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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.

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.

Member Business Toolkit

OHA created a Member Business Toolkit focused on helping members  engage insurance brokers, local employers and the broader business community to help them understand how the processes of specific insurance companies/TPAs impact patients and employees.

Access the toolkit here.


Data Collection

Please note that the submission application has been updated 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. 

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

  • Payer Scorecard FAQ (last updated Jan. 2024)
  • Submission Template - Based on feedback from our members, OHA has updated the submission template for this survey round.
  • The Denial Code Hierarchy and Matrix has been updated to include new denial codes to categorize initial and final denials. A change report is included as a tab in the Denial Code Matrix file. 
If you would like to create an automated data upload file from your system, please use these data specifications:
  • Qualitative Data Elements    PDF | XLS
  • Quantitative Data Elements  PDF | XLS
  • Additional details about what is needed for that process can be found in our User Guide.

Submit Data Here

Data submissions due Feb. 14, 2024.

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

Winter 2024 Data Collection
Round 11
Reporting Period
Jan. 1, 2023 - Dec. 31, 2023
Submission Portal Opens Jan. 15, 2024
Submission Deadline Feb. 14, 2024
Extended deadline: Feb. 28, 2024
Preliminary Reports Released
Reporting entity specific reports are released to reach reporting entity
Mar. 4, 2024
Preliminary Data Review Period
Reporting entities can review the preliminary report internally and correct data as needed
Mar. 4 - 22, 2024
Final Reports and Dashboard Released Mar. 26, 2024