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Healthcare Insights

25 hospitals with the greatest revenue loss from HAC penalties

In efforts to reduce the number of preventable illnesses and readmissions after a patient leaves the hospital, the Centers for Medicare and Medicaid Services (CMS) launched the Hospital-Acquired Condition (HAC) Reduction Program to incentivize hospitals to take stronger precautionary measures.

Ensuring that patients face fewer complications during their inpatient hospital stay helps lower the risk of death, decrease lengths of stay, and control healthcare costs. The HAC reduction program reduces Medicare reimbursement for the worst-performing hospitals.

Using data from the Definitive Healthcare HospitalView product, we review hospitals by their estimated revenue loss due to HAC penalties for 2021. This proprietary calculation uses CMS sourced Medicare and quality data to approximate a dollar amount related to HAC penalties. About 775 hospitals received HAC penalties in 2021 and about 765 will face penalties in 2022.

Top hospitals with the highest HAC penalty revenue loss

RankDefinitive IDHospital nameLocationHAC FY2021 total scoreEstimated revenue lossNumber of dischargesExplore dataset
1541974NewYork-Presbyterian Weill Cornell Medical CenterNew York, NY0.78$4,043,719 102,654Explore
2430Cedars-Sinai Medical CenterLos Angeles, CA0.61$3,138,689 50,098Explore
3560UCSF Helen Diller Medical Center at Parnassus HeightsSan Francisco, CA0.58$2,134,066 33,309Explore
4274110UK Albert B. Chandler HospitalLexington, KY0.41$1,983,509 35,897Explore
5273024Montefiore Hospital - Moses CampusBronx, NY1.3$1,859,209 73,728Explore
62915Stony Brook University HospitalStony Brook, NY0.61$1,732,451 37,984Explore
72066Beaumont Hospital - Royal OakRoyal Oak, MI0.59$1,650,237 45,700Explore
8754MedStar Washington Hospital CenterWashington, DC0.42$1,625,541 28,857Explore
93742Vanderbilt University Medical CenterNashville, TN0.34$1,611,425 60,138Explore
101940Baystate Medical CenterSpringfield, MA0.46$1,610,180 38,519Explore
113019ECU Health Medical CenterGreenville, NC0.83$1,598,955 39,794Explore
121135Northwestern Memorial HospitalChicago, IL0.49$1,561,746 41,891Explore
131970Beth Israel Deaconess Medical CenterBoston, MA0.65$1,535,578 37,590Explore
143817Baptist Memorial Hospital - MemphisMemphis, TN0.45$1,521,987 32,992Explore
152645Hackensack University Medical CenterHackensack, NJ0.38$1,502,814 40,402Explore
163572Thomas Jefferson University HospitalPhiladelphia, PA0.52$1,491,751 37,807Explore
171927Charlton Memorial HospitalFall River, MA0.54$1,490,526 29,364Explore
181631The University of Kansas HospitalKansas City, KS0.52$1,469,832 42,037Explore
193439UPMC PresbyterianPittsburgh, PA0.42$1,353,763 43,190Explore
203140Ohio State University Wexner Medical CenterColumbus, OH0.43$1,274,200 48,902Explore
212803Maimonides Medical CenterBrooklyn, NY0.81$1,266,625 32,048Explore
22274155UofL Health - Jewish HospitalLouisville, KY0.63$1,266,215 24,132Explore
232035Spectrum Health Butterworth HospitalGrand Rapids, MI0.54$1,260,153 61,681Explore
243055Sanford Broadway Medical CenterFargo, ND0.75$1,260,116 26,070Explore
254534Aurora St Luke's Medical Center of Aurora Health Care MetroMilwaukee, WI0.5$1,254,963 32,981Explore

Fig 1 Data from Definitive Healthcare HospitalView product. Quality measures are sourced from the Centers for Medicare and Medicaid Services (CMS) and updated annually. Data accessed October 2022.

Which hospital has the highest HAC penalty revenue loss?

NewYork-Presbyterian Weill Cornell Medical Center has the highest estimated revenue loss from HAC penalties at about $4 million. Cedars-Sinai Medical Center’s estimate HAC revenue loss is $3.1 million.

Of the hospitals facing the highest fines from the HAC Reduction Program, four of the top 25 are located in New York and three are in Massachusetts.

Four of the top five hospitals on the list are also some of the largest hospitals in the U.S. based on net patient revenue, including some of the top hospitals in the cities of New York City, Los Angeles, Chicago, Washington, DC, and Philadelphia. These hospitals serve large patient populations and have high patient discharge volumes, which likely contribute to their HAC scores and penalties.

How much revenue is lost to HAC penalties?

For fiscal year 2021, more than 773 hospitals faced HAC penalties for a total of $254 million in estimated lost revenue. The average revenue loss due to HAC penalties is about $328,800.

The top 25 hospitals that faced the largest penalties lost nearly $43 million, or about $1.7 million each.

What are hospital acquired conditions (HACs)?

The HAC Reduction Program is a value-based care program that links Medicare payments to inpatient quality. The hospitals that rank in the lowest quartiles of HAC performance face payment reductions.

The specific healthcare-associated infections tracked as part of the program include:

  • Clostridium Difficile (C.Diff)
  • Catheter-Associated Urinary Tract Infections (CAUTI)
  • Central-Line-Associated Blood Stream Infections (CLABSI)
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Surgical Site Infections for abdominal hysterectomies and colon surgeries

Learn more

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