[SO/URSA-CORE] Patient Timelines of Primary Plan Membership

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Object Description

One record per patient timeline period in which the patient has at least one active insurance plan coverage, with attribution to the primary plan; primary plan is determined based on the following criteria, evaluated in this order (1) the plan identified as primary in the membership record; (2) the plan with a plan-assigned provider; (3) the plan with the plurality of paid claims in that calendar year; (4) the plan that is not a Medicaid plan; (5) the plan with the lowest Plan ID (tiebreaker).

Metadata

  • Table Name: ursa.so_ursa_core_fin_005
  • Layer: SYNTHETIC_OBJECT
  • Object Type: Attribution 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

Published Fields

  • Data Model Keys

    • Patient ID
    • Primary Plan ID
  • Date Fields

    • Period Start Date
    • Period End Date
  • Validation Only Fields

    • Is Plan Designated Primary in Plan Membership Record
    • Is Plan with Assigned Provider
    • Count Claims in Calendar Year

Foreign Keys

  • pat_id → ursa.no_ursa_core_pat_001.pat_id
  • primary_plan_id → ursa.no_ursa_core_struct_005.plan_id