South Country Health Alliance
General Info
Disclaimers
HEDIS 2014 (Reporting Year 2013)
Page
Data Last Refreshed: 7/8/2015
2
Effectiveness of Care Measures
Code
Effectiveness of Care Measures
Code
Page
Medication Management
Page
26 MPM
Annual Monitoring for Patients on Persistent Medications
62
ABA
Adult BMI Assessment
3
27 MRP
Medication Reconciliation Post Discharge
69
WCC
Weight Assessment and Counseling for Nutrition and Physical Activity for
Children/Adolescents
4
DDE
Potentially Harmful Drug-Disease Interactions in the Elderly
70
CIS
Childhood Immunization Status
7
Use of High Risk Medications in the Elderly
72
IMA
Immunizations for Adolescents
13
Prevention and Screening
28
29 DAE
BCS
Breast Cancer Screening
16
Code
CCS
Cervical Cancer Screening
17
30 AAP
Adult's Access to Preventive/Ambulatory Health Services
74
COL
Colorectal Cancer Screening
18
31 CAP
Children's and Adolescents' Access to Primary Care Practitioners
81
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
84
Prenatal and Postpartum Care
91
CHL
Chlamydia Screening in Women
19
32
GSO
Glaucoma Screening in Older Adults
22
33 PPC
HPV
Human Papillomavirus Vaccine for Female Adolescents
23
34
Care for Older Adults
24
58 Code
COA
Respiratory Conditions
PCE
Pharmacotherapy Management of COPD Exacerbation
25
SPR
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
29
Use of Appropriate Medications for People with Asthma
30
ASM
Cardiovascular
IET
Access / Availability of Care Measures
Use of Services Measures
Page
Page
34 W15
Well Child Visits in the First 15 Months of Life
35 W34
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
97
Adolescent Well-Care Visits
98
36
AWC
94
Ambulatory Care
99
38
IPU
Inpatient Utilization - General Hospital/Acute Care
106
IAD
Identification of Alcohol and Other Drug Services
113
37 AMB
CMC
Cholesterol Management for Patients with Cardiovascular Conditions
33
39
CBP
Controlling High Blood Pressure
37
40 MPT
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services 120
Persistence of Beta Blocker Treatment After Heart Attack
38
41 PCR
Plan All-Cause Readmissions
PBH
Diabetes
CDC
Comprehensive Diabetes Care
39
Musculoskeletal
ART
OMW
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
46
Osteoporosis Management in Women Who had a Fracture
47
Behavioral Health
AMM
Antidepressant Medication Management
48
ADD
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
55
FUH
Follow-up After Hospitalization for Mental Illness
58
HEDIS 2014 (Reporting Year 2013)
127
41
Code
Health Plan Descriptive Information Measures
Page
42 BCR
Board Certification
131
43 ENP
Enrollment by Product Line (Age & Sex)
134
43
DISCLAIMERS
-1
( this page left blank intentionally )
0. Disclaimer Query located below
HEDIS 2014 (Reporting Year 2013)
Page 2
Effectiveness of Care
South Country Health Alliance
Adult BMI Assessment
Data Elements
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Medicare
Advantage
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population (before exclusions)
MA Expand
F& C
2013
H
1556
MN Care
2013
H
304
225
41
14.46%
411
5.00%
432
88
20.37%
13.49%
284
0.00%
284
42
14.79%
Number of Records Excluded Because of Valid
Data Errors
0
0
Number of administrative data records excluded
0
0
Number of medical record data records excluded
0
0
Number of employee/dependent medical records
excluded
0
0
0
432
88
279
84.95%
81.47%
88.44%
0
284
42
193
82.75%
78.18%
87.32%
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 3
Effectiveness of Care
South Country Health Alliance
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
BMI Percentile
Data Elements
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Nutrition
Total
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Physical Activity
Total
General
Measure
Data
Ages 3-11
Ages 1217
Total
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Page 4
Effectiveness of Care
South Country Health Alliance
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
BMI Percentile
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
General
Measure
Data
Ages 3-11 Ages 12-17
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Counseling for Nutrition
Total
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Physical Activity
Total
2013
H
General
Measure
Data
Total
2261
1152
3413
2261
1152
3413
2261
1152
3413
10
0.44%
13
1.13%
23
0.67%
13
0.57%
14
1.22%
27
0.79%
0
0.00%
0
0.00%
0
0.00%
0
NR
0
NR
0
NR
411
5.00%
411
5.00%
432
1
NR
3
NR
4
NR
432
1
NR
1
NR
2
NR
0
0
Number of administrative data records
excluded
0
0
Number of medical records excluded
0
0
