Patient Timelines of Within-Year-Updated CMS-HCC Results

Object Description

One record per period in which the patient qualified for either the version 24 or version 28 CMS-HCC model; the blended RAF score is generated using the appropriate blending ratio for the calendar year of the period; the HCC/RAF results in any given period are calculated using only diagnoses present at the beginning of that period within the current calendar year.

Metadata

• Table Name: ursa.so_ursa_hcc_pat_004
• Layer: SYNTHETIC_OBJECT
• Object Type: Complex Timeline
• Temporal Class: Interval (Timeline)
• Case ID: Patient ID
• Interval Start Date: Period Start Date
• Interval End Date: Period End Date
• Primary Key: Patient ID, Period Start Date, Period End Date

Dedicated Precursors

• [SO/URSA-HCC] Patient Timelines of Within-Year-Updated CMS-HCC Results, Precursor 1 (Periods of Potentially Updated Model Results): One record per patient-period during which the patient had an active membership in any plan (note: not just a Medicare plan) or was covered by an MMR record; this object additionally partitions periods of identical demographic inputs if a new acceptable qualifying diagnosis is documented (meaning there is some possibility of an update to the CMS-HCC model results).
• [SO/URSA-HCC] Patient Timelines of Within-Year-Updated CMS-HCC Results, Precursor 2 (Model Inputs): One record per distinct patient-period (for patients with no acceptable qualifying diagnoses in the prior calendar year) or per patient-period-diagnosis (for the first instances of diagnosis code in the prior calendar year for that patient); this unusual grain size is the required format for inputs sent to the CMS-HCC model. Patients with a qualifying membership but without any acceptable qualifying diagnosis codes will have a single record for that period, with a diagnosis code value of NULL.
• [SO/URSA-HCC] Patient Timelines of Within-Year-Updated CMS-HCC Results, Precursor 3 (Version 24 Model Output): One record per patient-period during which the patient was eligible to generate HCC/RAF results; the HCC/RAF results in any given period are calculated using only diagnoses present at the beginning of that period within the current calendar year, using model version 24.
• [SO/URSA-HCC] Patient Timelines of Within-Year-Updated CMS-HCC Results, Precursor 4 (Version 28 Model Output): One record per patient-period during which the patient was eligible to generate HCC/RAF results; the HCC/RAF results in any given period are calculated using only diagnoses present at the beginning of that period within the current calendar year, using model version 28.