[SO/URSA-HCC] Patient Timelines of Final Action CMS-HCC Model Demographic Inputs

Object Description

One record per patient-period during which the patient had an active membership or was covered by an MMR record; the most reliable demographic component values for each period are obtained (or imputed) from membership and/or MMR records. For months with multiple MMR records, the most recent ("final action") record is used.

Metadata

• Table Name: ursa.so_ursa_hcc_pat_001
• 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

Published Fields

• Data Model Keys

  • 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)

• Patient Fields

  • Patient Age Integer
  • Is Patient Sex Female

• Date Fields

  • Calendar Year Start Date
  • Period Start Date
  • Period End Date

• Insurance Fields

  • CMS RAF Type Code
  • CMS Original Reason for Entitlement Code
  • CMS Dual Status Code
  • Is CMS Full Dual Status
  • Is CMS Partial Dual Status
  • Is CMS ESRD Status
  • Is CMS LTI Status
  • Is CMS New Enrollee Status
  • CMS MMR Risk Adjustment Age Group Code -- That standard 4-digit CMS Risk Adjustment Age Group (RAAG) Code, describing the age category of the patient as used to calculate RAF scores. This field contains the same values as the CMS MMR "Risk Adjustment Age Group (RAAG)" field, which the CMS documentation defines as: "The Risk Adjustment Age Group for the beneficiary (BBEE). In general it is based upon the age as of February 1 of payment year. BB = Beginning Age; EE = Ending Age".

• Validation Only Fields

  • Is Patient Sex Female from Membership
  • Is Patient Sex Female from MMR Original Field
  • Is Dual Medicare-Medicaid Enrolled from Membership Original Field
  • Is CMS MMR Full or Partial Medicaid Status from MMR Original Field
  • Is CMS Full Dual Status from Membership RAF Type Code
  • Is CMS Full Dual Status from MMR RAF Type Code
  • Is CMS Partial Dual Status from Membership RAF Type Code
  • Is CMS Partial Dual Status from MMR RAF Type Code
  • Is CMS ESRD Status from Membership RAF Type Code
  • Is CMS ESRD Status from Membership Original Field
  • Is CMS ESRD Status from MMR RAF Type Code
  • Is CMS ESRD Status from MMR Original Field
  • Is CMS LTI Status from Membership RAF Type Code
  • Is CMS LTI Status from Membership Original Field
  • Is CMS LTI Status from MMR RAF Type Code
  • Is CMS LTI Status from MMR Original Field
  • Is CMS New Enrollee Status from Membership RAF Type Code
  • Is CMS New Enrollee Status from Membership Original Field
  • Is CMS New Enrollee Status from MMR RAF Type Code
  • Tokenized Membership CMS RAF Type Code
  • Tokenized Membership CMS Original Reason for Entitlement Code
  • Tokenized Membership CMS Dual Status Code
  • Tokenized MMR CMS RAF Type Code
  • Tokenized MMR CMS Original Reason for Entitlement Code
  • Tokenized MMR CMS Dual Status Code
  • CMS RAF Type Code According to Membership
  • CMS Original Reason for Entitlement Code According to Membership
  • CMS Dual Status Code According to Membership
  • CMS RAF Type Code According to MMR
  • CMS Original Reason for Entitlement Code According to MMR
  • CMS Dual Status Code According to MMR
  • Is CMS Full Dual Status According to Membership Original Field
  • Is CMS Partial Dual Status According to Membership Original Field
  • Is CMS Full Dual Status According to MMR Original Field
  • Is CMS Partial Dual Status According to MMR Original Field
  • Patient Age According to Membership
  • Patient Age According to MMR

• Module Fields

  • CMS-HCC Patient Age
  • CMS-HCC Patient Sex Code
  • CMS-HCC Eligibility Code
  • CMS-HCC Original Reason for Entitlement Code
  • Is CMS-HCC Medicaid Patient