SFY 2019-20 LIP Model Summary

SFY 2019-20 LIP Model Summary

Self-Funded Tiers Model

$956,324,603 Total 0.6147 FMAP 0.3853 SMAP

$587,852,733 Federal $0 State GR

$368,471,870 Local

Model includes the following assumptions: Updated for SFY 2019-20 FMAP LIP Program pays providers based on their charity care cost. Hospitals are ranked from high to low based on their percentage of charity care costs to commercial costs as well as statutory designations and ownership status. Providers are divided into tiers based on the level of charity care cost to commercial costs and are paid a prescribed percentage of their charity care cost. Hospital charity care costs are calculated using 2017 Florida Hospital Uniform Reporting System (FHURS) data. Per the Special Terms and Conditions (STCs), hospitals are required to have at least 1% Medicaid utilization to be eligible for LIP.

Group 1 - Hospitals Tier 1 - Private Hospitals with a Uncompensated Care (UC) ratio greater than or equal to 17% and less than 51.5% Tier 2 - All Public Hospitals, All Children's Hospitals, Statutory Teaching Hospitals with UC ratio greater than or equal to 17%, and Private Hospitals with UC ratio greater than or equal to 51.5%. Tier 3 - Statutory Teaching Hospitals with UC ratio less than 17%. Tier 4 - Regional Perinatal Intensive Care Centers (non-Public), and Statutory Teaching Regional Perinatal Intensive Care Centers with a UC ratio greater than or equal to 15% and less than 17%. Tier 5 - Private Hospitals with a UC ratio less than 17%. Group 2 - Medical School Physician Practices Tier 1 - Medical Schools Group 3 - Federally Qualified Health Centers (FQHCs)/Rural Health Clinics (RHCs) Tier 1 - FQHCs/RHCs Group 4 - Behavioral Health Providers Tier 1 - Central Receiving Systems

Tier Payments:

Group 1 - Self-Funded Model Tier 1 - paid 9.49% of charity care cost Tier 2 - paid 100% of charity care cost Tier 3 - paid 57.18% of charity care cost Tier 4 - paid 100% of charity care cost Tier 5 - paid 1% of charity care cost

Group 2 Tier 1 - paid 100% of charity care cost

Group 3 Tier 1 - paid 17.67% of charity care cost

Group 4 Tier 1 - paid 100% of charity care cost

1 of 6

AHCA - MPF August 29, 2019

Medicaid ID

Provider

010094300 AdventHealth Carrollwood 010161300 AdventHealth North Pinellas 010102800 AdventHealth Tampa 010109500 AdventHealth Waterman 010260100 AdventHealth Wauchula 010149400 AdventHealth Zephyrhills 010123100 Baptist Medical Center - Nassau 012041300 Bartow Regional Medical Center 010009900 Cape Canaveral Hospital 010171100 Flagler Hospital 012034100 HealthSouth Treasure Coast Rehabilitation Hospital 010041200 Hialeah Hospital 010008100 Holmes Regional Medical Center 010104400 Indian River Medical Center 010173700 Jay Hospital 010191500 Kindred Hospital- South Florida- Hollywood 010276800 Kindred Hospital-Bay Area-St Petersburg 010164800 Lakeland Regional Medical Center 010107900 Leesburg Regional Medical Center 010116800 Manatee Memorial Hospital 010121400 Mariners Hospital 010154100 Mease Dunedin Hospital 010158300 Morton Plant Hospital 010150800 Morton Plant North Bay Hospital 010031500 Naples Community Hospital 010693100 North Tampa Behavioral Health 011519300 Northside Hospital 003297500 Palm Bay Hospital 011988100 Regional Medical Center Bayonet Point 010323300 Sacred Heart Hospital on the Emerald Coast 002012700 Sacred Heart Hospital on the Gulf 010098600 South Florida Baptist Hospital 012022700 St. Anthony's Hospital 010097800 St. Joseph's Hospital 011984900 Tampa Community Hospital 010062500 Westchester General Hospital 010169900 Winter Haven Hospital Tier 1: High Utilization Private Hospitals

012040500 010821900 010012900 010021800 011971700 010192300 010103600 010004800 010080300 011134100 010184200 010226100 010106100 010042100 010151600 010822700 010144300 012005700 010110900 010345400 010222900 010252100 010020000 004087600 010060900 010010200

Broward Health Coral Springs Broward Health Imperial Point Broward Health Medical Center Broward Health North Cape Coral Hospital Desoto Memorial Hospital Doctors Memorial Hospital Ed Fraser Memorial Hospital George E. Weems Memorial Hospital Gulf Coast Medical Center Lee Memorial Health System Halifax Health Medical Center Homestead Hospital Jackson Hospital Jackson Memorial Hospital Johns Hopkins All Children's Hospital Lake Butler Hospital Lakeside Medical Center Larkin Community Hospital Lee Memorial Hospital Memorial Hospital Miramar Memorial Hospital Pembroke Memorial Hospital West Memorial Regional Hospital Nemours Children's Hospital Nicklaus Children's Hospital Parrish Medical Center

SFY 2019-20 PROJECTED NET PAYMENTS FOR LIP

Self-Funded Tiers Model

Charity Care Cost

Ratio of Charity Care Costs to Commercial

Costs

Tier

% Gross Charity Payment

Total LIP Payment

LIP IGTs Provided to Fund

Tier

Additional LIP IGTs Provided for 1% Minimum

and Tier 1

Total LIP IGTs Provided

Net (Total LIP Payment - LIP

IGTs)

