Democratizing insights into hospital cost reports

The Centers for Medicare and Medicaid Services (CMS) provides annual reports of costs, charges, utilization, payment, penalty, payroll, and general institutional characteristics for thousands of Medicare-certified hospitals. However, beyond the small fraction of features offered in dated finalized public use files, the size and complexity of cost report data can make it difficult to use. To gain a greater breadth of up-to-date insights, hospitals and researchers must either pay for third party services or acquire the appropriate expertise. To democratize insights into cost report data, we first developed an open-source public repository of 6908 hospital-specific dataset, each containing 2843 labeled features and spanning years between 2010 and 2023. We then developed an open-source application for analyzing and downloading these data. Users can download and run the application locally or access it online (https://hcris-app.herokuapp.com/), and compare cost report features among hospitals and across time, explore relationships between features, and design new cost report variables. As examples of insights gained from our application, we present results from comparing Rush University Medical Center to 66 non-governmental acute care Illinois hospitals. We look forward to developing our open-source resources according to feedback from the healthcare community.