As part its overall performance measurement and reporting strategy, UnitedHealthcare (UHC) compares risk-adjusted claims data across its network, thereby identifying variations in practice patterns.
This results in performance reports that show how a physician’s claims data compare with those of others in the same specialty for certain key measures over a given period. UHC sends reports to network physicians in 15 specialties whose paid claims data show patterns that vary significantly from expected practice patterns, based on risk-adjusted peer benchmarks. The aim is to highlight areas where these physicians may be able to improve quality and efficiency in their practice.
TMA’s Payment Advocacy staff warns you should watch for updates announcing changes to this process in the coming months.
Meanwhile, you can read about the methodology UHC uses to generate the reports for each specialty, and FAQs about the performance reports.
If you have questions or comments about your performance report, contact UHC using the dedicated email address physician_engagement[at]uhc[dot]com, or call the UHC Health Care Measurement Resource Center at (866) 270-5588.
Published March 28, 2017
TMA Practice E-Tips main page
Last Updated On
April 20, 2018
Originally Published On
March 28, 2017