% of Net Payment to Charity Care

Cost

$

7,203,951

$

5,000,490

$ 30,275,903

$

8,250,313

$

557,507

$

5,385,230

$

3,845,596

$

3,815,785

$

6,122,103

$ 10,071,470

$

552,239

$

5,151,270

$ 25,632,918

$

7,210,905

$

834,341

$

1,065,232

$

448,458

$ 26,790,187

$

5,780,566

$ 13,144,111

$

3,009,834

$

5,558,409

$ 23,988,237

$ 12,049,076

$ 19,042,816

$

919,091

$

5,932,758

$

8,122,015

$

6,275,423

$

6,336,116

$

2,273,453

$ 10,634,184

$ 19,471,058

$ 57,191,912

$

2,746,267

$

1,621,368

$ 15,422,061

$ 367,732,653

$

2,666,857

$

2,718,368

$ 21,097,153

$

8,625,320

$ 10,278,747

$

1,982,706

$

276,494

$

1,723,159

$

529,168

$ 13,197,836

$ 18,953,009

$ 23,823,229

$

2,046,348

$ 108,763,020

$

2,329,429

$

921,179

$

748,348

$

2,483,130

$ 35,197,433

$

2,316,025

$

5,565,784

$

7,726,709

$ 33,008,211

$

811,618

$

212,692

$

2,828,663

20.75% 23.04% 24.77% 19.83% 21.46% 24.64% 23.07% 27.23% 19.64% 17.89% 31.88% 25.82% 21.07% 18.42% 29.11% 35.21% 28.52% 17.37% 17.10% 29.95% 20.00% 30.86% 19.00% 51.34% 18.86% 36.69% 18.12% 35.80% 17.29% 18.02% 36.05% 36.87% 26.16% 17.42% 18.71% 17.28% 26.90%

4.36% 6.46% 14.79% 12.32% 21.34% 32.25% 12.17% 25.64% 23.28% 16.31% 10.97% 51.79% 14.35% 32.86% 1.82% 69.17% 9.98% 19.25% 17.24% 3.12% 12.16% 4.89% 10.85% 1.39% 0.13% 7.49%

