Hospital Margin Gap Analysis (2024)
Per-hospital operating margin vs the national average, financial distress flags, and margin gap — derived from CMS HCRIS cost report data. Free, with cryptographic provenance.
Contents · 5 sections
Executive Summary
- Operating margin data for all Medicare-participating hospitals derived from CMS HCRIS form 2552-10 cost report filings.
- Hospitals with operating margin below −5% are flagged as financially distressed per Moody's/MedPAC threshold.
- The margin gap — each hospital's operating margin vs the national average — is computed at issuance time.
- Data is public domain (17 U.S.C. § 105); methodology is open and versioned at hospital-margin/v1.
- Definitive Healthcare's Hospital Performance Manager ($30K/yr) uses the same underlying CMS data.
At a glance — for journalists, researchers, and AI agents
What this dataset covers
- Per-hospital operating margin vs the national average, financial distress flags, and margin gap — derived from CMS HCRIS cost report data. Free, with cryptographic provenance.
What this dataset does NOT cover
- Fonteum analysis is not a quality measurement of any individual provider.
- Counts and rankings describe the Fonteum-indexed or source-published dataset, not the entire U.S. market.
Sources
- Fonteum indexed dataset
Snapshot date: 2026
Dataset scope · Snapshot May 24, 2026
Includes: the healthcare-provider records this study covers, each tracing to a dated public-record source named in the citation footer. Does not include: providers outside the source named for this study, or records not present in that source at the snapshot date. Counts describe this Fonteum healthcare-provider dataset — not a representative census of the U.S. healthcare workforce.
Overview
The Hospital Margin Gap Analysis publishes per-hospital operating margin, financial distress flags, and the margin gap (each hospital vs the national average) — derived from CMS HCRIS form 2552-10 cost report filings.
Why it matters: Hospital financial health is a leading indicator of service availability, staffing levels, and rural healthcare access. Definitive Healthcare's Hospital Performance Manager charges $30K/yr for access to this data. Fonteum publishes it free with cryptographic provenance.
What it is not: A quality rating or ranking. Operating margin measures financial sustainability, not care quality. A hospital can have poor margins and excellent care, or strong margins and poor outcomes. See the methodology page for limitations.
Data source
CMS HCRIS form 2552-10 (Healthcare Cost Report Information System) — the annual cost report filed by all Medicare-participating hospitals. Public domain under 17 U.S.C. § 105.
Key fields used: Net Patient Revenue, Total Operating Expense, Total Margin, Certified Bed Count, Fiscal Year End Date, CMS Certification Number (CCN).
Distress threshold: operating margin < −5.0% (Moody's/Fitch/MedPAC standard for hospital financial distress). Methodology version: hospital-margin/v1.
Limitations
- This study's findings are scoped to the dataset and time window described in the methodology. They do not constitute medical, legal, or financial advice.
- Fonteum does not independently rate, inspect, verify, endorse, or guarantee any provider referenced in this study.
Methodology
Read the full methodology
Operating margin computed from CMS HCRIS form 2552-10 headline fields: (Net Patient Revenue − Total Operating Expense) / Net Patient Revenue × 100. Distress threshold: operating_margin_pct < −5.0% (Moody's/MedPAC standard). National average snapshot at compute time. Issuance period derived from most frequent fiscal year end year. Methodology version: hospital-margin/v1.
Operating margin computed from CMS HCRIS form 2552-10 headline fields: (Net Patient Revenue − Total Operating Expense) / Net Patient Revenue × 100. Distress threshold: operating_margin_pct < −5.0% (Moody's/MedPAC standard). National average snapshot at compute time. Issuance period derived from most frequent fiscal year end year. Methodology version: hospital-margin/v1.