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2018 Changes for the Hospital-Acquired Condition (HAC) Reduction Program

hospital care The Centers for Medicare & Medicaid Services has made changes to the FY 2018 HAC Reduction Program, which include a new scoring methodology as finalized in the FY 2017 Inpatient Prospective Payment System / Long-term Care Hospital Prospective Payment System (IPPS/LTCH PPS) Final Rule. These changes will affect payments to hospitals in the worst-performing quartile in FY 2018, starting on October 1, 2017.

In FY 2018, CMS will:
  • Replace the decile-based scoring method with the Winsorized z-score methodology.
  • Use a shortened 15-month data period for the Patient Safety Indicator (PSI) 90 Composite in Domain 1.
  • Use an updated version of the PSI 90 Composite.
  • Use the re-baselined CLABSI, CAUTI, SSI, MRSA, and CDI measures.
  • Use CLABSI and CAUTI measures expanded beyond ICUs to include data from medical, surgical, and medical-surgical wards.
  •  Remove the No Facilities waiver for the CLABSI and CAUTI measures.

For more information on FY 2018 changes, please refer to the FAQ document posted on at: >Hospitals-Inpatient>Hospital-Acquired Condition (HAC) Reduction Program>Resources

CMS will release FY 2018 Hospital Specific Reports (HSRs) in July 2017 via the QualityNet Secure Portal. The HSR will include a summary of results on the quality measures in the program, the domain scores, Total HAC Score, and whether hospitals will receive a payment reduction. The HSR delivery will include the HSR User Guide, which describes the HAC Reduction Program, as well as procedures for reviewing and replicating results in the HSR. Hospitals will have a 30 day Review and Correction period to review the information in the HSR before the information is published. Hospitals interested in a copy of the software used to calculate the PSI-90 results should send a request for the software through the QualityNet Help Desk.

Please email questions related to the HAC Reduction Program to

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