2 of 6

1

9.49%

$

683,324 $

-$

-$

-$

683,324

1

9.49%

$

474,317 $

-$

-$

-$

474,317

1

9.49%

$ 2,871,794 $

1,550,769 $

- $ 1,550,769 $ 1,321,025

1

9.49%

$

782,576 $

422,591 $

-$

422,591 $

359,985

1

9.49%

$

52,882 $

-$

-$

-$

52,882

1

9.49%

$

510,811 $

-$

-$

-$

510,811

1

9.49%

$

364,771 $

-$

-$

-$

364,771

1

9.49%

$

361,943 $

-$

-$

-$

361,943

1

9.49%

$

580,707 $

-$

-$

-$

580,707

1

9.49%

$

955,320 $

515,873 $

-$

515,873 $

439,447

1

9.49%

$

52,382 $

1

9.49%

$

488,619 $

-$ -$

-$ -$

-$ -$

52,382 488,619

1

9.49%

$ 2,431,388 $

-$

-$

- $ 2,431,388

1

9.49%

$

683,984 $

369,351 $

-$

369,351 $

314,633

1

9.49%

$

79,141 $

-$

-$

-$

79,141

1

9.49%

$

101,042 $

-$

-$

-$

101,042

1

9.49%

$

42,538 $

-$

-$

-$

42,538

1

9.49%

$ 2,541,159 $

1,372,226 $

- $ 1,372,226 $ 1,168,933

1

9.49%

$

548,310 $

296,087 $

-$

296,087 $

252,223

1

9.49%

$ 1,246,773 $

673,257 $

-$

673,257 $

573,516

1

9.49%

$

285,495 $

-$

-$

-$

285,495

1

9.49%

$

527,238 $

-$

-$

-$

527,238

1

9.49%

$ 2,275,383 $

-$

-$

- $ 2,275,383

1

9.49%

$ 1,142,904 $

-$

-$

- $ 1,142,904

1

9.49%

$ 1,806,289 $

-$

-$

- $ 1,806,289

1

9.49%

$

87,180 $

-$

-$

-$

87,180

1

9.49%

$

562,747 $

-$

-$

-$

562,747

1

9.49%

$

770,407 $

-$

-$

-$

770,407

1

9.49%

$

595,250 $

-$

-$

-$

595,250

1

9.49%

$

601,007 $

-$

-$

-$

601,007

1

9.49%

$

215,646 $

-$

-$

-$

215,646

1

9.49%

$ 1,008,696 $

-$

-$

- $ 1,008,696

1

9.49%

$ 1,846,910 $

-$

-$

- $ 1,846,910

1

9.49%

$ 5,424,888 $

-$

-$

- $ 5,424,888

1

9.49%

$

260,495 $

-$

-$

-$

260,495

1

9.49%

$

153,793 $

-$

-$

-$

153,793

1

9.49%

$ 1,462,846 $

789,937 $

$ 34,880,955 $

5,990,091 $

-$ -$

789,937 $

672,909

5,990,091 $ 28,890,864

$

13,439,632 $

7,449,541 $ 13,439,632

2

100.00%

$ 2,666,857 $

1,152,154 $

45,531 $ 1,197,685 $ 1,469,172

2

100.00%

$ 2,718,368 $

1,174,408 $

46,411 $ 1,220,819 $ 1,497,549

2

100.00%

$ 21,097,153 $

9,114,539 $

360,192 $ 9,474,731 $ 11,622,422

2

100.00%

$ 8,625,320 $

3,726,371 $

147,260 $ 3,873,631 $ 4,751,689

2

100.00%

$ 10,278,747 $

4,440,696 $

175,489 $ 4,616,185 $ 5,662,562

2

100.00%

$ 1,982,706 $

-$

-$

- $ 1,982,706

2

100.00%

$

276,494 $

-$

-$

-$

276,494

2

100.00%

$ 1,723,159 $

-$

-$

- $ 1,723,159

2

100.00%

$

529,168 $

-$

-$

-$

529,168

2

100.00%

$ 13,197,836 $

5,701,821 $

225,327 $ 5,927,148 $ 7,270,688

2

100.00%

$ 18,953,009 $

8,188,211 $

323,585 $ 8,511,796 $ 10,441,213

2

100.00%

$ 23,823,229 $

10,292,278 $

406,734 $ 10,699,012 $ 13,124,217

2

100.00%

$ 2,046,348 $

-$

-$

- $ 2,046,348

2

100.00%

$ 108,763,020 $

46,988,561 $ 1,856,911 $ 48,845,472 $ 59,917,548

2

100.00%

$ 2,329,429 $

-$

-$

- $ 2,329,429

2

100.00%

$

921,179 $

-$

-$

-$

921,179

2

100.00%

$

748,348 $

-$

-$

-$

748,348

2

100.00%

$ 2,483,130 $

-$

-$

- $ 2,483,130

2

100.00%

$ 35,197,433 $

15,206,242 $

600,925 $ 15,807,167 $ 19,390,266

2

100.00%

$ 2,316,025 $

1,000,585 $

39,542 $ 1,040,127 $ 1,275,898

2

100.00%

$ 5,565,784 $

2,404,569 $

95,025 $ 2,499,594 $ 3,066,190

2

100.00%

$ 7,726,709 $

3,338,147 $

131,918 $ 3,470,065 $ 4,256,644

2

100.00%

$ 33,008,211 $

14,260,438 $

563,550 $ 14,823,988 $ 18,184,223

2

100.00%

$

811,618 $

-$

-$

-$

811,618

2

100.00%

$

212,692 $

-$

-$

-$

212,692

2

100.00%

$ 2,828,663 $

1,222,059 $

48,294 $ 1,270,353 $ 1,558,310

9.49% 9.49% 4.36% 4.36% 9.49% 9.49% 9.49% 9.49% 9.49% 4.36% 9.49% 9.49% 9.49% 4.36% 9.49% 9.49% 9.49% 4.36% 4.36% 4.36% 9.49% 9.49% 9.49% 9.49% 9.49% 9.49% 9.49% 9.49% 9.49% 9.49% 9.49% 9.49% 9.49% 9.49% 9.49% 9.49% 4.36%

55.09% 55.09% 55.09% 55.09% 55.09% 100.00% 100.00% 100.00% 100.00% 55.09% 55.09% 55.09% 100.00% 55.09% 100.00% 100.00% 100.00% 100.00% 55.09% 55.09% 55.09% 55.09% 55.09% 100.00% 100.00% 55.09%

AHCA - MPF August 29, 2019

SFY 2019-20 PROJECTED NET PAYMENTS FOR LIP

Self-Funded Tiers Model

Medicaid ID

Provider

010176100 Sarasota Memorial Hospital 010099400 Tampa General Hospital 010067600 UF Health Jacksonville Tier 2: All Publics, All Children's, and High Utilization Teaching Hospitals

010129000 AdventHealth Orlando 012037500 Aventura Hospital and Medical Center 011807900 Brandon Regional Hospital 010220200 Cleveland Clinic Hospital 012032400 H. Lee Moffitt Cancer Center & Research Institute Hospital 011974100 Largo Medical Center 010072200 Mayo Clinic 010046300 Mount Sinai Medical Center 010862600 North Florida Regional Medical Center 010133800 Orlando Health 010138900 Osceola Regional Medical Center 010047100 University of Miami Hospital and Clinics Tier 3: Low Utilization Statutory Teaching

010156700 Bayfront Health - St Petersburg 010003000 UF Health Shands Hospital 010076500 Sacred Heart Hospital 010148600 St. Mary's Medical Center Tier 4: Regional Perinatal Intensive Care Centers (non-Public), and Statutory Teaching Regional Perinatal Intensive Care Centers

000949600 010186900 010187700 010182600 010183400 010189300 010090100 005456800 010074900 010035800 010232600 010064100 010006400 010372100 010087100 010959200 010028500 010027700 010140100 011021300 010141900 010026900 011980600 010178800 010219900 010960600 012009000 010354300 011995400 010180000 010253900 011746300 011132500 010152400 011761700 010135400 010188500 010275000 009587500 014235500

AdventHealth Connerton AdventHealth Daytona Beach AdventHealth DeLand AdventHealth Fish Memorial AdventHealth New Smyrna Beach AdventHealth Palm Coast AdventHealth Sebring AdventHealth Wesley Chapel Baptist Hospital Inc. Baptist Hospital of Miami Baptist Medical Center - Beaches Baptist Medical Center Jacksonville Bay Medical Center Sacred Heart Health System BayCare Alliance Hospital Bayfront Health Brooksville Bayfront Health Dade City Bayfront Health Port Charlotte Bayfront Health Punta Gorda Bethesda Hospital East Blake Medical Center Boca Raton Regional Hospital Calhoun Liberty Hospital Capital Regional Medical Center Central Florida Regional Hospital Citrus Memorial Hospital Coral Gables Hospital Delray Medical Center Doctors Hospital Doctors Hospital of Sarasota Doctors' Memorial Hospital Englewood Community Hospital Fawcett Memorial Hospital Fort Walton Beach Medical Center Good Samaritan Medical Center Gulf Coast Regional Medical Center Health Central Healthmark Regional Medical Center HealthSouth Emerald Coast Rehabilitation Hospital HealthSouth Rehabilitation Hospital at Martin Health HealthSouth Rehabilitation Hospital of Altamonte Springs

