URSA-QUALITY-ADD2: ADD-E Continuation and Maintenance Phase (ADD2)

Measure Description

The percentage of members 6–12 years of age with a prescription dispensed for ADHD medication, who remained on the medication for at least 210 days and who, in addition to the visit in the initiation phase, had at least two follow-up visits with a practitioner within 270 days (9 months) after the initiation phase ended.

Metadata

• Measure Type: Rate Measure
• Temporal Structure: Entity
• Component Class: Long-Form
• Denominator Case Field: Index Patient ID, Output NCQA Payer Type Code
• Target Direction: None

Denominator Description

Patients aged 6-12 years old who were dispensed an ADHD medication during the 12-month intake period.

Numerator Description

Qualifying denominator patients who had a follow-up visit with a practitioner with prescribing authority within 30 days following the index prescription start date and at least two (2) follow-up visits with a practitioner with prescribing authority from 31 to 300 days following the index prescription start date.

Published Fields

• Data Model Keys

  • Measure ID
  • Measure Name
  • Patient ID
  • Primary Payor ID
  • Primary Plan ID

• Patient Fields

  • Patient Age Integer at Start of Intake Period
  • Patient Age Integer at End of Intake Period
  • Patient Date of Birth
  • Patient Age Integer at Snapshot Date
  • Is Patient Sex Female
  • Is Patient Sex Male
  • Patient State Abbreviation
  • Patient ZIP Code 5-Digit
  • Patient Date of Death

• Date Fields

  • 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

• Medication Fields

  • ADHD Medication Treatment Days within 301 Days After IPSD
  • ADHD Medication Non-Treatment Days within 301 Days After IPSD

• Denominator Fields

  • Is Denominator Event Criteria Met
  • Is Measure Continuous Membership Criterion Met
  • Is Eligible Population
  • Is Any Required Exclusion
  • Is Required Exclusion for Hospice
  • Is Required Exclusion for Patient Death
  • Is Required Exclusion for Narcolepsy
  • Index Episode ID
  • Index Episode Start Date
  • Index Episode End Date
  • Index Episode Length Days
  • Index Episode Aggregate Days Supply
  • Index ADHD Medication Category
  • Denominator Excluded Reasons Description
  • Denominator NCQA Performance Period Start Date
  • Denominator Performance Period End Date
  • Denominator Performance Period Start Date
  • IPSD plus 301 days
  • Patient Operational ID

• Numerator Fields

  • Is NCQA Numerator Criteria Met
  • Earliest Numerator Compliance Date
  • Is Numerator Qualifying Using Standard End-of-Year Timing
  • Numerator Component Contribution Using Standard End-of-Year Timing

• Metadata Fields

  • Table Last Updated Datetime
  • Is Parameter Set to Override Continuous Enrollment Criteria
  • Is Parameter Set to Override Payor Criteria
  • Report Designated Control for Expanded Denominator Performance Period Start Date

• Validation Only Fields

  • Is Continuous Medication Treatment Criteria Met
  • Is Patient with Index Event
  • Is Patient Meet Mental Health Inpatient Criteria
  • Is Patient with a Negative ADHD Medication History

• Measure Fields

  • Denominator
  • Numerator

• Module Fields

  • Is Numerator 1 Criteria Met
  • Is Numerator 2 Criteria Met

• NCQA Cert Fields

  • Is Record with Payer that Meets NCQA Epop Criteria
  • NCQA Race Code
  • NCQA Ethnicity Code
  • NCQA Gender Code
  • Output NCQA Payer Type Code

• [No Field Group]

  • Ursa Serial ID