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21. Appendix A: Technical Expert Panel and Learning Network Members | Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/data/apcd/backgroundrpt/app-a.html
    April 01, 2017 - Data Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … Us Español FAQs Home Data & Analytics All-Payer Claims … Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … Inventory and Prioritization of Measures To Support the Growing Effort in Transparency Using All-Payer Claims … Databases Introduction Reviewing the Landscape of All-Payer Claims Databases Measure Inventory

22. Introduction | Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/data/apcd/backgroundrpt/intro.html
    April 01, 2017 - Data Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … Us Español FAQs Home Data & Analytics All-Payer Claims … Databases Introduction Reviewing the Landscape of All-Payer Claims Databases Measure Inventory … All-payer claims databases (APCDs) incorporate utilization and cost across the health care system and … APCDs are large datasets that aggregate medical, facility, pharmacy, and sometimes dental claims, as

23. Asthma 1: Emergency Room Visits for Children between 3 and 21 with identifiable asthma (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/pqmp/toolkits/sas-code.pdf
    October 31, 2018 - Claims will be filtered by time, diagnosis code, and age at service but can be pre-filtered to cut … Table: All (unfiltered) medical claims for at least the patients in the measure cohort. … These claims are in wide form and have 1 record per claim. … The Process: 1) 'Claims' dataset: claims are read in. 2) The program identifies whether … with that body system indicated (sum across claims). */ *indicator y/n; *sum across claims; if

24. Section 6, Tables 2 and 3 (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/section-6-table-2-3.pdf
    June 28, 2017 - Other ≥ 1 claim per body system for 2 different body systems during the measurement period* ≥ 2 claims … claim for a single body system not flagged as progressive during the measurement period* ≥ 2 claims … specificity for PMCA in Seattle Children’s Hospital (SCH) discharge and Washington State (WA) Medicaid claims

25. Materials X (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-164-materials-x.pdf
    March 09, 2017 - A: Dental Prophy -­‐ 2 claims PREV_A_3 Prev. Grp. A: Dental Prophy -­‐ 3+ claims PREV_A_CLM Prev. … B: Fluoride  Tx -­‐ 2 claims PREV_B_3 Prev. Grp. B: Fluoride  Tx -­‐ 3 claims PREV_B_4 Prev. … B: Fluoride  Tx -­‐ 4+ claims PREV_B_CLM Prev. Grp. … B: Fluoride  Tx -­‐ Count of claims PREV_B_DENT Prev. Grp. … B: Fluoride Tx -­‐ (Med Prov) 2 claims PREV_B_MED_3 Prev. Grp.

26. Measure Inventory | Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/data/apcd/backgroundrpt/measure.html
    April 01, 2017 - Data Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … Us Español FAQs Home Data & Analytics All-Payer Claims … Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … Inventory and Prioritization of Measures To Support the Growing Effort in Transparency Using All-Payer Claims … Databases Introduction Reviewing the Landscape of All-Payer Claims Databases Measure Inventory

27. Exploring Learning Health Systems’ Needs | Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/learning-health-systems/exploring-needs.html
    September 01, 2022 - Data Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … 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 … Developing and Assessing the Validity of Claims-based Indicators of Frailty & Functional Disabilities

28. Ratio of Magnetic Resonance Imaging Scans to Computed Tomography Scans for the Evaluation of Children with Atraumatic Seizure: Tables 13 & 14 (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0197-tables13-14.pdf
    October 17, 2019 - Min 25th Percentile Median 75th Percentile Max Subset following claims … $66,899 $29,432 $24,260 $44,612 59,082 $82,679 $191,200 Subset following claims … ZIP code or missing census data, yielding n=546 (98.0%). **** Among the subset of children following claims … code or missing census data, yielding n=426 (98.2%). ***** Among the subset of children following claims … 94.1 100 100 Subset who had an MRI (n=546)*** 77.6 33.2 0 68.5 95.4 100 100 Subset following claims

