EL-1-023-23

Data Quality Measure

Last updated

Key Information

Measure Name	% of MSIS IDs in which the primary home address county code, zip code, or state is not in-state
File Type	ELG
Measure ID	EL-1-023-23
Measure Type	Non-Claims Percentage
Content area	ELG

Validation

Validation Type	Inferential

Measure Priority

Measure Priority	High
Focus Area	N/A
Category	Beneficiary demographics

Claim Information

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

Thresholds

Minimum	0
Maximum	0.01
TA Minimun	0
TA Maximum	0.01
Longitudinal Threshold	N/A
For TA (for including in compliance training)	TA- Inferential
For TA (Longitudinal)	No

Data Elements

DD Data Element	ELIGIBLE-ZIP-CODE • SUBMITTING-STATE • MSIS-IDENTIFICATION-NUM • ELIGIBLE-COUNTY-CODE • ELIGIBLE-ADDR-TYPE • ELIGIBLE-STATE
DD Data Element Number	ELG071 • ELG062 • ELG064 • ELG072 • ELG065 • ELG070

Annotation	Calculate the percentage of eligibles where the primary address county code, zip code, or state is not in-state
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: Eligible contact on the last day of the DQ report month Using the MSIS IDs that meet the criteria from STEP 1, join to segment ELIGIBLE-CONTACT-INFORMATION-ELG00004 by keeping records that satisfy the following criteria: 1a. ELIGIBLE-ADDR-EFF-DATE<= last day of the DQ report month 2a. ELIGIBLE-ADDR-END-DATE >= last day of the DQ report month OR missing OR 1b. ELIGIBLE-ADDR-EFF-DATE is missing 2b. ELIGIBLE-ADDR-END-DATE is missing STEP 3: Primary home address Of the records that meet the criteria from STEP 2, restrict to segments where: 1. ELIGIBLE-ADDR-TYPE = "01" STEP 4: Eligible county code, zip code, or state is not in-state Of the segments that meet the criteria from STEP 3, further refine the population by keeping segments where: 1 ELIGIBLE-STATE does not equal SUBMITTING-STATE OR 2.ELIGIBLE-COUNTY-CODE is not in-state OR 3. ELIGIBLE-ZIP-CODE is not in-state STEP 5: Calculate percentage Divide the count of unique MSIS IDs from STEP 4 by the count of unique MSIS IDs from STEP 3

Annotation

Calculate the percentage of eligibles where the primary address county code, zip code, or state is not in-state

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: Eligible contact on the last day of the DQ report month

Using the MSIS IDs that meet the criteria from STEP 1, join to segment ELIGIBLE-CONTACT-INFORMATION-ELG00004 by keeping records that satisfy the following criteria:

1a. ELIGIBLE-ADDR-EFF-DATE<= last day of the DQ report month

2a. ELIGIBLE-ADDR-END-DATE >= last day of the DQ report month OR missing

OR

1b. ELIGIBLE-ADDR-EFF-DATE is missing

2b. ELIGIBLE-ADDR-END-DATE is missing

STEP 3: Primary home address

Of the records that meet the criteria from STEP 2, restrict to segments where:

1. ELIGIBLE-ADDR-TYPE = "01"

STEP 4: Eligible county code, zip code, or state is not in-state

Of the segments that meet the criteria from STEP 3, further refine the population by keeping segments where:

1 ELIGIBLE-STATE does not equal SUBMITTING-STATE

OR

2.ELIGIBLE-COUNTY-CODE is not in-state

OR

3. ELIGIBLE-ZIP-CODE is not in-state

STEP 5: Calculate percentage

Divide the count of unique MSIS IDs from STEP 4 by the count of unique MSIS IDs from STEP 3