Thousands of lives, billions of dollars saved by Affordable Care Act

The Affordable Care Act’s provisions to reduce hospital-acquired conditions (HACs) saved 87,000 lives and almost $20 billion in health care costs from 2010 to 2014, according to a report from HHS’ Agency for Healthcare Research and Quality (AHRQ). The report, Saving Lives & Saving Money: Hospital-Acquired Conditions Update, found that the four-year period saw 2.1 million fewer HACs—such as infections associated with catheters, central lines, and surgical sites—or a 17 percent decline. “Patients in America’s hospitals are safer today,” said HHS Secretary Sylvia Burwell.


Thousands of Americans die each year from preventable medical errors. HACs are conditions individuals acquire during the course of treatment for a different condition in a health care setting. Due to the high number of preventable deaths and injuries attributable to HACs, the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) included a number of provisions to reduce such problems. Under Section 3008, Medicare payments will be reduced by 1 percent to hospitals scoring in the top quartile of the national average for HACs. Section 3025 of the ACA also seeks to reduce hospital readmissions, which are associated with HACs, by reducing the base diagnosis-related group (DRG) payment to hospitals based on the ratio of actual to expected readmissions.

To implement the HAC reduction program, HHS created strong, diverse public-private partnerships and sought active engagement by patients and families. These efforts include the federal Partnership for Patients initiative, Hospital Engagement Networks, Quality Improvement Organizations, and many other public and private partners. According to HHS, public and private partners, including hospitals and other health care providers, are collaborating to identify and spread best practices and apply these solutions to reduce HACs and hospital readmissions.


The new AHRQ report shows that the HAC reduction program is accomplishing its goals of encouraging better care, smarter spending, and healthier people. An earlier report for 2010 through 2013 showed 50,000 fewer patients dying in hospitals and $12 billion in health care cost savings. After adding data from 2014, those numbers increased by 37,000 fewer deaths and $8 billion. HHS says that the updated data shows that the ACA’s patient safety improvements are holding steady, while showing an accumulation of impact over time.

To create the report, the AHRQ analyzed the incidence of a number of avoidable HACs compared to 2010 rates, using as a baseline estimates of deaths and excess health care costs that were developed when the Partnership for Patients was launched. CMS Deputy Administrator for Innovation and Quality and Chief Medical Officer Patrick Conway, M.D., said, “These results demonstrate that it’s possible to improve national patient safety performance resulting in millions of people avoiding infections and adverse events.” To assist providers in preventing HACs, the AHRQ produced a variety of tools and resources.