-
www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0198-technicalspecs.pdf
October 16, 2019 - Exclusions
• Denominator Exclusions
o Exclusions based on ICD-9-CM codes captured in administrative claims … obtained
Suspected abuse and neglect or other head trauma (IMG9 or the presence of an
E-code in claims
-
www.qualitymeasures.ahrq.gov/opioids/about.html
August 01, 2021 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims
-
www.qualitymeasures.ahrq.gov/patient-safety/settings/hospital/candor/acknowledgements.html
August 01, 2022 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … in research to test promising model programs to improve patient safety and reduce medical liability claims
-
www.qualitymeasures.ahrq.gov/data/innovations/3p-rd.html
April 01, 2024 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … Determinants of Health
Synthetic Healthcare Database for Research (SyH-DR)
All-Payer Claims … The database was supplemented and enhanced using available state and national claims files.
3P-RD contains
-
www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/cmsqualconf0615.pdf
September 01, 2015 - Dailey
The National Evaluation Team
2
Updates on data collection: site visits, claims, and … patients
and primary care physicians, and others
7
Site Visits: Early Observations
Claims
-
www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-135-graphics-section-6-b.pdf
November 26, 2013 - 2
(Percentage of Children in State with SCD Receiving Antibiotics by 3 Months
of Age)
Medicaid
Claims
-
www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-139-section-2.pdf
January 01, 2014 - Claims in the administrative records for any of the sickle cell disease variants listed in Table … Select cases
with TCD
Select cases
with TCD
IPOT2008
_TCD
Merge files,
eliminate
duplicate
claims … by date
of service for
each ID
IPOT2008_
Meas13Had
3
Select cases
that had 3 or
more claims … This frequency is for syntax testing only*/
/*Delete duplicate IDs (this not only deletes multiple claims
-
www.qualitymeasures.ahrq.gov/practiceimprovement/delivery-initiative/bozicstudysnapshots/index.html
August 01, 2018 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … incentive to invest in needed infrastructure, including clinical care redesign (by providers) and automated claims … Inadequate infrastructure for claims processing: Health plans' existing automated claims systems could
-
www.qualitymeasures.ahrq.gov/ncepcr/care/coordination/atlas/chapter6t.html
June 01, 2014 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … within 24 hours of discharge. 1
Format/Data Source: This process measure requires administrative claims … all of the specified elements. 1
Format/Data Source: This process measure requires administrative claims … missed a scheduled appointment. 1
Format/Data Source: This process measure requires administrative claims
-
www.qualitymeasures.ahrq.gov/challenges/patient-safety-tools/index.html
February 01, 2024 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … Agrees to assume any and all risks and waive claims against the Federal Government and its related entities … Agrees to indemnify the Federal Government against third-party claims for damages arising from or related
-
www.qualitymeasures.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/finalsummary/finalsummary2.html
September 01, 2015 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … Access to fee-for-service claims data enables but does not guarantee that all administrative measures … However, given delays in claims processing and infrequent reporting periods, the reports were difficult
-
www.qualitymeasures.ahrq.gov/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/access/strategy6n-price-transparency.html
March 01, 2020 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … Another option for external benchmarks and other data are the all-payer claims databases (APCD) that … Based on BCBSNC claims data over a 12-month period, the tool reports the average total costs for the … with 18 self-insured employers, the study found that use of the tool was associated with lower total claims
-
www.qualitymeasures.ahrq.gov/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/customer-service/strategy6q-custservice-standards.html
March 01, 2020 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … Developed a broader range of self-service options (e.g., change own address or PCP, see claims status … Improved internal communication and workflow between Customer Service and Claims departments to resolve … members' inquiries about claims.
-
www.qualitymeasures.ahrq.gov/npsd/how-does-npsd-work/index.html
February 01, 2024 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … agencies typically focus on all eligible members of the population identified using administrative claims
-
www.qualitymeasures.ahrq.gov/talkingquality/translate/organize/datasource.html
November 01, 2018 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … access to information from one particular source of data—a patient experience survey, administrative/claims
-
www.qualitymeasures.ahrq.gov/talkingquality/translate/organize/index.html
March 01, 2016 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … process, outcome, patient experience)
Organizing Measures by Data Source (e.g., medical records, claims
-
www.qualitymeasures.ahrq.gov/news/newsroom/case-studies/202104.html
October 01, 2021 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … The major point is not about lowering costs with claims, but to resolve unexpected issues so that patients
-
www.qualitymeasures.ahrq.gov/research/publications/pubcomguide/pcguide2apc.html
June 01, 2020 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … sources of all content are specifically identified and references are provided for health and scientific claims
-
www.qualitymeasures.ahrq.gov/data/meps.html
March 01, 2023 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims
-
www.qualitymeasures.ahrq.gov/data/data-tools/index.html
July 01, 2022 - Data
Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims … Data Infographics
Data Visualizations
Data Tools
Data Innovations
All-Payer Claims