GHA Payer Scorecard Pilot Program Project Overview Webinar-GHA Payer Scorecard Pilot Program Project Overview Recording

Video Transcription

Video Summary

GHA hosted a members-only webinar announcing a two-year GHA Payor Scorecard Pilot Program in partnership with Hive Health, funded by the GHA board and positioned as a key 2026 strategic priority. GHA leaders explained the urgent need for credible, current, statewide data as hospitals face severe financial pressures, rising denials, prior authorization burdens, downcoding, slow payments, and shifting payer policies—while policymakers increasingly demand concrete evidence rather than anecdotes.<br /><br />Hive Health described its Vitality platform, which builds scorecard analytics directly from hospitals’ 835 remittance and 837 claims files using de-identified transactional data. Participating hospitals can benchmark payer performance against statewide aggregates without seeing other hospitals’ data, supporting both internal revenue cycle/managed care work and GHA’s legislative and regulatory advocacy. The platform reports on metrics such as prompt pay speed, first-pass yield, denial rates and categories (normalized via CARC/RARC mapping), denial “cure” time, reimbursement patterns, and downcoding/lesser-rate-of-charge issues, with drill-downs by payer type, payer, setting (inpatient/outpatient/ED/observation), and specialty.<br /><br />Implementation was presented as lightweight (≤40 hours): install an on-prem PHI scrubber, submit up to two years of historical files, then automate ongoing feeds. Access is limited to hospitals contributing data. GHA will email a non-binding statement of interest and post the recording online.

Keywords

GHA Payor Scorecard Pilot Program

Hive Health Vitality platform

835 remittance and 837 claims analytics

hospital payer performance benchmarking

denial rates and CARC/RARC normalization

prior authorization and payment delays

revenue cycle and managed care metrics

legislative and regulatory advocacy data