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pcmh.ahrq.gov/data/apcd/index.htmlFebruary 01, 2018 - Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … Quality is undertaking activities to develop an effective and feasible approach for using all-payer claims … Overview of All-Payer Claims Databases All-payer claims databases (APCDs) are large State databases … that include medical claims, pharmacy claims, dental claims, and eligibility and provider files collected … i Go to The Basics of All-Payer Claims Databases: A Primer for States .
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pcmh.ahrq.gov/data/apcd/confrpt.htmlFebruary 01, 2018 - Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … The purpose of the Fifth All Payer Claims Database Conference, “Expanding and Enhancing All Payer Claims … The purpose of the Fifth All Payer Claims Database Conference, "Expanding and Enhancing All Payer Claims … Keywords All payer claims databases. … and Institutional claims that accommodate State reporting needs.
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3P-Rd-Data-Dictionary-Geographic-Level (xls file)
pcmh.ahrq.gov/sites/default/files/wysiwyg/data/3P-RD-Data-Dictionary-Geographic-Level.xlsxFebruary 02, 2023 - State APCD/CMS Claims ZIP_CD X X X X X X X X X X X X X X X STATE 2-Digit alpha state code Char $2. … physicians Char 2 XXXXX: Minimum Patient Age APCD/CMS Claims XXXXX_MIN_AGE X X B, F, G A, G A, G … per Month APCD/CMS Claims XXXXX_MIN_CLMS_PERMONTH X X B, F, G A, G A, G B, C, D, E, F, G A, G A, G … per month across all 3P-RD physicians Num 8 XXXXX: Average Number of Claims per Month APCD/CMS Claims … per month across all 3P-RD physicians Num 8 XXXXX: Maximum Number of Claims per Month APCD/CMS Claims -
pcmh.ahrq.gov/sites/default/files/wysiwyg/data/SyH-DR-Introduction-2023Dec.pdfDecember 01, 2023 - SyH-DR includes person files, inpatient and outpatient claims files, pharmacy claims files, and provider … For example, only the approved final action claims were retained in the source files. … Therefore, the claims in SyH-DR are the original claims with some data elements partially or fully replaced … Attending Specialty AT_Spclty Claims No Full No Claim Type Code Clm_Type_Cd Claims No No No CPT Procedure … No No No Type of Bill Code TOB_Cd Claims No No No Total Charged Amount Tot_Chrg_Amt Claims, RX No
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3P_RD_AHRQ_PUF_Data_Dictionary (xls file)
pcmh.ahrq.gov/sites/default/files/wysiwyg/data/3P-RD-Data-Dictionary.xlsxMarch 16, 2023 - SECTION IV: Source Claims Files Indicates data element names and availability in claims files for APCD … Organizational NPI APCD/ CMS Claims X X X X X X ORG_NPI Organizational NPI CHAR 10 $10. … Number of 3P-RD physicians associated with the physician practice site X APCD/ CMS Claims X X X X X … X 3P-RD Physician APCD/ CMS Claims X X X X X X SING_SPEC_TYPE If Single Specialty, Which? … State X APCD/ CMS Claims X X X X X X STATE State CHAR 7 $2. -
pcmh.ahrq.gov/data/innovations/syh-dr.htmlApril 01, 2024 - Determinants of Health Synthetic Healthcare Database for Research (SyH-DR) All-Payer Claims … The Synthetic Healthcare Database for Research (SyH-DR) is an all-payer, nationally representative claims … The database consists of a sample of inpatient, outpatient, and prescription drug claims, including utilization … SyH-DR The Agency for Healthcare Research and Quality (AHRQ) created SyH-DR from eligibility and claims … Claims Files Commercial Inpatient File. Commercial Outpatient File.
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pcmh.ahrq.gov/sites/default/files/wysiwyg/data/SyH-DR-Sampling-Weighting-Synthetization-Methodologies.pdfDecember 01, 2023 - Therefore, the claims in SyH-DR are the original claims with some data elements partially or fully replaced … Multiple claims might be observed for each person, and diagnosis codes might recur across claims—for … , 1,200 most frequent for outpatient claims, and 300 most frequent for ED claims. … Pharmacy Claims Files Generic Drug Name The source pharmacy claims files contain National Drug Codes … and pharmacy claims.
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pcmh.ahrq.gov/data/ushik.htmlJuly 01, 2022 - Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … The All-Payer Claims Databases portal contained APCD File Submission Specifications from 14 states. … APCDs are large-scale databases that systematically collect healthcare claims data from a variety of … , pharmacy claims, eligibility files, provider (physician and facility) files, and dental claims from … leveraging data from within the insurance claims and reimbursement system.
