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Private Acute Care Hospital Supplemental Payments for Rate Enhancement - FY 2019 Payments Made February 1, 2019 (Reporting Period October 2018 Through December 2018)

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Private Acute Care Hospital Supplemental Payments for Rate Enhancement - FY 2019 Payments Made February 1, 2019 (Reporting Period October 2018 Through December 2018) Private Acute Care Hospital Supplemental Payments for Rate Enhancement - FY 2019 Payments made February 1, 2019 (Reporting Period October 2018 through December 2018) FFS MCO TOTAL Inpatient Outpatient Inpatient Outpatient Facility Non-Exp Exp Non-Exp Exp Non-Exp Exp Non-Exp Exp Non-Exp Exp TOTAL LewisGale Hospital Montgomery 86,906 - 59,344 - 374,347 - 397,438 - 918,035 - 918,035 Buchanan General Hospital 8,399 - 15,534 - 140,070 - 221,906 - 385,908 - 385,908 John Randolph Medical Center 94,904 - 69,385 - 683,036 - 764,625 - 1,611,949 - 1,611,949 LewisGale Hospital Pulaski 34,662 - 75,840 - 148,757 - 286,719 - 545,978 - 545,978 Southside Regional Medical Center 277,895 - 115,276 - 2,392,400 - 1,064,549 - 3,850,120 - 3,850,120 Southampton Memorial Hospital 11,855 - 16,475 - 200,679 - 210,120 - 439,128 - 439,128 Augusta Health 102,809 - 129,932 - 927,851 - 875,053 - 2,035,645 - 2,035,645 Inova Alexandria Hospital 854,994 - 73,987 - 1,566,041 - 769,478 - 3,264,500 - 3,264,500 Inova Fair Oaks Hospital 656,133 - 50,376 - 1,084,077 - 459,741 - 2,250,327 - 2,250,327 Inova Fairfax Hospital 5,392,211 - 345,547 - 7,992,445 - 1,989,398 - 15,719,602 - 15,719,602 Inova Loudoun Hospital 507,361 - 92,113 - 718,288 - 544,597 - 1,862,358 - 1,862,358 Inova Mount Vernon Hospital 61,380 - 46,870 - 481,953 - 410,947 - 1,001,151 - 1,001,151 Stone Springs Hospital Center 73,855 - 10,788 - 213,728 - 68,517 - 366,889 - 366,889 Sentara Leigh Hospital 435,843 - 103,298 - 2,127,435 - 776,688 - 3,443,264 - 3,443,264 Sentara RMH Medical Center 470,971 - 161,367 - 905,372 - 960,816 - 2,498,526 - 2,498,526 Sentara Careplex Hospital 192,607 - 102,189 - 1,170,191 - 1,087,885 - 2,552,872 - 2,552,872 Sentara Obici Hospital 310,271 - 67,342 - 1,833,013 - 767,133 - 2,977,759 - 2,977,759 Sentara Northern Virginia Medical Center 530,081 - 118,938 - 1,451,909 - 926,689 - 3,027,618 - 3,027,618 Wellmont Lonesome Pine Mt. View Hospital 6,650 - 62,408 - 328,349 - 764,865 - 1,162,272 - 1,162,272 Sentara Halifax Regional Hospital 129,596 - 42,468 - 293,074 - 571,439 - 1,036,576 - 1,036,576 Sentara Norfolk General Hospital 1,371,038 - 310,665 - 6,474,093 - 1,730,983 - 9,886,780 - 9,886,780 Sentara Virginia Beach General Hospital 323,916 - 57,567 - 1,055,898 - 579,417 - 2,016,798 - 2,016,798 Sentara Williamsburg Regional Medical Center 100,377 - 44,501 - 529,159 - 398,381 - 1,072,418 - 1,072,418 Sentara Princess Anne Hospital 213,360 - 60,078 - 953,842 - 529,209 - 1,756,489 - 1,756,489 Norton Community Hospital 33,494 - 39,895 - 582,164 - 491,678 - 1,147,231 - 1,147,231 Martha Jefferson Hospital 111,024 - 77,216 - 571,750 - 477,656 - 1,237,646 - 1,237,646 Johnston Memorial Hospital 83,877 - 87,681 - 1,163,938 - 911,605 - 2,247,101 - 2,247,101 Smyth County Community Hospital 8,517 - 35,118 - 175,844 - 274,834 - 494,313 - 494,313 Riverside