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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 Name | State | Definitive ID | HAC Total Score | Est. Revenue Loss Due to HAC Penalty | Net Patient Revenue | Explore This Dataset | |
| 1. | Mayhill Hospital | TX | 4855 | -1.92 | $0 | $12,719,100 | Explore This Profile |
| 2. | St. Vincent’s Chilton | AL | 868588 | -1.92 | $0 | $16,356,812 | Explore This Profile |
| 3. | Indiana Orthopaedic Hospital | IN | 1357 | -1.87 | $0 | $165,674,223 | Explore This Profile |
| 4. | Kansas Surgery & Recovery Center | KS | 1617 | -1.87 | $0 | $41,864,366 | Explore This Profile |
| 5. | New England Baptist Hospital | MA | 1971 | -1.87 | $0 | $225,021,802 | Explore This Profile |
| 6. | OrthoNebraska Hospital | NE | 2524 | -1.87 | $0 | $80,351,192 | Explore This Profile |
| 7. | Orthopaedic and Spine Specialists Orthopaedic Hospital | PA | 553368 | -1.87 | $0 | $119,810,526 | Explore This Profile |
| 8. | Premier Surgical Institute | KS | 776981 | -1.87 | $0 | $28,855,180 | Explore This Profile |
| 9. | The Orthopedic Specialty Hospital | UT | 4220 | -1.87 | $0 | $96,828,964 | Explore This Profile |
| 10. | Jack Hughston Memorial Hospital | AL | 106 | -1.83 | $0 | $63,417,969 | Explore This Profile |
| 11. | Orthopaedic Hospital of Wisconsin | WI | 4530 | -1.82 | $0 | $72,890,848 | Explore This Profile |
| 12. | Midwest Orthopedic Specialty Hospital | WI | 4532 | -1.8 | $0 | $74,938,082 | Explore This Profile |
| 13. | Baylor Scott & White Orthopedic and Spine Hospital - Arlington | TX | 552496 | -1.77 | $0 | $108,929,468 | Explore This Profile |
| 14. | CHI St Lukes Health - Lakeside Hospital | TX | 4095 | -1.72 | $0 | $36,226,456 | Explore This Profile |
| 15. | Wiregrass Medical Center | AL | 59 | -1.72 | $0 | $19,891,706 | Explore This Profile |
| 16. | Smyth County Community Hospital | VA | 4299 | -1.71 | $0 | $47,384,792 | Explore This Profile |
| 17. | Wagoner Community Hospital | OK | 3371 | -1.71 | $0 | $24,137,244 | Explore This Profile |
| 18. | Straith Hospital for Special Surgery | MI | 2060 | -1.7 | $0 | $13,352,208 | Explore This Profile |
| 19. | Stilwell Memorial Hospital | OK | 3251 | -1.69 | $0 | $17,814,376 | Explore This Profile |
| 20. | AllianceHealth Clinton | OK | 3280 | -1.68 | $0 | $20,777,516 | Explore This Profile |
| 21. | Connally Memorial Medical Center | TX | 4195 | -1.68 | $0 | $32,754,267 | Explore This Profile |
| 22. | Jersey Community Hospital | IL | 1193 | -1.68 | $0 | $43,139,117 | Explore This Profile |
| 23. | Lakes Regional Healthcare | IA | 1439 | -1.68 | $0 | $39,645,044 | Explore This Profile |
| 24. | Regina Hospital | MN | 2140 | -1.68 | $0 | $59,599,356 | Explore This Profile |
| 25. | Samaritan Hospital - St Marys Campus | NY | 2884 | -1.68 | $0 | $77,082,939 | Explore This Profile |
| 26. | Crystal Clinic Orthopaedic Center | OH | 3236 | -1.67 | $0 | $160,470,401 | Explore This Profile |
| 27. | Healthmark Regional Medical Center | FL | 932 | -1.67 | $0 | $10,945,509 | Explore This Profile |
| 28. | Sevier Valley Hospital | UT | 4230 | -1.67 | $0 | $47,673,740 | Explore This Profile |
| 29. | Uintah Basin Medical Center | UT | 4209 | -1.67 | $0 | $78,139,611 | Explore This Profile |
| 30. | Atmore Community Hospital | AL | 53 | -1.66 | $0 | $17,062,699 | Explore This Profile |
| 31. | Banner Fort Collins Medical Center | CO | 585468 | -1.66 | $0 | $39,656,179 | Explore This Profile |
| 32. | Evergreen Medical Center | AL | 41 | -1.66 | $0 | $16,091,899 | Explore This Profile |
| 33. | Mena Regional Health System | AR | 266 | -1.66 | $0 | $26,778,469 | Explore This Profile |
| 34. | Northern Maine Medical Center | ME | 1842 | -1.66 | $0 | $50,125,396 | Explore This Profile |
| 35. | Northridge Medical Center | GA | 1017 | -1.66 | $0 | $20,139,218 | Explore This Profile |
| 36. | Oakdale Community Hospital | LA | 1729 | -1.66 | $0 | $12,551,998 | Explore This Profile |
| 37. | UPMC Susquehanna Sunbury | PA | 3558 | -1.66 | $0 | $16,005,016 | Explore This Profile |
| 38. | Ascension Seton Southwest | TX | 4162 | -1.65 | $0 | $26,258,327 | Explore This Profile |
| 39. | Baptist Health - Van Buren | AR | 237 | -1.65 | $0 | $19,125,843 | Explore This Profile |
| 40. | Cape Fear Valley - Hoke Hospital | NC | 764460 | -1.65 | $0 | $36,378,123 | Explore This Profile |
| 41. | Fleming County Hospital | KY | 1661 | -1.65 | $0 | $14,361,029 | Explore This Profile |
| 42. | Hill Regional Hospital | TX | 4040 | -1.65 | $0 | $21,223,714 | Explore This Profile |
| 43. | St James Hospital | NY | 2902 | -1.65 | $0 | $25,143,925 | Explore This Profile |
| 44. | Touchette Regional Hospital | IL | 1256 | -1.65 | $0 | $55,388,180 | Explore This Profile |
| 45. | UPMC Kane | PA | 3538 | -1.65 | $0 | $9,652,111 | Explore This Profile |
| 46. | AdventHealth Murray | GA | 1034 | -1.64 | $0 | $21,187,674 | Explore This Profile |
| 47. | Adventist Health Reedley | CA | 324 | -1.64 | $0 | $191,421,990 | Explore This Profile |
| 48. | Alliance Hospital | MS | 2296 | -1.64 | $0 | $9,009,301 | Explore This Profile |
| 49. | Astria Toppenish Hospital | WA | 4417 | -1.64 | $0 | $19,715,848 | Explore This Profile |
| 50. | Baptist Health Medical Center - Hot Spring County | AR | 252 | -1.64 | $0 | $23,774,707 | Explore 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.