Dimensional Warehouse Model Data Model

Entity

Entity HEDIS Health Plan Descriptive Information 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, Gender, Language, Race)
- Practitioner (Specialty)
- Analytical Classification (Optional - used for measures (ENP) (LDM) (WOP) & (TLM))

Attributes
Analytical Classification Dk
Board Certification (BCR)
Calendar Dk
Enrollment by Product Line (ENP)
Enrollment by State (EBS)
Geographic Area Dk
Language Diversity of Membership (LDM)
Number Of Board Certified Professional Providers (BCR-n)
Number Of Live Births (WOP-d)
Number Of Live Births By Gestational Age At Enrollment (WOP-n)
Number Of Members (LDM-d)
Number Of Members (RDM-d)
Number Of Members Of Known Race Or Ethnicity (RDM-n)
Number Of Members With Language Preference (LDM-n)
Number Of Professional Providers (BCR-d)
Patient Dk
Plan Member Dk
Practitioner Dk
Race/Ethnicity Diversity of Membership (RDM)
Total Membership (TLM)
Weeks of Pregnancy at Time of Enrollment (WOP)

Relationship
HEDIS Health Plan Descriptive Information Analysis_Calendar Dimension_FK
HEDIS Health Plan Descriptive Information Analysis_Geographic Area Dimension_FK
HEDIS Health Plan Descriptive Information Analysis_Plan Member Dimension_FK
HEDIS Health Plan Descriptive Information Analysis_Patient Dimension_FK
HEDIS Health Plan Descriptive Information Analysis_Practitioner Dimension_FK
HEDIS Health Plan Descriptive Information Analysis_Analytical Classification_FK

Primary Key
HEDIS Health Plan Descriptive Information Analysis PK

Dependencies
NONE

Reverse Dependencies

Attribute Details

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

Board Certification (BCR)

Description	The percentage of the following physicians whose board certification is active as of December 31 of the measurement year: - Family medicine physicians. - Internal medicine physicians. - Pediatricians. - OB/GYN physicians. - Geriatricians. - Other physician specialists. Board certification refers to the various specialty certification programs of the American Board of Medical Specialties and the American Osteopathic Association. Report each product separately as of December 31 of 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

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

Enrollment by Product Line (ENP)

Description	The total number of members enrolled in the product line, stratified by age and gender. 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.
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

Enrollment by State (EBS)

Description	The number of members enrolled as of December 31 of the measurement year, by state. 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.
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

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

Language Diversity of Membership (LDM)

Description	An unduplicated count and percentage of members enrolled at any time during the measurement year by spoken language preferred for health care and preferred language for written materials. 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

Number Of Board Certified Professional Providers (BCR-n)

Description	The number of physicians (by Specialty) whose board certification is active as of December 31 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 Live Births (WOP-d)

Description	The number of deliveries of live births by members 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 Live Births By Gestational Age At Enrollment (WOP-n)

Description	The number of women who delivered a live birth during the measurement year by the weeks of pregnancy at the time of their enrollment in the organization, according to the following periods: - Prior to pregnancy (280 days or more prior to delivery). - The first 12 weeks of pregnancy, including the end of the 12th week (279-196 days prior to delivery). - The beginning of the 13th week through the end of the 27th week of pregnancy (195-91 days prior to delivery). - The beginning of the 28th week of pregnancy or after (=90 days prior to delivery). - Unknown.
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 (LDM-d)

Description	The number of members enrolled in 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 (RDM-d)

Description	The number of members enrolled in 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 Of Known Race Or Ethnicity (RDM-n)

Description	The number of members with recorded details of their Race and / or ethnicity.
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 Language Preference (LDM-n)

Description	The number of members with a recorded preference for a spoken and / or written language.
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 Professional Providers (BCR-d)

Description	The number of physicians (by Specialty).
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

Practitioner 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

Race/Ethnicity Diversity of Membership (RDM)

Description	An unduplicated count and percentage of members enrolled any time during the measurement year, by race and ethnicity. 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

Total Membership (TLM)

Description	The number of members enrolled as of December 31 of 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.
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

Weeks of Pregnancy at Time of Enrollment (WOP)

Description	The percentage of women who delivered a live birth during the measurement year by the weeks of pregnancy at the time of their enrollment in the organization, according to the following periods: - Prior to pregnancy (280 days or more prior to delivery). - The first 12 weeks of pregnancy, including the end of the 12th week (279-196 days prior to delivery). - The beginning of the 13th week through the end of the 27th week of pregnancy (195-91 days prior to delivery). - The beginning of the 28th week of pregnancy or after (=90 days prior to delivery). - Unknown. 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 Health Plan Descriptive Information Analysis_Calendar Dimension_FK

Is Identifying Relationship	true
Child Table	HEDIS Health Plan Descriptive Information 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 Health Plan Descriptive Information Analysis_Geographic Area Dimension_FK

Is Identifying Relationship	true
Child Table	HEDIS Health Plan Descriptive Information 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 Health Plan Descriptive Information Analysis_Plan Member Dimension_FK

Is Identifying Relationship	true
Child Table	HEDIS Health Plan Descriptive Information 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 Health Plan Descriptive Information Analysis_Patient Dimension_FK

Is Identifying Relationship	true
Child Table	HEDIS Health Plan Descriptive Information 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 Health Plan Descriptive Information Analysis_Practitioner Dimension_FK

Is Identifying Relationship	true
Child Table	HEDIS Health Plan Descriptive Information 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	Practitioner Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

HEDIS Health Plan Descriptive Information Analysis_Analytical Classification_FK

Is Identifying Relationship	true
Child Table	HEDIS Health Plan Descriptive Information 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 Health Plan Descriptive Information Analysis PK

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

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