Number of employee/dependent records
excluded
0
0
Records Added from the Oversample List
0
0
HEDIS 2014 (Reporting Year 2013)
Ages 1217
2013
H
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Ages 3-11
301
131
432
301
131
432
301
131
432
1
170
56.81%
51.05%
62.57%
3
80
63.36%
54.73%
71.99%
4
250
58.80%
54.04%
63.55%
1
151
50.50%
44.68%
56.31%
1
56
43.51%
34.64%
52.38%
2
207
48.38%
43.55%
53.21%
0
130
43.19%
37.43%
48.95%
0
64
48.85%
39.91%
57.80%
0
194
44.91%
40.10%
49.71%
Page 5
Effectiveness of Care
South Country Health Alliance
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Number of administrative data records
Number of medical records excluded
Number of employee/dependent records
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
2013
H
BMI Percentile
Ages 3-11 Ages 12-17
222
2
0.90%
95
0
0.00%
Total
General
2013
H
317
2
0.63%
317
0.00%
317
Counseling for Nutrition
Ages 3-11 Ages 12-17
Total
222
5
2.25%
95
3
3.16%
317
8
2.52%
5
1.58%
3
0.95%
8
2.52%
222
5
125
58.56%
51.85%
65.26%
95
3
39
44.21%
33.70%
54.72%
317
8
164
54.26%
48.62%
59.90%
317
0.00%
317
2
0.63%
0
0.00%
2
0.63%
0
0
0
0
0
0
0
0
0
0
222
2
125
57.21%
50.47%
63.94%
95
0
61
64.21%
54.04%
74.38%
317
2
186
59.31%
53.74%
64.87%
Counseling for Physical Activity
General
Ages 3-11 Ages 12Total
2013
H
222
95
317
0
0
0
0.00%
0.00%
0.00%
317
0.00%
317
0
0
0
0.00%
0.00%
0.00%
0
0
0
0
0
222
95
317
0
0
0
105
53
158
47.30%
55.79%
49.84%
40.50%
45.28%
44.18%
54.09%
66.30%
55.50%
Page 6
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Data Elements
General
Measure
Data
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
IPV
MMR
HiB
Hepatitis B
VZV
Influenza
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Reported Rate
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Lower 95% Confidence Interval
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Upper 95% Confidence Interval
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical data records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by administrative Data
Numerator Events by Medical Record
HEDIS 2014 (Reporting Year 2013)
Page 7
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Data Elements
General
Measure
Data
DTaP
Combo 2
Combo 3
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Reported Rate
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Lower 95% Confidence Interval
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Upper 95% Confidence Interval
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical data records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by administrative Data
Numerator Events by Medical Record
HEDIS 2014 (Reporting Year 2013)
Page 8
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
Data Elements
General
Measure
Data
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
IPV
MMR
HiB
Hepatitis B
VZV
279
82.30%
317
93.51%
305
89.97%
316
93.22%
307
90.56%
305
89.97%
281
82.89%
262
77.29%
239
70.50%
187
55.16%
279
317
305
316
307
305
281
262
239
187
82.30%
93.51%
89.97%
93.22%
90.56%
89.97%
82.89%
77.29%
70.50%
55.16%
279
317
305
316
307
305
281
262
239
187
6
3
0
2
9
1
0
3
4
8
Reported Rate
84.07%
94.40%
89.97%
93.81%
93.22%
90.27%
82.89%
78.17%
71.68%
57.52%
Lower 95% Confidence Interval
80.03%
91.80%
86.63%
91.09%
90.39%
86.96%
78.73%
73.63%
66.74%
52.11%
Upper 95% Confidence Interval
88.11%
96.99%
93.32%
96.52%
96.04%
93.57%
87.05%
82.72%
76.63%
62.93%
Measurement Year
2013
Data Collection Methodology
H
Eligible Member Population
339
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
339
0
339
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
0
Number of administrative data records
excluded
0
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Denominator
Numerator Events by administrative Data
Numerator Events by Medical Record
HEDIS 2014 (Reporting Year 2013)
Influenza
339
Page 9
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
Data Elements
General
Measure
Data
DTaP
Combo 2
Combo 3
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
279
82.30%
260
76.70%
251
74.04%
220
64.90%
204
60.18%
162
47.79%
186
54.87%
146
43.07%
133
39.23%
123
36.28%
279
260
251
220
204
162
186
146
133
123
82.30%
76.70%
74.04%
64.90%
60.18%
47.79%
54.87%
43.07%
39.23%
36.28%
279
260
251
220
204
162
186
146
133
123
6
12
8
9
8
10
8
11
9
9
Reported Rate
84.07%
80.24%
76.40%
67.55%
62.54%
50.74%
57.23%
46.31%
41.89%
38.94%
Lower 95% Confidence Interval
80.03%
75.85%
71.73%
62.42%
57.24%
45.27%
51.81%
40.86%
36.49%
33.60%
Upper 95% Confidence Interval
88.11%
84.62%
81.07%
72.68%
67.84%
56.21%
62.64%
51.77%
