What is payer mix?

Payer mix is a type of financial payment received by a medical practice, including Medicare, Medicaid, indemnity insurance, managed care and individual payments. It is the percentage of income that a medical facility receives from private and government insurance sources versus self-payments from patients.

Payer mix impacts the financial status of a medical facility as Medicaid and Medicare pay less than the cost of treatment, somewhere between 60 and 80 percent of the actual cost of services rendered. To ensure the ongoing success of medical offices and centers, administrators continually analyze payer mix and adjust what amount of each payment type to accept.