CMS Identifies Hospitals to Receive Lower Payments in FY 2020 Under the HAC Reduction Program

The Centers for Medicare and Medicaid Services (CMS) published the dataset listing the hospitals that will receive a one percent reduction in payments in FY 2020 under the Hospital Acquired Conditions (HAC) Reduction Program. An analysis by Kaiser Health News identified 786 hospitals that will receive reductions in Medicare payment for patients discharged in FY 2020.

Over the years a number of prominent hospitals and health systems were penalized under this program. HAC penalties were criticized by the hospital community as being unfair and arbitrary.

Established under the Patient Protection and Affordable Care Act (ACA), the HAC Reduction Program is a pay-for-performance quality program that aims to reduce the number of hospital-acquired conditions (e.g. pressure sores after hip surgery) by reducing payments for the bottom 25% performers. Scores are based on a set of claims-based and chart abstracted measures.

Additional information about the program and scoring methodology can be found on the CMS HAC Reduction website.

 

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For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459 or smadhani@mcdermottplus.com.