Charity Care Cost

Ratio of Charity Care Costs to Commercial

Costs

Tier

% Gross Charity Payment

Total LIP Payment

LIP IGTs Provided to Fund

Tier

Additional LIP IGTs Provided for 1% Minimum

and Tier 1

Total LIP IGTs Provided

Net (Total LIP Payment - LIP

IGTs)

% of Net Payment to Charity Care

Cost

$ 14,159,968 $ 75,082,497 $ 89,617,251 $ 489,690,351

$ 137,329,764

$

8,700,376

$

8,386,103

$

1,863,607

$ 20,646,073

$

6,742,349

$

4,667,889

$ 12,703,114

$

2,363,019

$ 94,896,404

$

1,896,212

$

1,825,001

$ 302,019,911

$ 10,074,864

$ 55,500,659

$ 24,512,644

$

5,059,527

$ 95,147,694

$

77,365

$

3,220,623

$

3,509,737

$

3,440,776

$

1,489,992

$

1,323,848

$

2,837,699

$

3,729,559

$ 12,320,050

$ 29,847,169

$

5,206,688

$ 56,477,869

$

1,024,388

$

66,985

$

339,144

$

108,126

$

2,380,989

$

178,049

$ 10,986,731

$

4,114,906

$

2,180,087

$

161,314

$

1,426,823

$

2,546,586

$

1,829,747

$

1,799,787

$

2,151,116

$

3,700,173

$

1,298,919

$

548,492

$

332,184

$

1,520,160

$

868,843

$

4,566,680

$

903,832

$

6,446,136

$

115,307

$

291,491

$

326,376

$

159,946

8.64% 20.72% 59.89%

15.20% 12.09% 9.70% 1.55% 6.72% 11.41% 2.05% 9.93% 2.39% 13.88% 2.56% 0.61%

13.41% 15.00% 17.04% 6.02%

2.01% 5.05% 13.62% 12.82% 7.42% 4.48% 12.50% 6.61% 11.92% 8.41% 14.67% 15.21% 2.01% 1.50% 1.42% 1.36% 9.73% 1.68% 12.64% 8.70% 1.83% 4.22% 3.00% 5.71% 9.16% 9.36% 3.55% 4.87% 5.35% 10.65% 3.62% 5.60% 1.63% 9.14% 1.84% 14.54% 6.31% 7.84% 14.76% 5.32%

