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
| Rank | Definitive ID | Hospital name | Location | HAC FY2021 total score | Estimated revenue loss | Number of discharges | Explore dataset |
|---|---|---|---|---|---|---|---|
| 1 | 541974 | NewYork-Presbyterian Weill Cornell Medical Center | New York, NY | 0.78 | $4,043,719 | 102,654 | Explore |
| 2 | 430 | Cedars-Sinai Medical Center | Los Angeles, CA | 0.61 | $3,138,689 | 50,098 | Explore |
| 3 | 560 | UCSF Helen Diller Medical Center at Parnassus Heights | San Francisco, CA | 0.58 | $2,134,066 | 33,309 | Explore |
| 4 | 274110 | UK Albert B. Chandler Hospital | Lexington, KY | 0.41 | $1,983,509 | 35,897 | Explore |
| 5 | 273024 | Montefiore Hospital - Moses Campus | Bronx, NY | 1.3 | $1,859,209 | 73,728 | Explore |
| 6 | 2915 | Stony Brook University Hospital | Stony Brook, NY | 0.61 | $1,732,451 | 37,984 | Explore |
| 7 | 2066 | Beaumont Hospital - Royal Oak | Royal Oak, MI | 0.59 | $1,650,237 | 45,700 | Explore |
| 8 | 754 | MedStar Washington Hospital Center | Washington, DC | 0.42 | $1,625,541 | 28,857 | Explore |
| 9 | 3742 | Vanderbilt University Medical Center | Nashville, TN | 0.34 | $1,611,425 | 60,138 | Explore |
| 10 | 1940 | Baystate Medical Center | Springfield, MA | 0.46 | $1,610,180 | 38,519 | Explore |
| 11 | 3019 | ECU Health Medical Center | Greenville, NC | 0.83 | $1,598,955 | 39,794 | Explore |
| 12 | 1135 | Northwestern Memorial Hospital | Chicago, IL | 0.49 | $1,561,746 | 41,891 | Explore |
| 13 | 1970 | Beth Israel Deaconess Medical Center | Boston, MA | 0.65 | $1,535,578 | 37,590 | Explore |
| 14 | 3817 | Baptist Memorial Hospital - Memphis | Memphis, TN | 0.45 | $1,521,987 | 32,992 | Explore |
| 15 | 2645 | Hackensack University Medical Center | Hackensack, NJ | 0.38 | $1,502,814 | 40,402 | Explore |
| 16 | 3572 | Thomas Jefferson University Hospital | Philadelphia, PA | 0.52 | $1,491,751 | 37,807 | Explore |
| 17 | 1927 | Charlton Memorial Hospital | Fall River, MA | 0.54 | $1,490,526 | 29,364 | Explore |
| 18 | 1631 | The University of Kansas Hospital | Kansas City, KS | 0.52 | $1,469,832 | 42,037 | Explore |
| 19 | 3439 | UPMC Presbyterian | Pittsburgh, PA | 0.42 | $1,353,763 | 43,190 | Explore |
| 20 | 3140 | Ohio State University Wexner Medical Center | Columbus, OH | 0.43 | $1,274,200 | 48,902 | Explore |
| 21 | 2803 | Maimonides Medical Center | Brooklyn, NY | 0.81 | $1,266,625 | 32,048 | Explore |
| 22 | 274155 | UofL Health - Jewish Hospital | Louisville, KY | 0.63 | $1,266,215 | 24,132 | Explore |
| 23 | 2035 | Spectrum Health Butterworth Hospital | Grand Rapids, MI | 0.54 | $1,260,153 | 61,681 | Explore |
| 24 | 3055 | Sanford Broadway Medical Center | Fargo, ND | 0.75 | $1,260,116 | 26,070 | Explore |
| 25 | 4534 | Aurora St Luke's Medical Center of Aurora Health Care Metro | Milwaukee, WI | 0.5 | $1,254,963 | 32,981 | Explore |
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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