Tappahannock Hospital 14,004 - 23,040 - 99,218 - 290,409 - 426,670 - 426,670 Riverside Regional Medical Center 732,196 - 240,132 - 2,556,765 - 2,023,829 - 5,552,922 - 5,552,922 Riverside Walter Reed Hospital 32,123 - 20,333 - 261,778 - 298,702 - 612,936 - 612,936 Riverside Shore Memorial Hospital 83,701 - 132,824 - 230,754 - 504,245 - 951,524 - 951,524 Riverside Doctors' Hospital Williamsburg - - 9,200 - 68,523 - 160,513 - 238,236 - 238,236 Russell County Medical Center 14,170 - 10,543 - 175,851 - 237,659 - 438,223 - 438,223 Southern Virginia Regional Medical Center 8,270 - 12,888 - 180,305 - 188,952 - 390,414 - 390,414 Henrico Doctors' Hospital 1,321,258 - 124,420 - 2,800,245 - 1,102,421 - 5,348,344 - 5,348,344 Haymarket Medical Center 41,282 - 27,559 - 323,102 - 153,346 - 545,289 - 545,289 Novant Health Prince William Medical Center 597,251 - 97,749 - 776,212 - 482,967 - 1,954,178 - 1,954,178 Bon Secours St. Mary's Hospital 455,621 - 142,834 - 2,909,169 - 1,312,791 - 4,820,415 - 4,820,415 Bon Secours Mary Immaculate Hospital 140,990 - 58,981 - 1,153,522 - 452,179 - 1,805,672 - 1,805,672 Twin County Regional Hospital 54,344 - 47,929 - 295,451 - 391,881 - 789,604 - 789,604 Wythe County Community Hospital 51,205 - 57,010 - 251,689 - 358,925 - 718,829 - 718,829 Fauquier Hospital - Hospital in Northern Virginia 117,782 - 36,022 - 364,364 - 332,676 - 850,844 - 850,844 Bon Secours Maryview Medical Center 194,236 - 143,712 - 1,794,370 - 1,330,095 - 3,462,413 - 3,462,413 Bon Secours Memorial Regional Medical Center 154,380 - 81,759 - 1,742,915 - 926,055 - 2,905,109 - 2,905,109 Bon Secours Richmond Community Hospital 18,196 - 211,386 - 403,756 - 1,138,637 - 1,771,976 - 1,771,976 Danville Regional Medical Center 311,636 - 249,835 - 1,563,150 - 1,653,202 - 3,777,823 - 3,777,823 Memorial Hospital of Martinsville & Henry County 281,932 - 128,219 - 380,111 - 426,330 - 1,216,591 - 1,216,591 Bon Secours DePaul Medical Center 163,877 - 72,033 - 1,027,472 - 551,822 - 1,815,205 - 1,815,205 Bon Secours St. Francis Medical Center 249,732 - 50,476 - 978,355 - 511,720 - 1,790,283 - 1,790,283 Virginia Hospital Center 585,537 - 43,659 - 1,224,842 - 344,788 - 2,198,826 - 2,198,826 LewisGale Medical Center 399,838 - 140,263 - 2,209,654 - 956,481 - 3,706,236 - 3,706,236 Carilion Franklin Memorial Hospital 29,026 - 37,208 - 150,089 - 234,993 - 451,315 - 451,315 Carilion Medical Center 3,114,192 - 417,338 - 9,166,840 - 2,570,538 - 15,268,907 - 15,268,907 Carilion New River Valley dba St. Albans 194,675 - 88,150 - 958,696 - 632,142 - 1,873,664 - 1,873,664 Carilion Tazewell Community Hospital 3,513 - 7,165 - 35,433 - 104,407 - 150,518 - 150,518 LewisGale Hospital - Alleghany 39,479 - 22,497 - 168,122 - 193,413 - 423,512 - 423,512 Stafford Hospital Center 127,237 - 39,890 - 390,629 - 308,680 - 866,436 - 866,436 Spotsylvania Regional Medical Center 206,702 - 48,004 - 938,786 - 494,576 - 1,688,067 - 1,688,067 Valley Health Warren Memorial Hospital 9,296 - 38,531 - 99,043 - 386,923 - 533,793 - 533,793 Valley Health Winchester Medical Center 718,863 - 137,389 - 1,784,058 - 728,491 - 3,368,802 - 3,368,802 Reston Hospital Center 374,148 - 31,894 - 712,725 - 227,777 - 1,346,545 - 1,346,545 Novant Health UVA Health System Culpeper Hospital 165,301 - 71,107 - 369,107 - 