{ "study": { "slug": "hac-reduction-program-penalties", "title": "HAC Reduction Program: 719 Hospitals Penalized in FY2026", "url": "https://fonteum.com/research/hac-reduction-program-penalties", "methodology_version": "cms-hac-reduction-program/v1" }, "data_as_of": "2026-06-03", "temporal_coverage": "2025-10-01/2026-09-30", "sources": [ { "name": "HAC Reduction Program — Hospital file", "publisher": "U.S. Centers for Medicare & Medicaid Services", "url": "https://data.cms.gov/provider-data/dataset/yq43-i98g", "release_date": null, "retrieved_at": "2026-06-03", "license": "U.S. Government Works (17 U.S.C. §105)" } ], "headline": { "published": "2026-06-06", "fiscal_year": 2026, "total_hospitals_in_file": 3055, "scored_hospitals": 3012, "penalized_hospitals": 719, "na_hospitals": 43, "penalty_rate_pct": 23.9, "avg_total_hac_score": 0.005, "median_total_hac_score": -0.045, "p75_total_hac_score": 0.379, "payment_reduction_pct": 1, "program_start_fiscal_year": 2015, "paused_fiscal_year": 2023, "psi_measure_window": "July 1, 2022 – June 30, 2024", "hai_measure_window": "January 1, 2023 – December 31, 2024" }, "sections": [ { "id": "by_state", "label": "Top 20 states by scored-hospital count (states with 20+ scored hospitals)", "columns": [ "state", "state_name", "scored_hospitals", "penalized_hospitals", "penalty_rate_pct" ], "rows": [ { "state": "TX", "state_name": "Texas", "scored_hospitals": 284, "penalized_hospitals": 32, "penalty_rate_pct": 11.3 }, { "state": "CA", "state_name": "California", "scored_hospitals": 277, "penalized_hospitals": 76, "penalty_rate_pct": 27.4 }, { "state": "FL", "state_name": "Florida", "scored_hospitals": 169, "penalized_hospitals": 18, "penalty_rate_pct": 10.7 }, { "state": "PA", "state_name": "Pennsylvania", "scored_hospitals": 133, "penalized_hospitals": 36, "penalty_rate_pct": 27.1 }, { "state": "NY", "state_name": "New York", "scored_hospitals": 129, "penalized_hospitals": 45, "penalty_rate_pct": 34.9 }, { "state": "OH", "state_name": "Ohio", "scored_hospitals": 118, "penalized_hospitals": 31, "penalty_rate_pct": 26.3 }, { "state": "IL", "state_name": "Illinois", "scored_hospitals": 114, "penalized_hospitals": 31, "penalty_rate_pct": 27.2 }, { "state": "GA", "state_name": "Georgia", "scored_hospitals": 94, "penalized_hospitals": 27, "penalty_rate_pct": 28.7 }, { "state": "MI", "state_name": "Michigan", "scored_hospitals": 90, "penalized_hospitals": 30, "penalty_rate_pct": 33.3 }, { "state": "LA", "state_name": "Louisiana", "scored_hospitals": 82, "penalized_hospitals": 25, "penalty_rate_pct": 30.5 }, { "state": "IN", "state_name": "Indiana", "scored_hospitals": 82, "penalized_hospitals": 10, "penalty_rate_pct": 12.2 }, { "state": "NC", "state_name": "North Carolina", "scored_hospitals": 80, "penalized_hospitals": 20, "penalty_rate_pct": 25 }, { "state": "TN", "state_name": "Tennessee", "scored_hospitals": 78, "penalized_hospitals": 15, "penalty_rate_pct": 19.2 }, { "state": "AL", "state_name": "Alabama", "scored_hospitals": 77, "penalized_hospitals": 29, "penalty_rate_pct": 37.7 }, { "state": "OK", "state_name": "Oklahoma", "scored_hospitals": 76, "penalized_hospitals": 15, "penalty_rate_pct": 19.7 }, { "state": "VA", "state_name": "Virginia", "scored_hospitals": 71, "penalized_hospitals": 5, "penalty_rate_pct": 7 }, { "state": "WI", "state_name": "Wisconsin", "scored_hospitals": 65, "penalized_hospitals": 16, "penalty_rate_pct": 24.6 }, { "state": "AZ", "state_name": "Arizona", "scored_hospitals": 64, "penalized_hospitals": 12, "penalty_rate_pct": 18.8 }, { "state": "MO", "state_name": "Missouri", "scored_hospitals": 63, "penalized_hospitals": 9, "penalty_rate_pct": 14.3 }, { "state": "NJ", "state_name": "New Jersey", "scored_hospitals": 61, "penalized_hospitals": 5, "penalty_rate_pct": 8.2 } ] } ], "limitations": [ "FY2026 only. The production table holds the FY2026 CMS Hospital file; multi-year program history is described from CMS sources in prose and is never rendered as facility rows.", "A hospital with an N/A payment-reduction status is stored as null and excluded from the scored denominator — never counted as a pass.", "A suppressed component measure (blank value plus a CMS footnote code) is treated as suppressed, not as zero.", "The state table is the top 20 states by scored-hospital count, restricted to states with at least 20 scored hospitals; it is size-ranked, not penalty-ranked.", "The Total HAC Score is a CMS-computed composite of six measures over CMS-defined windows; it is not a Fonteum rating and is not adjusted here.", "Attestation coverage is snapshot-specific. A snapshot attestation covers its identified snapshot object and does not sign an individual displayed value." ], "reproducible_sql": "-- National FY2026 aggregate (scored = payment-reduction determination present)\nselect count(*) filter (where in_worst_quartile is not null) as scored,\n count(*) filter (where in_worst_quartile is true) as penalized,\n count(*) filter (where in_worst_quartile is null) as na,\n count(*) as total,\n round(avg(total_hac_score) filter (where total_hac_score is not null), 3) as avg_score,\n round((percentile_cont(0.5) within group (order by total_hac_score))::numeric, 3) as median_score,\n round((percentile_cont(0.75) within group (order by total_hac_score))::numeric, 3) as p75_score\nfrom hac_reduction_program\nwhere fiscal_year = 2026;\n-- => scored 3012 · penalized 719 · na 43 · total 3055\n-- avg 0.005 · median -0.045 · p75 0.379\n\n-- By state; the rate denominator excludes hospitals with an N/A determination.\nselect state,\n count(*) filter (where in_worst_quartile is not null) as scored,\n count(*) filter (where in_worst_quartile is true) as penalized,\n round(100.0 * count(*) filter (where in_worst_quartile is true)\n / nullif(count(*) filter (where in_worst_quartile is not null), 0), 1) as rate\nfrom hac_reduction_program\nwhere fiscal_year = 2026 and state is not null\ngroup by state\nhaving count(*) filter (where in_worst_quartile is not null) >= 20\norder by scored desc\nlimit 20;", "license": "U.S. Government Works (17 U.S.C. §105)", "generated_by": "Fonteum — https://fonteum.com", "notes": "Aggregate, source-traced figures frozen to the as-of date above. Re-derive by running the published query against the named source file; no per-person records are included." }