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In this dashboard you will find some descriptive analytics on healthcare sector data already publicly available from official sources like the US Department of Health and Human Services, US Census Bureau, and the Government of Puerto Rico. Using our data extraction and wrangling tools we have collected large amounts of data, summarized it, and created several interactive visualizations, solely for the convenience of our visitors and informative purposes. If you are interested in additional details, analysis and/or benchmarking of hospital statistical or financial data, we may gladly assist you. Some information included herein represents data provided by hospitals to the Centers for Medicare and Medicaid Services (CMS) in an annual cost report. Keep in mind while consuming these insights, that for standard fiscal year ends (i.e. 12-month), cost reports are due five (5) months after the fiscal year end. Non-standard fiscal year ends, are due on the greater of 150 days, or 37 days if a cost report reminder is received. Not all hospital fiscal years end on the same date. For this reason, we urge caution while interpreting or using these visualizations. We constantly update and improve these visualizations so keep coming back for new insights. Press over any title on the following list to navigate directly to the one which may be of particular interest to you:
Medicare Advantage Enrollment by Organization
The following visual is designed to keep track of enrollment across the different organizations currently holding a Medicare Advantage contract with the Centers for Medicare and Medicaid Services. We include a monthly trend graph to observe the different trends among organizations, which may or may not have an impact on patient mix across providers, proportion enrolled by organization during the latest reported period, total enrollees compared to the total eligible in Puerto Rico as of the last reported date, total enrollees by organization and municipality, and total enrollees by region (we used as a reference, the Puerto Rico Government Health Plan designated regions).
Medicare Advantage Enrollment by Organization 2020
This graph represents the number of hospitals that submitted a cost report during the period between 2011 and 2022, by type of facility. There are at least 11 types of hospitals recognized by CMS. As may be seen in the graph, most hospitals in the Island classify themselves as General Short Term Hospitals. As stated by CMS, "Medicare-certified institutional providers are required to submit an annual cost report to a Medicare Administrative Contractor (MAC).", hence there is a reasonable expectation that most hospitals certified in Puerto Rico are accounted for in these statistics.
Dashboard 1
Hospital Beds and Census in Puerto Rico reported on 2011 to 2022
This graph represents total beds reported by all hospitals in Puerto Rico from 2011 to 2022, irrespective of the type of hospital (e.g. Pediatric, Psychiatric, etc.) or type of control (e.g. Government, Private for profit, etc.). The number of beds include, among others, reported adults and pediatric beds, intensive care, coronary care, burn intensive care, nursery, surgical intensive care, etc.. The average daily census (ADC) by year is based on total inpatient days reported by those hospitals. Hospital beds reflect a decrease of -1.01% over the period, while ADC reports a decrease of -18.82% over the period of 12 years, although it is showing some recovery to pre-pandemic levels.
Dashboard 2
Patient Days and Population (US Census Bureau) in PR reported on 2011 to 2022
The following visualization presents the relationship between total population and patient days over time. As may be seen in this graph, as the population continues its downward trend, so does the total patient days reported by Puerto Rico hospitals over this period. The population registered a decline of approximately -12.47%, and patient days declined approximately -18.82% over the same period. Patient days by 1,000 population in 2011 were approximately 628.24, while in 2022 they decreased to 582.66 for a proportional reduction of approximately -7.26%. The year 2022 is finally showing some signs of recovery to pre-pandemic levels.
Dashboard 3
Medicare Patient Days in PR reported on 2011 to 2022
The next visualization shows a downward trend over time in Medicare Inpatient Days reported by all Puerto Rico hospitals during the period between 2011 and 2022, worsened by the COVID 19 Pandemic. Medicare patient days include those reported on adult beds, Medicare Advantage days, intensive care, coronary care, burn intensive care, surgical intensive care, and other special care days. Medicare Inpatient Days reflected a reduction of approximately -49.63% during the reported period. Medicare Inpatient Days per 1,000 population during 2011 were approximately 70.49, while in 2022 they decreased to 40.56, for a proportional reduction of approximately -42.46%. In 2022, It seems as if the declining trend may be ending.
Dashboard 4
ICU Patient Days in PR reported on 2011 to 2022
Our next graph shows the trend over time for Intensive Care Unit (ICU) patient days reported by all hospitals in Puerto Rico during the period between 2011 and 2022. As shown in the graph, ICU patient days reached its maximum amount for the period during 2015, and then began a steady decline for the rest of the reported period. Although the declining trend continued during the COVID 19 Pandemic, it was not as sudden as recorded in previous periods (e.g. 2015 to 2016). ICU patient days reflected a reduction of approximately -7.83% during the reported period. On the other hand, ICU patient days per 1,000 population during 2011 were approximately 54.90, while in 2022 they declined to 57.81, for a proportional decrease of approximately 5.30%. The year 2022 is showing an important increase in this metric, surpassing 2018 levels.
Dashboard 5
Hospital Occupation % PR reported on 2011 to 2022
As may be observed from previous visuals, hospital occupation in Puerto Rico has been steadily decreasing since 2014 (see hospital beds and census graph above), when it peaked at 76.64%. Its important to keep in mind that hospitals are granted a number of beds via a Certificate of Need (CON), but often licensed beds which are those that should be available and ready for use (i.e. as specified in an operating license granted under Act 101 of 1965, as amended, independent from a CON although derived from it), are lower than those granted by the Department of Health on a CON. Hospital occupation is generally measured taking into account licensed available beds. Although 2022 may reflect a recovery to pre-pandemic levels, during this 12-year period, occupation in Puerto Rico hospitals decreased considerably to 60.90% in 2022, as aggravated by the COVID 19 Pandemic, for a proportional reduction of approximately -17.99%.