29. Ratio of Magnetic Resonance Imaging Scans to Computed Tomography Scans for the Evaluation of Children with Atraumatic Seizure: Tables 11 & 12 (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0197-tables11-12.pdf
    October 17, 2019 - 546)*** 0.4 (0.4) 5.6 (8.6) 8.0 (11.8) 0.1 (0.2) 79.7 (16.8) 2.6 (1.5) 3.7 (6.1) Subset following claims … (8.2) 8.1 (12.3) 0.1 (0.5) 79.3 (16.9) 2.7 (2.1) 4.1 (6.2) Subset following claims … missing or unmatched ZIP code, yielding n=546 (98.0%). **** Among the subset of children following claims … missing or unmatched ZIP code, yielding n=426 (98.2%). ***** Among the subset of children following claims … CT exclusions (n=426)**** 10.8 (14.9) Subset following claims MRI exclusions (n=489)***** 9.6 (13.4

30. 1b.4_Input_File_Specifications_508 (xls file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/pqmp/toolkits/input-file-specifications.xlsx
    January 01, 2014 - Medical Claims Reference Name Concept Description Variable Type Note claim_header_id Claim level … unique identifier text or numeric Can be derived, just need a way to uniquely identify claims. … unique identifier text or numeric Can be derived, just need a way to uniquely identify claims. … Note: Comorbidity source table is in wide form, unlike the medical claims source table DX2 The ICD9 … End of Table Pharmacy Claims Pharmacy Claims Reference Name Concept Description Required Variable

31. Transcranial Doppler (TCD) Ultrasonography Screening for Children with SCD; and Appropriate Antibiotic Prophylaxis (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/chipra-1416-p007-2-ef.pdf
    November 01, 2015 - Claims data. … Claims data. … (MAX) administrative claims data from six States with a moderate to high prevalence of SCD … ● This measure was also tested using administrative claims acquired directly from the respective … Caveats These measures are based on administrative claims; incomplete reporting of claims or SCD diagnosis

32. CHIPRA 235: Section 6, Table 5. Reasons for Variance (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/availability/chipra-235-section-6-table-5.pdf
    January 01, 2013 - code was added/updated after Analyst 1 data extraction 1 Data update: Specialty-related visit claims … code was added/updated after Analyst 1 data extraction 2 Data update: Specialty-related visit claims … code was added/updated after Analyst 1 data extraction 2 Data update: Specialty-related visit claims … code was added/updated after Analyst 1 data extraction 1 Data update: Specialty-related visit claims … taxonomy record was added after Analyst 1 data extraction 1 Data update: Specialty-related visit claims

33. Chipra-141-Section-2-Tech-Specs (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-141-section-2-tech-specs.pdf
    December 01, 2012 - Algorithm to identify children with complex and non-complex chronic conditions using Medicaid claims … file that includes all claims (inpatient, outpatient, managed care encounter data) and has at … The Process: 1) 'Claims' dataset: claims are read in and the decimals are stripped from the … ICD-9 codes with or without decimals are thus accommodated. 2) Claims are sorted by person … <---- 1) SET LOCATION OF CLAIMS DATA TO BE USED; %let icdnum=25;

34. Section 8.A, Data Availability (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/duration/chipra-153-section-8a.pdf
    January 01, 2011 - Some states do not report enrollment data, and none reports claims for their state funded (S-CHIP) … Additionally, while some states usually provide managed care claims, others do not (Byrd and Verdier … Testing managed care claims data quality in each state Managed care claims data is sometimes absent … States highlighted in Gray did not meet criteria to be utilized for studying appendectomy claims. … All claims data in these states is reported via FFS or PCCM, wherein claims are billed as FFS.

