URSA-QUALITY-GSD1: Glycemic Status Assmt for Pts w/ Diabetes (GSD1)

Measure Description

Among patients aged 18 to 75 with diabetes and a prior qualifying visit in the last 12 months, the percentage with a most recent HbA1c < 8% or without documentation of HbA1c results 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: Down

Denominator Description

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

Numerator Description

Patients with qualifying documentation in the last 12 months characterizing the result of the most recent prior HbA1c, and with the most recent prior instance of this documentation indicating a result < 8%. If the patient does not have a documented HbA1c in the last 12 months it is considered "not controlled".

Published Fields

• Data Model Keys

  • 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
  • Patient Date of Death

• 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

• Clinical Services Fields

  • NB HCPCS Description
  • NL1 HCPCS 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
  • Effective Document Effective Date
  • Effective Numerator Document ID
  • Effective Lab Test Result Numeric
  • NB Document ID
  • NB Document Effective Date
  • NB HCPCS Code
  • NL1 Document Effective Date
  • NL1 HCPCS Code
  • NL1 Service LOINC Code
  • NL1 Result Type LOINC Code
  • NL1 Result Description
  • NL1 Result Numeric
  • Is NL1 HbA1c Lab Test Document
  • Is NL1 HbA1c LOINC 97506-0 Document
  • Is NL1 HbA1c Test Result or Finding Document
  • Is NL1 HbA1c Level Less than 8.0 Document
  • Is NL1 HbA1c Level Greater Than or Equal to 8.0 Document
  • Is NL1 HbA1c Level Less Than or Equal to 9.0 Document

• Metadata Fields

  • Table Last Updated Datetime
  • 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

• [No Field Group]

  • Numerator Component Contribution Using In-year Timing
  • Measure ID
  • Measure Name
  • Ursa Serial ID