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.