Downloadable evidence

Download the Almanac and data

Start with the editable Almanac workbook, the printable report or the facility data. Technical files are listed below.

Release 2026-09-26 · 722ce7ffd6ab. Draft release.

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Search the cohort, select a metric, group the results, and download the finished chart as PNG or SVG, or its exact data as CSV or an Excel sheet built from the chart templates below.

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Start with these

Primary downloads

The same release as a workbook, a report, a brief and a data file.

XLSX

Editable Almanac workbook

Almanac-format worksheets with native charts, visible chart data, metric definitions, notes, and print layouts.

PDF

Draft Almanac (PDF)

20 report pages with findings, charts, source notes and methods, matched to the workbook’s evidence.

PDF

Executive brief

6 findings, interpretation and next steps from the same 20-page evidence release.

CSV

Facility-level data

299 comparable general acute hospitals with selected utilization, financial, and quality fields.

Excel chart templates

Figure templates

Every “Excel sheet” export fills one of these 4 workbooks with the figure’s data, plot series and source notes. Download them to build new figures in the same format.

XLSX

Bar chart template

Native Excel bar chart with Figure, Data, Plot and Source notes sheets. Used for bar chart exports.

XLSX

Line chart template

Native Excel line chart with the same four sheets. Used for trend exports.

XLSX

Scatter chart template

Native Excel scatter chart with the same four sheets. Used for exports that plot two measures.

XLSX

Table template

Print-ready table with Data, Plot and Source notes sheets. Used for table exports.

Evidence library

Find a topic or fileFile type

52 matching files

XLSX

Editable Almanac workbookAlmanac-format worksheets with native charts, visible chart data, metric definitions, notes, and print layouts.

PDF

Draft Almanac (PDF)20 report pages with findings, charts, source notes and methods, matched to the workbook’s evidence.

CSV

Facility-level data299 comparable general acute hospitals with selected utilization, financial, and quality fields.

CSV

Regional comparison data14 Health Service Areas with ratio-of-sums utilization, financial, liquidity, and cost measures.

CSV

Quality and spending dataCMS, HCAI IMI, OHCA spending, current-quarter, equity, identifier, and system fields for the 299-hospital cohort.

CSV

CMS quality measuresCCN-linked HCAHPS, SEP-1, ED-throughput, and condition-level HRRP measures with reporting periods.

CSV

California–U.S. hospital benchmarks7 capacity, volume, ownership, system, and spending rows with numerators, denominators, comparison classes, and limitations.

CSV

Pricing evidence summaryOHCA 2023 payer medians with the RAND research boundary kept explicit.

CSV

California price evidence matrix5 free peer-reviewed California studies separated by payer, service, period, price concept, and design.

CSV

County market structure2024 inpatient patient-flow HHI, top-four share, leading facility, and volume for all 58 California counties.

CSV

Federal Medi-Cal exposure screenIllustrative 1%, 3% and 5% sensitivities applied to 2024 Medi-Cal net patient revenue. Not an official estimate or forecast.

PDF

Executive brief6 findings, interpretation and next steps from the same 20-page evidence release.

XLSX

Bar chart templateNative Excel bar chart with Figure, Data, Plot and Source notes sheets. Used for bar chart exports.

XLSX

Line chart templateNative Excel line chart with the same four sheets. Used for trend exports.

XLSX

Scatter chart templateNative Excel scatter chart with the same four sheets. Used for exports that plot two measures.

XLSX

Table templatePrint-ready table with Data, Plot and Source notes sheets. Used for table exports.

CSV

Operating-to-net income reconciliation299 exact income bridges, including nonoperating expenses and income taxes.

CSV

Documented ownership sensitivityCounty system HHI with 9 hospitals from 4 documented 2024 ownership changes regrouped at year-end ownership.

JSON

Admissions source decisionAdmissions source field, exact reporting-date matching and coverage (296 of 299 hospitals).

JSON

Pricing literature updateSeptember 26 focused search: queries, eligibility rules, screened studies and decisions.

JSON

Current financing source checkSeptember 26 check of DHCS and federal sources separating the final MCO-tax rule from proposed directed-payment and provider-tax rules.

CSV

Bed types and inpatient services6 HCAI care types with licensed beds, patient days, discharge counts and their shares.

JSON

Service definitions and hospital inputsAll 299 hospitals, source fields, service-type reconciliation, and HCAI Glossary definitions.

CSV

Operating losses and Medi-Cal revenue299 hospital records with operating results, payer revenue shares, care volumes, and reporting-period flags.

CSV

Medi-Cal revenue group comparisonsThree analyst-defined Medi-Cal revenue groups with loss prevalence, aggregate margins and all-payer emergency department visits.

CSV

Regional financial vulnerabilityLoss prevalence and care delivered across all 14 Health Service Areas.

JSON

Financial vulnerability definitionsSource hash, complete paired-input coverage, revenue-band definitions, and standard-period sensitivity.

JSON

Facility snapshotVersioned facility records used by the site.

JSON

Metric dictionaryDefinitions, units, source fields, and formulas.

JSON

Historical trendsCalendar-year cohort totals and provenance.

JSON

Regional comparisonsHealth Service Area totals, ratio-of-sums measures, and reporting-period flags.

JSON

Data-quality reportAutomated assertions and documented handling.

JSON

Source manifestResource IDs, extract dates, hashes, and runtime policy.

JSON

External source manifestCross-domain public files with publishers, coverage, access, hashes, and cache provenance.

JSON

External linkage QAIdentifier linkage coverage, assertions, and cross-source limitations.

JSON

Market structureCounty detail with the top ten facility shares and methodology.

JSON

Quality benchmarksCMS rating distributions for the United States, California, and the core cohort.

JSON

National hospital benchmarksAHA and CMS national context with California numerators, denominators, periods, and comparability warnings.

JSON

CMS quality measuresHospital-level component measures plus the exact-period California and national HCAHPS comparison.

JSON

Data-access matrixImplemented public sources and optional paid alternatives.

CSV

Paid data optionsCurrent official list prices or quote requirements for HPD, RAND, AHA, and confidential HCAI options.

JSON

Policy contextOfficial Medi-Cal financing facts, resource links, and modeling limits.

CSV

Cross-domain regional rollups14 Health Service Areas spanning finance, utilization, quality, spending, and concentration screens.

JSON

Cross-domain regional rollupsStructured HSA rollups with denominators, matched-facility counts, and methodology.

CSV

Policy and subsidy timelineDated events with the status each source gives.

JSON

Policy and subsidy timelineStructured policy events with status, effective dates, sources, and caveats.

JSON

Federal Medi-Cal exposure screenState, HSA, and facility sensitivities plus a separate HQAF financing-cap screen.

JSON

Peer-reviewed price evidence matrix5 free California studies with precise population, method, price concept, and limits.

JSON

Pricing evidenceRAND commercial-price research and OHCA adjusted-unit spending measures kept as separate tracks.

XLSX

CHCF Almanac worksheet template (2025)CHCF’s publicly posted Almanac worksheet format, kept unmodified as a layout reference.

CSV

Reporting-period sensitivity299 comparable hospitals versus 292 standard-period hospitals; matched ratios and denominators.

CSV

Claim and evidence ledgerEvery Almanac page mapped to evidence, source URLs and review status.

Before reuse

These files are a draft CRWDHEALTH Almanac release derived from public HCAI, OHCA, CMS, AHRQ, DHCS, and research sources. They are independent analysis, not produced or endorsed by CHCF. Hospital submissions are self-reported, reporting periods can differ, and definitions may change. Preserve source, period, denominator, and quality fields when publishing derived work.