Hospital and health system financial data are critical tools for states to evaluate hospital performance, support state health care systems, and address health care costs. In November 2023, NASHP launched the year-long Hospital and Health System Financial Data Learning Collaborative with the support of Arnold Ventures. The collaborative has engaged officials representing multiple offices and agencies from ten different states to explore hospital and health system financial data, with the goal of empowering states to employ this data as they work to make health care more affordable and accessible.
NASHP is eager to support all state officials working to address hospital and health system costs, including by publicly sharing lessons that emerge from the collaborative. This toolkit features resources developed by NASHP for the learning collaborative, as well as relevant pre-existing publications, that state officials can use to guide their understanding and application of hospital and health system financial data sources.
Overview of Data Sources
There are a variety of publicly available resources that state officials can use to assess hospital financial performance. This resource highlights six sources of data — the NASHP Hospital Cost Tool, Audited Financial Statements, the Electronic Municipal Market Access (EMMA) database, Centers for Medicare & Medicaid Services (CMS) provider and service data, IRS Form 990s, and the RAND’s corporation’s Hospital Price Transparency Study — and compares what state officials can learn from each source. You can also download a chart with this information as a reference.
This blog expands upon the data sources captured in the above chart and offers guidance to state officials seeking to use these resources to assess a hospital or health system’s financial health.
The Municipal Securities Rulemaking Board (MSRB) operates the EMMA database, which houses data and information on virtually all municipal bonds. This guide by Marilyn Bartlett introduces users to EMMA and explores the hospital financial information accessible via the database.
Model Legislation: Hospital Finance Transparency
These resources are also available on NASHP’s Model Legislation and Resources to Address Rising Health Care Costs webpage under the heading “Hospital Finance Transparency.”
August 2020
State officials need detailed hospital financial information in addition to publicly available data resources to understand hospitals’ assets, expenses, and liabilities. NASHP has created model legislation to increase hospital and health system financial transparency. NASHP’s model bill identifies data for collection, describes the documents that can be used to obtain that information, and establishes that a stage agency or office will analyze the data.
August 2020
NASHP has developed a reporting template to accompany the above model bill and assist with state implementation. This template includes suggested financial metrics that states can use to evaluate a health system’s financial well-being. With adaptations, states can also use this template to collect information at the hospital level.
This NASHP blog discusses the importance of hospital financial transparency and offers guidance to users of the model act and accompanying reporting template.
This report, prepared by Sarah Gunther Lane, MS, Elizabeth Longstreth, BA, Victoria Nixon, MS, and Nancy Kane, DBA, provides an overview of the key questions policymakers can ask to understand hospital financial performance, including background on hospital revenues and expenses, sources of financial information, and evaluations of financial health.