URSA-PHF-003: ED Visits without Admission PMPM Plan Spending

Measure Description

Among active plan membership patient-periods, the per-member-per-month plan spending on hospital emergency department visits not resulting in an admission

Metadata

• Measure Type: Rate Measure
• Temporal Structure: Interval
• Component Class: Long-Form
• Denominator Case Field: Patient ID
• Target Direction: Down

Denominator Description

The elapsed patient-months of active plan membership periods during which the patient was alive and had medical claims data coverage.

Numerator Description

Total plan spending for claims associated with an emergency department visit not resulting in admission to inpatient status or transfer to a short-term or psychiatric hospital, and with covered start date falling within the observation period start and end dates.

Related Key Concepts

None.

FAQs

None.