Report Name
HCC by Stratum
About This Report
This report tracks progress of IVA Program by Stratum level.
Project Type
IVA
Service Type
Full Service, Clinical Only
Intended User
Manager / Technical User
Best For
Acquiring the counts of members and HCCs in each stratum category.
Using This Report
- Download the report and use within Excel
- Create pivot table to group values that aggregate the individual line items to discrete categories like Total RADVDE HCC Count, Total Non-RADVDE Hcc Count, Counts of Submittable, Unsubmittable, Conditional and Pending HCCs
What Information Can I Filter?
| Project |
| Stratum Level |
What Do The Fields Mean?
| Field | Data Dictionary Definition |
| Total RADVDE HCCs | (Original Measure: Total Radvde Hcc Count) This provides the count of unique enrollee id/CC combinations that are recognized as an EDGE provided HCC |
| Total Primary RADVDE HCCs | (Original Measure: Primary Submittable Radvde Hcc Count ) This provides the count of unique enrollee id / CC combinations that are primary (highest hierarchy), submittable, and are recognized as an EDGE provided HCC |
| Total Primary Net New HCCs | (Original Measure: Primary Submittable Net New Non Radvde Count) This provides the count of unique enrollee id / CC combinations that are submittable, primary (highest hierarchy), not sourced from an edge provided diagnosis (new diagnosis), and are NOT an EDGE provided HCC |
| Total Primary Non RADVDE HCCs | (Original Measure: Primary Submittable Non Net New Non Radvde Hcc Count) This provides the count of unique enrollee id / CC combinations that are submittable, primary (highest hierarchy), sourced from an edge provided diagnosis, and are NOT an EDGE provided HCC |
| Total Primary HCCs | (Original Measure: Total Submittable Primary Hccs) This provides the count of unique enrollee id / CC combinations that are submittable and primary (highest hierarchy) |
| Percent of Primary RADVDE HCCs | (Original Measure: Percent Primary Radvde Hccs) Percentage of primary submittable RADVDE HCCs over the total identified count of RADVDE HCCs |
| Percent Primary Net New HCCs | (Original Measure Percent Primary Net New Hccs) Percentage of primary net new HCCs over the total identified count of RADVDE HCCs |
| Primary Non Net New Non RADVDE HCCs | (Original Measure: Percent Primary Non Net New Non Radvde Hccs) Percentage of non net new non radvde HCCs over the total identified count of RADVDE HCCs |
| Percent Primary HCCs | (Original Measure: Percent Primary Hccs) Percentage of primary HCCs over the total identified count of RADVDE HCCs |
| HCC by Stratum (Table) | Aggregates condition category (CC) up to the stratum level, counting the statuses of individual member/cc combinations |
| Project ID | The internal identifier associated with a project |
| Project Name | The name associated with a project |
| Hios | The Health Insurance Oversight System (HIOS) identifier assigned by CMS to a given health plan |
| Stratum Level | The stratum indicator of the stratum in which the enrollee was included. Strata 1-9 represent low, medium and high-risk enrollees with at least one (1) HCC or (1) RXC for each age model. Stratum 10 includes enrollees with no HCCs and no RXCs. Note: Only the adult RA model includes RXCs therefore only the adult strata 1-3 will include enrollees with RXCs |
| Enrollee Count | A distinct count measure of the associated data items |
| Primary Submittable Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are primary (highest hierarchy), submittable, and are recognized as an EDGE provided HCC |
| Subordinate Submittable Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are subordinate (lower hierarchy), submittable, and are recognized as an EDGE provided HCC |
| Submittable Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are submittable and are recognized as an EDGE provided HCC |
| Conditional Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are conditional (requires valid signature), not submittable, and are recognized as an EDGE provided HCC |
| Pending Radvde Hcc Chart Inhouse Count | This provides the count of unique enrollee id / CC combinations that are pending (have yet to be coded), not submittable nor conditional, chart received, and are recognized as an EDGE provided HCC |
| Pending Radvde Hcc Chart Outstanding Count | This provides the count of unique enrollee id / CC combinations that are pending (have yet to be coded), not submittable nor conditional, chart has not been received, and are recognized as an EDGE provided HCC |
