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Domain

Quality

HEDIS, Stars ratings, measures, outcomes and accreditation

1,622 quality terms

outcome addressoutc_addr

The physical or mailing address associated with a treatment outcome record, typically referring to the patient or facility location where the outcome was documented or care was delivered. Used for care coordination, follow-up communication, and geographic analysis of patient health results.

outcome adjustment amountoutc_adj_amt

The dollar value representing a financial modification applied to a treatment outcome record, such as a contractual adjustment, write-off, or payer-negotiated reduction. Used in revenue cycle management to reconcile billed charges against actual reimbursement amounts for outcomes-based payment models.

outcome ageoutc_age

The patient's age in years at the time a treatment outcome was recorded or assessed. Used in clinical quality measurement, risk stratification, and population health analytics to evaluate how patient age correlates with treatment effectiveness, recovery rates, and health program results.

outcome allowed amountoutc_alwd_amt

The maximum dollar amount a payer has contractually agreed to reimburse for services associated with a specific treatment outcome. Used in claims adjudication and outcomes-based payment analysis to determine the ceiling for reimbursement before patient cost-sharing responsibilities are applied.

outcome amountoutc_amt

The total monetary value associated with a treatment outcome record, representing charges, payments, or financial liability linked to the care episode. Used in healthcare financial reporting, value-based care analytics, and cost-effectiveness studies to quantify the economic impact of specific clinical outcomes.

outcome approval statusoutc_appr_sts

Indicates whether a recorded treatment outcome has been reviewed and authorized by a clinical or administrative authority, such as a care manager, physician, or quality reviewer. Tracks the outcome through review workflows including pending, approved, rejected, or conditionally approved states.

outcome approved byoutc_appr_by

Identifies the specific clinician, care manager, or administrative user who reviewed and authorized a documented treatment outcome. Provides an audit trail for quality assurance, compliance reporting, and accountability in outcomes-based care management and value-based contracting programs.

outcome arrival timeoutc_arrv_tm

The recorded time at which a patient arrived at a care setting associated with a treatment outcome, such as an emergency department, clinic, or inpatient facility. Used to calculate time-to-treatment metrics, throughput analysis, and quality measures tied to timeliness of care delivery.

outcome arrived dateoutc_arrv_dt

The calendar date on which a patient arrived at a care setting relevant to a documented treatment outcome. Used in clinical quality reporting, length-of-stay calculations, and episode-of-care analytics to establish the start of a care event and support outcomes measurement timelines.

outcome assessmentoutc_asmt

A structured or narrative clinical evaluation documenting a provider's findings, impressions, or judgments regarding a patient's treatment outcome. Captures whether clinical goals were achieved, the patient's current health status, and recommended next steps in the care continuum following an intervention.

outcome balanceoutc_bal

The remaining financial amount owed on a treatment outcome account after payments, adjustments, and credits have been applied. Used in revenue cycle management and patient billing to track outstanding liabilities associated with care episodes and ensure accurate accounts receivable reporting.

outcome billed amountoutc_bill_amt

The total charges submitted to a payer or patient for healthcare services associated with a specific treatment outcome. Represents the gross invoice amount before payer adjustments, contractual discounts, or patient cost-sharing reductions are applied during claims adjudication.

outcome birth dateoutc_birth_dt

The recorded date of birth of the patient associated with a treatment outcome record. Used to calculate patient age at the time of the outcome, support demographic reporting, verify patient identity across systems, and enable age-stratified analysis in clinical quality and population health programs.

outcome blood pressureoutc_bp

The systolic and diastolic arterial blood pressure measurements recorded as part of a treatment outcome assessment. Used to track cardiovascular health results, monitor chronic disease management effectiveness, and support quality measures related to hypertension control and care program outcomes.

outcome cancelled dateoutc_cncl_dt

The calendar date on which a previously scheduled or initiated treatment outcome record was formally cancelled or voided. Used in care management and clinical operations to track service cancellations, analyze no-show patterns, and reconcile open outcome records in administrative and clinical reporting systems.

outcome categoryoutc_cat

A standardized classification that groups treatment outcomes by type, clinical domain, or program context, such as chronic disease management, surgical recovery, or behavioral health. Used in quality reporting, population health segmentation, and value-based care analytics to aggregate and compare outcome data across patient cohorts.

outcome charge amountoutc_chrg_amt

The billed charge amount associated with a specific clinical or care management outcome event. Captures the gross financial value before adjustments, used in claims processing and revenue cycle analysis to reconcile costs tied to documented patient treatment results.

outcome chief complaintoutc_cc

The primary symptom or condition reported by the patient at the time a clinical outcome was documented. Used in care management and clinical data systems to link presenting complaints with final treatment results, supporting quality reporting and care pathway analysis.

outcome childoutc_chld

Identifies a subordinate or dependent outcome record linked to a parent outcome in a hierarchical data structure. Used in clinical data warehouses to represent branching care pathways, nested episode components, or follow-up outcomes derived from an initiating treatment event.

outcome cityoutc_city

The name of the municipality where the clinical outcome event occurred or where the patient resided at the time of the outcome. Used in population health and care management systems to support geographic analysis, regional reporting, and health disparity assessments.

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