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 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. View this document to see a markup of changes made since the last data collection. 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 Sept. 15, 2023. Completed surveys must be submitted via OHA’s Data Submission Portal. Click here to access the portal user guide. Summer Submission Period: July 1, 2022 - June 30, 2023 Submission Portal Opens: July 19, 2023 Submission Deadline: Sept. 15, 2023
Need Help? If you need help with login credentials, please contact support@ohiohospitals.org. If you need help with the data definitions or the Payer Scorecard Dashboard, please contact Andy Sturgess-White. If you need help with the denial codes, contact Quyen Weaver. If you need help with using the portal application, contact support@ohiohospitals.org.