Measure Description
Among skilled nursing facility (SNF) encounters, the average plan paid amount for the full encounter.
Metadata
- Measure Type: Rate Measure
- Temporal Structure: Event
- Component Class: Normal-Form
- Denominator Case Field: Encounter ID
- Target Direction: Down
Denominator Description
One per skilled nursing facility encounter; excludes SNF encounters that do not yet have a discharge date.
Numerator Description
The total plan paid amount for the encounter.
Published Fields
-
Data Model Keys
- Encounter ID
- Patient ID
- Encounter Primary Payor ID
- Encounter Primary Plan ID
- Facility Provider ID
- Attending Provider ID
-
Date Fields
- Encounter Start Date
- Encounter 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)
-
Encounter Fields
- Encounter LOS in Distinct Calendar Days
- Encounter Calendar Days LOS Category Tier 1
- Is LOS in Days > 100
- Is Discharge Status Home or Home with Home Health
-
Provider Fields
- Facility Provider Description
- Facility Provider Primary NUCC Provider Taxonomy Description
-
Location Fields
- Facility Provider Practice Address ZIP Code 5-Digit
- Facility Provider Practice Address State Abbreviation
- Facility Provider Dartmouth Atlas HRR ID
- Facility Provider Dartmouth Atlas HRR Description
-
Insurance Fields
- Encounter Primary Payor Description
- Encounter Primary Plan Description
- Encounter Primary Plan Financial Class Description
-
Diagnosis Fields
- Principal Discharge Diagnosis ICD-10-CM Code
- Principal Discharge Diagnosis ICD-10-CM Description
- Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Code
- Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Description
- Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Code
- Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Description
-
Billing and Claims Fields
- MS-DRG Code
- MS-DRG Description
- MS-DRG MDC Code
- MS-DRG MDC Description
- CMS Admit Source Code
- CMS Admit Source Description
- CMS Admit Type Code
- CMS Admission Type Description
- CMS Patient Discharge Status Code
- CMS Patient Discharge Status Description
-
Financial Fields
- Total Plan Paid Amount from All Plans
- Primary Plan Paid Amount
- Primary Plan Allowed Amount
- Patient Paid Amount
- Encounter Total Plan Paid Amount Category
- Is Encounter with Zero Dollar Plan Paid Amount
- Average Calendar Day Plan Paid Amount
- Average Calendar Day Patient Paid Amount
-
Measure Fields
- Denominator