URSA-PHF-R01: Patients with Active Membership

Measure Description

Patients with active membership in any plan. This measure represents a view of the Data Mart for URSA-CORE Patient Timelines and provides the count of patients which, as of the snapshot date, are alive and have active plan membership in any plan. Patients are considered to be alive unless a date of death available from a validated data source.

Metadata

• Measure Type: Registry
• Temporal Structure: Entity
• Component Class: Normal-Form
• Denominator Case Field: Patient ID
• Target Direction: None

Published Fields

• Data Model Keys

  • Patient ID
  • Primary Plan Attributee Provider ID
  • Primary Plan Attributee Individual Provider ID
  • Primary Plan Attributee Provider Group 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

  • Is Hospice in Last 12 Months
  • Patient Last Name
  • Patient Date of Birth
  • Patient Age Integer
  • Patient Age Category Tier 1
  • Patient Age Category Tier 2
  • Patient Sex Category
  • Is Patient Sex Female
  • Is Patient Sex Male
  • 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
  • Specialty Care Engagement Category
  • Count Specialty Care Office Visits in Last 36 Months
  • Primary or Specialty Care Engagement Category
  • Count Clinician Office Visits in Last 3 Years

• 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

  • Is Patient with Primary Plan Attributed Provider
  • Is Patient with Empirically Attributed Individual PCP
  • Primary Plan Attributee Provider Description
  • Primary Plan Attributee Primary NUCC Provider Taxonomy Description
  • Empirical Attributee Primary Care Individual Provider Description
  • Empirical Attributee Primary Care Provider Group Provider Description
  • Count Visits with Attributee Individual Primary Care Provider in Last 36 Months
  • Count Visits with Attributee Primary Care Provider Group in Last 36 Months
  • Is Empirically Attributed Individual PCP Match to Plan Attributed PCP

• Location Fields

  • Patient State Abbreviation
  • Patient ZIP Code 5-Digit
  • Patient County Description
  • UW HIP Area Deprivation Index National Percentile
  • UW HIP ADI Quintile Category
  • UW HIP ADI Decile 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

  • Is Patient with Multiple Active Plan Memberships
  • Count Active Plan Memberships
  • Primary Payor Description
  • Primary Plan Description
  • Primary Plan Financial Class Description
  • Member HICN
  • Member MBI
  • Is CMS ESRD Status
  • Is CMS Hospice Status
  • Is Dual Medicare-Medicaid Enrolled
  • CMS Dual Status Code
  • Member Medicaid Number

• 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
  • Is Patient with any CCW Condition

• Measure Fields

  • Denominator