The Center for Health Care Data is a leading data center located in the heart of the Texas Medical Center- Houston, Texas.
The Center for Health Care Data is a service division within the University of Texas School of Public Health, a non-profit institution of higher learning. The Center offers services related to health care data analyses and reporting to state entities, qualified researchers, non-profit organizations, institutions and foundations, and other clients with a non-proprietary interest in health care costs and quality.
The Center holds data related to health care delivery through administrative claims data and electronic medical records data, most of which is de-identified and research-ready. The Center also has several public use data files of aggregated health events data and survey data.
The Center has received CMS designation as a Qualified Entity. This designation validates our rigorous data privacy and security processes and acknowledges our appropriate application of quality measures and standards of research and reporting.
The Center is committed towards providing a fair and reliable resource on provider performance to the patients, providers, and policymakers by publishing the most up-to-date reports that summarize results on key performance parameters including health care costs, health services utilization, and quality of care of three providers that include Medicare, Medicaid, and Commercial providers.
The Health of Texas reporting website is reflective of our commitment to healthcare transparency as required of a qualified entity.
The Center for Health Care Data is the only Qualified Entity in the State of Texas. Along with the production of the Health of Texas reporting website, our goals as a Qualified Entity include: use of the claims data for public transparency reporting on variations in health care costs, utilization and quality, and to inform all stakeholders and policy makers in collaboration with the state reporting efforts.
One of the greatest challenges facing our nation and our state is the need to make the healthcare system more affordable while maintaining and improving its quality. The nation has endorsed the Triple Aim objectives, which are to improve the health of the population served, improve the experience of each individual, and make healthcare services affordable.
A key strategy in meeting the Triple Aim revolves around transparency. Transparency refers to the public reporting of meaningful cost and quality information to patients, providers and purchasers to enable value-based healthcare decision-making. The Health of Texas is committed to addressing the healthcare challenges our nation is facing through transparency in data reporting.
The Center for Health Care Data is a leading data center located in the heart of the Texas Medical Center- Houston, Texas.
The Center for Health Care Data is a service division within the University of Texas School of Public Health, a non-profit institution of higher learning. The Center offers services related to health care data analyses and reporting to state entities, qualified researchers, non-profit organizations, institutions and foundations, and other clients with a non-proprietary interest in health care costs and quality.
The Center holds data related to health care delivery through administrative claims data and electronic medical records data, most of which is de-identified and research-ready. The Center also has several public use data files of aggregated health events data and survey data.
The Center has received CMS designation as a Qualified Entity. This designation validates our rigorous data privacy and security processes and acknowledges our appropriate application of quality measures and standards of research and reporting.
The Center is committed towards providing a fair and reliable resource on provider performance to the patients, providers, and policymakers by publishing the most up-to-date reports that summarize results on key performance parameters including health care costs, health services utilization, and quality of care of three providers that include Medicare, Medicaid, and Commercial providers.
The Health of Texas reporting website is reflective of our commitment to healthcare transparency as required of a qualified entity.
The Center for Health Care Data is the only Qualified Entity in the State of Texas. Along with the production of the Health of Texas reporting website, our goals as a Qualified Entity include: use of the claims data for public transparency reporting on variations in health care costs, utilization and quality, and to inform all stakeholders and policy makers in collaboration with the state reporting efforts.
One of the greatest challenges facing our nation and our state is the need to make the healthcare system more affordable while maintaining and improving its quality. The nation has endorsed the Triple Aim objectives, which are to improve the health of the population served, improve the experience of each individual, and make healthcare services affordable.
A key strategy in meeting the Triple Aim revolves around transparency. Transparency refers to the public reporting of meaningful cost and quality information to patients, providers and purchasers to enable value-based healthcare decision-making. The Health of Texas is committed to addressing the healthcare challenges our nation is facing through transparency in data reporting.
Mean ratios (mean cost for zip code area divided by TX mean) are color-coded and represent variation from Texas mean for each 3-digit zip code. Red (>20% of TX mean) to Dark green (<20% of TX mean).
Total cost represent sum of medical and pharmacy cost incurred during the measurement year. Numbers represent average per member per year cost. The measure is derived from the NQF 1604 sponsored by Health Partners. It includes all costs associated with treating members including professional, facility inpatient and outpatient, pharmacy, lab, radiology, ancillary and behavioral health services
This is a subcomponent of Total Cost: Medical cost represent cost for all health care-related services incurred during the measurement year. Numbers represent average per member per year cost.
