Measure Description
Among patients aged 18 to 75 with diabetes, a prior qualifying visit in the last 12 months, and data completeness for the prior 12 months, the percentage with a most recent HbA1c =< 9% in the last 12 months. Due to its inverseness, a higher calculated performance rate for this measure indicates better clinical care or control.
Metadata
- Measure Type: Rate Measure
- Temporal Structure: Entity
- Component Class: Normal-Form
- Denominator Case Field: Patient ID
- Target Direction: Down
Denominator Description
Patients aged 18 to 75 with diabetes, a prior qualifying visit in the last 12 months, and data completeness.
Numerator Description
Patients with qualifying documentation in the last 12 months characterizing the result of the most recent prior HbA1c, and with the most recent prior instance of this documentation indicating a result <= 9%. If the patient does not have a documented HbA1c in the last 12 months it is considered "not controlled".
Published Fields
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Data Model Keys
- Measure ID
- Patient ID
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Operations Support Fields
- Affiliated Program Entity ID
- Affiliated Program Entity Provider ID
- Primary Plan Attributee Provider Contract ID
- Program Entity Operational ID
- Program Operational ID
- Patient Operational ID
- Is Patient Affiliated to a Program Entity
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Denominator Fields
- Is Denominator Event Criterion Met
- Qualifying Denominator Encounter Date
- Qualifying Denominator Encounter Provider ID
- Qualifying Denominator Encounter Provider Description
- Is Data Completeness Continuous Membership Criterion Met
- Is Any Required Exclusion
- Is Required Exclusion for Hospice
- Is Required Exclusion for Palliative Care
- Is Required Exclusion for 66+ with Institutional Special Needs Plan
- Is Required Exclusion for 66+ with Frailty and Dementia Medications
- Is Required Exclusion for 66+ with Frailty and Advanced Illness
- Required Exclusions Description
- Is Eligible Population
- Affiliated Program Entity Provider NPI
- Affiliated Program Entity Provider Description
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Numerator Fields
- Numerator Component Contribution
- Numerator Category Description
- Numerator Document ID
- Numerator Document Effective Date
- Numerator HCPCS Code
- Numerator HCPCS Description
- Numerator Result Numeric
- Numerator Source ID
- Is Numerator Qualifying Using Standard End-of-Year Timing
- Numerator Component Contribution Using Standard End-of-Year Timing
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Patient Fields
- Patient Age on Date of Qualifying Encounter
- Patient Date of Birth
- Patient State Abbreviation
- Patient ZIP Code 5-Digit
- Is Patient Sex Female
- Is Patient Sex Male
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Insurance Fields
- Primary Payor ID
- Primary Plan ID
- Primary Plan Attributee Provider ID
- Primary Plan Attributee Provider Description
- Member MBI
- Primary Payor Description
- Primary Plan Description
- Primary Plan Financial Class Description
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Date Fields
- 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.
- 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)
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Measure Fields
- Denominator
- Numerator
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Metadata Fields