MHA, HIDI Announce Payer Performance Initiative

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Hospitals across Missouri are facing increasing complexity in managing payer relationships — from delayed payments and denials to shifting contract structures and rising administrative burdens. These challenges directly impact hospital finances and the ability to deliver quality care to patients and communities.

To address these complexities, the Hospital Industry Data Institute and Missouri Hospital Association are launching the Payer Performance Initiative, a statewide effort to strengthen hospitals’ financial performance through clearer, more actionable payer insights. At the center of this initiative is the Vitality Index Payer Scorecard, through partnership with Hyve Health. Leveraging real-time 837 and 835 transaction data, along with Claims Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC), the scorecard helps hospitals with: 
  • benchmark payer performance across peers 
  • identify friction points that impact cash flow and revenue 
  • improve transparency and accountability in payer relationships
  • strengthen MHA’s advocacy through credible, timely financial data
HIDI has streamlined participation by working directly with hospitals to collect and anonymize the necessary data. A pilot cohort already is underway to refine the transition process and training resources. Broader availability of the scorecard is planned for 2026.

The Payer Performance Initiative will ultimately replace the Insurance Performance Scorecard and complement existing resources such as the Hospital Performance Insights Dashboard and HIDI Fiscal Optics®. Together, these tools provide hospitals with timely, comparative financial data to drive meaningful change and sustain fiscal health.

Coupled with MHA’s financial advocacy and the Payer Pulse Newsletter, this initiative paints a clearer picture of payer behavior across Missouri. Our collective goal remains the same – to ensure hospitals have the information and influence necessary to deliver high-quality care for every community they serve.

Interested in Participating?

If your hospital or health system would like to participate in the initiative and receive access to the Vitality Index Payer Scorecard, please complete this short form and email it to HIDI@mohospitals.org