Dimensional Warehouse Model Data Model

Entity

Entity HEDIS Access Availability of Care Analysis

Description

This Analytical Requirement includes measures developed by the National Committee for Quality Assurance (NCQA) and published as part of the Healthcare Effectiveness Data and Information Set (HEDIS) 2015 Volume 2 specification.

Dimensions (and sample axes of analysis):
- Time Period (Reporting Year)
- Geographic Area (Region, State)
- Plan Member (Plan, Line of Business(Medicare, Medicaid, Commercial))
- Patient (Age range)
- Analytical Classification (Optional - used for measures (IET) & (PPC))

Attributes
Adults Access to Preventive/Ambulatory Health Services (AAP)
Analytical Classification Dk
Annual Dental Visit (ADV)
Calendar Dk
Call Answer Timeliness (CAT)
Children and Adolescents Access to Primary Care Practitioners (CAP)
Geographic Area Dk
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET)
Number Of Calls Answered On Time (CAT-n)
Number Of Calls Received (CAT-d)
Number Of Child Members (CAP-d)
Number Of Child Members With PCP Visit (CAP-n)
Number Of Children And Adolescents On Antipsychotics (APP-d)
Number Of Children And Adolescents On Antipsychotics With First-Line Psychosocial Care (APP-n)
Number Of Deliveries Of Live Births (PPC-d)
Number Of Member Pregnancies Receiving Timely Postpartum Care (PPC-n)
Number Of Member Pregnancies Receiving Timely Prenatal Care (PPC-n)
Number Of Members (AAP-d)
Number Of Members (ADV-d)
Number Of Members Engaging In AOD Treatment (IET-n)
Number Of Members Initiating AOD Treatment (IET-n)
Number Of Members With Ambulatory Or Preventive Care Visit (AAP-n)
Number Of Members With Dental Visit (ADV-n)
Number Of Members With New AOD Episode (IET-d)
Patient Dk
Plan Member Dk
Prenatal and Postpartum Care (PPC)
Use Of First-Line Psychosocial Care For Children And Adolescents On Antipsychotics (APP)

Relationship
HEDIS Access Availability of Care Analysis_Calendar Dimension_FK
HEDIS Access Availability of Care Analysis_Geographic Area Dimension_FK
HEDIS Access Availability of Care Analysis_Plan Member Dimension_FK
HEDIS Access Availability of Care Analysis_Patient Dimension_FK
HEDIS Access Availability of Care Analysis_Analytical Classification_FK

Primary Key
HEDIS Access Availability of Care Analysis PK

Dependencies
NONE

Reverse Dependencies

Attribute Details

Adults Access to Preventive/Ambulatory Health Services (AAP)

Description	The percentage of members 20 years and older who had an ambulatory or preventive care visit. The organization reports three separate percentages for each product line. - Medicaid and Medicare members who had an ambulatory or preventive care visit during the measurement year. - Commercial members who had an ambulatory or preventive care visit during the measurement year or the two years prior to the measurement year. This definition is included with the permission of the National Committee for Quality Assurance (NCQA) and is an extract from the full measure definition published by NCQA. Refer to NCQA's HEDIS vol 2 measures for the complete measure definition. Formula: [(A/B) *100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Analytical Classification Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Annual Dental Visit (ADV)

Description	The percentage of members 2-21 years of age who had at least one dental visit during the measurement year. This measure applies only if dental care is a covered benefit in the organization's Medicaid contract. This definition is included with the permission of the National Committee for Quality Assurance (NCQA) and is an extract from the full measure definition published by NCQA. Refer to NCQA's HEDIS vol 2 measures for the complete measure definition. Formula: [(A/B) *100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Calendar Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Call Answer Timeliness (CAT)

Description	The percentage of calls received by the organization's Member Services call centers (during operating hours) during the measurement year that were answered by a live voice within 30 seconds. This definition is included with the permission of the National Committee for Quality Assurance (NCQA) and is an extract from the full measure definition published by NCQA. Refer to NCQA's HEDIS vol 2 measures for the complete measure definition. Formula: [(A/C) *100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Children and Adolescents Access to Primary Care Practitioners (CAP)

Description	The percentage of members 12 months-19 years of age who had a visit with a PCP. The organization reports four separate percentages for each product line. - Children 12-24 months and 25 months-6 years who had a visit with a PCP during the measurement year. - Children 7-11 years and adolescents 12-19 years who had a visit with a PCP during the measurement year or the year prior to the measurement year. This definition is included with the permission of the National Committee for Quality Assurance (NCQA) and is an extract from the full measure definition published by NCQA. Refer to NCQA's HEDIS vol 2 measures for the complete measure definition. Formula: [(A/B) *100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Geographic Area Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET)

