URSA-PHARM-103: Statin PDC

Measure Description

Among patients with a continuous period of plan membership of 180 days or longer in the 12 months prior to a snapshot date, and with 2 or more statin fills during that membership period, the percentage of days between the first qualifying fill and the earlier of the snapshot date or membership period end date with positive supply of statins

Metadata

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

Denominator Description

One per qualifying patient-episode

Numerator Description

The statin PDC for the period from the first qualifying fill to the snapshot date or the end of the continuous membership period, whichever comes first

Published Fields

• Data Model Keys

  • Patient ID
  • Episode ID
  • Primary Plan Attributee Provider ID
  • Empirical Attributee Primary Care Individual Provider ID
  • Empirical Attributee Primary Care Provider Group Provider ID
  • Primary Payor ID
  • Primary Plan ID
  • First Fill Document ID
  • Second Fill Document ID

• Date Fields

  • Reference Date
  • PDC Numerator Period Start Date
  • PDC Numerator Period End Date
  • Period Start Date
  • Period End Date
  • Truncated Continuous Membership Episode Start Date
  • Truncated Continuous Membership Episode End Date
  • First Fill Filled Date
  • Second Fill Filled 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.

• Episode Fields

  • Truncated Coverage Episode Length Days
  • Is Guaranteed PDC Below 80 Percent by Second Fill
  • Missing Supply Days for PDC of 80 Percent

• Medication Fields

  • First Fill Label Description
  • First Fill Calendar Date Aggregate Days Supply
  • Second Fill Label Description
  • Second Fill Calendar Date Aggregate Days Supply

• Patient Fields

  • Is 3+ Hospital IP Admissions Last 12 Months
  • Is 3+ ED Visits Last 12 Months
  • Patient Date of Birth
  • Patient Sex Category
  • Is Patient Sex Female
  • Is Patient Sex Male
  • Patient Age Category Tier 1
  • Patient Age Category Tier 2
  • Patient Age Integer
  • PCP Attribution Category
  • Primary Care Engagement Category
  • Count Hospital Inpatient Admissions in Last 12 Months
  • Count ED Visits Without Inpatient Admissions in Last 12 Months
  • Is Patient Alive
  • Is Any Current Plan Membership
  • Is Any Current Data Coverage

• Provider Fields

  • Count Primary Care Visits in Last 36 Months
  • Primary Plan Attributee Provider Description
  • Primary Plan Attributee Practice Address State Abbreviation
  • Primary Plan Attributee Practice Address ZIP Code 5-Digit
  • Empirical Attributee Primary Care Individual Provider Description
  • Empirical Attributee Primary Care Provider State
  • Empirical Attributee Primary Care Provider Zip

• Location Fields

  • 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 Quintile Category

• Insurance Fields

  • Primary Payor Description
  • Primary Plan Description
  • Primary Plan Financial Class Description
  • Is Primary Plan Financial Class Commercial
  • Is Primary Plan Financial Class Medicare Advantage
  • Is Primary Plan Financial Class Medicaid
  • Is CMS ESRD Status
  • Is CMS Hospice Status
  • Is Dual Medicare-Medicaid Enrolled

• Numerator Fields

  • Numerator Supply Period Start Date
  • Numerator Supply Period End Date
  • Numerator Count Distinct Statins

• Validation Only Fields

  • PDC Numerator Contribution in Days
  • PDC Numerator Contribution Scaled
  • First Fill Supply Exhausted Date
  • Days from First Fill Supply Exhausted to Second Fill
  • Original Membership Episode Start Date
  • Original Membership Episode End Date

• [No Field Group]

  • Ursa Serial ID

• Diagnosis Fields

  • CCW Count Category
  • Count CCW Conditions
  • CCW Systems Category
  • Count CCW Systems
  • Is CCW System Behavioral Health
  • Is CCW System Cardiovascular
  • Is CCW System Congenital
  • Is CCW System Endocrine/Metabolic
  • Is CCW System Genitourinary
  • Is CCW System Hematologic
  • Is CCW System Musculoskeletal
  • Is CCW System Neurological
  • Is CCW System Oncologic
  • Is CCW System Ophthalmologic
  • Is CCW System Pulmonary
  • Is CCW System Other

• Metadata Fields

  • Random Integer 1 to 1000
  • Is Medical Claim Data Coverage
  • Is Pharmacy Claim Data Coverage

• Measure Fields

  • Denominator
  • Numerator