Key Information

Measure Name	# of plans with at least 100 enrollments, capitations, or encounters, that do not have a managed care record
File Type	MCR
Measure ID	MCR-54-009-9
Measure Type	Count
Content area	MCR

Validation

Validation Type	Inferential

Measure Priority

Measure Priority	N/A
Focus Area	N/A
Category	N/A

Claim Information

Claim Type	N/A
Adjustment Type	N/A
Crossover Type	N/A

Thresholds

Minimum	0
Maximum	0
TA Minimun
TA Maximum
Longitudinal Threshold	N/A
For TA (for including in compliance training)	No
For TA (Longitudinal)	No

Data Elements

DD Data Element	PLAN-ID-NUMBER • PLAN-ID-NUMBER • PLAN-ID-NUMBER • PLAN-ID-NUMBER • MANAGED-CARE-PLAN-TYPE • STATE-PLAN-ID-NUM • MANAGED-CARE-PLAN-TYPE • MANAGED-CARE-PLAN-ID • TYPE-OF-SERVICE • ADJUSTMENT-IND • ADJUSTMENT-IND • ADJUSTMENT-IND • ADJUSTMENT-IND • TYPE-OF-CLAIM • TYPE-OF-CLAIM • TYPE-OF-CLAIM
DD Data Element Number	CIP130 • CLT080 • COT066 • CRX056 • MCR024 • MCR019 • ELG193 • ELG192 • COT186 • CIP026 • CLT025 • COT025 • CRX025 • CIP100 • CLT052 • COT037

Annotation	Count plan ids in the EL-8-002-2 table with at least 100 enrollments, 100 capitations, or 100 encounters that do not link to a plan id on the managed care file
Specification	STEP 1: Enrollment or capitation or encounters Of the Plan_Ids identified in EL-8-002-2, restrict them by keeping those that satisfy the following criteria: 1a. Enrollment >= 100 OR 1b. Total_Capitation >= 100 OR 1c. Total_Encounters >= 100 STEP 2: Do not link to managed care file Of the Plan_Ids that meet the criteria in STEP 1, count the non-missing Plan_Ids where: 1. In_MCR_File = "No"