Healthcare Insights
Hospital payor mix by state
A hospital’s payor mix breaks down its sources of revenue – from commercial insurance plans to government programs such as Medicare and Medicaid – and provides insight into its financial performance and patient population.
In the Definitive Healthcare HospitalView product, payor mix is a proprietary calculation based on revenues, charges, discharges, and patient days that come from different medical insurance payors. The figure is aggregated from the most recent 12-month interval tracked in our database and updated from the April 2025 Medicare Cost Report release.
This Healthcare Insight reviews payor mix data tracked for more than 5,900 U.S. hospitals and compares the results by the state in which the hospital is located.
| State/Territory | Medicaid | Medicare | Private/Self Pay/Other | Explore dataset |
|---|---|---|---|---|
| Puerto Rico | 4.20% | 7.30% | 88.50% | Explore |
| Vermont | 5.30% | 9.20% | 85.50% | Explore |
| Wisconsin | 6.30% | 12.30% | 81.40% | Explore |
| Florida | 6.70% | 15.10% | 78.20% | Explore |
| Georgia | 10.80% | 11.90% | 77.30% | Explore |
| South Dakota | 5.20% | 17.80% | 76.90% | Explore |
| Maine | 12.40% | 10.90% | 76.70% | Explore |
| Ohio | 10.60% | 12.80% | 76.60% | Explore |
| Minnesota | 9.20% | 14.30% | 76.50% | Explore |
| Utah | 13.10% | 10.50% | 76.40% | Explore |
| Idaho | 11.60% | 12.00% | 76.40% | Explore |
| Colorado | 11.80% | 12.40% | 75.80% | Explore |
| New Hampshire | 7.40% | 17.00% | 75.60% | Explore |
| Wyoming | 5.50% | 19.00% | 75.50% | Explore |
| Tennessee | 10.50% | 14.20% | 75.30% | Explore |
| North Dakota | 7.90% | 16.80% | 75.30% | Explore |
| West Virginia | 11.30% | 13.50% | 75.20% | Explore |
| Washington | 10.90% | 14.10% | 75.00% | Explore |
| Indiana | 12.50% | 12.60% | 74.90% | Explore |
| U.S. Virgin Islands | 13.00% | 12.10% | 74.80% | Explore |
| Texas | 12.70% | 13.40% | 74.00% | Explore |
| Alabama | 11.70% | 14.30% | 74.00% | Explore |
| North Carolina | 14.70% | 11.80% | 73.50% | Explore |
| Kansas | 7.40% | 19.10% | 73.50% | Explore |
| Pennsylvania | 11.00% | 15.70% | 73.30% | Explore |
| Nebraska | 7.90% | 19.10% | 73.00% | Explore |
| Michigan | 14.10% | 13.70% | 72.20% | Explore |
| Missouri | 13.40% | 14.50% | 72.20% | Explore |
| Oregon | 15.00% | 13.10% | 71.90% | Explore |
| South Carolina | 13.10% | 15.40% | 71.50% | Explore |
| Hawaii | 15.40% | 13.20% | 71.40% | Explore |
| Connecticut | 13.10% | 15.70% | 71.20% | Explore |
| Nevada | 12.50% | 16.50% | 71.00% | Explore |
| Guam | 18.30% | 10.90% | 70.80% | Explore |
| Montana | 13.00% | 16.60% | 70.40% | Explore |
| Arkansas | 9.20% | 20.80% | 70.00% | Explore |
| Illinois | 14.50% | 15.70% | 69.80% | Explore |
| Delaware | 9.70% | 20.50% | 69.80% | Explore |
| Arizona | 15.50% | 15.10% | 69.50% | Explore |
| California | 17.40% | 13.90% | 68.70% | Explore |
| New Jersey | 13.90% | 17.50% | 68.50% | Explore |
| Virginia | 17.70% | 15.50% | 66.80% | Explore |
| Oklahoma | 17.50% | 16.30% | 66.20% | Explore |
| Iowa | 16.70% | 17.20% | 66.20% | Explore |
| New Mexico | 22.00% | 12.30% | 65.60% | Explore |
| Louisiana | 21.20% | 13.60% | 65.20% | Explore |
| Rhode Island | 20.70% | 14.20% | 65.00% | Explore |
| New York | 19.50% | 15.70% | 64.80% | Explore |
| Alaska | 18.00% | 17.90% | 64.10% | Explore |
| Massachusetts | 14.50% | 22.20% | 63.30% | Explore |
| Mississippi | 20.80% | 17.50% | 61.70% | Explore |
| Washington D.C. | 18.30% | 20.50% | 61.10% | Explore |
| Kentucky | 27.70% | 11.80% | 60.50% | Explore |
| Maryland | 17.10% | 22.40% | 60.50% | Explore |
Fig. 1 Analysis of data from the Definitive Healthcare HospitalView product and is aggregated from the most recent 12-month interval tracked in our database. Accessed August 2025.
Which states have the highest Medicare payor mix?
Hospitals in Maryland and Massachusetts both have an estimated Medicare payor mix of more than 22% of hospital revenue. Arkansas, Delaware, and Washington D.C. fall just behind, with Medicare payor mixes averaging above 20%. Generally, the aging population and increases in healthcare costs contribute to a higher Medicare payor mix.
Which states have the lowest Medicare payor mix?
Vermont and Puerto Rico have the lowest percentage of their payor revenue coming from Medicare at 9.2% and 7.3% respectively.
Which states have the highest Medicaid payor mix?
Kentucky has the highest Medicaid payor mix at over 27% followed by New Mexico and Louisiana at 22% and 21% respectively.
Which states have the lowest Medicaid payor mix?
Wyoming, Vermont, South Dakota, and Puerto Rico have the lowest percentages of Medicaid payor mix, all with less than 6% of hospital revenue on average.
Which states have the highest commercial payor mix?
Puerto Rico, Vermont, and Wisconsin have the highest commercial/private insurance payor mix, with more than 81% of their hospitals’ revenue coming from those sources.
Which states have the lowest commercial payor mix?
Kentucky and Maryland have the lowest payor mix from commercial/private insurance at 60.5% each. As noted above, these states have some of the highest Medicare and Medicaid payor mixes, which reduces their commercial payor mix.
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