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title | Beneficiary and Provider Data |
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Beneficiary and Provider DataSchema | Description | CDR Hive Schema | CDR Table Layouts | Data Dictionaries and Supplemental Information | Refresh |
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Assessment (iQIES) | QIES underwent a series of modernizing, system enhancements resulting in what is now called the Internet Quality Improvement and Evaluation System (iQIES). IQIES data in the CDR includes assessment data for HHA, MDS, LTCH, IRF, and Hospice schemas. This data is extracted from iQIES system and the "Most Recent Refresh" column reflects the date at which the data was extracted. The data is generally made available in the CDR within 2 business days of extraction. | assessment_iqies | assessment_iqies | iQIES CDR Data Dictionary.xlsx | Monthly - 1st Business Day of the month | Provider (iQIES) | QIES underwent a series of modernizing, system enhancements resulting in what is now called the Internet Quality Improvement and Evaluation System (iQIES). iQIES data in the CDR includes provider data from CASPER and iQIES_CMN schemas. This data is extracted from iQIES system and the "Most Recent Refresh" column reflects the date at which the data was extracted. The data is generally made available in the CDR within 2 business days of extraction. | provider_iqies | provider_iqies | iQIES CDR Data Dictionary.xlsx iQIES S&C Code Tables Data Dictionary.xls | Monthly - 1st Business Day of the month
| Beneficiary | This source contains beneficiary demographics, entitlement, enrollment, premium, health status and other coverage information from the Beneficiary Information on the Cloud (BIC) source. CDR Hive tables point directly to BIC data in the CMS Enterprise Data Lake (EDL). This data is refreshed each weekend in the CMS EDL and it is made available by Monday in the CDR. CDR contains only a Subset of tables listed in BIC Data Dictionary. | beneficiary_data | beneficiary_data | | Weekly - Mondays | CMS Master Data Management (MDM) Provider Master Index/ Shared Provider Profile (PMI/SPP) | The PMI/SPP contains an integrated view of identity resolved provider data across multiple CMS provider data systems. It includes data from PECOS, NPPES, NPICS, QIES, and T-MSIS. It provides both "current" and "historical" provider data from multiple CMS source systems of record. This data will be the source of provider data (including PECOS) within the CDR. CDR Hive tables point directly to PMI/SPP data in the CMS Enterprise Data Lake (EDL). This data is refreshed each weekend in the CMS EDL and it is made available by Monday in the CDR. | provider_pmi_data | Provider_PMI_Data | Guides: Guide to Using the MDM PMI SPP NPI Profile Tables.docx Guide to Using the MDM Comprehensive PMI and SPP Tables.docx MDM 3rd Qtrly Training.pptx DDES Quarterly Training.pptx NPI Profile Data Dictionary: MDM 3.0 NPI Profile Delta Tables Dictionary.pdf MDM 3.0 NPI Profile Logical Hive Data Model.pdf MDM 3.0 NPI Profile Physical Hive Data Model.pdf MDM 2.0 NPI Tables Model Diagram.pdf PMISPP Data Dictionary: MDM 3.0 PMISPP Delta Tables Dictionary.pdf MDM 3.0 PMISPP Logical Hive Data Model.pdf MDM 3.0 PMISPP Physical Data Dictionary.pdf MDM table Partition information: provider pmi data Partition Info.xlsx Contact the Data & Analytics team for the password to unlock the documents. | Weekly - Mondays | DARRT QII | This source includes Quality Improvement Initiative (QII) Data from the Deliverable Administration Review Repository Tool (DARRT). A QII is any formal plan designed to assist a provider(s) and/or practitioner(s) in identifying the root cause of a confirmed quality of care concern, develop a framework in which to address the concern and improve a process or system. QIIs may consist of system-wide (organization-based) and/or non-system-wide (practitioner-based) activities. QII initiation and tracking are performed in DARRT and QII data in the CDR are refreshed every Wednesday at 1:00 AM ET. | quality_measures_darrt_qii | quality_measures_darrt_qii | DARRT QII Data Definition.xls DARRT QII Model.pdf | Weekly - Wednesdays | Hospital Quality Reporting (HQR)
