URSA-QUALITY-SPD1: Statin Therapy for Patients With Diabetes (SPD1)

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Measure Description

Among diabetes patients aged 40 to 75 without ASCVD, the percentage who were dispensed at least one statin medication of any intensity in the last 12 months. Unadjusted Certified Measure 35cff603-3fe5-4ca2-8d0b-c570e53872ab

Metadata

  • Measure Identifier: URSA-QUALITY-SPD1
  • Measure Type: Rate Measure
  • Temporal Structure: Entity
  • Component Class: Normal-Form
  • Denominator Case Field: Patient ID, Output NCQA Payer Type Code
  • Target Direction: Up

Denominator Description

Patients aged 40-75 with diabetes and who do not have clinical atherosclerotic cardiovascular disease (ASCVD).

Numerator Description

Qualifying denominator patients who were dispensed at least one statin medication of any intensity in the prior 12 months.

Published Fields

  • Data Model Keys

    • Measure ID
    • Measure Name
    • Patient ID -- The internal database identifier (used, e.g., for joins and primary keys) for the patient. This value is typically mastered, i.e., all records for the same patient, regardless of the source data system from which that record originated, should have the same Patient ID value. (Note that while the mastered Patient ID value might resemble a local identifier used in one of the upstream data sources, this does not indicate any special priority of that source system in determining the characteristics of the patient.) (See also [URSA-CORE] Patient)
    • Primary Payor ID -- The internal database identifier (used, e.g., for joins and primary keys) for the Primary Payor. (See also [URSA-CORE] Primary Payor)
    • Primary Plan ID -- The identifier for the health insurance plan product that is the first party responsible for payment.
  • Date Fields

    • Current Continuous Primary Payor Membership Episode Start Date -- The start date of the Continuous Primary Payor Membership Episode in effect as of the (potentially historical) period covered by the record. (See also [URSA-CORE] Continuous Primary Payor Membership Episode)
    • Current Continuous Primary Payor Membership Episode End Date -- The end date of the Continuous Primary Payor Membership Episode in effect as of the (potentially historical) period covered by the record. Values follow the standard exclusive convention for Period End Dates. (See also [URSA-CORE] Continuous Primary Payor Membership Episode, [URSA-CORE] Period 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.
  • Patient Fields

    • Patient Operational ID -- The user-facing value used by staff used to uniquely identify the Patient in their administrative systems and/or day-to-day operations. (See also [URSA-CORE] Patient)
    • Patient Date of Birth -- The patient's date of birth. On the Patients Natural Object, this field reflects the "best" known value for the patient available from all data sources; on other Natural Objects, e.g., MMR Member-Months, the value faithfully reflects the date of birth found on that particular type of record in the source data.
    • Patient Age Integer -- Patient age, expressed as an integer, as of a reference date or interval.
    • Is Patient Sex Female -- Indicates the patient's sex is female. On the Patients Natural Object, this field reflects the "best" known value for the patient available from all data sources; on other Natural Objects, e.g., MMR Member-Months, the value faithfully reflects the patient sex documented on that particular type of record in the source data.
    • Is Patient Sex Male -- Indicates the patient's sex is male. On the Patients Natural Object, this field reflects the "best" known value for the patient available from all data sources; on other Natural Objects, e.g., MMR Member-Months, the value faithfully reflects the patient sex documented on that particular type of record in the source data.
    • Patient State Abbreviation
    • Patient ZIP Code 5-Digit
    • Patient Date of Death
  • 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
    • Qualifying Denominator Event Date
    • Is Continuous Membership Criterion Met
    • Is Eligible Population
    • Is Any Required Exclusion
    • Is Required Exclusion for Inpatient Setting MI in Previous Year
    • Is Required Exclusion for CABG in Previous Year
    • Is Required Exclusion for PCI in Previous Year
    • Is Required Exclusion for Other Revascularization in Previous Year
    • Is Required Exclusion for IVD Diagnosis
    • Is Required Exclusion for Pregnancy
    • Is Required Exclusion for IVF
    • Is Required Exclusion for Estrogen Agonists Medications
    • Is Required Exclusion for Cirrhosis
    • Is Required Exclusion for Muscular Pain and Disease
    • Is Required Exclusion for Muscular Reactions to Statins
    • Is Required Exclusion for Hospice
    • Is Required Exclusion for Death
    • Is Required Exclusion for Palliative Care
    • Is Required Exclusion for Medicare 66+ Institutionalized Status
    • Is Required Exclusion for 66+ Frailty and Advanced Illness
    • Is Required Exclusion for ESRD Diagnosis
    • Is Required Exclusion for Dialysis Procedure
    • Denominator Excluded Reasons Description
  • Numerator Fields

    • Numerator Category Description
    • Is Numerator Qualifying Using Standard End-of-Year Timing
    • Observation-Level Numerator Using Standard End-of-Year Timing
    • Numerator Component Contribution Using Standard End-of-Year Timing
    • Numerator Document ID
    • Numerator Document Effective Date
    • Numerator HCPCS Code
    • Numerator HCPCS Description
  • NCQA Cert Fields

    • Is NCQA Numerator Criteria Met
    • Output NCQA Payer Type Code
    • NCQA Race Code -- The code used to identify race in official NCQA measure submissions; e.g., 1 = White, 2 = Black or African American, 3 = American Indian and Alaska Native, 4 = Asian, etc.
    • NCQA Ethnicity Code -- The code used to identify ethnicity in official NCQA measure submissions; e.g., 1 = Hispanic or Latino, 2 = Not Hispanic or Latino, 3 = Unknown Ethnicity.
    • NCQA Gender Code -- The code used to identify gender in official NCQA measure submissions; e.g., M = male; F = female.
    • Patient Age Integer Unbounded by Death
  • Metadata Fields

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

    • Denominator