Maryland Hospital Acquired Conditions Program (MHAC)


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 2025

​Communications ​and Memos ​ ​
​TypeDocument TitleDate
​Final PolicyRY 2025 Final MHAC Recommendation
Dec 14, 2022
Updated RY 2025 MHAC Memo​​
Jan 19, 2023

RY 2024

​Communications ​and Memos ​ ​
​TypeDocument TitleDate
​Final Policy
RY 2024 Final MHAC Recommendation
​Jan 12, 2022
RY 2024 MHAC Memo
Aug 2, 2022

RY 2023

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

​*Quarterly final summary reports are posted to the HSCRC website. Preliminary monthly summary reports are also available to hospitals through the CRISP Reporting Services Portal. ​

RY 2022

​Communications ​and Memos ​ ​
​Type Document Title Date
​Final Policy Final RY 2022 MHAC Recommendation
Feb 28, 2020
Memo RY 2022 MHAC Policy Memo
Feb 28, 2020​
​Revenue Adjustment RY 2022 MHAC Scaling​ ​Jun 30, 2021

​RY 2021

​Communications ​and Memos ​ ​
​Type Document Title Date
​Final Policy 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

​Communications ​and Memos ​ ​
​Type Document Title Date
​Final Policy RY 2020 Final MHAC Policy
Feb 26, 2018
Memos​ RY 2020 Final MHAC Memo Mar 02, 2018
Data Workbooks​​ ​ ​
​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

​Communications ​and Memos ​ ​
​Type Document Title Date
​Final Policy RY 2019 MHAC Final Policy.pdf ​Mar 8, 2017
Memos​ RY 2019 MHAC Policy Memo.pdf
RY 2019 MHAC Policy Memo - Clinical Logic Update
​Apr 25, 2017
Jul 13, 2017
Data Workbooks​​ ​ ​
​Base Period Data MHAC Base Period Workbook RY 2019​ ​​Apr 25, 2017
​Performance Period Data*

RY 2018

​Communications and Memos ​ ​
​Type Document Title Date
​Final Pol​icy RY18 MHAC Final Policy Recommendation
Jan 13, 2016
Memos​ RY 2018 MHAC Program and Data Update- PPC Assignment Logic Changes

RY 2018 MHAC Program Summary

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

Sep 2, 2016

May 12, 2017
Data Workbooks​​ ​ ​
​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

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