| Public Reporting data provides Hospital Quality Reporting (HQR) data to the Hospital Compare website. The data educates consumers by providing them with detailed information on a hospital’s quality of care. This schema is a replacement for ‘legacy_hqr_public_reporting’ and is being made available from the permanent cloud source of data. CDR |
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title | Beneficiary and Provider Data |
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Beneficiary and Provider Data
Schema | Description | CDR Hive Schema | CDR Table Layouts | Data Dictionaries and Supplemental Information | Most Recent Refresh | Refresh Frequency | Next Refresh | DUA Required |
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Assessment
(iQIES) Anchor |
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Assessment_iQIES | Assessment_iQIES | QIES underwent a series of modernizing, system enhancements resulting in what is now called the Internet Quality Improvement and Evaluation System (iQIES). IQIES data in the CDR includes assessment data for HHA, MDS, LTCH, IRF, and Hospice schemas. This data is extracted from iQIES system and the "Most Recent Refresh" column reflects the date at which the data was extracted. The data is generally made available in the CDR within 2 business days of extraction. | assessment_iqies | assessment_iqies_TableLayout.xlsx
| 5/18/2021 | Monthly | 6/3/2021 | Yes | Beneficiary Image Removed **Data Issue Identified: See Known Issues Log for current status** | This source contains beneficiary demographics, entitlement, enrollment, premium, health status and other coverage information from the Beneficiary Information on the Cloud (BIC) source. CDR Hive tables point directly to BIC data in the CMS Enterprise Data Lake (EDL). This data is refreshed each weekend in the CMS EDL and it is made available by Monday in the CDR. | beneficiary_data | | | 5/17/2021 | Weekly | 5/24/2021 | Yes |
CRIS | The Case Review Information System (CRIS) was the predecessor to the QMARS system (see below). It was decommissioned October 31, 2018. All data in this system is archival. | legacy_cris | | | 1/13/2020 | None | Never | Yes |
DARRT QII | This source includes Quality Improvement Initiative (QII) Data from the Deliverable Administration Review Repository Tool (DARRT). A QII is any formal plan designed to assist a provider(s) and/or practitioner(s) in identifying the root cause of a confirmed quality of care concern, develop a framework in which to address the concern and improve a process or system. QIIs may consist of system-wide (organization-based) and/or non-system-wide (practitioner-based) activities. QII initiation and tracking are performed in DARRT and QII data in the CDR are refreshed every Wednesday at 1:00 AM ET. | quality_measures_darrt_qii | | | 5/19/2021 | Weekly | 5/26/2021 | Yes |
Hospital Quality Reporting (HQR) Image Removed **Data Issue Identified: See Known Issues Log for current status** | Public Reporting data provides Hospital Quality Reporting (HQR) data to the Hospital Compare website. The data educates consumers by providing them with detailed information on a hospital’s quality of care. This schema is a replacement for ‘legacy_hqr_public_reporting’ and is being made available from the permanent cloud source of data. CDR Hive tables point directly to Hospital Quality Reporting (HQR) data in the HQR cloud. The data refresh frequency is controlled by the HQR ADO. | quality_measures_hqr_pub_report | | 3/18/2020 | Quarterly | 6/17/2021 | Yes | Data Form, formerly known as Structural Measures or Web-Based Data Collection Tool, allows IQR, OQR, ASCQR, IPFQR, MU, PCHQR, and HCAHPS providers (or authorized vendors) to enter information related to the environment in which care is provided. CDR Hive tables point directly to Hospital Quality Reporting (HQR) data in the HQR cloud. The data refresh frequency is controlled by the HQR ADO. This schema is the replacement for the following legacy schemas:- legacy_hqr_struct_msrs