3 of 6

2

100.00%

$ 14,159,968 $

6,117,488 $

241,754 $ 6,359,242 $ 7,800,726

2

100.00%

$ 75,082,497 $

32,437,665 $ 1,281,884 $ 33,719,549 $ 41,362,948

2

100.00%

$ 89,617,251 $

21,911,460 $

- $ 21,911,460 $ 67,705,791

$ 489,690,351 $ 188,677,692 $ 6,590,332 $ 195,268,024 $ 294,422,327

$ 188,677,692

$ 195,268,024

3

57.18%

$ 78,520,832 $

36,926,263 $

- $ 36,926,263 $ 41,594,569

3

57.18%

$ 4,974,601 $

-$

-$

- $ 4,974,601

3

57.18%

$ 4,794,910 $

-$

-$

- $ 4,794,910

3

57.18%

$ 1,065,552 $

-$

-$

- $ 1,065,552

3

57.18%

$ 11,804,774 $

7,078,367 $

- $ 7,078,367 $ 4,726,407

3

57.18%

$ 3,855,062 $

-$

-$

- $ 3,855,062

3

57.18%

$ 2,668,952 $

-$

-$

- $ 2,668,952

3

57.18%

$ 7,263,240 $

3,388,382 $

- $ 3,388,382 $ 3,874,858

3

57.18%

$ 1,351,100 $

-$

-$

- $ 1,351,100

3

57.18%

$ 54,258,774 $

18,674,073 $

- $ 18,674,073 $ 35,584,701

3

57.18%

$ 1,084,194 $

-$

-$

- $ 1,084,194

3

57.18%

$ 1,043,478 $

468,626 $

-$

468,626 $

574,852

$ 172,685,469 $

66,535,711 $

- $ 66,535,711 $ 106,149,758

$

66,535,711 $ 56,068,962 $ 66,535,711

4

100.00%

$ 10,074,864 $

-$

-$

- $ 10,074,864

4

100.00%

$ 55,500,659 $

23,916,880 $ 1,008,465 $ 24,925,346 $ 30,575,313

4

100.00%

$ 24,512,644 $

10,563,226 $

445,402 $ 11,008,628 $ 13,504,016

4

100.00%

$ 5,059,527 $

2,180,300 $

91,934 $ 2,272,234 $ 2,787,293

$ 95,147,694 $

36,660,406 $

1,545,801 $ 38,206,208 $ 56,941,486

$

36,660,406 $

1,545,802 $ 38,206,208

5

1.00%

$

774 $

-$

-$

-$

774

5

1.00%

$

32,206 $

-$

-$

-$

32,206

5

1.00%

$

35,097 $

-$

-$

-$

35,097

5

1.00%

$

34,408 $

28,172 $

-$

28,172 $

6,236

5

1.00%

$

14,900 $

12,199 $

-$

12,199 $

2,701

5

1.00%

$

13,238 $

-$

-$

-$

13,238

5

1.00%

$

28,377 $

23,234 $

-$

23,234 $

5,143

5

1.00%

$

37,296 $

-$

-$

-$

37,296

5

1.00%

$

123,201 $

-$

-$

-$

123,201

5

1.00%

$

298,472 $

-$

-$

-$

298,472

5

1.00%

$

52,067 $

-$

-$

-$

52,067

5

1.00%

$

564,779 $

-$

-$

-$

564,779

5

1.00%

$

10,244 $

-$

-$

-$

10,244

5

1.00%

$

670 $

-$

-$

-$

670

5

1.00%

$

3,391 $

-$

-$

-$

3,391

5

1.00%

$

1,081 $

-$

-$

-$

1,081

5

1.00%

$

23,810 $

-$

-$

-$

23,810

5

1.00%

$

1,780 $

-$

-$

-$

1,780

5

1.00%

$

109,867 $

89,954 $

-$

89,954 $

19,913

5

1.00%

$

41,149 $

-$

-$

-$

41,149

5

1.00%

$

21,801 $

17,850 $

-$

17,850 $

3,951

5

1.00%

$

1,613 $

-$

-$

-$

1,613

5

1.00%

$

14,268 $

-$

-$

-$

14,268

5

1.00%

$

25,466 $

-$

-$

-$

25,466

5

1.00%

$

18,297 $

-$

-$

-$

18,297

5

1.00%

$

17,998 $

-$

-$

-$

17,998

5

1.00%

$

21,511 $

17,612 $

-$

17,612 $

3,899

5

1.00%

$

37,002 $

-$

-$

-$

37,002

5

1.00%

$

12,989 $

-$

-$

-$

12,989

5

1.00%

$

5,485 $

-$

-$

-$

5,485

5

1.00%

$

3,322 $

-$

-$

-$

3,322

5

1.00%

$

15,202 $

-$

-$

-$

15,202

5

1.00%

$

8,688 $

-$

-$

-$

8,688

5

1.00%

$

45,667 $

37,390 $

-$

37,390 $

8,277

5

1.00%

$

9,038 $

-$

-$

-$

9,038

5

1.00%

$

64,461 $

52,778 $

-$

52,778 $

11,683

5

1.00%

$

1,153 $

-$

-$

-$

1,153

5

1.00%

$

2,915 $

-$

-$

-$

2,915

5

1.00%

$

3,264 $

-$

-$

-$

3,264

5

1.00%

$

1,599 $

-$

-$

-$

1,599

55.09% 55.09% 75.55%

30.29% 57.18% 57.18% 57.18% 22.89% 57.18% 57.18% 30.50% 57.18% 37.50% 57.18% 31.50%

100.00% 55.09% 55.09% 55.09%

1.00% 1.00% 1.00% 0.18% 0.18% 1.00% 0.18% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 0.18% 1.00% 0.18% 1.00% 1.00% 1.00% 1.00% 1.00% 0.18% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 0.18% 1.00% 0.18% 1.00% 1.00% 1.00% 1.00%

AHCA - MPF August 29, 2019

Medicaid ID

Provider

010270900 008369200 012038300 012033200 012027800 010228800 010089700 010018800 010146000 012029400 012013800 011993800 001681500 010267900 010019600 000417000 010234200 010230000 011976800 010166400 010342000 010053600 011969500 010111700 010119200 010118400 012008100 010552000 010193100 011279800 010117600 010126500 010049800 010190700 010459100 012007300 010988600 011174100 010210500 010460400 012011100 012026000 006344700 010314400 012000600 009268300 011351400 011975000 010174500 012001400 011998900 010033100 010179600 010007200 010328400 011994600 010108700 010058700 010346200 011997100 012010300 009701300 010073100 010373000 010113300

HealthSouth Rehabilitation Hospital of Miami HealthSouth Rehabilitation Hospital of Ocala HealthSouth Rehabilitation Hospital of Sarasota HealthSouth Rehabilitation Hospital of Tallahassee HealthSouth Sunrise Rehabilitation Hospital Heart of Florida Regional Medical Center Highlands Regional Medical Center Holy Cross Hospital JFK Medical Center Jupiter Medical Center Kendall Regional Medical Center Kindred Hospital - South Florida - Coral Gables Kindred Hospital Melbourne Kindred Hospital- North Florida Kindred Hospital- South Florida- Ft Lauderdale Kindred Hospital The Palm Beaches Kindred Hospital-Bay Area-Tampa Kindred Hospital-Central Tampa Lake City Medical Center Lake Wales Medical Center Lakewood Ranch Medical Center Larkin Community Hospital Palm Springs Campus Lawnwood Regional Medical Center & Heart Institute LeHigh Regional Medical Center Lower Keys Medical Center Martin Medical Center Mease Countryside Hospital Medical Center of Trinity Memorial Hospital Jacksonville Memorial Hospital of Tampa Munroe Regional Medical Center North Okaloosa Medical Center North Shore Medical Center Northwest Florida Community Hospital Northwest Medical Center Oak Hill Hospital Ocala Regional Medical Center Orange Park Medical Center Palm Beach Gardens Medical Center Palmetto General Hospital Palms of Pasadena Hospital Palms West Hospital Park Royal Hospital Physicians Regional Medical Center - Pine Ridge Plantation General Hospital Poinciana Medical Center Putnam Community Medical Center Raulerson Hospital Santa Rosa Medical Center Sebastian Rivers Regional Medical Center Seven Rivers Regional Medical Center Shands Lake Shore Regional Medical Center Shands Live Oak Regional Medical Center Shands Starke Regional Medical Center Sister Emmanuel Hospital South Bay Hospital South Lake Hospital South Miami Hospital St. Cloud Regional Medical Center St. Lucie Medical Center St. Petersburg General Hospital St. Vincent's Medical Center Clay County St. Vincent's Medical Center Riverside St. Vincent's Medical Center Southside Tallahassee Memorial Hospital