Description	The percentage of adolescent and adult members with a new episode of alcohol or other drug (AOD) dependence who received the following. - Initiation of AOD Treatment. The percentage of members who initiate treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis. - Engagement of AOD Treatment. The percentage of members who initiated treatment and who had two or more additional services with a diagnosis of AOD within 30 days of the initiation visit. This definition is included with the permission of the National Committee for Quality Assurance (NCQA) and is an extract from the full measure definition published by NCQA. Refer to NCQA's HEDIS vol 2 measures for the complete measure definition. Formula: [((A/C) or (B/C))*100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Calls Answered On Time (CAT-n)

Description	The number of calls received by the organization's Member Services call centers (during operating hours) during the measurement year that were answered by a live voice within 30 seconds.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Calls Received (CAT-d)

Description	The number of calls received by the organization's Member Services call centers (during operating hours) during the measurement year.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Child Members (CAP-d)

Description	The number of children and adolescents enrolled as members.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Child Members With PCP Visit (CAP-n)

Description	The number of children and adolescents who had a visit with a PCP during the measurement year or the year prior to the measurement year.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Children And Adolescents On Antipsychotics (APP-d)

Description	The number of children and adolescents 1–17 years of age who had a new prescription for an antipsychotic medication.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Children And Adolescents On Antipsychotics With First-Line Psychosocial Care (APP-n)

Description	The number of children and adolescents 1–17 years of age who had a new prescription for an antipsychotic medication and had documentation of psychosocial care as first-line treatment.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Deliveries Of Live Births (PPC-d)

Description	The number of deliveries of live births between November 6 of the year prior to the measurement year and November 5 of the measurement year.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Member Pregnancies Receiving Timely Postpartum Care (PPC-n)

Description	The number of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Member Pregnancies Receiving Timely Prenatal Care (PPC-n)

Description	The number of deliveries that received a prenatal care visit as a member of the organization in the first trimester or within 42 days of enrollment in the organization.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Members (AAP-d)

Description	The number of members enrolled.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Members (ADV-d)

Description	The number of members 2-21 years of age during the measurement year.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Members Engaging In AOD Treatment (IET-n)

Description	The number of members who initiated treatment and who had two or more additional services with a diagnosis of AOD within 30 days of the initiation visit.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Members Initiating AOD Treatment (IET-n)

Description	The number of members who initiate treatment through an inpatient Alcohol or Other Drug dependence (AOD) admission, outpatient visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Members With Ambulatory Or Preventive Care Visit (AAP-n)

Description	The number of members who had an ambulatory or preventive care visit during the measurement year.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Members With Dental Visit (ADV-n)

Description	The number of members 2-21 years of age who had at least one dental visit during the measurement year.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Members With New AOD Episode (IET-d)

Description	The number of adolescent and adult members with a new episode of alcohol or other drug (AOD) dependence.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Patient Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Plan Member Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Prenatal and Postpartum Care (PPC)

Description	The percentage of deliveries of live births between November 6 of the year prior to the measurement year and November 5 of the measurement year. For these women, the measure assesses the following facets of prenatal and postpartum care. - Timeliness of Prenatal Care. The percentage of deliveries that received a prenatal care visit as a member of the organization in the first trimester or within 42 days of enrollment in the organization. - Postpartum Care. The percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery. This definition is included with the permission of the National Committee for Quality Assurance (NCQA) and is an extract from the full measure definition published by NCQA. Refer to NCQA's HEDIS vol 2 measures for the complete measure definition. Formula: [((A/C) or (B/C))*100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Use Of First-Line Psychosocial Care For Children And Adolescents On Antipsychotics (APP)

Description	The percentage of children and adolescents 1–17 years of age who had a new prescription for an antipsychotic medication and had documentation of psychosocial care as first-line treatment. This definition is included with the permission of the National Committee for Quality Assurance (NCQA) and is an extract from the full measure definition published by NCQA. Refer to NCQA's HEDIS vol 2 measures for the complete measure definition. Formula: [(A/B) *100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Relationship Details

HEDIS Access Availability of Care Analysis_Calendar Dimension_FK

Is Identifying Relationship	true
Child Table	HEDIS Access Availability of Care Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Calendar Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

HEDIS Access Availability of Care Analysis_Geographic Area Dimension_FK

Is Identifying Relationship	true
Child Table	HEDIS Access Availability of Care Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Geographic Area Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

HEDIS Access Availability of Care Analysis_Plan Member Dimension_FK

Is Identifying Relationship	true
Child Table	HEDIS Access Availability of Care Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Plan Member Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

HEDIS Access Availability of Care Analysis_Patient Dimension_FK

Is Identifying Relationship	true
Child Table	HEDIS Access Availability of Care Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Patient Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

HEDIS Access Availability of Care Analysis_Analytical Classification_FK

Is Identifying Relationship	true
Child Table	HEDIS Access Availability of Care Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Common Code Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Primary Key Details

HEDIS Access Availability of Care Analysis PK

Key Attribute	Plan Member Dk
Key Attribute	Patient Dk
Key Attribute	Analytical Classification Dk
Key Attribute	Calendar Dk
Key Attribute	Geographic Area Dk

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