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    URSA-HCC-001: Within-Year-Updated CMS-HCC RAF Score
    • 28 Jun 2025
    • 4 Minutes to read
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    URSA-HCC-001: Within-Year-Updated CMS-HCC RAF Score

    • Updated on 28 Jun 2025
    • 4 Minutes to read
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    Article summary

    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.

    Published Fields

    • Data Model Keys

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

    • Patient Fields

      • Patient Age Integer
      • Patient Age Category Tier 1
      • Patient Age Category Tier 2
      • Patient First Name
      • Patient Last Name
      • Patient Date of Birth
      • Patient State Abbreviation
      • Patient ZIP Code 5-Digit
      • UW HIP Area Deprivation Index National Percentile
      • UW HIP ADI Quintile Category
      • UW HIP ADI Decile Category
      • CDC SVI Overall National Percentile
      • CDC SVI Overall Quintile Category

    • Date Fields

      • Period Start Date
      • Period End Date
      • Current Continuous Primary Payor Membership Episode Start Date
      • Current Continuous Primary Payor Membership Episode End Date
      • Current Continuous Medical Claim Data Coverage Episode Start Date
      • Current Continuous Medical Claim Data Coverage 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.

    • Insurance Fields

      • CMS RAF Type Code
      • Primary Payor Description
      • Primary Plan Description
      • Primary Plan CMS Contract Number
      • Primary Plan CMS PBP Number
      • Primary Plan Financial Class Description

    • Denominator Fields

      • Is Continuous Year-to-Date Primary Payor Membership

    • Metadata Fields

      • Random Integer 1 to 1000

    • Measure Fields

      • Denominator
      • Numerator

    • Module Fields

      • CMS-HCC Patient Age
      • CMS-HCC Age Category
      • CMS-HCC Patient Sex Code
      • Is CMS-HCC Medicaid Patient
      • CMS-HCC Eligibility Code
      • CMS-HCC Eligibility Code Description
      • CMS-HCC Original Reason for Entitlement Code
      • CMS-HCC Original Reason for Entitlement Code Description
      • Standard Final Action CMS-HCC RAF Score
      • Standard Final Action CMS-HCC Raw RAF Score
      • Standard Final Action CMS-HCC Demographic Component RAF Score
      • Standard Final Action CMS-HCC Disease Component RAF Score
      • Standard Final Action CMS-HCC v24 RAF Score
      • Standard Final Action CMS-HCC v28 RAF Score
      • Standard Final Action CMS-HCC v24 to v28 Increase in RAF Score
      • Standard Final Action CMS-HCC RAF Score Using 2024 Blend
      • Standard Final Action CMS-HCC RAF Score Using 2025 Blend
      • Standard Final Action CMS-HCC v24 All Outputs Summary
      • Standard Final Action CMS-HCC v28 All Outputs Summary
      • Within-Year-Updated CMS-HCC RAF Score
      • Within-Year-Updated CMS-HCC Raw RAF Score
      • Within-Year-Updated CMS-HCC Demographic Component RAF Score
      • Within-Year-Updated CMS-HCC Disease Component RAF Score
      • Within-Year-Updated CMS-HCC v24 RAF Score
      • Within-Year-Updated CMS-HCC v28 RAF Score
      • Within-Year-Updated CMS-HCC RAF Score Using 2024 Blend
      • Within-Year-Updated CMS-HCC RAF Score Using 2025 Blend
      • Within-Year-Updated CMS-HCC v24 All Outputs Summary
      • Within-Year-Updated CMS-HCC v28 All Outputs Summary
      • Within-Year-Updated Count CMS-HCC v24 HCCs
      • Within-Year-Updated Count CMS-HCC v28 HCCs
      • Historical-Diagnoses CMS-HCC RAF Score
      • Historical-Diagnoses vs. Standard Final Action CMS-HCC RAF Score Gap
      • Historical-Diagnoses vs. Within-Year-Updated CMS-HCC RAF Score Gap
      • Historical-Diagnoses CMS-HCC Raw RAF Score
      • Historical-Diagnoses CMS-HCC Demographic Component RAF Score
      • Historical-Diagnoses CMS-HCC Disease Component RAF Score
      • Historical-Diagnoses CMS-HCC v24 RAF Score
      • Historical-Diagnoses CMS-HCC v28 RAF Score
      • Historical-Diagnoses CMS-HCC RAF Score Using 2024 Blend
      • Historical-Diagnoses CMS-HCC RAF Score Using 2025 Blend
      • Historical-Diagnoses CMS-HCC v24 All Outputs Summary
      • Historical-Diagnoses CMS-HCC v28 All Outputs Summary
      • Historical-Diagnoses Count CMS-HCC v24 HCCs
      • Historical-Diagnoses Count CMS-HCC v28 HCCs
      • Count Historical-Diagnoses CMS-HCC v24 Outputs Missing from Within-Year-Updated Outputs
      • Count Historical-Diagnoses CMS-HCC v28 Outputs Missing from Within-Year-Updated Outputs
      • Historical-Diagnoses CMS-HCC v24 Outputs Missing from Within-Year-Updated Outputs Summary
      • Historical-Diagnoses CMS-HCC v28 Outputs Missing from Within-Year-Updated Outputs Summary
      • Standard Initial Run CMS-HCC RAF Score
      • Standard Initial Run CMS-HCC Raw RAF Score
      • Standard Initial Run CMS-HCC Demographic Component RAF Score
      • Standard Initial Run CMS-HCC Disease Component RAF Score
      • Standard Initial Run CMS-HCC RAF Score Using 2024 Blend
      • Standard Initial Run CMS-HCC RAF Score Using 2025 Blend
      • Standard Initial Run CMS-HCC v24 RAF Score
      • Standard Initial Run CMS-HCC v28 RAF Score
      • Standard Initial Run CMS-HCC v24 All Outputs Summary
      • Standard Initial Run CMS-HCC v28 All Outputs Summary
      • Standard Midyear Run CMS-HCC RAF Score
      • Standard Midyear Run CMS-HCC Raw RAF Score
      • Standard Midyear Run CMS-HCC Demographic Component RAF Score
      • Standard Midyear Run CMS-HCC Disease Component RAF Score
      • Standard Midyear Run CMS-HCC RAF Score Using 2024 Blend
      • Standard Midyear Run CMS-HCC RAF Score Using 2025 Blend
      • Standard Midyear Run CMS-HCC v24 RAF Score
      • Standard Midyear Run CMS-HCC v28 RAF Score
      • Standard Midyear Run CMS-HCC v24 All Outputs Summary
      • Standard Midyear Run CMS-HCC v28 All Outputs Summary
      • Is Patient With CMS-HCC Calculations Using MAO-004 Diagnoses
      • Is Patient With CMS-HCC Calculations Using Claim Diagnoses
      • Is Patient With CMS-HCC Calculations Using Bill Diagnoses
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