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    URSA-PHF-060: Patients with PCP Visit Last 12 Months
    • 28 Jun 2025
    • 4 Minutes to read
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    URSA-PHF-060: Patients with PCP Visit Last 12 Months

    • Updated on 28 Jun 2025
    • 4 Minutes to read
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    Article summary

    Measure Description

    Among patients with active plan coverage, the percentage with at least one Primary Care Office Visit in the last 365 days.

    Metadata

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

    Denominator Description

    Patient-periods with active plan coverage during which they are alive.

    Numerator Description

    The most recent prior Primary Care Office Visit in the last 12 months.

    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 Integer
      • Patient Age Category Tier 1
      • Patient Age Category Tier 2
      • Patient Sex Category
      • Is Patient with Any Plan or Empirically Attributed Provider
      • PCP Attribution Category
      • Primary Care Engagement Category
      • Count Primary Care Visits in Last 36 Months
      • Specialty Care Engagement Category
      • Primary or Specialty Care Engagement Category
      • Count Hospital Inpatient Admissions in Last 12 Months
      • Count ED Visits Without Inpatient Admissions in Last 12 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)
      • 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.

    • Provider Fields

      • Primary Plan Attributee Provider Description
      • Empirical Attributee Primary Care Individual Provider Description
      • Empirical Attributee Primary Care Provider Group Provider Description

    • 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
      • CDC SVI Household / Disability Quintile Category
      • CDC SVI Minority / Language Quintile Category
      • CDC SVI Housing / Transportation 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

      • PCP Visit Encounter ID
      • PCP Visit Facility Provider ID
      • PCP Visit Service Provider ID
      • PCP Visit Attending Provider ID
      • PCP Visit Provider Group Provider ID
      • PCP Visit Prior Primary Care Office Visit Encounter ID
      • PCP Visit Encounter Date
      • PCP Visit Prior Primary Care Office Visit Encounter Date
      • PCP Visit Days Since Prior Primary Care Office Visit
      • Is PCP Visit Preventive Care Visit from Non-Primary Care Specialist
      • Is PCP Visit Annual Wellness Visit
      • Is PCP Visit First AWV with Provider
      • Is PCP Visit Subsequent AWV with Provider
      • Is PCP Visit Initial Preventive Physician Examination (IPPE)
      • Is PCP Visit FQHC Visit for IPPE or AWV
      • Is PCP Visit Urgent Care Visit
      • PCP Visit Principal Discharge Diagnosis ICD-10-CM Code
      • PCP Visit Principal Discharge Diagnosis ICD-10-CM Description
      • PCP Visit Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Code
      • PCP Visit Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Description
      • PCP Visit Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Code
      • PCP Visit Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Description
      • PCP Visit Service Provider Provider NPI
      • PCP Visit Service Provider Provider Description
      • PCP Visit Service Provider Affiliated Provider Group Description
      • PCP Visit Provider Group Description
      • PCP Visit Ursa Service Provider Specialty Type Category
      • PCP Visit Service Provider Practice Address State Abbreviation
      • PCP Visit Service Provider Practice Address ZIP Code 5-Digit
      • PCP Visit Provider Group Practice Address ZIP Code 5-Digit
      • Is PCP Visit Qualifying Preventive Primary Care Service
      • PCP Visit Qualifying Document HCPCS Code
      • PCP Visit Qualifying Preventive Primary Care HCPCS Code
      • PCP Visit Qualifying Preventive Primary Care HCPCS Code Description
      • PCP Visit Qualifying Annual Wellness Visit HCPCS Code
      • PCP Visit Qualifying Annual Wellness Visit HCPCS Code Description
      • PCP Visit Encounter Total Plan Paid Amount from All Plans Category
      • PCP Visit Primary Plan Allowed Amount
      • PCP Visit Primary Plan Paid Amount
      • PCP Visit Total Plan Paid Amount from All Plans
      • PCP Visit Patient Paid Amount
      • PCP Visit Qualifying Document EMR Encounter Type Description

    • Measure Fields

      • Denominator
      • Numerator
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