Dashboard 6
Hospital Beds by Region reported on 2011 to 2022
The following visual presents the total number of beds reported by Puerto Rico hospitals during the period between 2011 and 2022. We made reference to the Puerto Rico Government Health Plan regions to group each hospital according to its physical location. As may be seen in the graphs for each area, most regions approximate or exceed 1,000 beds except for the Northeast and Southeast regions. Total beds reported include hospital adults and pediatrics, intensive care units, coronary care, burn intensive, surgical intensive, other special care and nursery. Bed categories as skilled nursing facilities or inpatient rehabilitation facilities are excluded from this total. San Juan region hospitals reported a total of 2,586 beds for the most recent period, while Southeast region hospitals reported a total of 324, which is the lowest number of beds among the 8 regions.
Dashboard 7
Hospital Beds by Type of Control reported on 2011 to 2022
The following graph shows a distribution of beds by type of control in Puerto Rico for the cost reporting periods between 2011 and 2022. As may be seen, ‘Proprietary Corporation’ accounts for most beds in the Island reporting a total of 4,458 beds in the most recent period, followed by ‘Voluntary Nonprofit Other’ which reported a total of 2,438 beds during the most recent period. Private hospitals accounted for 52.81% from a total of 8,441 beds in Puerto Rico during the latest year.
Dashboard 8
Our next visualization portrays the trend of the aggregated Cash on Hand and in Banks over the years for all hospitals in Puerto Rico during the selected period. The amounts included are limited to reported figures in the General Fund column in the cost report of each hospital, excluding special purpose funds, endowments, or plant funds (the General Fund Column is to be used by hospitals which do not maintain fund-type accounting records, other additional columns are available in the cost report worksheets for those which do use it). These amounts represent cash on deposit in banks and immediately available for use in financing activities, amounts on hand for minor disbursements and amounts invested in savings accounts and certificates of deposit. The period shows an important increase in cash balances of approximately 214.74% between the years 2011 and 2022, most likely due to financial assistance provided to hospitals by Federal and State Government during the Covid 19 Pandemic.
Dashboard 9
On the following graph you may observe combined accounts receivable and allowance for doubtful accounts balances for all hospitals in Puerto Rico during the selected period. Accounts receivable include all unpaid inpatient and outpatient billings, both for insurance carriers and patient balances. On the other side, allowance balances represent valuation accounts which reflect an estimated amount of noncollectable receivables from patients and third party payers. For the period presented, accounts receivables increased approximately 28.17%, while the allowance increased 46.81% between the years 2011 and 2022.
Dashboard 10
On our next graph you may observe combined accounts payable balances for all hospitals in Puerto Rico during the selected period. Accounts payable include the amounts due trade creditors and others for supplies and services purchased. It does not include salaries and wages payable, payroll taxes payable, or other short term notes and loans payable. For the period presented, accounts payable decreased approximately -3.15%, between the years 2011 and 2022.
Dashboard 11
The next line graph displays the combined long-term debt balance reported by all hospitals in Puerto Rico for the selected cost reporting periods. Long-term debt balances is composed of mortgages payable, notes payable, unsecured loans, and other long term liabilities. For the cost reporting periods included, long term payable have remained relatively stable with a slight increase during 2017, and decrease on the next year, only to revert to average levels in 2019. The average long-term debt for the whole period is $1.1B.
Dashboard 12
In the following area chart you may observe the combined Total Patient Revenues, Discounts and Allowances on Patients Accounts, and Net Patient Revenues reported by all hospitals during the selected time period. Total Patient Revenues include, among others, revenues generated by the hospital component of the facility, sub-providers such as Inpatient Rehabilitation Facilities or Psychiatric Units, Skilled Nursing Facilities, other long term care components, Outpatient Services, and Ancillary Services. Discounts and Allowances are composed of provisions for bad debt, contractual adjustments, charity discounts, and administrative adjustments, among others. Net Patient Revenues has remained relatively constant near the 3.0B mark, with an average of $2.9B over the period. Total patient revenues increased approximately 20.04%, between the years 2011 and 2022, while Discounts and Allowances increased approximately 16.52%, taking into consideration the Covid 19 Pandemic period effects.
Dashboard 13
In our next visualization we portray the trend in Total Revenues for all hospitals reported during the selected cost reporting periods. Total Revenues include Net Patient Revenues and Total Other Income generated during the ordinary course of operating the hospital facility. As may be observed, Total Revenues have fluctuated from a minimum of $2.8B to a maximum for the period of $3.7B, with an average of $3.2B. The net change between the beginning and end of the period is a proportional increase of 33.85%, or an approximate change of 2.82% per period.
Dashboard 14
In our next line graph we portray the trend in Operating Expenses for all hospitals reported during the selected cost reporting periods. Operating expenses include all costs incurred during the ordinary course of operating the hospital facility. As may be observed the Operating Costs have fluctuated from a minimum of $2.9B to a maximum for the period of $3.7B, with an average of $3.3B. The net change between the beginning and end of the period is a proportional increase of 28.31%, or an approximate change of 2.36% change per period.
Dashboard 15
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