Release Notes

Removed errant test object from package.

Bug fix for a rare scenario in which a professional claim diagnosis would be considered qualifying for HCC/RAF model use when it shouldn't have (occurring when a different service line item on the same claim had a qualifying HCPCS).

Fixed bug that was resulting in failure to use MAO-004 diagnoses; fixed bug that was resulting in some non-duals being flagged as duals.

Major overhaul of approach and object infrastructure: added dedicated objects for patient timelines of demographic information (which now incorporates information from the new MMR Member-Months Natural Object) and all qualifying diagnoses (which now incorporates information from the new MAO-004 Diagnoses Natural Object); now allowing model demographics to change from month to month; rebranded “Calendar Year” scenario to “Standard Final Action” scenario, and changed the diagnosis catchment period of this scenario to mirror the standard CMS approach (i.e., using diagnoses in the prior calendar year).

Updates to the pre-built "Overview" board (cosmetic only) in Analytics Portal. No structural changes to the objects or measures.

Refinements to Qualifying Diagnoses for CMS-HCC Calculation; added new Synthetic Objects: CMS MAO-004 Diagnosis Transaction Influence Periods and Patient Timelines of CMS-HCC Model Eligibility.

Added new object, Qualifying Diagnoses for CMS-HCC Calculations, to include MAO-004 records and provide patient-date-diagnosis code grain data.

Minor changes related to upstream changes in how LTI and OREC fields are structured.

Relaxed restriction to patient-years with MA or Medicare FFS membership; now any membership in a calendar year will result in HCC/RAF calculations being performed. (This change is to make the logic less brittle to missing information about plan financial class, not necessarily because it typically would make sense to calculate HCC/RAF results for, e.g., commercial members, though there are some use cases there in theory.)

Published fields in the Data Mart for URSA-HCC Patient Timelines related to patient demographic features (e.g., eligibility code, OREC, etc.) used by the model to generate RAF results in that calendar year.

Remapped fields on objects / measures affected by the de-truncation of long column names.

Initial commit of URSA-HCC 1.0. Added boards to foundations report; updated some terms; revised logic for including patients (to include patients with a calculated RAF score regardless of any other status).