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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.

Starting in FY2018 The Winsorsized z-score methodology was implemented. to calculate HAC Total Score. With the Winsorization, the raw measure result of hospitals that fall below the 5th percentile and above the 95th percentile are set to the 5th and 95th percentile respectively. After this adjustment, the Winsorsized measure result is equal to the raw measure result. The scores displayed are determined by taking a hospital’s Winsorsized measure result subtracting the mean of Winsorsized measure results and dividing that result by the standard deviation of Winsorsized measure results.

With this calculation, a negative domain score indicates a better performance since it reflects measure values below (or better than) the national mean. Of the hospitals receiving the lowest scores for HAC Reduction Program, 6 of the top 50 are located in Texas — more than any other single state. Alabama had 5 on the list and Arkansas, Oklahoma, Pennsylvania, and Utah all had 3 hospitals on the list.

Coversely, for FY2019 more than 773 hospitals were fined for reporting excess cases of hospital-acquired conditions (HACs), losing a total of $258.4 million in revenue.

Top 50 Hospitals by HAC Score

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Hospital NameStateDefinitive IDHAC Total ScoreEst. Revenue Loss Due to HAC PenaltyNet Patient RevenueExplore This Dataset
1.Mayhill HospitalTX4855-1.92$0$12,719,100Explore This Profile
2.St. Vincent’s ChiltonAL868588-1.92$0$16,356,812Explore This Profile
3.Indiana Orthopaedic HospitalIN1357-1.87$0$165,674,223Explore This Profile
4.Kansas Surgery & Recovery CenterKS1617-1.87$0$41,864,366Explore This Profile
5.New England Baptist HospitalMA1971-1.87$0$225,021,802Explore This Profile
6.OrthoNebraska HospitalNE2524-1.87$0$80,351,192Explore This Profile
7.Orthopaedic and Spine Specialists Orthopaedic HospitalPA553368-1.87$0$119,810,526Explore This Profile
8.Premier Surgical InstituteKS776981-1.87$0$28,855,180Explore This Profile
9.The Orthopedic Specialty HospitalUT4220-1.87$0$96,828,964Explore This Profile
10.Jack Hughston Memorial HospitalAL106-1.83$0$63,417,969Explore This Profile
11.Orthopaedic Hospital of WisconsinWI4530-1.82$0$72,890,848Explore This Profile
12.Midwest Orthopedic Specialty HospitalWI4532-1.8$0$74,938,082Explore This Profile
13.Baylor Scott & White Orthopedic and Spine Hospital - ArlingtonTX552496-1.77$0$108,929,468Explore This Profile
14.CHI St Lukes Health - Lakeside HospitalTX4095-1.72$0$36,226,456Explore This Profile
15.Wiregrass Medical CenterAL59-1.72$0$19,891,706Explore This Profile
16.Smyth County Community HospitalVA4299-1.71$0$47,384,792Explore This Profile
17.Wagoner Community HospitalOK3371-1.71$0$24,137,244Explore This Profile
18.Straith Hospital for Special SurgeryMI2060-1.7$0$13,352,208Explore This Profile
19.Stilwell Memorial HospitalOK3251-1.69$0$17,814,376Explore This Profile
20.AllianceHealth ClintonOK3280-1.68$0$20,777,516Explore This Profile
21.Connally Memorial Medical CenterTX4195-1.68$0$32,754,267Explore This Profile
22.Jersey Community HospitalIL1193-1.68$0$43,139,117Explore This Profile
23.Lakes Regional HealthcareIA1439-1.68$0$39,645,044Explore This Profile
24.Regina HospitalMN2140-1.68$0$59,599,356Explore This Profile
25.Samaritan Hospital - St Marys CampusNY2884-1.68$0$77,082,939Explore This Profile
26.Crystal Clinic Orthopaedic CenterOH3236-1.67$0$160,470,401Explore This Profile
27.Healthmark Regional Medical CenterFL932-1.67$0$10,945,509Explore This Profile
28.Sevier Valley HospitalUT4230-1.67$0$47,673,740Explore This Profile
29.Uintah Basin Medical CenterUT4209-1.67$0$78,139,611Explore This Profile
30.Atmore Community HospitalAL53-1.66$0$17,062,699Explore This Profile
31.Banner Fort Collins Medical CenterCO585468-1.66$0$39,656,179Explore This Profile
32.Evergreen Medical CenterAL41-1.66$0$16,091,899Explore This Profile
33.Mena Regional Health SystemAR266-1.66$0$26,778,469Explore This Profile
34.Northern Maine Medical CenterME1842-1.66$0$50,125,396Explore This Profile
35.Northridge Medical CenterGA1017-1.66$0$20,139,218Explore This Profile
36.Oakdale Community HospitalLA1729-1.66$0$12,551,998Explore This Profile
37.UPMC Susquehanna SunburyPA3558-1.66$0$16,005,016Explore This Profile
38.Ascension Seton SouthwestTX4162-1.65$0$26,258,327Explore This Profile
39.Baptist Health - Van BurenAR237-1.65$0$19,125,843Explore This Profile
40.Cape Fear Valley - Hoke HospitalNC764460-1.65$0$36,378,123Explore This Profile
41.Fleming County HospitalKY1661-1.65$0$14,361,029Explore This Profile
42.Hill Regional HospitalTX4040-1.65$0$21,223,714Explore This Profile
43.St James HospitalNY2902-1.65$0$25,143,925Explore This Profile
44.Touchette Regional HospitalIL1256-1.65$0$55,388,180Explore This Profile
45.UPMC KanePA3538-1.65$0$9,652,111Explore This Profile
46.AdventHealth MurrayGA1034-1.64$0$21,187,674Explore This Profile
47.Adventist Health ReedleyCA324-1.64$0$191,421,990Explore This Profile
48.Alliance HospitalMS2296-1.64$0$9,009,301Explore This Profile
49.Astria Toppenish HospitalWA4417-1.64$0$19,715,848Explore This Profile
50.Baptist Health Medical Center - Hot Spring CountyAR252-1.64$0$23,774,707Explore This Profile

Fig 1. Data is from the Centers for Medicare and Medicaid Services (CMS) Quality Metrics Update (October 2019). Next set of data is set to be updated in January 2020.