URSA-HCC-002: Documentation of All Historical HCC Diagnoses

Measure Description

Among patients with a calculated CMS-HCC RAF score, the percentage with all historical HCCs documented in the current calendar year as of the snapshot date; uses both v24 and v28 of the CMS-HCC model to identify historical diagnoses.

Metadata

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

Denominator Description

Patients with a calculated 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

One per qualifying denominator case for which all HCCs identified using the Historical-Diagnoses CMS-HCC standard have been documented in the current calendar year-to-date as of the snapshot date; a patient is considered to have missing HCCs if a historical HCC in either the v24 or v28 of the CMS-HCC model is not documented in the current year.