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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 Type | Inferential |
---|
Measure Priority | N/A |
---|---|
Focus Area | N/A |
Category | N/A |
Claim Type | N/A |
---|---|
Adjustment Type | N/A |
Crossover Type | N/A |
Minimum | 0 |
---|---|
Maximum | 0 |
TA Minimun | |
TA Maximum | |
Longitudinal Threshold | N/A |
For TA
(for including in compliance training) |
No |
For TA
(Longitudinal) |
No |
DD Data Element | STATE-PLAN-ID-NUM • MANAGED-CARE-PLAN-TYPE • ADJUSTMENT-IND • TYPE-OF-CLAIM • TYPE-OF-SERVICE • ADJUSTMENT-IND • TYPE-OF-CLAIM • TYPE-OF-CLAIM • PLAN-ID-NUMBER • MANAGED-CARE-PLAN-TYPE • MANAGED-CARE-PLAN-ID • ADJUSTMENT-IND • PLAN-ID-NUMBER • PLAN-ID-NUMBER • ADJUSTMENT-IND • PLAN-ID-NUMBER |
---|---|
DD Data Element Number | MCR019 • ELG193 • CRX025 • COT037 • COT186 • CIP026 • CIP100 • CLT052 • CLT080 • MCR024 • ELG192 • COT025 • CIP130 • CRX056 • CLT025 • COT066 |
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" |