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RESEARCH · ISSUE 048
cms-hospital-compareData Snapshot

Hospital Profit Margins: The Gap Between Systems

Hospital profit margins vary enormously between systems: per-hospital operating margin vs the national average, derived from CMS HCRIS cost report data. The study identifies financially distressed hospitals and quantifies the margin gap with the named CMS source and reporting period; a snapshot-artifact signature does not sign the study figures.

BY FONTEUM LLC · MAY 24, 2026 · 8 MIN READLAST UPDATED MAY 24, 2026
CMS HCRIS (form 2552-10) · 2024
Built on CMS HCRIS (form 2552-10) · snapshot 2024 · reproducible · re-derive the figures yourself
Key findings
U.S. hospitals analyzed from HCRIS cost reports
cms-hospital-compare · CMS
data derived from CMS HCRIS (form 2552-10)
cms-hospital-compare · CMS
6,019
Hospitals analyzed
-13.8%
National avg op margin
2,368
In financial distress (< −5%)
39.3%
Distress rate

Operating Margin Distribution

Red bars indicate hospitals below the −5% distress threshold. 232 of 6,019 hospitals lack a computable operating margin and are excluded from the distribution.

< −10%
1,759 (30.4%)
−10% to −5%
609 (10.5%)
−5% to 0%
754 (13%)
0% to 5%
723 (12.5%)
5% to 10%
586 (10.1%)
> 10%
1,356 (23.4%)

State Median Operating Margin

Median operating margin across hospitals in each state — medians are used because self-reported HCRIS margins contain extreme outliers that dominate a mean. View state detail →

Highest median margin
UT+8.8% (56)
SC+7.8% (81)
DE+7.3% (15)
FL+6.8% (266)
VA+6.6% (104)
Lowest median margin
VT-20.7% (15)
RI-15.0% (13)
HI-14.6% (24)
KS-14.3% (148)
NY-13.1% (164)

Data & Methodology

Operating margin is computed from CMS HCRIS form 2552-10 headline fields: (Net Patient Revenue − Total Operating Expense) / Net Patient Revenue × 100. Hospitals with operating margin below −5% are flagged as financially distressed per the hospital-margin/v1 methodology.

Fonteum does not independently rate or rank hospitals. This index reflects CMS-published self-reported financial data. Explore the full underlying dataset on the HCRIS hospital cost report data page.

Re-derive this

Every figure on this page comes from the named federal file below, as of 2024. The downloads carry the same figures in machine-readable form, so a reader can re-check the numbers against the source instead of taking them on trust.

Download the data: Download JSON · Download CSV · Download re-derivation SQL

Methodology hospital-margin/v1 · data as of 2024 · CSV 8676 bytes · SHA-256 75af38c9ab3714d9 · the SQL download is the query these figures come from.

Cite this study

BibTeX
@misc{fonteum_hospital_margin_2024,
  title        = {Hospital Margin Gap Analysis (2024)},
  author       = {{Fonteum}},
  year         = {2024},
  howpublished = {\url{https://fonteum.com/research/hospital-margin-gap}},
  note         = {Accessed 2026-08-25. Methodology: hospital-margin/v1. Data: U.S. Centers for Medicare \& Medicaid Services HCRIS (form CMS-2552-10)},
}
APA

Fonteum. (2024). Hospital Margin Gap Analysis (2024). Fonteum. https://fonteum.com/research/hospital-margin-gap

Chicago

Fonteum. "Hospital Margin Gap Analysis (2024)." Fonteum, 2024. https://fonteum.com/research/hospital-margin-gap.

Data source: U.S. Centers for Medicare & Medicaid Services, Hospital Cost Reporting Information System (HCRIS), form CMS-2552-10. Public domain per 17 U.S.C. § 105.

Press angle

Definitive Healthcare charges $30,000/year for their Hospital Performance Manager, which leads with hospital financial margins. This study publishes the same underlying data — CMS HCRIS — free, with its methodology and named CMS source. When a separately attested snapshot is supplied, the attestation applies to that snapshot object and does not sign the study figures. The published calculations are re-derivable from the cited CMS cost report filings.

What’s on file, by the numbers

Platform snapshot · 2026-08-24

13.4Mproviders & companiesProviders, organizations, owners, and facilities on file
26.2Msource-linked factsSource-linked field facts in the dated platform snapshot
90sources with dataDistinct snapshot source IDs with at least one positive record count
70fresh sourcesDistinct source IDs whose latest positive-data snapshot falls within the preceding 45 days
111sources integratedActive registry rows; integration does not establish a load
13state Medicaid jurisdictionsDistinct states represented in the state-exclusions serving table

Integrated, with-data, and fresh-observation counts are separate. No platform-wide source-completeness count is published. Completeness is source-specific and must be evaluated against the named source's expected scope. State coverage is a separate jurisdiction measure.

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Daily observations

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Named medical review

Reviewed by Jennifer Montecillo, MD, medical reviewer. Non-practicing medical reviewer.

Read the full provenance and attestation methodology →

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