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Measure Name | % of MSIS IDs with a non-missing plan ID that are missing plan type |
---|---|
File Type | ELG |
Measure ID | EL-10-008-8 |
Measure Type | Non-Claims Percentage |
Content area | ELG |
Validation Type | Inferential |
---|
Measure Priority | N/A |
---|---|
Focus Area | N/A |
Category | N/A |
Claim Type | N/A |
---|---|
Adjustment Type | N/A |
Crossover Type | N/A |
Minimum | 0 |
---|---|
Maximum | 0.01 |
TA Minimun | |
TA Maximum | |
Longitudinal Threshold | N/A |
For TA
(for including in compliance training) |
No |
For TA
(Longitudinal) |
No |
DD Data Element | MSIS-IDENTIFICATION-NUM • MANAGED-CARE-PLAN-ID • MANAGED-CARE-PLAN-TYPE |
---|---|
DD Data Element Number | ELG191 • ELG192 • ELG193 |
Annotation | Calculate the percentage of unique MSIS IDs that have a non-missing managed care plan ID and are missing a managed care plan type |
---|---|
Specification |
STEP 1: Enrolled on the last day of DQ report month Define the eligible population from segment ENROLLMENT-TIME-SPAN-ELG00021 by keeping active records that satisfy the following criteria: 1. ENROLLMENT-EFF-DATE <= last day of the DQ report month 2. ENROLLMENT-END-DATE >= last day of the DQ report month OR missing 3. MSIS-IDENTIFICATION-NUM is not missing STEP 2: Managed care enrollment on the last day of DQ report month Using the MSIS IDs that meet the criteria from STEP 1, join to segment MANAGED-CARE-PARTICIPATION-ELG00014 by keeping records that satisfy the following criteria: 1a. MANAGED-CARE-PLAN-ENROLLMENT-EFF-DATE <= last day of the DQ report month 2a. MANAGED-CARE-PLAN-ENROLLMENT-END-DATE >= last day of the DQ report month OR missing OR 1b. MANAGED-CARE-PLAN-ENROLLMENT-EFF-DATE is missing 2b. MANAGED-CARE-PLAN-ENROLLMENT-END-DATE is missing STEP 3: Non-missing Plan ID Of the MSIS IDs which meet the criteria from STEP 3, restrict to those with a non-missing plan ID 1. MANAGED-CARE-PLAN-ID is non-missing STEP 4: Missing managed care plan type Of the MSIS IDs which meet the criteria from STEP 3, restrict to those with a missing MANAGED-CARE-PLAN-TYPE: 1. MANAGED-CARE-PLAN-TYPE is missing STEP 5: Percentage Divide the count of unique MSIS IDs from STEP 4 by the count in STEP 3 |