- legacy_qnol_pch_app
- legacy_hqr_asc
- legacy_hqr_hcahps
- legacy_hqr_hcahps_final
- legacy_cldw_rpt_etl
- legacy_hqr_pprs_app
- legacy_opps_prs
| quality_measures_hqr_data_form | | N/A | Daily | 1100 UTC Daily | Yes | IQR and OQR Chart Abstracted Calculations & Outcomes (CACAO) system provide CMS and its stakeholders with system functionality that calculates measure outcomes for clinical quality measures that evaluates data submitted via XML file. CDR Hive tables point directly to Hospital Quality Reporting (HQR) data in the HQR cloud. The data refresh frequency is controlled by the HQR ADO. The following measures are included in this data set: OP-2, OP-3, OP-3a, OP-3b, OP-3c, OP-23, OP-18a, OP-18b, OP-18c, OP-18d, and SEP-1 and Bundle Data This schema is the replacement for the following legacy schemas: - legacy_hqr_opps_import
- legacy_hqr_opps
- legacy_hqr_cart
- legacy_hqr_cart_final
| quality_measures_hqr_char_abst | | | N/A | Daily | 1000 UTC Daily | Yes |
Notice of Participation is a contract between CMS and hospitals that identifies whether or not they are participating in the IQR, OQR, IPF, and PCH programs. Each of these programs have specific requirements that determine whether or not a facility is participating in a quality reporting program. This data will describe the programs, whether a given hospital is participating, and the date. CDR Hive tables point directly to Hospital Quality Reporting (HQR) data in the HQR cloud. The data refresh frequency is controlled by the HQR ADO. This schema is the replacement for the following legacy schemas: - legacy_hqr_ipledge_app
- legacy_hqr_opledge_app
- legacy_hqr_nop_app
| provider_hqr_nop | | N/A | Daily | 1000 UTC Daily | Yes | The Centers for Medicare & Medicaid Services (CMS) assesses the accuracy of chart-abstracted data submitted to the Hospital Outpatient Quality Reporting (OQR) Program and the Hospital Inpatient Quality Reporting (IQR) Program through the validation process. CMS verifies on a quarterly basis that hospital-abstracted data, submitted to CMS’s Clinical Warehouse via the Hospital Quality Reporting (HQR) system, can be reproduced by a trained abstractor using a standardized process. CDR Hive tables point directly to Hospital Quality Reporting (HQR) data in the HQR cloud. The data refresh frequency is controlled by the HQR ADO. This schema is the replacement for the following legacy schemas: - legacy_hqr_validation_app
- legacy_hqr_oat_app
- legacy_hqr_cart_cdac
| quality_measures_hqr_val | | N/A | Daily | 1000 UTC Daily | Yes | The HQR system consumes eCQM QRDA files and processes the data based on measure logic to determine the measure outcomes for the follow measures: STK-06 STK-05 STK-03 STK-02 ED-2 VTE-1 VTE-2 PC-05 CDR Hive tables point directly to Hospital Quality Reporting (HQR) data in the HQR cloud. The data refresh frequency is controlled by the HQR ADO. This schema is the replacement for the following legacy schema: | quality_measures_hqr_ecqm | | N/A | Daily | 1000 UTC Daily | Yes | This source contains Active Security Administrators /Officials for Hospital Quality Reporting (HQR). CDR Hive tables point directly to Hospital Quality Reporting (HQR) data in the HQR cloud. The data refresh frequency is controlled by the HQR ADO. |
This schema is the replacement for the following legacy schema:
