URSA-QUALITY-BPD: Blood Pressure Control for Pts With Diabetes (BPD)

Measure Description

The percentage of members 18–75 years of age with diabetes (types 1 and 2) whose blood pressure (BP) was adequately controlled (<140/90 mm Hg) during the measurement year.

Metadata

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

Denominator Description

Patients aged 18 to 75 with diabetes and a prior qualifying visit in the last 12 months.

Numerator Description

None

Published Fields

• Data Model Keys

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

• 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 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

• Denominator Fields

  • Is Denominator Event Criterion Met
  • Is Eligible Population
  • Is Continuous Membership Criterion Met
  • Is Any Required Exclusion
  • Is Required Exclusion for Medicare 66+ Institutionalized Status
  • Is Required Exclusion for Hospice
  • Is Required Exclusion for Patient Death
  • Is Required Exclusion for Palliative Care
  • Denominator Excluded Reasons Description
  • Is Required Exclusion for Age 66+ with Frailty and Advanced Illness

• Numerator Fields

  • Is Numerator Qualifying Using Standard End-of-Year Timing
  • Numerator Window Start Date
  • Numerator Source ID
  • Numerator Documentation Date
  • Numerator SBP Document ID
  • Numerator SBP HCPCS Code
  • Numerator SBP HCPCS Description
  • Numerator SBP Result Numeric
  • Numerator DBP Document ID
  • Numerator DBP HCPCS Code
  • Numerator DBP HCPCS Description
  • Numerator DBP Result Numeric

• Metadata Fields

  • Is Parameter Set to Override Continuous Enrollment Criteria
  • Is Parameter Set to Override Payor Criteria

• Measure Fields

  • Denominator
  • Numerator

• NCQA Cert Fields

  • Is NCQA Numerator Criteria Met
  • Output NCQA Payer Type Code
  • NCQA Race Code
  • NCQA Ethnicity Code
  • NCQA Gender Code
  • Patient Age Integer Unbounded by Death