This is a subcomponent of Total Cost: Pharmacy cost represent cost for all prescription medications incurred during the measurement year. Numbers represent average per member per year cost.
Mean ratios (utilization in zip code area divided by TX mean) are color-coded and represent variation from Texas mean for each 3-digit zip code. Red (>20% of TX mean) to Dark green (<20% of TX mean).
ER visits represents total number of unique ER claims (by unique patient and date of service) during the measurement year displayed per 1000 member year, per member year, or by percentage.
Acute inpatient visits (Bill type: 1-1-1 or 1-1-4) represent total number of unique acute inpatient claims (by unique patients and unique admission date) during the measurement year displayed per 1000 member year, per member year, or by percentage.
Observation stays (Revenue codes: 760-762; 769) represent total number of unique claims for observation stay (by unique patients and service date) during the measurement year displayed per 1000 member year, per member year, or by percentage.
Outpatient visits represents total number of unique outpatient facility claims (Facility code: 1 or classification code: 3 or bill type: 13X) during the measurement year displayed per 1000 member year, per member year, or by percentage.
Professional visits represents total number of unique professional visit claims (POS codes: 1-99) during the measurement year displayed per 1000 member year, per member year, or by percentage
Readmissions represent 30-day preventable readmissions after discharge from an inpatient stay identified using the 3M® proprietary software during the measurement year displayed as percentage.
Mean ratios (prevalence in zip code area divided by TX mean) are color-coded and represent variation from Texas mean for each 3-digit zip code. Red (>20% of TX mean) to Dark green (<20% of TX mean).
Percentage of members with persistent asthma in the measurement year or any prior year. Persistent asthma was defined using NQF 1799 criteria.
Percentage of members with cancer in the measurement year. Persistent asthma was defined using HEDIS Cancer Value Code Sets.
Percentage of members with congestive heart failure in the measurement year or any prior year. Congestive Heart Failure was defined using HEDIS Congestive Heart Failure Value Code Sets.
Percentage of members with chronic kidney disease in the measurement year or any prior year. Chronic Kidney Disease was defined using HEDIS Chronic Kidney Disease Value Code Sets.
Percentage of members with chronic liver disease (including Cirrhosis and Chronic Hepatitis) in the measurement year or any prior year. Chronic liver disease was defined using HEDIS Chronic liver disease Value Code Sets.
Percentage of members with chronic pain in the measurement year. Chronic liver disease was defined using HEDIS Chronic liver disease Value Code Sets.
Percentage of members with chronic obstructive pulmonary disease in the measurement year or any prior year. Chronic obstructive pulmonary disease was defined using HEDIS criteria.
Percentage of members with Dementia or Alzheimer’s disease in the measurement year or any prior year. Dementia or Alzheimer’s disease were defined using HEDIS criteria.
Percentage of members with Diabetes in the measurement year or any prior year. Diabetes was defined using HEDIS criteria.
Percentage of members with Diabetes in the measurement year or any prior year. Diabetes was defined using Healthcare Cost Institute criteria.
Percentage of members with multiple sclerosis in the measurement year or any prior year. Multiple sclerosis was defined using HEDIS criteria.
Percentage of members with rheumatoid arthritis in the measurement year or any prior year. Multiple sclerosis was defined using HEDIS criteria.
A stroke occurs when something blocks blood supply to part of the brain or when a blood vessel in the brain bursts. In either case, parts of the brain become damaged or die.
A hemorrhagic stroke happens when an artery in the brain leaks blood or ruptures
An ischemic stroke happens when blood flow through the artery that supplies oxygen-rich blood to the brain becomes blocked.
Subarachnoid hemorrhage (SAH) is a stroke caused by bleeding into the space surrounding the brain.
Percentage of members with up to two comorbid conditions in the measurement year or any prior year.
Percentage of members with more than two comorbid conditions in the measurement year or any prior year.
Mean ratios (quality of care in the zip code area divided by TX mean) are color-coded and represent variation from Texas mean for each 3-digit zip code. Red (<20% of TX mean) to Dark green (>20% of TX mean).
The percentage of members 5–64 years of age during the measurement year who were identified as having persistent asthma, and were dispensed appropriate medications and remained on medications at least 75% of their treatment period.
The percentage of members 18-75 years of age with diabetes (type 1 and type 2) who had an eye exam (retinal) performed during the measurement year.
