The hospital-acquired condition reduction program for colorectal surgery: Current initiatives and implications for the future

The 2010 Patient Protection and Affordable Care Act (PPACA)(1) sought to reform healthcare in the United States through a myriad of initiatives that included expanding health insurance accessibility, mandating coverage, revising and expanding a multitude of government programs, and incentivizing improved quality and value in healthcare delivery.(2) One initiative aimed at containing costs and improving patient outcomes is the Hospital-Acquired Condition Reduction Program (HACRP). Like the Hospital Readmission Reduction Program (HRRP), the goal of this program is to stratify hospitals based on their outcomes, in this case a composite score of multiple hospital-acquired conditions (HACs), and financially penalize the bottom performers. It is important for surgeons and hospitals understand the metrics behind these measures, and to lend a voice to the discussion of the benefits and alternative strategies to quality improvement. (C) 2018 Elsevier Inc. All rights reserved.