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

Rank Definitive ID Hospital name Location HAC FY2021 total score Estimated revenue loss Number of discharges
1 541974 NewYork-Presbyterian Weill Cornell Medical Center New York, NY 0.78 $4,043,719 102,654
2 430 Cedars-Sinai Medical Center Los Angeles, CA 0.61 $3,138,689 50,098
3 560 UCSF Helen Diller Medical Center at Parnassus Heights San Francisco, CA 0.58 $2,134,066 33,309
4 274110 UK Albert B. Chandler Hospital Lexington, KY 0.41 $1,983,509 35,897
5 273024 Montefiore Hospital - Moses Campus Bronx, NY 1.3 $1,859,209 73,728
6 2915 Stony Brook University Hospital Stony Brook, NY 0.61 $1,732,451 37,984
7 2066 Beaumont Hospital - Royal Oak Royal Oak, MI 0.59 $1,650,237 45,700
8 754 MedStar Washington Hospital Center Washington, DC 0.42 $1,625,541 28,857
9 3742 Vanderbilt University Medical Center Nashville, TN 0.34 $1,611,425 60,138
10 1940 Baystate Medical Center Springfield, MA 0.46 $1,610,180 38,519
11 3019 ECU Health Medical Center Greenville, NC 0.83 $1,598,955 39,794
12 1135 Northwestern Memorial Hospital Chicago, IL 0.49 $1,561,746 41,891
13 1970 Beth Israel Deaconess Medical Center Boston, MA 0.65 $1,535,578 37,590
14 3817 Baptist Memorial Hospital - Memphis Memphis, TN 0.45 $1,521,987 32,992
15 2645 Hackensack University Medical Center Hackensack, NJ 0.38 $1,502,814 40,402
16 3572 Thomas Jefferson University Hospital Philadelphia, PA 0.52 $1,491,751 37,807
17 1927 Charlton Memorial Hospital Fall River, MA 0.54 $1,490,526 29,364
18 1631 The University of Kansas Hospital Kansas City, KS 0.52 $1,469,832 42,037
19 3439 UPMC Presbyterian Pittsburgh, PA 0.42 $1,353,763 43,190
20 3140 Ohio State University Wexner Medical Center Columbus, OH 0.43 $1,274,200 48,902
21 2803 Maimonides Medical Center Brooklyn, NY 0.81 $1,266,625 32,048
22 274155 UofL Health - Jewish Hospital Louisville, KY 0.63 $1,266,215 24,132
23 2035 Spectrum Health Butterworth Hospital Grand Rapids, MI 0.54 $1,260,153 61,681
24 3055 Sanford Broadway Medical Center Fargo, ND 0.75 $1,260,116 26,070
25 4534 Aurora St Luke's Medical Center of Aurora Health Care Metro Milwaukee, WI 0.50 $1,254,963 32,981

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

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