| Dimensional Warehouse Model Data Model |
| Description | The analysis of capitation and claim payments by the Health Plan Organization to healthcare providers. |
| Primary Key | |
 Provider Payments Analysis PK |
|
| Dependencies | |
 NONE |
|
| Reverse Dependencies | |
| |
|
| Attribute Details |
Average Capitated Encounter Cost Amount
| Description | The average capitation cost of each encounter. Formula: [A/B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Average Capitation Per Member Amount
| Description | The total capitation amount in relation to the number of members. Formula: [A/B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Average Claim Payment Amount
| Description | The average claim payment amount. Formula: [A/B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| 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 |
Capitation Payment Amount
| Description | The total amount paid out to healthcare providers as capitation payments. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Capitation Savings Amount
| Description | The amount saved by the health plan through the capitation agreements as a contrast to fee-for-service equivalent amounts. Formula: [A-B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Capitation Withhold Amount
| Description | The total amount withheld from capitation payments to support provider agreements. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Capitation Withhold Percentage
| Description | The percentage of capitation amounts withheld. 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 |
Claim Payment Amount
| Description | The total amount of claim payments made to healthcare providers. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Fee-for-service Equivalent Amount
| Description | The total amount that would have been paid on a fee-for-service basis for all capitated encounters had a capitation agreement not been in place. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| 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 |
Group 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 |
Health Plan Product 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 |
Number Of Capitated Encounters
| Description | The total number of encounters occurring with healthcare providers that are covered under a capitation agreement. |
| 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 Claims Paid
| Description | The total number of claims paid to healthcare providers. |
| 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
| Description | The total count of members, during the period of analysis. This may be the total number of people with one or more active memberships at a given point in time during the period, or the average number of people with active memberships over the full period. |
| 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 |
Percentage Capitation Savings
| Description | The percentage of money saved through the existence of a capitation agreement in contrast to fee-for-service equivalent amounts. 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 |
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 |
Provider 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 |
| Relationship Details |
Provider Payments Analysis_Calendar Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Provider Payments 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 |
Provider Payments Analysis_Geographic Area Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Provider Payments 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 |
Provider Payments Analysis_Group Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Provider Payments 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 | Group Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Provider Payments Analysis_Provider Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Provider Payments 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 | Provider Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Provider Payments Analysis_Practitioner Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Provider Payments 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 |
Provider Payments Analysis_Health Plan Product Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Provider Payments 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 | Health Plan Product 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 |
Provider Payments Analysis PK
| Key Attribute | Calendar Dk |
| Key Attribute | Geographic Area Dk |
| Key Attribute | Group Dk |
| Key Attribute | Provider Dk |
| Key Attribute | Practitioner Dk |
| Key Attribute | Health Plan Product Dk |
| Dimensional Warehouse Model Data Model |