Annually, approximately 2 million patients suffer with healthcare-associated infections (HAIs) in the USA, and nearly 90,000 are estimated to die. The overall direct cost of HAIs to hospitals ranges from US$28 billion to 45 billion. While the range is wide, HAIs are clearly expensive. In addition, most HAIs are thought to be preventable; however, published guidelines are not congruent. Important policy changes include mandating hospitals to publically report HAI rates and a federal pay-for-performance measure that will no longer allow Medicare to pay more for patients with HAIs. Further rigorous economic evaluations of specific interventions, as well as on evaluations of the policies, are required.