URSA-QUALITY-AAP: Adult Access to Preventive Services (AAP)

Measure Description

The percentage of members 20 years of age and older who had an ambulatory or preventive care visit in the last 12 months

Metadata

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

Denominator Description

None

Numerator Description

None

Published Fields

• Data Model Keys

  • Patient ID
  • Primary Payor ID
  • Primary Plan ID
  • Numerator Document ID
  • Numerator Source ID

• Patient Fields

  • Patient Operational ID
  • Patient Date of Birth
  • Patient Age Integer
  • Is Patient Sex Female
  • Is Patient Sex Male
  • Patient State Abbreviation
  • Patient ZIP Code 5-Digit
  • Patient Date of Death

• Date Fields

  • Current Continuous Primary Payor Membership Episode Start Date
  • Current Continuous Primary Payor Membership Episode End Date
  • Numerator Document Effective 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 ID
  • Primary Plan Attributee Provider Description
  • Primary Plan Attributee Primary NUCC Provider Taxonomy Description

• Insurance Fields

  • Primary Payor Description
  • Primary Plan Description
  • Primary Plan Financial Class Description
  • Is Commercial Output NCQA Payer Type Code
  • Is Medicare Output NCQA Payer Type Code
  • Is Medicaid Output NCQA Payer Type Code
  • Is SNP Output NCQA Payer Type Code
  • Is Exchange Output NCQA Payer Type Code
  • Is MMP Output NCQA Payer Type Code

• Denominator Fields

  • Is Eligible Population
  • Is Any Required Exclusion
  • Is Required Exclusion for Hospice
  • Is Required Exclusion for Patient Death
  • Is Continuous Enrollment Criteria Met
  • Denominator Excluded Reasons Description

• Numerator Fields

  • Is Numerator Qualifying Using Standard End-of-Year Timing
  • Numerator Component Contribution Using Standard End-of-Year Timing
  • Is NCQA Numerator Criteria Met
  • Is Numerator Source Claim
  • Is Numerator Source Bill
  • Is Numerator Source EMR

• Metadata Fields

  • Table Last Updated Datetime
  • Is Parameter Set to Override Continuous Enrollment Criteria
  • Is Parameter Set to Override Payor Criteria

• Measure Fields

  • Measure ID
  • Measure Name
  • Denominator
  • Numerator

• NCQA Cert Fields

  • Output NCQA Payer Type Code
  • NCQA Race Code
  • NCQA Ethnicity Code
  • NCQA Gender Code
  • Patient Age Integer Unbounded by Death

• [No Field Group]

  • Ursa Serial ID