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pcmh.ahrq.gov/learning-health-systems/exploring-needs.htmlSeptember 01, 2022 - Multiple claims-based frailty indexes (CFIs) have been developed and validated over the past few years … ; however, healthcare providers often do not have access to the insurance claims records of their entire … This project focused on validating an established CFI using linked claims-EHR databases of multiple large … data can be used by healthcare providers to identify frail patients using validated EFIs; however, claims … Developing and Assessing the Validity of Claims-based Indicators of Frailty & Functional Disabilities
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pcmh.ahrq.gov/chsp/about-chsp/centers/nber.htmlJuly 01, 2019 - These States have different health systems and all-payer claims databases (APCDs), which have facilitated … sources (e.g., Medicare Provider Enrollment, Chain, and Ownership System [PECOS], Medicare and commercial claims … The team identifies health systems in claims data using tax identification numbers and Medicare provider … Administrative and claims data that can be used to measure the use of PCOR-based evidence, related clinical … These include Medicare claims data, national commercial insurance claims data, cancer registry data,
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pcmh.ahrq.gov/sites/default/files/wysiwyg/data/SyH-DR-Codebook.pdfDecember 01, 2023 - Synthetic Healthcare Database for Research (SyH-DR) A Synthetic Nationally Representative All-Payer Claims … The commercial claims files do not contain any discharge codes that indicate a death occurred (i.e., … Missing 1 Encounter claims (i.e., Medicare Advantage or Medicaid managed care organizations) do not … wounds, were removed from the claims’ files. … Missing 1 Encounter claims (i.e., Medicare Advantage or Medicaid managed care organizations) do not
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pcmh.ahrq.gov/sites/default/files/attachments/Prospects+for+Care+Coord.+Using+Elect+Data+Sources+3-16-12.pdfJune 01, 2012 - , HIE* (if includes claims data) or payer files Use claims data to examine instances of redundant … All-Payer Claims Databases (APCD) –Large-scale databases that systematically collect health care claims … data (medical claims, pharmacy claims, eligibility files, provider files, and dental claims) from a … Using Claims Data for Measurement Panelists suggested several ways in which claims data, particularly … , pharmacy claims, eligibility files, provider (physician and facility) files, and dental claims from
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pcmh.ahrq.gov/teamstepps/lep/handouts/lepevidencesum.htmlDecember 01, 2012 - case cost a hospital $71 million. 4 A malpractice carrier operating in four States found that LEP claims … accounted for 2.5 percent of all claims (35 claims total) and cost more than $5 million over a 4-year … period. 5 Almost all of these claims related to poor communication and failure to provide a competent
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pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/psml-planning-grants-final-report.pdfMay 01, 2016 - First, an actuarial review of claims concluded that the use of an ACEx2 system might stabilize claims … inflation and reduce costs through an accelerated claims process. … The RMCM was modeled after the University of Michigan Claims Management Model. … During this time period, 41 claims had sufficient data for analysis. … Claims were categorized by six unique claim types that ranged from grievances to formal claims against
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pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/lep/handouts/lepevidencesum.pdfJanuary 01, 2012 - case cost a hospital $71 million. 4 o A malpractice carrier operating in four States found that LEP claims … accounted for 2.5 percent of all claims (35 claims total) and cost more than $5 million over a 4-year … period. 5 Almost all of these claims related to poor communication and failure to provide a competent
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pcmh.ahrq.gov/patient-safety/reports/candor-demo-program/candor/demo-program/index.htmlAugust 01, 2022 - improve care in clinical areas that frequently are the subject of a large number of medical malpractice claims … Alternative Methods of Settling Claims.
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pcmh.ahrq.gov/news/newsletters/e-newsletter/863.htmlMay 01, 2023 - The authors analyzed closed malpractice claims from January 2015 to September 2021 for ambulatory care … Of 199 diagnosis-related claims, EHRs were considered a potential contributor to diagnostic errors in … 61 percent of claims. … About 92 percent involved the testing stage, and the most prevalent outcome for claims (71 percent) was
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pcmh.ahrq.gov/topics/a.htmlApril 22, 2024 - A Access to Care Adverse Drug Events (ADE) Adverse Events Alcohol Use All-Payer Claims
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pcmh.ahrq.gov/teamstepps-program/training/accreditation-ceus.htmlMarch 01, 2024 - SHARE: More topics in this section TeamSTEPPS Program TeamSTEPPS Updates Welcome Guides Curriculum Materials Diagnosis Improvement Course Tools and Resources TeamSTEPPS Training Accreditation and Continuing Education Units …
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pcmh.ahrq.gov/es/topics/index.htmlOctober 01, 2008 - All-Payer Claims AHRQ activities focus on developing an effective, feasible approach for using all-payer … claims databases to improve healthcare affordability, efficiency, and cost transparency.
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