license: other
license_name: tensorust-sample-license
license_link: https://tensorust.com/datasets/hospital-penalty-stack/
pretty_name: Medicare Hospital Penalty Stack (free sample)
language:
- en
tags:
- tensorust
- sample
- healthcare-finance
- government-data
- finance
size_categories:
- n<1K
configs:
- config_name: sample
data_files:
- split: train
path: sample.csv
- config_name: summary
data_files:
- split: train
path: summary_by_state.csv
Medicare Hospital Penalty Stack: free sample (Tensorust LLC)
Three Medicare quality penalties stacked into one dollar figure per hospital: about $736M a year across 2,993 hospitals.
Headline: Medicare cuts hospital inpatient pay through three separate quality programs (readmissions, value-based purchasing and hospital-acquired conditions), and CMS publishes each as a factor in a different table, never as one dollar figure.
This repository is a free teaser, not the dataset. It holds 25 example rows and a summary table with no names in it. The full file has 5,419 rows and is sold by Tensorust LLC: https://tensorust.com/datasets/hospital-penalty-stack/.
Files here
| file | what it is |
|---|---|
sample.csv |
25 rows of the full file (the same sample shown on tensorust.com) |
summary_by_state.csv |
row counts and totals by state across the full file, no entity names (groups with fewer than 3 rows are folded into "Other") |
Summary by state (largest groups)
| State | rows | Est. total penalties (USD) |
|---|---|---|
| TX | 467 | 42,875,150 |
| CA | 377 | 87,186,793 |
| FL | 221 | 57,675,284 |
| OH | 193 | 30,824,934 |
| IL | 193 | 28,775,726 |
| NY | 192 | 51,802,048 |
| PA | 186 | 40,867,247 |
| LA | 161 | 11,980,469 |
| GA | 149 | 24,691,449 |
| MI | 149 | 17,709,070 |
| IN | 148 | 15,517,647 |
| WI | 140 | 5,574,696 |
| TOTAL | 5,419 | 736,408,415 |
Full table: summary_by_state.csv.
What the full file has
- 5,419 rows
- Key fields: ccn, facility_name, city_town, state, county_parish, hospital_type, hospital_ownership, hospital_overall_rating, in_ipps_programs, hrrp_paf_fy2027
- Parquet and CSV, a README with sources, method and limits, and the build script
- Free 25-row sample (no personal contact data)
Coverage: All 5,419 hospitals in CMS Hospital General Information; program fields filled for the 2,993 IPPS hospitals in at least one program file (critical access, Maryland and other exempt hospitals carry no penalty). FY2027 HRRP and proxy VBP factors (federal fiscal year Oct 1 2026 to Sep 30 2027); HAC list FY2026; cost reports 2024; built Nov 6 2026.
Columns in the full file
| column | meaning |
|---|---|
ccn |
CMS certification number |
facility_name |
Hospital name (Hospital General Information) |
city_town |
City |
state |
State |
county_parish |
County |
hospital_type |
CMS hospital type |
hospital_ownership |
CMS ownership type |
hospital_overall_rating |
CMS overall star rating |
in_ipps_programs |
Appears in at least one program file (IPPS hospitals; CAHs, Maryland and others are exempt) |
hrrp_paf_fy2027 |
FY2027 HRRP payment adjustment factor (Table 15) |
hrrp_penalty_pct |
HRRP cut in percent |
hrrp_measures_over_1 |
FY2026 HRRP measures with excess readmission ratio above 1 |
hrrp_max_err |
Highest excess readmission ratio |
vbp_factor_fy2027_proxy |
FY2027 proxy VBP adjustment factor (Table 16A) |
vbp_adjustment_pct |
VBP adjustment in percent (negative = cut) |
hac_total_score_fy2026 |
FY2026 HAC Reduction Program total score |
hac_reduction_fy2026 |
FY2026 HAC 1% reduction (Yes/No) |
hac_penalized |
True when the HAC cut applies |
drg_base_payment |
Medicare DRG payments excluding outliers (HCRIS Worksheet E Part A) |
ipps_payment_base_for_hac |
DRG + outlier + DSH + IME payments, the HAC base |
base_source |
Cost report year used for the payment base |
hrrp_penalty_usd_est |
Estimated yearly HRRP cut, USD |
vbp_net_usd_est |
Estimated yearly VBP adjustment, USD (positive = bonus) |
hac_penalty_usd_est |
Estimated yearly HAC cut, USD |
total_penalty_usd_est |
Sum of the cuts (negative VBP only), USD |
net_quality_adjustment_usd_est |
Net of all three including VBP bonuses, USD |
programs_penalizing |
Number of the three programs cutting payment (0 to 3) |
net_patient_revenue_cr2024 |
Net patient revenue, 2024 cost report |
net_income_cr2024 |
Net income, 2024 cost report |
fy_end_cr2024 |
Fiscal year end of the 2024 cost report |
ontology_org_id |
Tensorust Ontology organization id |
Get the full file
| tier | price | includes |
|---|---|---|
| Hospital or system report | $950 | Your hospital or up to 10 hospitals in one system: the three penalties in dollars, the measures driving each, and peer hospitals in your state for comparison. |
| National penalty file | $4,500 | All 5,419 hospitals with factors, payment bases and estimated dollars for each program, plus one refresh when the final FY2027 VBP factors and FY2027 HAC list post. |
| Vendor territory license | $12,000 a year | The national file refreshed with each CMS release (IPPS proposed and final rules, HAC and HRRP updates), ranked by dollars at stake, for one vendor or consulting firm's sales team. |
Email mattbusel@tensorust.com with the tier and a billing contact, and we will send a proper invoice (ACH or card). The file is delivered once the invoice is paid. Details and the live sample: https://tensorust.com/datasets/hospital-penalty-stack/. All datasets: https://tensorust.com/datasets/
Method and limits
Parse FY2027 IPPS Final Rule Table 15 (HRRP) and Table 16A (proxy VBP). Join the FY2026 HAC reduction list and HRRP measure ratios on CCN. Take Medicare DRG payments from the 2024 HCRIS report, else 2023. Dollarize: HRRP = base x (1 - factor); VBP = base x (factor - 1); HAC = 1% x (DRG + outlier + DSH + IME). Sum the cuts into total_penalty_usd_est (negative VBP only) and the net of all three including VBP bonuses.
Not CMS-computed dollar amounts: dollars are Tensorust estimates from cost-report payment bases. The VBP factors are CMS proxy factors; final FY2027 factors replace them. The HAC list is FY2026; FY2027 HAC results publish later. Not clinical quality advice.
Sources
- CMS FY2027 IPPS Final Rule, Table 15 (HRRP payment adjustment factors) and Table 16A (proxy VBP adjustment factors), https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2027-ipps-final-rule-home-page
- CMS Provider Data Catalog: FY2026 HAC Reduction Program (yq43-i98g), FY2026 HRRP (9n3s-kdb3), Hospital General Information (xubh-q36u), https://data.cms.gov/provider-data/
- CMS HCRIS hospital cost reports 2023 and 2024, https://data.cms.gov/provider-compliance/cost-report/hospital-provider-cost-report
- Tensorust Ontology organization objects
License
The sample and summary here are free to view, analyze and cite with attribution to "Tensorust LLC, https://tensorust.com/datasets/hospital-penalty-stack/". The full dataset is licensed separately per tier. No resale or redistribution of Tensorust data without a written license.
Tensorust LLC, Tuckahoe NY. mattbusel@tensorust.com | https://tensorust.com