660,956 - 1,266,471 - 1,266,471 Centra Health - Virginia Baptist Hospital 838,468 - 220,860 - 3,304,110 - 1,288,727 - 5,652,165 - 5,652,165 Centra Southside Community Hospital 94,126 - 40,625 - 573,147 - 409,774 - 1,117,672 - 1,117,672 CJW Medical Center 2,139,776 - 296,302 - 5,943,391 - 1,902,016 - 10,281,485 - 10,281,485 Clinch Valley Medical Center 75,057 - 80,635 - 677,975 - 700,526 - 1,534,194 - 1,534,194 Mary Washington Hospital 935,993 - 132,688 - 2,235,002 - 937,599 - 4,241,281 - 4,241,281 Bedford Memorial Hospital 15,185 - 14,751 - 124,261 - 135,123 - 289,319 - 289,319 TOTAL 27,589,580 0 6,360,037 0 87,942,690 0 47,359,652 0 169,251,959 0 169,251,959 Source: MCO encounters, FFS claims, and BHSA claims payments October 2018 through December 2018 Notes: Totals are net of all encounter and claim payment adjustments; claims with dates of service prior to 4/1/2018 are excluded; encounters with denied/voided status are included; FAMIS claims are excluded Private Acute Care Hospital Supplemental Payments for Rate Enhancement - FY 2019 Payments made May 3, 2019 (Reporting Period January 2019 through February 2019) FFS MCO TOTAL Inpatient Outpatient Inpatient Outpatient Facility Non-Exp Exp Non-Exp Exp Non-Exp Exp Non-Exp Exp Non-Exp Exp TOTAL LewisGale Hospital Montgomery 16,555 3,981 35,783 8,779 269,584 8,312 195,014 8,494 516,936 29,566 546,502 Buchanan General Hospital 4,359 4,676 32,936 81,438 4,283 118,733 8,959 127,692 John Randolph Medical Center 109,435 32,091 32,583 23,355 484,444 41,171 386,292 31,529 1,012,754 128,147 1,140,901 LewisGale Hospital Pulaski 25,362 25,665 11,582 140,190 151,418 18,337 342,635 29,919 372,555 Southside Regional Medical Center 277,436 92,525 58,790 43,075 1,380,730 105,940 628,991 51,166 2,345,946 292,706 2,638,653 Southampton Memorial Hospital 12,960 1,181 6,497 7,626 49,632 7,727 131,181 11,436 200,270 27,970 228,240 Augusta Health 78,027 73,460 35,460 902,724 17,717 507,471 41,147 1,561,682 94,324 1,656,006 Inova Alexandria Hospital 246,823 6,586 34,744 10,240 1,032,927 14,107 438,189 36,099 1,752,684 67,032 1,819,715 Inova Fair Oaks Hospital 180,161 3,942 19,573 9,353 646,567 3,902 249,830 12,566 1,096,131 29,763 1,125,894 Inova Fairfax Hospital 2,744,894 90,765 108,342 29,064 4,431,744 17,945 1,152,211 51,742 8,437,191 189,517 8,626,708 Inova Loudoun Hospital 398,313 7,782 57,093 11,784 492,689 7,352 297,791 10,863 1,245,885 37,781 1,283,666 Inova Mount Vernon Hospital 45,314 6,814 9,916 3,517 277,976 6,169 261,928 14,159 595,134 30,660 625,794 Stone Springs Hospital Center 34,036 3,525 440 91,870 33,979 3,161 163,409 3,600 167,010 Sentara Leigh Hospital 238,602 15,416 32,543 24,884 1,810,117 25,090 550,400 52,590 2,631,662 117,980 2,749,643 Sentara RMH Medical Center 272,600 39,418 102,867 61,794 1,314,208 32,430 562,385 36,179 2,252,060 169,821 2,421,881 Sentara Careplex Hospital 151,323 31,110 31,433 13,132 1,159,254 16,129 625,665 52,940 1,967,676 113,312 2,080,988 Sentara Obici Hospital 93,641 15,349 30,984 11,119 1,467,182 20,868 481,285 32,916 2,073,092 80,251 2,153,343 Sentara Northern Virginia Medical Center 244,157 24,867 58,216 20,526 1,174,528 22,103 464,948 24,158 1,941,849 91,655 2,033,504 Wellmont Lonesome Pine Mt.
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