resource_hqr_sec_admin | | N/A | Daily | 1000 UTC Daily | Yes | HQR - Legacy
These schema are copies of the former HQR Oracle databases and applications in SDOL, QNOL, and CLDW. | legacy_hqr_hvbp | | | 10/19/2020 | None | Never | Yes | Program Resource System (PRS)
Program Resource System (PRS) is a repository of demographic information for hospital providers in the Centers for Medicare & Medicaid Services (CMS), Survey and Certification System (CASPER), and Quality Improvement and Evaluation System (QIES). PRS assists Quality Improvement Organizations (QIOs) and Program Support Contractors in maintaining CMS Programs. PRS data is extracted from the HQR source database and the "Most Recent Refresh" column indicates the date at which the data was extracted. The refreshed data is available each Monday morning however it is typically extracted 1-2 business days earlier. The resource_hqr_prs schema is a replacement for legacy_sdol_np_sdps and resource_hqr_prs_supplemental schema is a replacement for legacy_sddw_np_sdps. | resource_hqr_prs resource_hqr_prs_supplemental | | | 5/20/2021 | Weekly | 5/31/2021 | Yes | NPPES | The National Plan and Provider Enumeration System contains provider NPIs, names, and location information. | nppes | | NPPES dissemination information on CMS Website | 5/12/2021 | Quarterly | 8/12/2021 | No |
CMS Master Data Management (MDM) Provider Master Index/
Shared Provider Profile (PMI/SPP)
The PMI/SPP contains an integrated view of identity resolved provider data across multiple CMS provider data systems. It includes data from PECOS, NPPES, NPICS, QIES, and T-MSIS. It provides both "current" and "historical" provider data from multiple CMS source systems of record. This data will be the source of provider data (including PECOS) within the CDR. CDR Hive tables point directly to PMI/SPP data in the CMS Enterprise Data Lake (EDL). This data is refreshed each weekend in the CMS EDL and it is made available by Monday in the CDR. | provider_pmi_data | | | 5/17/2021 | Weekly | 5/24/2021 | Yes | Provider (iQIES) | QIES underwent a series of modernizing, system enhancements resulting in what is now called the Internet Quality Improvement and Evaluation System (iQIES). iQIES data in the CDR includes provider data from CASPER and iQIES_CMN schemas. This data is extracted from iQIES system and the "Most Recent Refresh" column reflects the date at which the data was extracted. The data is generally made available in the CDR within 2 business days of extraction. | provider_iqies | | | 5/18/2021 | Monthly | 6/3/2021 | Yes |
QMARS Image Removed **Data Issue Identified: See Known Issues Log for current status** | Quality Management and Review Systems (QMARS) is a system for case management and review. This data is extracted from QMARS system and the "Most Recent Refresh" column reflects the date at which the data was extracted. The data is generally made available in the CDR within 2 business days of extraction. | qmars | | 5/5/2021 | Monthly | 6/9/2021 | Yes | Quality Payment Program (QPP) Universal Data Set (UDS) | The Quality Payment Program (QPP) Universal Data Set (UDS) is a curated data warehouse of all QPP data for analytics and reporting. The QPP team provides an extract of the UDS each month. The "Most Recent Refresh" column reflects the date at which the extract was made available in the CDR however the extract may be several days older. | quality_measures_qpp_uds | | | 5/3/2021 | Monthly | 6/2/2021 | Yes |
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title | Mapping DUA to Beneficiary and Provider Data |
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Mapping DUA to Beneficiary and Provider Data
Schema | CDR Hive Schema | Preferred DUA Entry | Acceptable DUA Entry |