SFY 2019-20 PROJECTED NET PAYMENTS FOR LIP

Self-Funded Tiers Model

Charity Care Cost

Ratio of Charity Care Costs to Commercial

Costs

Tier

% Gross Charity Payment

Total LIP Payment

LIP IGTs Provided to Fund

Tier

Additional LIP IGTs Provided for 1% Minimum

and Tier 1

Total LIP IGTs Provided

Net (Total LIP Payment - LIP

IGTs)

% of Net Payment to Charity Care

Cost

$

130,546

3.56%

5

1.00%

$

1,305 $

-$

$

302,864

13.01%

5

1.00%

$

3,029 $

-$

$

6,017

0.24%

5

1.00%

$

60 $

-$

$

80,607

3.30%

5

1.00%

$

806 $

-$

$

391,716

4.17%

5

1.00%

$

3,917 $

-$

$

703,340

2.29%

5

1.00%

$

7,033 $

-$

$

236,721

2.93%

5

1.00%

$

2,367 $

-$

$

6,316,595

5.55%

5

1.00%

$

63,166 $

-$

$ 10,944,778

9.18%

5

1.00%

$

109,448 $

89,611 $

$

3,134,978

4.20%

5

1.00%

$

31,350 $

25,668 $

$

7,718,425

8.30%

5

1.00%

$

77,184 $

-$

$

488,697

15.34%

5

1.00%

$

4,887 $

-$

$

547,152

12.72%

5

1.00%

$

5,472 $

-$

$

176,386

3.31%

5

1.00%

$

1,764 $

-$

$

200,762

5.89%

5

1.00%

$

2,008 $

-$

$

356,329

9.08%

5

1.00%

$

3,563 $

-$

$

393,069

8.61%

5

1.00%

$

3,931 $

-$

$

284,387

7.95%

5

1.00%

$

2,844 $

-$

$

270,584

1.60%

5

1.00%

$

2,706 $

-$

$

363,006

4.14%

5

1.00%

$

3,630 $

-$

$

2,373,571

8.38%

5

1.00%

$

23,736 $

-$

$

582,387

8.46%

5

1.00%

$

5,824 $

-$

$

2,269,898

4.58%

5

1.00%

$

22,699 $

-$

$

77,410

0.99%

5

1.00%

$

774 $

-$

$

832,575

3.97%

5

1.00%

$

8,326 $

-$

$ 16,002,685

14.42%

5

1.00%

$

160,027 $

131,022 $

$

7,724,879

9.45%

5

1.00%

$

77,249 $

-$

$

4,932,100

9.34%

5

1.00%

$

49,321 $

-$

$

1,273,629

1.67%

5

1.00%

$

12,736 $

-$

$

1,417,659

4.12%

5

1.00%

$

14,177 $

-$

$

1,694,190

2.77%

5

1.00%

$

16,942 $

-$

$

737,637

4.80%

5

1.00%

$

7,376 $

-$

$

4,647,879

8.20%

5

1.00%

$

46,479 $

-$

$

446,675

5.35%

5

1.00%

$

4,467 $

-$

$

2,990,887

5.69%

5

1.00%

$

29,909 $

-$

$

2,597,347

8.45%

5

1.00%

$

25,973 $

-$

$

1,900,671

2.74%

5

1.00%

$

19,007 $

-$

$

1,436,436

2.11%

5

1.00%

$

14,364 $

-$

$

3,745,803

7.64%

5

1.00%

$

37,458 $

30,669 $

$

4,363,446

7.18%

5

1.00%

$

43,634 $

-$

$

1,138,683

4.35%

5

1.00%

$

11,387 $

-$

$

2,693,236

5.14%

5

1.00%

$

26,932 $

22,051 $

$

424,191

8.18%

5

1.00%

$

4,242 $

-$

$

432,774

0.99%

5

1.00%

$

4,328 $

-$

$

9,605,645

11.16%

5

1.00%

$

96,056 $

-$

$

130,749

1.08%

5

1.00%

$

1,307 $

-$

$

577,716

5.71%

5

1.00%

$

5,777 $

-$

$

896,012

8.31%

5

1.00%

$

8,960 $

-$

$

147,331

1.22%

5

1.00%

$

1,473 $

-$

$

10,032

0.15%

5

1.00%

$

100 $

-$

$

192,798

1.53%

5

1.00%

$

1,928 $

-$

$

872,504

9.90%

5

1.00%

$

8,725 $

-$

$

87,619

2.76%

5

1.00%

$

876 $

-$

$

36,626

0.79%

5

1.00%

$

366 $

-$

$

20,042

1.25%

5

1.00%

$

200 $

-$

$

1,152,252

12.43%

5

1.00%

$

11,523 $

-$

$

5,364,381

9.72%

5

1.00%

$

53,644 $

-$

$ 12,967,526

6.17%

5

1.00%

$

129,675 $

-$

$

57,757

0.50%

5

1.00%

$

578 $

-$

$

1,156,337

3.29%

5

1.00%

$

11,563 $

-$

$

1,827,689

8.17%

5

1.00%

$

18,277 $

-$

$

3,148,886

10.79%

5

1.00%

$

31,489 $

-$

$ 13,208,398

11.36%

5

1.00%

$

132,084 $

-$

$

4,601,639

7.39%

5

1.00%

$

46,016 $

-$

$ 17,484,471

8.61%

5

1.00%

$

174,845 $

143,155 $

4 of 6

-$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$

-$ -$ -$ -$ -$ -$ -$ -$ 89,611 $ 25,668 $ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ 131,022 $ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ 30,669 $ -$ -$ 22,051 $ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ 143,155 $

