URSA-MSSP-MIPS-HWR: Unplanned All-Condition 30-Day Readmissions (HWR)

  • Published on Aug 21, 2025
  • 2 minute(s) read
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Measure Description

Among qualifying hospital inpatient admissions for non-cancer, non-psychiatric, and non-rehabilitation conditions, the percentage with an unplanned all-condition readmission within 30 days of discharge.

Metadata

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

Denominator Description

Qualifying hospital inpatient admissions for non-cancer, non-psychiatric, and non-rehabilitation conditions.

Numerator Description

Qualifying denominator cases with an unplanned all-condition readmission within 30 days.

Published Fields

  • Data Model Keys

    • Measure ID
    • Patient ID
    • Index Encounter ID
    • Index Encounter Facility Provider ID
    • Affiliated Program Entity ID
    • Affiliated Program Entity Provider ID
    • Primary Payor ID
    • Primary Plan ID
    • Primary Plan Attributee Provider ID
    • Primary Plan Attributee Individual Provider ID
    • Primary Plan Attributee Provider Group Provider ID
    • Primary Plan Attributee Provider Contract ID

  • Operations Support Fields

    • Is Patient Affiliated to a Program Entity
    • Program Entity Operational ID
    • Program Operational ID
    • Patient Operational ID

  • Patient Fields

    • Is Patient Alive
    • Patient Age Integer
    • Patient Date of Birth
    • Patient Date of Death

  • Date Fields

    • Index Encounter Start Date
    • Index Encounter 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.

  • Encounter Fields

    • Is Surgery/Gynecology Specialty Cohort Encounter
    • Cohort Category Description

  • Provider Fields

    • Index Facility Provider NPI
    • Index Facility Provider CCN
    • Index Facility Provider Description
    • Index Facility Primary NUCC Provider Taxonomy Code
    • Index Facility Primary NUCC Provider Taxonomy Description

  • Insurance Fields

    • Member MBI
    • Is Any Current Plan Membership
    • Primary Payor Description
    • Primary Plan Description
    • Primary Plan Financial Class Description

  • Diagnosis Fields

    • Index Encounter Principal Discharge Diagnosis ICD-10-CM Code
    • Index Encounter Principal Discharge Diagnosis ICD-10-CM Description
    • Index Encounter Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Code
    • Index Encounter Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Description

  • Denominator Fields

    • Is Continuous Membership Criterion Met
    • Is Cohort Exclusion for Index Event Not within Defined Cohort
    • Is Exclusion for Facility Type
    • Is Exclusion for Same-Day Readmission
    • Is Denominator Exclusion
    • Is Eligible Index Admission
    • Is Neurology Specialty Cohort Encounter
    • Is Medicine Specialty Cohort Encounter
    • Is Cardiovascular Specialty Cohort Encounter
    • Is Cardiorespiratory Specialty Cohort Encounter
    • Is Medical Treatment of Cancer Encounter Exclusion
    • Is Rehabilitation Encounter Exclusion
    • Is Psychiatric Encounter Exclusion
    • Is Covid Admitting Diagnosis Exclusion
    • Is Exclusion for Discharge Against Medical Advice
    • Is Exclusion for Patient Discharge due to Death
    • Is Facility CCN Type CAH or Short-Term General or Specialty

  • Numerator Fields

    • Is Readmission Facility CCN Type CAH or Short-Term General or Specialty
    • Readmission Facility Provider ID
    • Readmission Encounter ID
    • Readmission Encounter Start Date
    • Readmission Encounter End Date

  • Metadata Fields

    • Next Encounter Start Date
    • Next Encounter ID
    • Next Encounter Facility Provider ID

  • Validation Only Fields

    • Next Encounter Principal Discharge Diagnosis ICD10CM
    • Elapsed Days from Encounter End Date to Next Encounter Start Date

  • Measure Fields

    • Denominator
    • Numerator

  • Numerator

    • Is Readmission Encounter with Always Planned Procedure
    • Is Readmission Encounter with Potentially Planned Procedure
    • Is Readmission Encounter with Always Planned Diagnosis