URSA-QUALITY-TRCM: Transitions of Care - MR (TRCM)

Measure Description

The percentage of discharges for members 18 years of age and older.

Metadata

• Measure Type: Rate Measure
• Temporal Structure: Entity
• Component Class: Long-Form
• Denominator Case Field: Patient ID, Output NCQA Payer Type Code, Parent Document Effective End Date (Index Parent Document Effective End Date)
• Target Direction: Down

Denominator Description

None

Numerator Description

None

Published Fields

• Data Model Keys

  • Index 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
  • Index Parent Document Effective End Date
  • Is Continuous Membership Criterion Met
  • Is Eligible Population
  • Is Any Required Exclusion
  • Is Required Exclusion for Hospice in Measurement Year
  • Is Required Exclusion for Patient Death in Measurement Year
  • Denominator Excluded Reasons Description
  • Denominator NCQA Performance Period Start Date
  • Denominator Performance Period End Date
  • Denominator Performance Period Start Date

• Numerator Fields

  • Is Numerator Qualifying Using Standard End-of-Year Timing
  • Numerator Component Contribution Using Standard End-of-Year Timing
  • Numerator Document ID
  • Numerator Source ID
  • Numerator Document Effective Date
  • Numerator HCPCS Code
  • Numerator HCPCS Description
  • Numerator Document Type Description

• 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

• 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]

  • Measure ID
  • Measure Name
  • Ursa Serial ID