The Payer Scorecard provides hospitals, health systems and the hospital association with the opportunity to collaborate with payers to reduce administrative burden in the health care system.

By providing measurable data, the Scorecard informs hospital association 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 the state hospital association and its participating members an interactive dashboard to view results.

Submitting and Accessing Scorecard Data

OHA’s Ohio Data Analytics Platform is your one-stop shop for submitting and accessing payer scorecard data for participating hospitals.

• The Data Submission Application enables you to submit data effortlessly and securely using either a data entry or file upload option.
• The Payer Scorecard Dashboard provides a comprehensive overview of the aggregate data from each survey round, filtered by payer category.
• The Responding Entity Benchmark Report provides hospital specific data for participating hospitals.

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.

Ohio Data Analytics Platform

Florida Hospital Association Information

FHA Round 5 Data Reporting Period: Jan. 1, 2024 – Dec. 31, 2024

FHA Round 5 Data Collection Timeline – TBA

• Submission Portal Opens:
• Submission Deadline:
• Preliminary Reports Released:
• Preliminary Data Review Period:
• Final Data Released:

FHA Data Specification Guides and Data Dictionary

Additional Resources

Denial Code Hierarchy and Matrix (updated for Round 5)

OHDAP User Guide 

FAQ (last updated Jan. 2024)

Notes:

• Payer Codes are listed in the Qualitative and Quantitative Data Specification Guides under the ‘Data Element Lookup Tables’ section of each guide.
• The Denial Code Hierarchy and Matrix has been updated for Round 5 to include new denial codes to categorize initial and final denials. A change report is included in the Denial Code Hierarchy and Matrix file.

Need Help?

• To submit data, use the OHA Data Analytics Platform
• For general questions about the Payer Scorecard, please contact your state hospital association’s payer scorecard program administrator.
• For questions regarding the data submission application or accessing data, contact  support@ohiohospitals.org