URSA-QUALITY-SPD2: Statin Adherence for Diabetes (SPD2)

Measure Description

Among diabetes patients aged 40 to 75 without ASCVD, the percentage who remained on a statin medication of any intensity for at least 80% of the treatment period in the last 12 months.

Metadata

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

Denominator Description

Patients aged 40-75 with diabetes and who do not have clinical atherosclerotic cardiovascular disease (ASCVD).

Numerator Description

Patients with at least 80% medication coverage of the treatment period in the prior 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
  • Qualifying Cardiovascular Event Date
  • Medication Document ID
  • Medication Document Effective Date
  • Medication HCPCS Code
  • Medication HCPCS Description
  • Is Continuous Membership Criterion Met
  • Is Eligible Population
  • Is Any Required Exclusion
  • Is Required Exclusion for Inpatient Setting MI in Previous Year
  • Is Required Exclusion for CABG in Previous Year
  • Is Required Exclusion for PCI in Previous Year
  • Is Required Exclusion for Other Revascularization in Previous Year
  • Is Required Exclusion for IVD Diagnosis
  • Is Required Exclusion for Pregnancy
  • Is Required Exclusion for IVF
  • Is Required Exclusion for Estrogen Agonists Medications
  • Is Required Exclusion for ESRD Diagnosis
  • Is Required Exclusion for Dialysis Procedure
  • Is Required Exclusion for Cirrhosis
  • Is Required Exclusion for Muscular Pain and Disease
  • Is Required Exclusion for Muscular Reactions to Statins
  • Is Required Exclusion for Hospice
  • Is Required Exclusion for Death
  • Is Required Exclusion for Palliative Care
  • Is Required Exclusion for Medicare 66+ Institutionalized Status
  • Is Required Exclusion for 66+ Frailty and Advanced Illness
  • Denominator Excluded Reasons Description

• Numerator Fields

  • Statin PDC
  • Is PDC >=79.5
  • Earliest Statin Dispensing Event
  • Total Days Covered by a Statin in the Treatment Period
  • Total Days in Treatment Period
  • Is Numerator Qualifying Using Standard End-of-Year Timing
  • Observation-Level Numerator 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

• 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

• [No Field Group]

  • Ursa Serial ID