The percentage of members 18-75 years of age with diabetes (type 1 and type 2) who had HbA1c testing performed during the measurement year.
The percentage of members 18–75 years of age with diabetes type 1 and type 2 who had underwent nephropathy screening test or received medical attention for nephropathy during the measurement year.
The percentage of members 40 years of age and older with a new diagnosis of COPD or newly active COPD, who received appropriate spirometry testing to confirm the diagnosis during the measurement year.
Mean ratios (risk score for zip code area divided by TX risk score) are color-coded and represent variation from Texas mean for each 3-digit zip code. Red (>20% of TX mean) to Dark green (<20% of TX mean).
Population risk were estimated using 3M® software. The software estimates clinical risk for each individual patient using a combination of clinical diagnosis, procedural, and prescription drug codes identified from medical and pharmacy claims and history of resource utilization using a copyrighted formula. Population is segmented by level of health status (first digit 1-9) and disease severity (second digit 0-6) where a higher number represents poorer health status and increased disease severity, respectively.
Social determinants of health (SDOH) are considered to be factors in a person’s lifestyle, social, economic, and physical environment that influence health status. The data are derived from publicly available sources and reported by county. As the relative values of each measure are very different, the results were converted to a score between 1-5 with 1 representing the most favorable level and 5 the most hazardous level.
The selection of social determinants differs by population group, of which there are three: child and adolescent, general population, and over age 65. The determinants are then grouped into categories as follows
The overall social determinant score for the county
The access to select health care professionals or coverage
Key health behaviors include smoking, obesity, exercise, sexual activity, sleep, alcohol use, nutrition
Measures of health, including subjective responses relating to perceived health status, and surveillance data on life expectancy or mortality.
The elements in the physical environment such as air and water quality, housing, food availability,
The elements within the social and community setting such as safety, violence, high school graduation rate, income, unemployment, single parent households
Mean ratios (mean cost for zip code area divided by TX mean) are color-coded and represent variation from Texas mean for each 3-digit zip code. Red (>20% of TX mean) to Dark green (<20% of TX mean).
Total cost represent sum of medical and pharmacy cost incurred during the measurement year. Numbers represent average per member per year cost. The measure is derived from the NQF 1604 sponsored by Health Partners. It includes all costs associated with treating members including professional, facility inpatient and outpatient, pharmacy, lab, radiology, ancillary and behavioral health services
This is a subcomponent of Total Cost: Medical cost represent cost for all health care-related services incurred during the measurement year. Numbers represent average per member per year cost.
This is a subcomponent of Total Cost: Pharmacy cost represent cost for all prescription medications incurred during the measurement year. Numbers represent average per member per year cost.
Mean ratios (utilization in zip code area divided by TX mean) are color-coded and represent variation from Texas mean for each 3-digit zip code. Red (>20% of TX mean) to Dark green (<20% of TX mean).
ER visits represents total number of unique ER claims (by unique patient and date of service) during the measurement year displayed per 1000 member year, per member year, or by percentage.
Acute inpatient visits (Bill type: 1-1-1 or 1-1-4) represent total number of unique acute inpatient claims (by unique patients and unique admission date) during the measurement year displayed per 1000 member year, per member year, or by percentage.
Observation stays (Revenue codes: 760-762; 769) represent total number of unique claims for observation stay (by unique patients and service date) during the measurement year displayed per 1000 member year, per member year, or by percentage.
Outpatient visits represents total number of unique outpatient facility claims (Facility code: 1 or classification code: 3 or bill type: 13X) during the measurement year displayed per 1000 member year, per member year, or by percentage.
Professional visits represents total number of unique professional visit claims (POS codes: 1-99) during the measurement year displayed per 1000 member year, per member year, or by percentage
Readmissions represent 30-day preventable readmissions after discharge from an inpatient stay identified using the 3M® proprietary software during the measurement year displayed as percentage.
Mean ratios (prevalence in zip code area divided by TX mean) are color-coded and represent variation from Texas mean for each 3-digit zip code. Red (>20% of TX mean) to Dark green (<20% of TX mean).
Percentage of members with persistent asthma in the measurement year or any prior year. Persistent asthma was defined using NQF 1799 criteria.
Percentage of members with cancer in the measurement year. Persistent asthma was defined using HEDIS Cancer Value Code Sets.
