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​Quality

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Maryland Hospital Acquired Conditions Program (MHAC)

Overview

The MHAC program aims to improve patient care and hospital decision-making by putting two percent (2%) of inpatient hospital revenue at risk (maximum penalty/reward) based on performance for 14 identified potentially preventable complications (PPCs). PPCs are harmful events that develop after the patient is admitted to the hospital and may result from processes of care and treatment rather than from the natural progression of the underlying illness. PPCs can lead to poor patient outcomes, including longer hospital stays, permanent harm, and death, as well as increased costs. Examples of PPCs include an accidental laceration during a procedure, improper administration of medication, and hospital-acquired pneumonia.

The MHAC Program is similar to the federal Medicare HAC Reduction Program (HACRP) but:
  • Is all-payer
  • Uses a Maryland-specific list of PPC measures, and 
  • Does not relatively rank hospitals in assigning financial rewards and penalties.
The MHAC Program is based on a system developed by 3M Health Information Systems (3M) to identify PPCs using present-on-admission codes available in claims data.  See the current rate year policy for additional information on the specific PPCs included in the payment program and how performance is converted to hospital revenue adjustments.
For detailed information via webinar on HSCRC Quality Initiatives, please visit the Quality Overview​​ web page.​


Key MHAC Policy Documents

RY 2028

 
​Type​
Document Title​​
​Date
​Policy
​RY 2028 Final MHAC Recommendation​​​​​​
​February 11, 2026
Final ​Memo
​RY 2028 Final MHAC Memo​
​March 20, 2026


RY 2027

 
​Type​
Document Title​​
​Date
​Policy
​RY 2027 Final MHAC Recommendation​​​​
​April 9, 2025
Composite Recording
​RY 2027 MHAC Composite Webinar Recording  Passscode:FP^8m^$B
April 14, 2025
​Composite Excel Workbook
​RY 2027 MHAC Composite Overview Workbook​
​​April 14, 2025
​Composite Slides
​RY 2027 MHAC Composite Overview ​Slides
​April 14, 2025
​Final Memo
​RY 2027 Final MHAC Memo​
​June 11, 2025


RY 2026

 

​Type​
Document Title​​
​Date
​Final Policy

​RY 2026 Final MHAC Recommendation​​
​Feb 14, 2024
​Final Memo
​RY 2026 Final MHAC Memo​
​May 8, 2024

RY 2025

 
​Type​
Document Title​​
​Date
​Final Policy
​RY 2025 Final MHAC Recommendation
​Dec 24, 2022
​Memo
​Updated RY 2025 MHAC Memo
​Jan 19, 2023

RY 2024

 
​Type
Document Title​​
​Date
​Final Policy
​RY 2024 Final MHAC Recommendation
​Jan 12, 2022
​Memo
​RY 2024 MHAC Memo
​Aug 2, 2022


RY 2023

 
​Type
Document Title​​
​Date
​Final Policy
​RY 2023 Final MHAC Recommendation
​Feb 22, 2021
​Memo
​RY 2023 MHAC Memo
​Mar 16, 2021

RY 2022

 
​Type
Document Title​​
​Date
​Final Poli​​​​​​cy
​Final RY 2022 MHAC Recommendation
​Feb 28, 2020
​Memo​
​RY 2022 MHAC Policy Memo
​Feb 28, 2020

​Revenue Adjustm​​​ent

​RY 2022 MHAC Scaling​​
​June 30, 2021


RY 2021

 
​
​Type
Document Title​​
​Date
​Final Poli​​​​​​cy
​RY 2021 Final MHAC Policy
​Mar 15, 2019​
​Memo​
​RY 2021 MHAC Policy Memo
​April 12, 2019
​Performance Standards
​​RY 2021 Performance Standards and Modeling Summary Workbook
​​May 02, 2019
​Performance Period Data

​RY 2021 Performance Period Workbook 
​​​June 02, 2020​
​Revenue Adjustment
​RY2021 MHAC Scaling​​

​​Updated July 13, 2020


RY 2020

 
​Type
Document Title​​
​Date
​Final Poli​​​​​​cy
​RY 2020 Final MHAC Policy
​Feb 26, 2018​​
​Memo​
​RY 2020 Final MHAC Memo
​Mar 02, 2018
Base Period Data
​​RY 2020 Base Period Workbook
​​Mar 02, 2018
​Performance Period Data

​RY 2020 Performance Period Workbook 
​​​May 29, 2019​
​Revenue Adjustment
​RY 2020 MHAC Scaling Workbook​​​

​​May 29, 2019



RY 2019

 
​Type
Document Title​​
​Date
​Final Poli​​​​​​cy
​RY 2019 MHAC Final Policy.pdf
​Mar 8, 2017​
​Memo​
​RY 2019 MHAC Policy Memo.pdf
RY 2019 MHAC Policy Memo - Clinical Logic Update
​Apr 25, 2017
Jul13, 2017

Base Period Data
​​MHAC Base Period Workbook RY 2019​
​​Apr 25, 2017

RY 2018

 
​Type
Document Title​​
​Date
​Final Poli​​​​​​cy
​RY18 MHAC Final Policy Recommendation
​Jan 13, 2016​​
​Memo​
RY 2018 MHAC Program and Data Update- PPC Assignment Logic Changes

RY 2018 MHAC Program Summary

RY18 Qu​ality Program R​evenue Adjustments memo.pdf ​
​Sep 23, 2016


Sep 2, 2016

May 12, 2017

​Base Period Data
​​RY18 MHAC Base Period Workbook​
​​Jun 15, 2016
Results
​MHAC Summary CY16-01 to CY16-12 FINAL.xlsx​​​​

​​Mar 08, 2017



For questions or inquiries about HSCRC's Quality Improvement Initiatives, please click here. ​