Hospital Performance Based Compensation Program

You can access reports in the UnitedHealthcare Provider Portal under the Documents & Reporting drop-down menu.

Need help using the report tool? Check out our resources on UHCprovider.com/portal.

Baseline Reports provide facility performance data on all available performance measures. This information is available to view in aggregate for a health system or individually by hospital.

• Shows the date range and baseline performance for each performance measure along with each component of the calculation that determined the baseline performance
• Presents baseline performance data from the composite score of the third party’s data, including Centers for Medicare & Medicaid Services’ (CMS) Hospital Compare Site

Facilities that are contracted with an HPBC program provision will receive quarterly Performance Reports. This report schedule will include quarterly interim reports as well as a Final Performance Report prior to implementation of the next contract rate adjustment.

The Performance Reports include:

• Performance measures negotiated into the contract
• Baseline performance including any restatements
• Total possible performance points
• Facility’s actual performance
• Performance points earned to date
• Percentage of the performance escalator earned

The following Detail Data Reports provide more specific detail to support the Baseline and Performance Reports in a format that lets you sort the data and execute your own analysis.

Patient Level Detail Report for Claims-Based Performance Measures

Provides Diagnosis Related Group (DRG) or Agency for Healthcare Research and Quality (AHRQ) disease group detail and member claims information. The information provided is confidential and may not be further disclosed without UnitedHealthcare's or the member's (as applicable) prior written consent. Individually identifiable health information is subject to the provisions of the Health Insurance Portability and Accountability Act of 1996, as amended from time to time and may be further subject to one or more state or federal privacy laws. Other information may be proprietary and subject to the confidentiality provisions of the participation agreement between UnitedHealthcare and the facility.

Measurement Summary Report for Quality Performance Measures

Provides information from the third party source and the calculations used to determine a composite baseline performance. The information is considered third-party data. UnitedHealthcare will use the most current data available at the time of each quarterly data capture period.

The HBPC Program currently includes 13 performance measures that fall under three measure categories: Efficiency, Operational and Quality.