URSA-HCC-001: Within-Year-Updated CMS-HCC RAF Score

Measure Description

Among patients with a calculated Within-Year-Updated (WYU) CMS-HCC RAF score, the normalized WYU CMS-HCC RAF score per patient; uses the appropriate blend of v24 and v28 models based on the reporting period.

Metadata

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

Denominator Description

Patient with a calculated Within-Year-Updated CMS-HCC RAF score as of the snapshot date. CMS-HCC RAF scores are generated during calendar years in which the patient had an active membership at any time.

Numerator Description

The normalized Within-Year-Updated RAF Score as of the snapshot date; uses the appropriate blend of v24 and v28 models based on the reporting period.