For fiscal year 2018, more than 740 hospitals were fined for reporting excess cases of hospital-acquired conditions (HACs), losing a total of $244.3 million in revenue. The top 25 hospitals that faced the largest penalties lost more than $42.3 million. In an effort to reduce the number of preventable illnesses and readmissions post-acute care, the Center for Medicare and Medicaid Services (CMS) launched the HAC Reduction Program as a means to incentivize hospitals to take stronger precautionary measures.

Development of HACs leads to increased healthcare spending, a higher risk of patient deaths and readmissions, longer length of stay, and other complications. CMS tracks 14 HACs across several categories, including surgical site infections, blood stream infections, and pressure ulcers. However, the HAC Reduction Program only takes 6 of these into account: Clostridium Difficile (C.Diff), Catheter-Associated Urinary Tract Infections (CAUTI), Central-Line-Associated Blood Stream Infections (CLABSI), Methicillin-resistant Staphylococcus aureus (MRSA), and Surgical Site Infections for colon surgeries and hysterectomies.

Of the hospitals facing the highest fines from the HAC Reduction Program, 7 of the top 25 are located in New York — more than any other single state. Connecticut, Florida, New Jersey, and Pennsylvania all had 2 hospitals on the list.