35. Ratio of Magnetic Resonance Imaging Scans to Computed Tomography Scans for the Evaluation of Children with Atraumatic Seizure: Table 7 - 10 (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0197-tables7-10.pdf
    January 01, 2006 - days after the date of evaluation for atraumatic seizure, was calculated using 5 consecutive years of claims … data drawn from Medicaid Analytic eXtract (MAX) administrative claims data provided by the Centers … range) 0.98 (0.81-0.99) Table 9: Contingency Table for Presence of Exclusions in Administrative Claims … Measurement Year Exclusion Documented in Charts Present Absent Total Exclusion present based on claims … 97 Total 13 91 104 Table 10: Contingency Table for Presence of Exclusions in Administrative Claims

36. Tables 7-10 (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-196-section-6.pdf
    January 01, 2006 - after the date of evaluation for atraumatic headache, was calculated using 5 consecutive years of claims … data drawn from Medicaid Analytic eXtract (MAX) administrative claims data provided by the Centers … range) 0.99 (0.90-1.00) Table 9: Contingency Table for Presence of Exclusions in Administrative Claims … Measurement Year Exclusion Documented in Charts Present Absent Total Exclusion present based on claims … 62 Total 18 48 66 Table 10: Contingency Table for Presence of Exclusions in Administrative Claims

37. Overuse of Imaging for the Evaluation of Children with Simple Febrile Seizure: Tables 12 - 15 (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0192-tables12-15.pdf
    October 16, 2019 - 7.2 (10.2) 8.5 (12.5) 0.2 (0.6) 75.1 (18.7) 3.2 (2.2) 5.4 (7) Subset following claims … missing or unmatched ZIP code, yielding n=458 (97.4%). ** Among the subset of children following claims … ‡ Mean (SD) Eligible children who had a febrile seizure (n=458)* 13.7 (15.8) Subset following claims … missing or unmatched ZIP code, yielding n=458 (97.4%). ** Among the subset of children following claims … missing or unmatched ZIP code, yielding n=457 (97.2%). ** Among the subset of children following claims

38. Section 6.A, Figures 1 to 4 and Table 5 (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-0138-section-6a.pdf
    December 01, 2013 - tested using a sample drawn from 5 consecutive years of Medicaid Analytic eXtract (MAX) administrative claims … tested using a sample drawn from 5 consecutive years of Medicaid Analytic eXtract (MAX) administrative claims …                                                       Figure 3: Michigan Medicaid Claims … CHAMPS) compared with a corresponding sample drawn from Medicaid Analytic eXtract (MAX) administrative claims … Figure 4: Michigan Medicaid Claims Results Compared with MAX data for 350‐Day Rate 0% 5% 10%

39. Tables 8-11 (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-195-tables%208-11.pdf
    December 18, 2019 - 2,918)** 0.5 (1.0) 4.9 (7.9) 8.0 (12.6) 0.1 (0.2) 80.2 (16.8) 2.6 (1.4) 3.7 (6.1) Subset following claims … )*** 0.5 (1.0) 4.8 (7.8) 8.2 (12.7) 0.1 (0.2) 80.3 (16.8) 2.6 (1.4) 3.6 (6.0) Subset following claims … headache (n=5,807)* 9.7 (13.5) Subset who had a CT or MRI (n=2,918)** 9.8 (13.6) Subset following claims … denominator exclusions (n=2,386)*** 9.5 (13.3) Subset following claims numerator exclusions (n=1,985 … CT or MRI (n=2,917)** $69,540 $29,624 $16,036 $47,028 $63,542 $85,462 $219,688 Subset following claims

40. Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/research/publications/search.html?page=5
    July 01, 2017 - Data Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … Publication Date: July 2017 Publication Number: 17-M018-1-EF All-Payer Claims … large-scale databases that systematically collect professional, facility, pharmacy, laboratory, and dental claims … Inventory and Prioritization of Measures To Support the Growing Effort in Transparency Using All-Payer Claims … Databases AHRQ funded the All-Payer Claims Databases (APCDs) project to learn more about how APCDs