Percentage of members with congestive heart failure in the measurement year or any prior year. Congestive Heart Failure was defined using HEDIS Congestive Heart Failure Value Code Sets.
Percentage of members with chronic kidney disease in the measurement year or any prior year. Chronic Kidney Disease was defined using HEDIS Chronic Kidney Disease Value Code Sets.
Percentage of members with chronic liver disease (including Cirrhosis and Chronic Hepatitis) in the measurement year or any prior year. Chronic liver disease was defined using HEDIS Chronic liver disease Value Code Sets.
Percentage of members with chronic pain in the measurement year. Chronic liver disease was defined using HEDIS Chronic liver disease Value Code Sets.
Percentage of members with chronic obstructive pulmonary disease in the measurement year or any prior year. Chronic obstructive pulmonary disease was defined using HEDIS criteria.
Percentage of members with Dementia or Alzheimer’s disease in the measurement year or any prior year. Dementia or Alzheimer’s disease were defined using HEDIS criteria.
Percentage of members with Diabetes in the measurement year or any prior year. Diabetes was defined using HEDIS criteria.
Percentage of members with Diabetes in the measurement year or any prior year. Diabetes was defined using Healthcare Cost Institute criteria.
Percentage of members with multiple sclerosis in the measurement year or any prior year. Multiple sclerosis was defined using HEDIS criteria.
Percentage of members with rheumatoid arthritis in the measurement year or any prior year. Multiple sclerosis was defined using HEDIS criteria.
A stroke occurs when something blocks blood supply to part of the brain or when a blood vessel in the brain bursts. In either case, parts of the brain become damaged or die.
A hemorrhagic stroke happens when an artery in the brain leaks blood or ruptures
An ischemic stroke happens when blood flow through the artery that supplies oxygen-rich blood to the brain becomes blocked.
Subarachnoid hemorrhage (SAH) is a stroke caused by bleeding into the space surrounding the brain.
Percentage of members with up to two comorbid conditions in the measurement year or any prior year.
Percentage of members with more than two comorbid conditions in the measurement year or any prior year.
Mean ratios (quality of care in the zip code area divided by TX mean) are color-coded and represent variation from Texas mean for each 3-digit zip code. Red (<20% of TX mean) to Dark green (>20% of TX mean).
The percentage of members 5–64 years of age during the measurement year who were identified as having persistent asthma, and were dispensed appropriate medications and remained on medications at least 75% of their treatment period.
The percentage of members 18-75 years of age with diabetes (type 1 and type 2) who had an eye exam (retinal) performed during the measurement year.
The percentage of members 18-75 years of age with diabetes (type 1 and type 2) who had HbA1c testing performed during the measurement year.
The percentage of members 18–75 years of age with diabetes type 1 and type 2 who had underwent nephropathy screening test or received medical attention for nephropathy during the measurement year.
The percentage of members 40 years of age and older with a new diagnosis of COPD or newly active COPD, who received appropriate spirometry testing to confirm the diagnosis during the measurement year.
Mean ratios (risk score for zip code area divided by TX risk score) are color-coded and represent variation from Texas mean for each 3-digit zip code. Red (>20% of TX mean) to Dark green (<20% of TX mean).
Population risk were estimated using 3M® software. The software estimates clinical risk for each individual patient using a combination of clinical diagnosis, procedural, and prescription drug codes identified from medical and pharmacy claims and history of resource utilization using a copyrighted formula. Population is segmented by level of health status (first digit 1-9) and disease severity (second digit 0-6) where a higher number represents poorer health status and increased disease severity, respectively.
Social determinants of health (SDOH) are considered to be factors in a person’s lifestyle, social, economic, and physical environment that influence health status. The data are derived from publicly available sources and reported by county. As the relative values of each measure are very different, the results were converted to a score between 1-5 with 1 representing the most favorable level and 5 the most hazardous level.
The selection of social determinants differs by population group, of which there are three: child and adolescent, general population, and over age 65. The determinants are then grouped into categories as follows
The overall social determinant score for the county
The access to select health care professionals or coverage
Key health behaviors include smoking, obesity, exercise, sexual activity, sleep, alcohol use, nutrition
Measures of health, including subjective responses relating to perceived health status, and surveillance data on life expectancy or mortality.
The elements in the physical environment such as air and water quality, housing, food availability,
The elements within the social and community setting such as safety, violence, high school graduation rate, income, unemployment, single parent households
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