principal payor for the hospital stay.

Figures reflect payor mixes from 2009, the latest year available. For categories marked "n/a" the survey had deemed those figures as not meeting a standard of reliability or precision.

United States
Medicare: 40.9 percent
Medicaid: 17.2 percent
Worker's compensation and other government programs: 2 percent
HMO or PPO: 14 percent
Blue Cross Blue Shield, other private insurance: 16.5 percent
Self-pay: 4.9 percent
Other payments: 1.2 percent

Northeast
Medicare: 42.9 percent
Medicaid: 15.7 percent
Worker's compensation and other government programs: 1.2 percent
HMO or PPO: 16.6 percent
Blue Cross Blue Shield, other private insurance: 16.6 percent
Self-pay: 3.2 percent
Other payments: > 1 percent  

Midwest
Medicare: 44.5 percent
Medicaid: 16 percent
Worker's compensation and other government programs: n/a
HMO or PPO: n/a
Blue Cross Blue Shield, other private insurance: 19.2 percent
Self-pay: 4.5 percent  
Other payments: > .5 percent  

South
Medicare: 41.7 percent
Medicaid: 16 percent
Worker's compensation and other government programs: 3 percent
HMO or PPO: 11.3 percent
Blue Cross Blue Shield, other private insurance: 15.8 percent  
Self-pay: 6.2 percent   
Other payments: 1.5 percent

West
Medicare: 32.9 percent
Medicaid: n/a
Worker's compensation and other government programs: n/a
HMO or PPO: 18.4 percent  
Blue Cross Blue Shield, other private insurance: n/a
Self-pay: n/a
Other payments: n/a

More Articles on Payor Mix:

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Moody's: 4 Reasons 2012 Will Be Financially Challenging for Non-Profit Hospitals
Earning Regional Referrals: 8 Steps to Grow Hospital Volume








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