{"id":3041,"date":"2025-08-01T07:00:55","date_gmt":"2025-08-01T11:00:55","guid":{"rendered":"https:\/\/www.ncqa.org\/?page_id=3041"},"modified":"2026-01-30T08:02:23","modified_gmt":"2026-01-30T13:02:23","slug":"hospitalization-for-potentially-preventable-complications-hpc","status":"publish","type":"page","link":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/","title":{"rendered":"Hospitalization for Potentially Preventable Complications (HPC)"},"content":{"rendered":"<p>For persons 67 years of age and older, the rate of discharges for ambulatory care sensitive conditions (ACSC) per 1,000 persons and the risk-adjusted ratio of observed-to-expected discharges for ACSC by chronic and acute conditions.<\/p>\n<h2>Why it Matters<\/h2>\n<p>Ambulatory care sensitive conditions are acute and chronic health conditions that can be managed or treated in the outpatient setting.<br \/>\n<strong><br \/>\nAppropriate access to care, high-quality care coordination, a focus on chronic disease self-management and connection to community resources can reduce the probability that individuals with these chronic and acute conditions will develop complications or exacerbations that result in hospitalization.<br \/>\n<\/strong><\/p>\n<p>Hospital and inpatient care accounts for a large component of total health care costs for older adults (41% of Medicare spending, approximately $303B dollars in 2018) <sup>(1)<\/sup>. Hospitalization also poses several risks for older adults, who frequently develop serious conditions as a result of hospitalization such as delirium, infection and decline in functional ability <sup>(2,3)<\/sup>.<\/p>\n<p>Reducing the rate of hospitalization for potentially preventable complications of acute and chronic conditions for older adults will improve patient health, reduce costs and improve quality of life. It is important to note that some complications or exacerbations are unavoidable and therefore the appropriate rate of hospitalization is not \u201czero\u201d; however, this measure will provide important information to health plans, providers and consumers and other stakeholders about how well a system of care helps older adults with chronic and acute conditions prevent hospitalization.<\/p>\n<p><em>* Adapted with financial support from CMS and with permission from the measure developer, the Agency for Healthcare Research and Quality (AHRQ).<\/em><\/p>\n<h2>Historical Results \u2013 National Averages<\/h2>\n<p><strong>Performance results for this measure are currently unavailable. <\/strong>Visit our <a href=\"https:\/\/www.ncqa.org\/programs\/data-and-information-technology\/data-purchase-and-licensing\/quality-compass\/\">Quality Compass<\/a> page to explore data licensing options and gain access to detailed performance results for this measure.<\/p>\n<div class=\"footnotes\"><\/p>\n<h3>References<\/h3>\n<ol>\n<li><span data-contrast=\"auto\">Kaiser Family Foundation (KFF). The Facts on Medicare Spending and Financing. https:\/\/www.kff.org\/medicare\/issue-brief\/the-facts-on-medicare-spending-and-financing\/ (Accessed March 25, 2020)<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:80,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/li>\n<li><span data-contrast=\"auto\">Gillick, M.R., N.A. Serrell, and L.S. Gillick. 1982. \u201cAdverse Consequences of Hospitalization in the Elderly.\u201d Social Science &amp; Medicine 16(10), 1033\u20138.\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:80,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/li>\n<li><span data-contrast=\"auto\">Covinsky, K.E., E. Pierluissi, &amp; C.B. Johnston. 2011. \u201cHospitalization-Associated Disability.\u201d JAMA: The Journal of the American Medical Association,306(16): 1782\u201393.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:80,&quot;335559739&quot;:0,&quot;335559740&quot;:240}\">\u00a0<\/span><\/li>\n<\/ol>\n<p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>For persons 67 years of age and older, the rate of discharges for ambulatory care sensitive conditions (ACSC) per 1,000 persons and the risk-adjusted ratio of observed-to-expected discharges for ACSC by chronic and acute conditions. Why it Matters Ambulatory care sensitive conditions are acute and chronic health conditions that can be managed or treated in [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"parent":733,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page.php","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-3041","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Hospitalization for Potentially Preventable Complications (HPC) - NCQA<\/title>\n<meta name=\"description\" content=\"This measure looks at the rate of inpatient admission and observation stay discharges for ambulatory care sensitive conditions (ACSC) per 1,000 members. It also measures the risk-adjusted ratio of observed-to-expected discharges for ACSC among members 67 years of age and older.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hospitalization for Potentially Preventable Complications (HPC) - NCQA\" \/>\n<meta property=\"og:description\" content=\"This measure looks at the rate of inpatient admission and observation stay discharges for ambulatory care sensitive conditions (ACSC) per 1,000 members. It also measures the risk-adjusted ratio of observed-to-expected discharges for ACSC among members 67 years of age and older.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/\" \/>\n<meta property=\"og:site_name\" content=\"NCQA\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/NCQA.org\" \/>\n<meta property=\"article:modified_time\" content=\"2026-01-30T13:02:23+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ncqa.org\/wp-content\/uploads\/2021\/04\/NCQA_cmyk_tag.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"627\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@NCQA\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/\",\"url\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/\",\"name\":\"Hospitalization for Potentially Preventable Complications (HPC) - NCQA\",\"isPartOf\":{\"@id\":\"https:\/\/www.ncqa.org\/#website\"},\"datePublished\":\"2025-08-01T11:00:55+00:00\",\"dateModified\":\"2026-01-30T13:02:23+00:00\",\"description\":\"This measure looks at the rate of inpatient admission and observation stay discharges for ambulatory care sensitive conditions (ACSC) per 1,000 members. It also measures the risk-adjusted ratio of observed-to-expected discharges for ACSC among members 67 years of age and older.