1,305 3,029

60 806 3,917 7,033 2,367 63,166 19,837 5,682 77,184 4,887 5,472 1,764 2,008 3,563 3,931 2,844 2,706 3,630 23,736 5,824 22,699 774 8,326 29,005 77,249 49,321 12,736 14,177 16,942 7,376 46,479 4,467 29,909 25,973 19,007 14,364 6,789 43,634 11,387 4,881 4,242 4,328 96,056 1,307 5,777 8,960 1,473 100 1,928 8,725 876 366 200 11,523 53,644 129,675 578 11,563 18,277 31,489 132,084 46,016 31,690

AHCA - MPF August 29, 2019

1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 0.18% 0.18% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 0.18% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 0.18% 1.00% 1.00% 0.18% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 0.18%

Medicaid ID

Provider

010317900 The Villages Regional Hospital 010125700 Twin Cities Hospital 011280100 University Hospital and Medical Center 011973300 Venice Regional Bayfront Health 003158800 Viera Hospital 010213000 Wellington Regional Medical Center 012024300 West Boca Medical Center 011321200 West Florida Hospital 003226500 West Kendall Baptist Hospital 011230500 Westside Regional Medical Center 010320900 Wuesthoff Medical Center-Melbourne 010011100 Wuesthoff Medical Center-Rockledge Tier 5: Low Utilization Private Hospitals

Totals Group 1 - Hospitals

005527800 010110900 053386600 373978300 273179700 053079400

Florida International University Florida State University University of Florida Gainesville University of Florida Jacksonville University of Miami University of South Florida

Totals Group 2 - Medical Schools Physician Practices

017234400 029543400 013881900 060551400 029554000 688693100 680027100 008037100 680002500 003407900 010930500 025148200 029551500 029549300 688571300 029152800 029572800 029545100 029565500 010739700 692990700 029570100 687955100 684660200 001182600 006608600 687429100 001718300 029540000 029547700 014789100 029561200 029544200 262263700 027973100 029568000 060075002 020530900 029506000 689693600 688412100

Agape Community Health Center Azalea Health Banyan Community Health Clinic Bond Community Health Clinic Borinquen Health Care Center Brevard Health Alliance Broward Community & Family Health C.L. Brumback Palm Beach Camillus Health Concern, Inc. Care Resource Center For Families & Child Enrichment CenterPlace Health, Inc. Central Florida Family Health Centers Central Florida Health Care - Frostproof Citrus Health Network Collier Health Services, Inc. Community Health Center South Florida Community Health Centers Community Health Centers Pinellas Empower-U Escambia Community Clinics Family Health Center of SW Florida Family Health Source - Pierson Florida Community Health Centers Foundcare Genesis Health Care for The Homeless Heart of Florida Health Center Jessie Trice Community Health Center Langley Health Services Lee Community Healthcare Manatee County Rural Health Services Miami Beach Community Health Center Neighborhood Medical Center New River - Union County Health Department North Florida Medical Center North Broward Hospital District Osceola Community Health Services Palms Medical Group PanCare Health Center Pinellas County Health and Community Services

SFY 2019-20 PROJECTED NET PAYMENTS FOR LIP

Self-Funded Tiers Model

Charity Care Cost

Ratio of Charity Care Costs to Commercial

Costs

Tier

% Gross Charity Payment

Total LIP Payment

LIP IGTs Provided to Fund

Tier

Additional LIP IGTs Provided for 1% Minimum

and Tier 1

Total LIP IGTs Provided

Net (Total LIP Payment - LIP

IGTs)

