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OHA Payer Scorecard

OHA's Payer Scorecard provides hospitals, health systems and payers with the opportunity to collaborate and reduce administrative burden in the health care system. By providing measurable data, the Scorecard informs OHA advocacy efforts and allows hospitals and health systems to benchmark their organization’s experience with a payer relative to all Scorecard respondents. This promotes internal process improvements with providers and payers.

Scorecard Methodology

OHA collects payer performance data specific to each member organization semiannually. The Payer Scorecard survey asks hospitals and health systems to report data on their top Commercial and Medicare payers, and all Medicaid payers. The quantitative portion of the survey collects data on gross charges and accounts, initial and final denials, average days to pay and aging accounts receivable. The qualitative portion of the survey asks respondents to evaluate critical processes between payers and providers. These include prior authorization, appeals, downgrades, credentialing and general operations. OHA's team aggregates the data and analysis providing members with an interactive dashboard to view results. The team meets individually with the largest payers to review improvement opportunities.

Data Collection

For the current survey cycle, we have identified an issue with the Qualitative Template and have reposted a new template below. If you had already begun populating your data in the old template, please send the completed template or csv upload file to support@ohiohospitals.org and we can upload the data for you.
 
Please also note that the submission application has been uploaded this round to include validations on the quantitative submission. These validations are meant to improve the quality of the data collected and reduce the amount of resubmissions needed to correct data after the preliminary review. If you used the older template to populate your quantitative data, please send the completed template or csv upload file to support@ohiohospitals.org and we can upload the data for you.

There are several items to assist in your data collection and submission:

Submit Data Here

Data submissions due Feb. 28, 2023.

Completed surveys must be submitted via OHA’s Data Submission Portal. Click here to access the portal user guide.

Winter Submission Period: Jan. 1, 2022-Dec. 31, 2022
Submission Portal Opens: Jan. 16, 2023
Submission Deadline: Feb. 28, 2023

View Scorecard Reports

The Payer Scorecard Dashboard provides a comprehensive overview of the aggregate data from each survey round, filtered by payer category and individual payers. Hospital-specific benchmark reports can be found in the OHA Web Document Portal. Access to both resources is limited to finance leadership and other designated individuals. To request access, contact Andy Sturgess-White.

No hospital-specific payer performance data will be shared or made public. It will only be used in aggregate form to produce updated reports for your organization's use and to guide OHA's advocacy efforts.