URSA-QUALITY-KED: Kidney Health Eval for Pts with Diabetes (KED)

Measure Description

Among diabetes patients aged 18 to 85 without ESRD, the percentage with both a eGFR test and a uACR test performed in the last 12 months.

Metadata

• Measure Type: Rate Measure
• Temporal Structure: Entity
• Component Class: Normal-Form
• Denominator Case Field: Patient ID, Output NCQA Payer Type Code
• Target Direction: Up

Denominator Description

Diabetes patients aged 18 to 85 without ESRD.

Numerator Description

Patients with both a eGFR test and a uACR test performed in the last 12 months.

Published Fields

• Data Model Keys

  • Measure ID
  • Measure Name
  • Patient ID
  • Primary Payor ID
  • Primary Plan ID

• Patient Fields

  • Patient Operational ID
  • Patient Date of Birth
  • Patient Age Integer
  • Is Patient Sex Female
  • Is Patient Sex Male
  • Patient State Abbreviation
  • Patient ZIP Code 5-Digit
  • Patient Date of Death

• Date Fields

  • Current Continuous Primary Payor Membership Episode Start Date
  • Current Continuous Primary Payor Membership Episode 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)
  • Snapshot Date -- The date, evaluated at 00:00:00 AM, giving the moment the state of the world will be set to for the purposes of an analysis. The snapshot date does not represent the freshness of the data, or the date in real time at which an analysis was executed.

• Provider Fields

  • Primary Plan Attributee Provider ID
  • Primary Plan Attributee Provider Description
  • Primary Plan Attributee Primary NUCC Provider Taxonomy Description

• Insurance Fields

  • Primary Payor Description
  • Primary Plan Description
  • Primary Plan Financial Class Description

• Denominator Fields

  • Is Denominator Event Criterion Met
  • Is Eligible Population
  • Is Continuous Membership Criterion Met
  • Is Required Exclusion for Medicare 66+ Institutionalized Status
  • Is Any Required Exclusion
  • Is Required Exclusion for Hospice
  • Is Required Exclusion for Patient Death
  • Is Required Exclusion for Palliative Care
  • Is Required Exclusion for ESRD or Dialysis
  • Denominator Excluded Reasons Description
  • Is Required Exclusion for Age 66-80 with Frailty and Advanced Illness
  • Is Required Exclusion for Age 81+ with Frailty

• Numerator Fields

  • Numerator Criteria Met Date
  • Numerator eGFR Document ID
  • Numerator eGFR Date
  • Numerator eGFR HCPCS Code
  • Numerator eGFR HCPCS Description
  • Numerator eGFR Source ID
  • Numerator uACR Document ID
  • Numerator uACR Date
  • Numerator uACR HCPCS Code
  • Numerator uACR HCPCS Description
  • Is Numerator Qualifying Using Standard End-of-Year Timing
  • Numerator Component Contribution Using Standard End-of-Year Timing

• Metadata Fields

  • Table Last Updated Datetime
  • Is Parameter Set to Override Continuous Enrollment Criteria
  • Is Parameter Set to Override Payor Criteria

• Measure Fields

  • Denominator
  • Numerator

• Numerator

  • Numerator Contribution

• NCQA Cert Fields

  • Is NCQA Numerator Criteria Met
  • Output NCQA Payer Type Code
  • NCQA Race Code
  • NCQA Ethnicity Code
  • NCQA Gender Code
  • Patient Age Integer Unbounded by Death