The penalty formula, authorized by the Patient Protection and Affordable Care Act, gives hospitals a score from 1 to 10 and is based largely on associated central line rates to hospitals bloodstream infections and catheter-associated urinary tract infections. (Clark, 2014). Therefore, hospitals are incentivized to use guidelines that help prevent HACs, which will result in penalties. This is one of many economic factors that hospitals can control as they attempt to manage healthcare costs. Preventing HACs also helps insurance companies by decreasing the amount of healthcare services they will have to cover for the patients they need to cover.