A centralized database managed by the Centers for Medicare & Medicaid Services (CMS) containing cost report data from healthcare providers participating in Medicare and Medicaid programs. HCRIS serves as a critical resource for analyzing healthcare costs, reimbursement rates, and financial performance.
A detailed financial document submitted by healthcare providers to report their costs, revenues, and utilization of services. These reports are essential for reimbursement calculations and financial oversight.
A federal health insurance program primarily for individuals aged 65 and older, certain younger people with disabilities, and individuals with end-stage renal disease. Medicare relies on cost reporting data for reimbursement purposes.
A joint federal and state program providing healthcare coverage to eligible low-income individuals and families. Medicaid also utilizes HCRIS data to determine reimbursement rates and monitor financial compliance.
The compensation paid to healthcare providers by Medicare, Medicaid, or private insurers for services rendered to patients. Reimbursement rates are often based on the data reported in cost reports stored within HCRIS.
Different categories of healthcare entities, such as hospitals, skilled nursing facilities, home health agencies, and hospices, each with specific reporting requirements and reimbursement methodologies within HCRIS.
Information detailing the volume and types of services provided by healthcare providers, including patient admissions, procedures performed, lengths of stay, and other utilization metrics.
Key financial metrics extracted from cost reports stored in HCRIS, such as total revenue, operating expenses, net income, and balance sheet items. These indicators help assess the financial health and performance of healthcare providers.
The process of assigning expenses to specific cost centers or service lines within a healthcare organization. HCRIS captures detailed cost allocation data, enabling analysis of resource utilization and cost efficiency.
Software applications and analytical techniques used to extract, manipulate, and interpret data from HCRIS for research, policy development, reimbursement rate setting, and financial decision-making in the healthcare industry.