URSA-CKD-101: Controlled High Blood Pressure for CKD Patients

Measure Description

Among CKD patients, the percentage with controlled high blood pressure documented in the most recent office visit in the last 12 months

Metadata

• Measure Type: Rate Measure
• Temporal Structure: Entity
• Component Class: Long-Form
• Denominator Case Field: Patient ID
• Target Direction: Up

Denominator Description

Patients with chronic kidney disease, aged 18 - 85, with current active membership in a targeted health plan and at least 12 months of continuous prior membership with the same payor

Numerator Description

Numerator takes a value of 1 if the patient has at least one physician office visit in the past 12 months with documentation of systolic blood pressure < 140 and diastolic blood pressure < 90; else 0.

Published Fields

• Data Model Keys

  • Patient ID
  • Primary Plan ID
  • Primary Payor ID
  • Empirical Attributee Individual Nephrology Provider ID
  • Empirical Attributee Nephrology Group Provider ID

• Patient Fields

  • Patient Date of Birth
  • Patient Age Integer
  • Count Hospital Inpatient Admissions in Last 12 Months
  • Count ED Visits Without Inpatient Admissions in Last 12 Months

• Date Fields

  • Start of Measurement Period
  • Current Continuous Primary Payor Membership Episode Start Date
  • Current Continuous Primary Payor Membership Episode End Date
  • Current Dialysis Episode Start Date
  • Current Dialysis Episode End Date
  • Segment Start Date -- The start date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
  • Segment End Date -- The end date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
  • Snapshot Date -- The date, evaluated at 00:00:00 AM, giving the moment the state of the world will be set to for the purposes of an analysis. The snapshot date does not represent the freshness of the data, or the date in real time at which an analysis was executed.

• Provider Fields

  • CKD Physician Management Category
  • Plan Attributee Provider Description
  • Count Nephrology Provider Visits in Last 12 Months
  • Empirical Attributee Individual Nephrology Provider Description
  • Empirical Attributee Nephrology Group Provider Description
  • Count Primary Care Visits for CKD in Last 12 Months
  • Primary Care Engagement Category
  • Count Primary Care Visits in Last 36 Months
  • Empirical Attributee Primary Care Provider Group Description
  • Empirical Attributee Individual Primary Care Provider Description
  • Count Visits with Attributee Individual Primary Care Provider in Last 36 Months
  • Count Visits with Attributee Primary Care Provider Group in Last 36 Months

• Location Fields

  • Patient ZIP Code 5-Digit
  • UW HIP ADI Quintile Category

• Insurance Fields

  • Primary Plan Description
  • Primary Plan Financial Class Description

• Clinical Services Fields

  • Is Hospice in Last 12 Months
  • Is Last Dialysis Modality Hemodialysis
  • Is Last Dialysis Modality Peritoneal Dialysis

• Diagnosis Fields

  • Count CCW Conditions
  • Is CCW System Behavioral Health
  • Is CCW System Cardiovascular
  • Is CCW System Genitourinary
  • Is CCW System Musculoskeletal
  • Is CCW System Pulmonary
  • Is CCW Acquired Hypothyroidism
  • Is CCW Acute Myocardial Infarction
  • Is CCW Alzheimers Disease
  • Is CCW Anemia
  • Is CCW Anxiety Disorders
  • Is CCW Asthma
  • Is CCW Atrial Fibrillation
  • Is CCW Benign Prostatic Hyperplasia
  • Is CCW Bipolar Disorder
  • Is CCW Breast Cancer
  • Is CCW Cataract
  • Is CCW CKD
  • Is CCW COPD and Bronchiectasis
  • Is CCW Colorectal Cancer
  • Is CCW Depression
  • Is CCW Depressive Disorders
  • Is CCW Diabetes
  • Is CCW Endometrial Cancer
  • Is CCW Glaucoma
  • Is CCW Heart Failure
  • Is CCW Ischemic Heart Disease
  • Is CCW Hip or Pelvic Fracture
  • Is CCW Hyperlipidemia
  • Is CCW Hypertension
  • Is CCW Lung Cancer
  • Is CCW Osteoporosis
  • Is CCW Prostate Cancer
  • Is CCW Rheumatoid Arthritis or Osteoarthritis
  • Is CCW Stroke or Transient Ischemic Attack
  • Is CCW Schizophrenia or Other Psychotic Disorders
  • CCW Count Category
  • Is CCW Alzheimers Disease and Related Disorders or Senile Dementia
  • CCW Systems Category
  • Count CCW Systems
  • Is CCW System Congenital
  • Is CCW System Endocrine/Metabolic
  • Is CCW System Hematologic
  • Is CCW System Neurological
  • Is CCW System Oncologic
  • Is CCW System Ophthalmologic
  • Is CCW System Other

• Numerator Fields

  • HCPCS Code
  • Is Encounter Controlled BP
  • Document ID
  • Claim ID
  • HCPCS Description
  • Is Last SBP < 140 Code
  • Is Last DBP < 90 Code

• Measure Fields

  • Denominator
  • Numerator

• Module Fields

  • CKD Stage Category
  • Is Chronic Dialysis Patient
  • Is History of Kidney Transplantation

• [No Field Group]

  • Ursa Serial ID