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Reports and Quality Programs

UnitedHealthcare offers a variety of reports and quality programs to help care providers provide operational efficiency and member support. For more information on what is available, click the [+] below. 

Access a variety of reports including capitation, claim, quality, profile / provider rosters with the UnitedHealthcare Reports tool on Link.

UnitedHealthcare West providers for SignatureValue and Medicare Advantage HMO plans have access to a variety of reports families including Capitation, Settlement, Shared Risk, Claims, Eligibility and Patient Management reports.

We believe in helping UnitedHealthcare Medicare Advantage members receive the resources they need to successfully recover at home or in a skilled nursing facility. To help our care providers and our members make more informed choices during the discharge planning process, we’re compiling a list of high-performing home health care providers and skilled nursing facilities that may demonstrate improved patient outcomes based on quality and cost efficiency criteria.

UnitedHealthcare’s disciplined approach to payment reform leverages years of experience with incentive-based contracting models.One component of this overall strategy is the Hospital Performance-Based Compensation (HPBC) program, which provides an incentive to hospitals for quality and efficiency improvements in the delivery of health care affecting the overall health of UnitedHealthcare Commercial members and cost of health care.

Learn more about the Hospital Performance-Based Compensation Program.

Collaborate. Educate. Evaluate. These core values define the PATH program’s tools and resources, which were designed to help patients live healthier lives. Together, we can work to help make this goal a reality. 

Learn more about PATH.

UnitedHealthcare Peer Comparison Reports (formerly Performance Reports) provide physicians with actionable information to help deliver better care, better health outcomes and better costs. 

Learn more about Peer Comparison Reports.

UnitedHealthcare is committed to providing physicians with actionable, patient-specific information that will help them deliver the best possible clinical care while empowering them to meet personal and professional goals through our Physician Performance-Based Compensation Program (PPBC).

This program includes the Patient Care Opportunity Reports (PCOR), the Patient-Centered Medical Home Program (PCMH) and the Primary Care Physician Incentive Program (PCPi).

Learn more about the Physician Performance-Based Compensation Program.

UnitedHealthcare will launch the Preferred Lab Network on July 1, 2019. The Preferred Lab Network will feature currently contracted laboratory care providers that have met higher standards for access, cost, data, quality and service based upon a rigorous application and review process.  We will work with these distinguished labs to continue our efforts to improve the care provider and member experience.   

We are excited to announce the following labs were selected to be part of the Preferred Lab Network effective July 1, 2019:

  • AmeriPath Inc.
  • BioReference Laboratories, Inc.
  • GeneDX
  • Invitae Corporation
  • LabCorp
  • Mayo Clinic Laboratories
  • Quest Diagnostics Inc.

The Preferred Lab Network won’t change a member’s access to labs or lab services but it may offer additional advantages. The UnitedHealthcare Preferred Lab Network will be available for all members in all lines of business.

View the Preferred Lab Network Frequently Asked Questions.

As a UnitedHealthcare network care provider, you have options on where your patients who are our plan members receive their surgical care – in the office, at an ambulatory surgical center, or in an in-patient hospital setting. Like you, we’re always looking for new ways to better achieve positive outcomes, which is one of the reasons we created and are piloting the Quality-Based Physician Incentive Program (QPIP) for care providers in select markets.

With QPIP, you have the opportunity to earn an incentive payment by performing clinically appropriate procedures at designated facilities and meeting certain quality metrics.

Learn more about the Quality-Based Physician Incentive Program.

The Centers for Medicare & Medicaid Services (CMS) has developed Medicare Advantage plan quality measurements called Star Ratings. CMS Star Ratings are used to rate qualify plan performance for:

  • Medicare Advantage (Part C), including special needs plans
  • Prescription drug plans (Part D)

Learn more about CMS Star Ratings.

The UnitedHealth Premium program provides physician designations based on quality and cost efficiency criteria to help members make more informed and personally appropriate choices for their medical care. 

Physicians may also use these designations when referring patients to other physicians. Employers may choose to offer their employees a tiered benefit plan, which may provide an enhanced benefit in the form of lower member cost share for using Premium Care Physicians.

Learn more about the UnitedHealth Premium Program.

Need Help With Your Reports?

If you have questions or need help accessing your reports, please call the Health Care Measurement Resource Center at 866-270-5588.