URSA-PHF-023b: Primary Care Office Visits per 1000 Patient-Years

Measure Description

Among living patients with medical claims data coverage and active plan membership, the population rate of primary care office visits per 1000 patient-years.

Metadata

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

Denominator Description

The elapsed patient-months among active membership periods during which the patient was alive and had medical claims data coverage, expressed in units of 1000s of patient-years.

Numerator Description

The count of primary care office visits occurring during qualifying denominator membership periods.

Published Fields

• Data Model Keys

  • Patient 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

• Patient Fields

  • Patient Date of Birth
  • Patient Age Category Tier 1
  • Patient Age Category Tier 2
  • Patient Sex Category
  • Count Hospital Inpatient Admissions in Last 12 Months
  • Count ED Visits Without Inpatient Admissions in Last 12 Months
  • PCP Attribution Category
  • Primary Care Engagement Category
  • Count Primary Care Visits in Last 36 Months

• Date Fields

  • Current Continuous Primary Payor Membership Episode Start Date
  • Current Continuous Primary Payor Membership 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)
  • Segmented Period Start Date
  • Segmented Period End Date

• Location Fields

  • Patient State Abbreviation
  • Patient ZIP Code 5-Digit
  • Patient County Description
  • UW HIP ADI Quintile Category
  • CDC SVI Overall Quintile Category
  • CDC SVI Socioeconomic Quintile Category

• Insurance Fields

  • Primary Payor Description
  • Primary Plan Description
  • Primary Plan Financial Class Description

• Diagnosis Fields

  • CCW Count Category
  • Count CCW Conditions
  • Is CCW Acquired Hypothyroidism
  • Is CCW Acute Myocardial Infarction
  • Is CCW ADHD, Conduct Disorders, and Hyperkinetic Syndrome
  • Is CCW Alzheimers Disease
  • Is CCW Alzheimers Disease and Related Disorders or Senile Dementia
  • Is CCW Anemia
  • Is CCW Anxiety Disorders
  • Is CCW Asthma
  • Is CCW Atrial Fibrillation
  • Is CCW Autism Spectrum Disorder
  • Is CCW Benign Prostatic Hyperplasia
  • Is CCW Bipolar Disorder
  • Is CCW Blindness and Visual Impairment
  • Is CCW Breast Cancer
  • Is CCW Cataract
  • Is CCW Cerebral Palsy
  • Is CCW CKD
  • Is CCW Colorectal Cancer
  • Is CCW COPD and Bronchiectasis
  • Is CCW Cystic Fibrosis and Other Metabolic Disorder
  • Is CCW Deafness and Hearing Impairment
  • Is CCW Depression
  • Is CCW Depressive Disorders
  • Is CCW Diabetes
  • Is CCW Endometrial Cancer
  • Is CCW Epilepsy
  • Is CCW Fibromyalgia and Chronic Pain and Fatigue
  • Is CCW Glaucoma
  • Is CCW Heart Failure
  • Is CCW Hip or Pelvic Fracture
  • Is CCW Hyperlipidemia
  • Is CCW Hypertension
  • Is CCW Intellectual Disability
  • Is CCW Ischemic Heart Disease
  • Is CCW Learning Disability
  • Is CCW Leukemia
  • Is CCW Lung Cancer
  • Is CCW Migraine and Chronic Headache
  • Is CCW Mobility Impairment
  • Is CCW Multiple Sclerosis
  • Is CCW Muscular Dystrophy
  • Is CCW Obesity
  • Is CCW Osteoporosis
  • Is CCW Other Developmental Delay
  • Is CCW Personality Disorder
  • Is CCW Pressure or Chronic Ulcer
  • Is CCW Prostate Cancer
  • Is CCW PTSD
  • Is CCW PVD
  • Is CCW Rheumatoid Arthritis or Osteoarthritis
  • Is CCW Schizophrenia
  • Is CCW Schizophrenia or Other Psychotic Disorders
  • Is CCW Stroke or Transient Ischemic Attack
  • 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

• Numerator Fields

  • Encounter ID
  • Service Provider ID
  • Provider Group Provider ID
  • Encounter Date
  • Is Preventive Care Visit from Non-Primary Care Specialist
  • Is Annual Wellness Visit
  • Is First AWV with Provider
  • Is Subsequent AWV with Provider
  • Is Initial Preventive Physician Examination (IPPE)
  • Principal Discharge Diagnosis ICD-10-CM Code
  • Principal Discharge Diagnosis ICD-10-CM Description
  • Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Code
  • Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Description
  • Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Code
  • Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Description
  • Is Any Provider Qualifying Primary Care Provider
  • Service Provider Provider NPI
  • Service Provider Provider Description
  • Service Provider Primary NUCC Provider Taxonomy Description
  • Provider Group Description
  • Provider Group Primary NUCC Provider Taxonomy Description
  • Service Provider Practice Address State Abbreviation
  • Service Provider Practice Address ZIP Code 5-Digit
  • Provider Group Practice Address State Abbreviation
  • Provider Group Practice Address ZIP Code 5-Digit
  • Is Qualifying Preventive Primary Care Service
  • Qualifying Document HCPCS Code
  • Qualifying Preventive Primary Care HCPCS Code
  • Qualifying Preventive Primary Care HCPCS Code Description
  • Encounter Total Plan Paid Amount from All Plans Category
  • Primary Plan Allowed Amount
  • Primary Plan Paid Amount
  • Total Plan Paid Amount from All Plans
  • Patient Paid Amount

• Measure Fields

  • Denominator
  • Numerator

• [No Field Group]