\",\"breadcrumb\":{\"@id\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.ncqa.org\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Report Cards\",\"item\":\"https:\/\/www.ncqa.org\/report-cards\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Health Plans\",\"item\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"State of Health Care Quality Report\",\"item\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/\"},{\"@type\":\"ListItem\",\"position\":5,\"name\":\"Hospitalization for Potentially Preventable Complications (HPC)\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.ncqa.org\/#website\",\"url\":\"https:\/\/www.ncqa.org\/\",\"name\":\"NCQA\",\"description\":\"Measuring quality. Improving health care.\",\"publisher\":{\"@id\":\"https:\/\/www.ncqa.org\/#organization\"},\"alternateName\":\"National Committee for Quality Assurance\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.ncqa.org\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/www.ncqa.org\/#organization\",\"name\":\"NCQA\",\"alternateName\":\"National Committee for Quality Assurance\",\"url\":\"https:\/\/www.ncqa.org\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.ncqa.org\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/www.ncqa.org\/wp-content\/uploads\/NCQA-Blog-Logo-Thumbnail.jpg\",\"contentUrl\":\"https:\/\/www.ncqa.org\/wp-content\/uploads\/NCQA-Blog-Logo-Thumbnail.jpg\",\"width\":876,\"height\":673,\"caption\":\"NCQA\"},\"image\":{\"@id\":\"https:\/\/www.ncqa.org\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.facebook.com\/NCQA.org\",\"https:\/\/x.com\/NCQA\",\"https:\/\/www.instagram.com\/ncqa_dc\/\",\"https:\/\/www.youtube.com\/@NcqaOrg\",\"https:\/\/www.linkedin.com\/company\/ncqa\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Hospitalization for Potentially Preventable Complications (HPC) - NCQA","description":"This measure looks at the rate of inpatient admission and observation stay discharges for ambulatory care sensitive conditions (ACSC) per 1,000 members. It also measures the risk-adjusted ratio of observed-to-expected discharges for ACSC among members 67 years of age and older.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/","og_locale":"en_US","og_type":"article","og_title":"Hospitalization for Potentially Preventable Complications (HPC) - NCQA","og_description":"This measure looks at the rate of inpatient admission and observation stay discharges for ambulatory care sensitive conditions (ACSC) per 1,000 members. It also measures the risk-adjusted ratio of observed-to-expected discharges for ACSC among members 67 years of age and older.","og_url":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/","og_site_name":"NCQA","article_publisher":"https:\/\/www.facebook.com\/NCQA.org","article_modified_time":"2026-01-30T13:02:23+00:00","og_image":[{"width":1200,"height":627,"url":"https:\/\/www.ncqa.org\/wp-content\/uploads\/2021\/04\/NCQA_cmyk_tag.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_site":"@NCQA","twitter_misc":{"Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/","url":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/","name":"Hospitalization for Potentially Preventable Complications (HPC) - NCQA","isPartOf":{"@id":"https:\/\/www.ncqa.org\/#website"},"datePublished":"2025-08-01T11:00:55+00:00","dateModified":"2026-01-30T13:02:23+00:00","description":"This measure looks at the rate of inpatient admission and observation stay discharges for ambulatory care sensitive conditions (ACSC) per 1,000 members. It also measures the risk-adjusted ratio of observed-to-expected discharges for ACSC among members 67 years of age and older.","breadcrumb":{"@id":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/hospitalization-for-potentially-preventable-complications-hpc\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.ncqa.org\/"},{"@type":"ListItem","position":2,"name":"Report Cards","item":"https:\/\/www.ncqa.org\/report-cards\/"},{"@type":"ListItem","position":3,"name":"Health Plans","item":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/"},{"@type":"ListItem","position":4,"name":"State of Health Care Quality Report","item":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/"},{"@type":"ListItem","position":5,"name":"Hospitalization for Potentially Preventable Complications (HPC)"}]},{"@type":"WebSite","@id":"https:\/\/www.ncqa.org\/#website","url":"https:\/\/www.ncqa.org\/","name":"NCQA","description":"Measuring quality. Improving health care.","publisher":{"@id":"https:\/\/www.ncqa.org\/#organization"},"alternateName":"National Committee for Quality Assurance","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.ncqa.org\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/www.ncqa.org\/#organization","name":"NCQA","alternateName":"National Committee for Quality Assurance","url":"https:\/\/www.ncqa.org\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.ncqa.org\/#\/schema\/logo\/image\/","url":"https:\/\/www.ncqa.org\/wp-content\/uploads\/NCQA-Blog-Logo-Thumbnail.jpg","contentUrl":"https:\/\/www.ncqa.org\/wp-content\/uploads\/NCQA-Blog-Logo-Thumbnail.jpg","width":876,"height":673,"caption":"NCQA"},"image":{"@id":"https:\/\/www.ncqa.org\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/NCQA.org","https:\/\/x.com\/NCQA","https:\/\/www.instagram.com\/ncqa_dc\/","https:\/\/www.youtube.com\/@NcqaOrg","https:\/\/www.linkedin.com\/company\/ncqa\/"]}]}},"_links":{"self":[{"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages\/3041","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/comments?post=3041"}],"version-history":[{"count":1,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages\/3041\/revisions"}],"predecessor-version":[{"id":49517,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages\/3041\/revisions\/49517"}],"up":[{"embeddable":true,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages\/733"}],"wp:attachment":[{"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/media?parent=3041"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}