| Pending Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are pending (have yet to be coded), not submittable nor conditional, and are recognized as an EDGE provided HCC |
| Unsubmittable By Pend Code Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are unsubmittable, not submittable, conditional, or pending, has a pend code associated with the chase, and are recognized as an EDGE provided HCC |
| Unsubmittable By Vrc Radvde Hcc Count | This provides the count of unique enrollee id /CC combinations that are unsubmittable, not submittable, conditional, or pending, has a VRC that designates an invalid diagnosis, and are recognized as an EDGE provided HCC |
| Unsubmittable Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are unsubmittable, not submittable, conditional, or pending, and are recognized as an EDGE provided HCC |
| Total Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are recognized as an EDGE provided HCC |
| Primary Submittable Net New Non Radvde Count | This provides the count of unique enrollee id / CC combinations that are submittable, primary (highest hierarchy), not sourced from an edge provided diagnosis (new diagnosis), and are NOT an EDGE provided HCC |
| Subordinate Submittable Net New Non Radvde Count | This provides the count of unique enrollee id / CC combinations that are submittable, subordinate (lower hierarchy), not sourced from an edge provided diagnosis (new diagnosis), and are NOT an EDGE provided HCC |
| Submittable Net New Non Radvde Count | This provides the count of unique enrollee id / CC combinations that are submittable, not sourced from an edge provided diagnosis (new diagnosis), and are NOT an EDGE provided HCC |
| Primary Submittable Non Net New Non Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are submittable, primary (highest hierarchy), sourced from an edge provided diagnosis, and are NOT an EDGE provided HCC |
| Subordinate Submittable Non Net New Non Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are submittable, subordinate (lower hierarchy), sourced from an edge provided diagnosis, and are NOT an EDGE provided HCC |
| Submittable Non Net New Non Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are submittable, sourced from an edge provided diagnosis, and are NOT an EDGE provided HCC |
| Submittable Non Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are submittable and are NOT an EDGE provided HCC |
| Conditional Non Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are conditional (requires valid signature), not submittable, and are NOT an EDGE provided HCC |
| Pending Non Radvde Hcc Chart In House Count | This provides the count of unique enrollee id / CC combinations that are pending (have yet to be coded), not submittable nor conditional, chart received, and are NOT an EDGE provided HCC |
| Pending Non Radvde Hcc Chart Outstanding Count | This provides the count of unique enrollee id / CC combinations that are pending (have yet to be coded), not submittable nor conditional, and are NOT an EDGE provided HCC |
| Pending Non Radvde Hcc Count | This provides the count of unique enrollee id /CC combinations that are pending (have yet to be coded), not submittable nor conditional, and are NOT an EDGE provided HCC |
| Unsubmittable By Pend Code Non Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are unsubmittable, not submittable, conditional, or pending, has a pend code associated with the chase, and are NOT an EDGE provided HCC |
| Unsubmittable By Vrc Non Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are unsubmittable, not submittable, conditional, or pending, has a VRC that designates an invalid diagnosis, and are NOT an EDGE provided HCC |
| Unsubmittable Non Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are unsubmittable, not submittable, conditional, or pending, and are NOT an EDGE provided HCC |
| Total Non Radvde Hcc Count | This provides the count of unique enrollee id / CC combinations that are NOT an EDGE provided HCC |
| Total Submittable Primary Hccs | This provides the count of unique enrollee id / CC combinations that are submittable and primary (highest hierarchy) |
| Total Submittable Subordinate Hccs | This provides the count of unique enrollee id / CC combinations that are submittable and subordinate (lower hierarchy) |
| Total Submittable Hccs | This provides the count of unique enrollee id / CC combinations that are submittable |