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

Object Description

One record per patient timeline period in which the patient has at least one active insurance plan coverage, with attribution to the primary plan; primary plan is determined based on the following criteria, evaluated in this order (1) the plan identified as primary in the membership record; (2) the plan with a plan-assigned provider; (3) the plan with the plurality of paid claims in that calendar year; (4) the plan that is not a Medicaid plan; (5) the plan with the lowest Plan ID (tiebreaker).

Metadata

• Table Name: ursa.so_ursa_core_fin_005
• Layer: SYNTHETIC_OBJECT
• Object Type: Attribution 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
  • Primary Plan ID

• Date Fields

  • Period Start Date
  • Period End Date

• Validation Only Fields

  • Is Plan Designated Primary in Plan Membership Record
  • Is Plan with Assigned Provider
  • Count Claims in Calendar Year

Foreign Keys

• pat_id → ursa.no_ursa_core_pat_001.pat_id
• primary_plan_id → ursa.no_ursa_core_struct_005.plan_id