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| assessment_iqies | IQIES - Internet-based Quality Improvement and Evaluation System | QIESWB - QUALITY IMPROVEMENT EVALUATION SYSTEM (QIES) WORKBENCH HOSPCE - HOSPICE HIS - HOSPICE ITEM SET (HIS) SYSTEM - HOSPICE QUALITY REPORTING PROGRAM (HQRP) IRFPAI - INPATIENT REHAB FACILITY PATIENT ASSESSMENT INSTRUMENT DATA LTCH - MEDPAR LONG TERM CARE (MDS) LTCH-QRP - LONG TERM CARE HOSPITALS QUALITY REPORTING PROGRAM LTCHOS - LONG TERM CARE HOSPITALS ASSESSMENT (CARE) ASSESSMENT DATA SET LTCMDS - LONG TERM CARE MINIMUM DATA SET MDS - MINIMUM DATA SET (NURSING HOME) MDS - PROVIDER HEALTH QUALITY ASSESSMENT DATA MDS2.0 - MINIMUM DATA SET VERSION 2.0 FOR NURSING HOME RESIDENT ASSESSMENT & CARE SCREENING OASIS - OASIS CASPER - CERTIFICATION AND SURVEY PROVIDER ENHANCED REPORT SYSTEM (CASPER) |
Beneficiary | beneficiary_data | EDB MBD (for Part D enrollees) | CRIS | legacy_cris | NCH-SS NATIONAL CLAIMS HISTORY - 100% STATE SPECIFIC PDE - PART D - PRESCRIPTION DRUG EVENT DATA EDB MBD (for Part D enrollees) | Mandatory: EDB MBD Plus one of the following for FFS Claims: NCHDB - NATIONAL CLAIMS HISTORY DATABASE FFSCLM - FFS CLAIMS DATA NCH - NCH - MEDICARE INFORMATION ON PART A AND PART B SERVICES Plus one of the following for Prescription Drug Claims: DDPS - DRUG DATA PROCESSING SYSTEM PDE - PART D - PRESCRIPTION DRUG EVENT DATA |
DARRT QII | quality_measures_darrt_qii | QIO - QUALITY IMPROVEMENT ORGANIZATION (QIO) DELIVERABLE DATA (PATRIOT AND DDST) | HQR
quality_measures_hqr_pub_report | HQR - HOSPITAL QUALITY REPORTING, OTHER-OTHER (SPECIFY): HQR, HQCIS | IPT - INPATIENT OPT - OUTPATIENT | quality_measures_hqr_data_form | HQR - HOSPITAL QUALITY REPORTING, OTHER-OTHER (SPECIFY): HQR, HQCIS | CAHPS - CONSUMER ASSESSMENT OF HEALTH PLAN STUDY SURVEY OPT - OUTPATIENT IPT - INPATIENT |
quality_measures_hqr_char_abst | HQR - HOSPITAL QUALITY REPORTING, OTHER-OTHER (SPECIFY): HQR, HQCIS | CDAC - CLINICAL DATA ABSTRACTION CENTER IPT - INPATIENT OPT - OUTPATIENT |
provider_hqr_nop | HQR - HOSPITAL QUALITY REPORTING, OTHER-OTHER (SPECIFY): HQR, HQCIS | IPT - INPATIENT OPT - OUTPATIENT |
quality_measures_hqr_val | HQR - HOSPITAL QUALITY REPORTING, OTHER-OTHER (SPECIFY): HQR, HQCIS | CDAC - CLINICAL DATA ABSTRACTION CENTER IPT - INPATIENT OPT - OUTPATIENT |
quality_measures_hqr_ecqm | HQR - HOSPITAL QUALITY REPORTING, OTHER-OTHER (SPECIFY): HQR, HQCIS | IPT - INPATIENT |
resource_hqr_sec_admin | N/A | quality_measures_hqr_hvbp | HQR - HOSPITAL QUALITY REPORTING, OTHER-OTHER (SPECIFY): HQR, HQCIS | IPT - INPATIENT |
PRS | resource_hqr_prs | PRS - PROGRAM RESOURCE SYSTEM DATA | resource_hqr_prs_supplemental | PRS - PROGRAM RESOURCE SYSTEM DATA | NPPES | nppes | N/A - Public | CMS Master Data Management (MDM) Provider Master Index/ Shared Provider Profile (PMI/SPP) | provider_pmi_data | PECOS - PROVIDER/PHYSICIAN DATA | PECOS - SYSTEM FOR TRACKING HHA OWNERSHIP PECUGE - PECOS UGE FILE CASPER - CERTIFICATION AND SURVEY PROVIDER ENHANCED REPORT SYSTEM (CASPER) QIESWB - QUALITY IMPROVEMENT EVALUATION SYSTEM (QIES) WORKBENCH |
Provider (iQIES) | provider_iqies | IQIES - Quality Improvement and Evaluation System | CASPER CASPER - CERTIFICATION AND SURVEY PROVIDER ENHANCED REPORT SYSTEM (CASPER) QIESWB - QUALITY IMPROVEMENT EVALUATION SYSTEM (QIES) WORKBENCH |
QMARS | qmars | NCH, DDPS, EDB and PECOS | Quality Payment Program (QPP) Universal Data Set (UDS) | quality_measures_qpp_uds | QPP - QUALITY AND PERFORMANCE DATA | SDDW | legacy_sddw_np_sdps | SDPS - STANDARD DATA PROCESSING SYSTEM | Mandatory: EDB MBD Plus one of the following for FFS Claims: NCHDB - NATIONAL CLAIMS HISTORY DATABASE FFSCLM - FFS CLAIMS DATA NCH - NCH - MEDICARE INFORMATION ON PART A AND PART B SERVICES Plus one of the following for Prescription Drug Claims: DDPS - DRUG DATA PROCESSING SYSTEM PDE - PART D - PRESCRIPTION DRUG EVENT DATA |
SDOL | legacy_sdol_np_sdps | SDPS - STANDARD DATA PROCESSING SYSTEM | EDB - ENROLLMENT DATA BASE |