Hospital-Acquired Condition Reduction Program

The Hospital-Acquired Condition Reduction Program ties performance on patient safety issues such as infections, bed sores and post-operative blood clots to payment. Under the program, the Centers for Medicare & Medicaid Services penalizes the lowest performing 25% of all hospitals each year 1% of their Medicare hospital payments. In addition to these penalties, the law requires CMS to post publicly hospitals' performance on HAC quality measures.

The AHA is committed to eliminating avoidable harm to patients. We support well-designed pay-for-performance programs, but the HAC Reduction Program is flawed.

  • Some quality measures are inaccurate.
  • The program fails to to take into account patient safety improvements that hospitals have made.
  • The program unfairly penalizes teaching hospitals, large hospitals and small hospitals.

The HAC Reduction Program needs reform to more effectively promote improvement. The program also needs better measures that accurately reflect performance on important issues.

Related Resources

Advisory
Member
The Centers for Medicare & Medicaid Services (CMS) Aug.
Letter
Public
The AHA supports several of the proposed rule’s provisions. In particular, we appreciate and endorse the agency’s proposal to permanently withdraw the 25% Rule…
Letter
Public
AHA comments on the Centers for Medicare & Medicaid Services’ hospital inpatient prospective payment system proposed rule for fiscal year 2019.
Toolkits/Methodology
Member
Hospital-Acquired Conditions (HAC) Penalty Calculator FY 2017 Inpatient PPS Final Rule (Uses HAC List Posted by CMS in Dec. 2016)
Toolkits/Methodology
Member