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Update: SFY 2024 PPR and PPC Hospital Adjustments Resumed

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This article is an update to “PPR and PPC Performance Reports for Hospitals Now Available,” which was published on this website on August 29, 2025.

Background

Hospitals received access to their state fiscal year (SFY) 2024 Potentially Preventable Readmissions (PPR) and Potentially Preventable Complications (PPC) hospital-level reports in portable document format (PDF) files and underlying Microsoft Excel data files in August 2025.

The Texas Health and Human Services Commission (HHSC) originally scheduled the release of these reports for June 1, 2025, but delayed publication to examine potential impacts to the underlying data related to provider flexibilities for reprocessing claims with dates of service in SFY 2024.

Due to the delay, HHSC temporarily paused the application of reimbursement adjustments to hospitals. These adjustments are pending while HHSC completes additional data quality inspections.

Update

HHSC has confirmed that the data files that they provided to hospitals in August 2025 are reliable and that provider flexibilities for reprocessing claims had no significant impact on the program results. Accordingly, HHSC will resume the reimbursement adjustments for fee-for-service (FFS) claims for the second half of SFY 2026, effective March 1, 2026, through August 31, 2026.

HHSC is evaluating the impact that the reimbursement adjustments may have on managed care organization (MCO) capitation rates, and a rate adjustment is being considered. HHSC does not direct MCOs on the specific terms of their payments to hospitals or other providers.

Accessing the Reports

To securely access the reports, visit the Texas Medicaid & Healthcare Partnership (TMHP) web page and follow these steps:

  1. Click My Account in the top banner.
  2. Enter your credentials.
  3. Click the Potentially Preventable Events (PPE) Provider Reports tab to download the PPR and PPC reports.

Note: Only personnel who routinely access Remittance and Status (R&S) Reports, submit claims, and check eligibility can access and download the reports from the portal.

If you need help with accessing the provider portal or creating an account, call the TMHP EDI Help Desk at 888-863-3638.

PPR and PPC Information

Information about the hospital quality-based PPR and PPC program is available on the HHSC PPE web page. This web page features additional documents and resources that pertain to this program.

For questions about the program, email MCD_PPR_PPC@hhs.texas.gov or call the TMHP Contact Center at 800-925-9126.