[SO/URSA-CORE] Patient Timelines of Any Plan Membership

Object Description

One record per patient timeline period in which the patient had at least one active plan membership.

Metadata

• Table Name: ursa.so_ursa_core_pat_005
• Layer: SYNTHETIC_OBJECT
• Object Type: Complex Timeline
• Temporal Class: Interval (Timeline)
• Case ID: Patient ID
• Interval Start Date: Period Start Date
• Interval End Date: Period End Date
• Primary Key: Patient ID, Period Start Date, Period End Date

Published Fields

• Data Model Keys

  • Patient ID -- The internal database identifier (used, e.g., for joins and primary keys) for the patient. This value is typically mastered, i.e., all records for the same patient, regardless of the source data system from which that record originated, should have the same Patient ID value. (Note that while the mastered Patient ID value might resemble a local identifier used in one of the upstream data sources, this does not indicate any special priority of that source system in determining the characteristics of the patient.) (See also [URSA-CORE] Patient)
  • Primary Plan ID
  • Primary Payor ID
  • Primary Plan Attributee Provider ID
  • Primary Plan Attributee Individual Provider ID
  • Primary Plan Attributee Provider Group Provider ID
  • Primary Plan Attributee Provider Contract ID

• Date Fields

  • Period Start Date
  • Period End Date
  • Current Continuous Primary Payor Membership Episode Start Date
  • Current Continuous Primary Payor Membership Episode End Date

• Patient Fields

  • Primary Plan Employer Description

• Metadata Fields

  • Last Continuous Primary Payor Membership Episode Start Date
  • Last Continuous Primary Payor Membership Episode End Date
  • Last Continuous Primary Payor Membership Episode Payor ID
  • Next Continuous Primary Payor Membership Episode Start Date
  • Next Continuous Primary Payor Membership Episode End Date
  • Next Continuous Primary Payor Membership Episode Payor ID

• Insurance Fields

  • Primary Plan Financial Class Description
  • Is Primary Plan Coverage Type Medical
  • Is Primary Plan Coverage Type Pharmacy
  • Is Primary Plan Financial Class Commercial
  • Is Primary Plan Financial Class Medicare FFS
  • Is Primary Plan Financial Class Medicare Advantage
  • Is Primary Plan Financial Class Medicaid
  • Is Primary Plan Financial Class Other
  • Count Active Plan Memberships
  • Count Distinct Payors with Active Plan Membership
  • Is Any Plan Coverage Type Medical
  • Is Any Plan Coverage Type Pharmacy
  • Is Any Plan Financial Class Commercial
  • Is Any Plan Financial Class Medicare FFS
  • Is Any Plan Financial Class Medicare Advantage
  • Is Any Plan Financial Class Medicaid
  • Is Any Plan Financial Class Other
  • Member HICN
  • Member MBI
  • Is CMS Hospice Status -- Indicates the patient is considered to be Hospice status.
  • Is CMS ESRD Status -- Indicates the patient meets the Medicare ESRD eligibility criterion as of a particular date; can be derived from the CMS Medicare Beneficiary Status Code. (See also [URSA-CORE] CMS Medicare Beneficiary Status Code)
  • Is CMS LTI Status -- Indicates the patient meets the CMS criteria to be considered a Long-Term Institutional (LTI) patient. Among other potential uses, this status is used in the calculation of RAF scores.
  • Is Dual Medicare-Medicaid Enrolled -- Indicates that the patient is concurrently enrolled in both Medicare and Medicaid programs. (Identifies the population often described as "dually eligible" or "duals".)
  • CMS Dual Status Code -- The standard 2-character CMS Dual Status Code, which identifies the patient's most recent entitlement status for Medicaid and other qualifying non-Medicare programs; e.g., 01 = QMB only, 02 = QMB + full Medicaid, etc.
  • Member Medicaid Number

Foreign Keys

• primary_plan_id → ursa.no_ursa_core_struct_005.plan_id
• primary_payor_id → ursa.no_ursa_core_struct_004.payor_id
• primary_plan_attributee_prov_id → ursa.no_ursa_core_prov_001.prov_id