At GBMC HealthCare, we believe that every patient, every time, deserves the care we’d want for our own loved ones. This core principle is what drives us, even when the playing field shifts and the rules are complex. One recent area of both achievement and challenge is our work around Maryland’s Hospital-Acquired Conditions (MHAC) program.
Turning the Tide on MHACs
Seven years ago, GBMC was in the red zone for MHAC performance, meaning we were among the hospitals being penalized for patient safety concerns. But instead of accepting the status quo, our team rolled up their sleeves. While most of the problem was not truly about patient harm but rather documentation problems, we dove deep into the data, forming condition-specific committees and working closely with physicians and coders to understand and improve how we documented patient conditions like sepsis, pneumonia, and respiratory failure.
Under the leadership of Dr. Jack Flowers, the team moving this work forward includes Dr. Joseph Fuscaldo, data guru Ryan Curran, Director of Quality Laura Wieber, and clinical documentation expert Denise Kosmas. This group has helped develop a system to review each case thoroughly. They began asking critical questions: Was the condition truly hospital-acquired? Was it present on admission but documented too late? This attention to detail, along with physician education, allowed us to not only improve care but also ensure that our performance was accurately reflected in the state's metrics.
Our efforts paid off! Last year, for the first time in recent memory, GBMC found itself in the MHAC reward zone.
New Rules, New Risks
However, just as we were beginning to see the fruits of our labor, the rules changed. In April, the Health Services Cost Review Commission (HSCRC) retroactively adjusted how scores for the 2025 calendar year would be calculated, altering the formula in a way that removed the neutral zone, gave equal weight to all potentially preventable complications (PPCs), and shifted hospitals’ targets based on volume and case mix.
These changes have major implications. Without the buffer of a neutral zone, even a small increase in MHACs can lead to financial penalties. Meanwhile, lower-volume hospitals may find themselves with disproportionate leeway, while systems like ours must now work harder to justify each case, ensure every illness is accurately documented, and improve the severity scores that determine our benchmarks.
Despite these hurdles, we remain focused on what matters most: quality care. Our mission hasn’t changed, even if the metrics have. And while it's frustrating to lose ground due to a change in scoring methodology, it doesn’t take away from the meaningful improvements we've made to safeguard our patients.
Excellence in Care, Not Just in Coding
It’s true that accurate documentation and coding are essential. But they are not our goal; they are tools to help us measure and showcase the real goal: improving patient outcomes. By continuing to focus on reducing hospital-acquired conditions, educating our teams, and refining our clinical protocols, we are keeping our promise to the community.
This is one of the many ways we make sure our patients are safer, healthier, and treated with the dignity and compassion we would expect for our own family members.
Let’s stay the course and keep striving for better care, even when the rules get harder to navigate.