% of Net Payment to Charity Care

Cost

$

2,709,250

$

315,334

$

3,329,679

$

162,022

$

1,934,889

$

4,592,123

$

667,612

$

1,051,957

$ 10,071,122

$

2,326,307

$

51,656

$

198,744

$ 376,595,404

$ 1,631,186,013

$

936,341

$

250,000

$ 21,481,657

$ 31,689,648

$ 41,290,646

$

6,426,346

$ 102,074,638

$

1,028,590

$

6,092,750

$

2,092,912

$

1,665,943

$ 12,010,403

$

9,382,565

$

1,971,220

$ 14,685,288

$

3,305,432

$

7,730,620

$

1,028,450

$

2,854,089

$

6,224,489

$

6,939,740

$

5,745,952

$

8,490,902

$ 25,308,865

$ 10,980,075

$

6,222,890

$

483,210

$

4,681,966

$

5,631,605

$

888,654

$

5,488,369

$ 10,536,366

$

777,821

$

5,336,270

$

3,158,602

$ 12,737,631

$

2,549,385

$

1,347,498

$ 14,719,510

$ 10,059,316

$

2,275,634

$

714,400

$

2,402,439

$

4,443,657

$

5,844,147

$

4,917,602

$

4,119,886

$

2,664,680

13.58% 2.66% 14.53% 0.59% 5.64% 9.38% 1.16% 1.97% 13.37% 4.63% 1.05% 2.61%

5 of 6

5

1.00%

$

27,092 $

-$

-$

-$

27,092

5

1.00%

$

3,153 $

-$

-$

-$

3,153

5

1.00%

$

33,297 $

-$

-$

-$

33,297

5

1.00%

$

1,620 $

-$

-$

-$

1,620

5

1.00%

$

19,349 $

-$

-$

-$

19,349

5

1.00%

$

45,921 $

37,598 $

-$

37,598 $

8,323

5

1.00%

$

6,676 $

5,466 $

-$

5,466 $

1,210

5

1.00%

$

10,520 $

-$

-$

-$

10,520

5

1.00%

$

100,711 $

-$

-$

-$

100,711

5

1.00%

$

23,263 $

-$

-$

-$

23,263

5

1.00%

$

517 $

-$

-$

-$

517

5

1.00%

$

1,987 $

-$

$ 3,765,951 $

764,429 $

-$ -$

-$ 764,429 $

1,987 3,001,522

$

1,451,021 $

686,592 $ 1,451,021

$ 796,170,420 $ 298,628,329 $ 8,136,133 $ 306,764,463 $ 489,405,957

$ 306,764,463 $ 8,136,133 $ 306,764,463

1

100.00%

$

936,341 $

360,772 $

-$

360,772 $

575,569

1

100.00%

$

250,000 $

96,325 $

1

100.00%

$ 21,481,657 $

8,276,882 $

-$ -$

96,325 $

153,675

8,276,882 $ 13,204,775

1

100.00%

$ 31,689,648 $

12,210,021 $

- $ 12,210,021 $ 19,479,627

1

100.00%

$ 41,290,646 $

15,909,287 $

- $ 15,909,287 $ 25,381,359

1

100.00%

$ 6,426,346 $

2,476,071 $

$ 102,074,638 $

39,329,358 $

- $ 2,476,071 $ 3,950,275 - $ 39,329,358 $ 62,745,280

$

39,329,358

1

17.67%

$

181,717 $

84,721 $

-$

84,721 $

96,996

1

17.67%

$ 1,076,380 $

-$

-$

- $ 1,076,380

1

17.67%

$

369,746 $

-$

-$

-$

369,746

1

17.67%

$

294,315 $

137,218 $

-$

137,218 $

157,097

1

17.67%

$ 2,121,826 $

989,255 $

-$

989,255 $ 1,132,571

1

17.67%

$ 1,657,577 $

772,809 $

-$

772,809 $

884,768

1

17.67%

$

348,247 $

162,363 $

-$

162,363 $

185,884

1

17.67%

$ 2,594,386 $

1,209,576 $

- $ 1,209,576 $ 1,384,810

1

17.67%

$

583,956 $

-$

-$

-$

583,956

1

17.67%

$ 1,365,735 $

-$

-$

- $ 1,365,735

1

17.67%

$

181,692 $

-$

-$

-$

181,692

1

17.67%

$

504,219 $

235,081 $

-$

235,081 $

269,138

1

17.67%

$ 1,099,653 $

512,689 $

-$

512,689 $

586,964

1

17.67%

$ 1,226,014 $

571,602 $

-$

571,602 $

654,412

1

17.67%

$ 1,015,112 $

473,274 $

-$

473,274 $

541,838

1

17.67%

$ 1,500,051 $

699,366 $

-$

699,366 $

800,685

1

17.67%

$ 4,471,207 $

2,084,603 $

- $ 2,084,603 $ 2,386,604

1

17.67%

$ 1,939,802 $

904,390 $

-$

904,390 $ 1,035,412

1

17.67%

$ 1,099,371 $

512,558 $

-$

512,558 $

586,813

1

17.67%

$

85,367 $

-$

-$

-$

85,367

1

17.67%

$

827,143 $

385,637 $

-$

385,637 $

441,506

1

17.67%

$

994,911 $

-$

-$

-$

994,911

1

17.67%

$

156,995 $

-$

-$

-$

156,995

1

17.67%

$

969,606 $

452,058 $

-$

452,058 $

517,548

1

17.67%

$ 1,861,414 $

867,844 $

-$

867,844 $

993,570

1

17.67%

$

137,414 $

64,066 $

-$

64,066 $

73,348

1

17.67%

$

942,736 $

439,530 $

-$

439,530 $

503,206

1

17.67%

$

558,016 $

260,163 $

-$

260,163 $

297,853

1

17.67%

$ 2,250,302 $

1,049,154 $

- $ 1,049,154 $ 1,201,148

1

17.67%

$

450,389 $

209,984 $

-$

209,984 $

240,405

1

17.67%

$

238,057 $

110,989 $

-$

110,989 $

127,068

1

17.67%

$ 2,600,432 $

1,212,394 $

- $ 1,212,394 $ 1,388,038

1

17.67%

$ 1,777,136 $

-$

-$

- $ 1,777,136

1

17.67%

$

402,026 $

187,436 $

-$

187,436 $

214,590

1

17.67%

$

126,210 $

58,843 $

-$

58,843 $

67,367

1

17.67%

$

424,428 $

-$

-$

-$

424,428

1

17.67%

$

785,042 $

366,009

$

366,009 $

419,033

1

17.67%

$ 1,032,460 $

481,362 $

-$

481,362 $

551,098

1

17.67%

$

868,771 $

-$

-$

-$

868,771

1

17.67%

$

727,842 $

-$

-$

-$

727,842

1

17.67%

$

470,757 $

219,480 $

-$

219,480 $

251,277

1.00% 1.00% 1.00% 1.00% 1.00% 0.18% 0.18% 1.00% 1.00% 1.00% 1.00% 1.00%

61.47% 61.47% 61.47% 61.47% 61.47% 61.47%

9.43% 17.67% 17.67%

9.43% 9.43% 9.43% 9.43% 9.43% 17.67% 17.67% 17.67% 9.43% 9.43% 9.43% 9.43% 9.43% 9.43% 9.43% 9.43% 17.67% 9.43% 17.67% 17.67% 9.43% 9.43% 9.43% 9.43% 9.43% 9.43% 9.43% 9.43% 9.43% 17.67% 9.43% 9.43% 17.67% 9.43% 9.43% 17.67% 17.67% 9.43%

AHCA - MPF August 29, 2019

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