47.29%
44.28%
Measurement Year
2013
Data Collection Methodology
H
Eligible Member Population
339
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
339
0
339
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
0
Number of administrative data records
excluded
0
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Denominator
Numerator Events by administrative Data
Numerator Events by Medical Record
HEDIS 2014 (Reporting Year 2013)
339
Page 10
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
Measurement Year
General
Measure
Data
H
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
14
Minimum Required Sample Size
14
Oversampling Rate
0
Final Sample Size (FSS)
14
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
0
Number of administrative data records
excluded
0
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Denominator
14
HEDIS 2014 (Reporting Year 2013)
IPV
MMR
HiB
Hepatitis B
VZV
Influenza
8
10
8
10
10
8
9
5
9
7
57.14%
71.43%
57.14%
71.43%
71.43%
57.14%
64.29%
35.71%
64.29%
50.00%
8
10
8
10
10
8
9
5
9
7
57.14%
71.43%
57.14%
71.43%
71.43%
57.14%
64.29%
35.71%
64.29%
50.00%
8
10
8
10
10
8
9
5
9
7
2013
Data Collection Methodology
Numerator Events by administrative Data
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
Page 11
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
Measurement Year
General
Measure
Data
H
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
14
Minimum Required Sample Size
14
Oversampling Rate
0
Final Sample Size (FSS)
14
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
0
Number of administrative data records
excluded
0
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Denominator
14
HEDIS 2014 (Reporting Year 2013)
Combo 2
Combo 3
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
8
7
7
4
7
7
4
4
7
4
57.14%
50.00%
50.00%
28.57%
50.00%
50.00%
28.57%
28.57%
50.00%
28.57%
8
7
7
4
7
7
4
4
7
4
57.14%
50.00%
50.00%
28.57%
50.00%
50.00%
28.57%
28.57%
50.00%
28.57%
8
7
7
4
7
7
4
4
7
4
2013
Data Collection Methodology
Numerator Events by administrative Data
DTaP
Page 12
Effectiveness of Care
South Country Health Alliance
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Immunizations for Adolescents
Commercial
Commercial
Data Elements
General
Measure Data
Meningococcal
Tdap
Combo 1
Current Year's Admin Rate
NR
NR
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
NR
NR
NR
Reported Rate
NR
NR
NR
Lower 95% Confidence Interval
NR
NR
NR
Upper 95% Confidence Interval
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
HEDIS 2014 (Reporting Year 2013)
Page 13
Effectiveness of Care
South Country Health Alliance
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Immunizations for Adolescents
Commercial
Minnesota Health Care Programs - Managed Care (MA-Expand)
General
Data Elements
Measure Data
Measurement Year
2013
Data Collection Methodology
H
Eligible Member Population
286
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
0
Number of administrative data records excluded
0
Number of medical data records excluded
0
Number of employee/dependent medical records
excluded
0
HEDIS 2014 (Reporting Year 2013)
Tdap
Combo 1
137
242
136
47.90%
84.62%
47.55%
137
47.90%
243
84.97%
136
47.55%
137
5
49.65%
43.68%
55.62%
243
0
84.97%
80.65%
89.28%
136
4
48.95%
42.98%
54.92%
286
0.00%
286
Records Excluded because of Valid Data Errors
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Meningococcal
0
286
Page 14
Effectiveness of Care
South Country Health Alliance
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Immunizations for Adolescents
Commercial
Minnesota Health Care Programs - Managed Care (MN Care)
General
Data Elements
Measure Data
Measurement Year
2013
Data Collection Methodology
H
Eligible Member Population
21
Numerator Events by Admin Data on Eligible
Current Year's Admin Rate
Minimum Required Sample Size
21
Oversampling Rate
0.00%
Final Sample Size (FSS)
21
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
0
Number of administrative data records excluded
0
Number of medical data records excluded
0
Number of employee/dependent medical records
0
Records Added from the Oversample List
0
Denominator
21
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Meningococcal
Tdap
Combo 1
13
61.90%
21
100.00%
13
61.90%
13
61.90%
21
100.00%
13
61.90%
13
0
NA
NA
NA
21
0
NA
NA
NA
13
0
NA
NA
NA
Page 15
Effectiveness of Care
South Country Health Alliance
Breast Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
NR
NR
NR
Medicare
Advantage
NR
NR
NR
MSHO
MA Expand
F& C
MN Care
SNBC
SNP
SNBC
Non SNP
2013
A
190
118
62.11%
54.94%
69.27%
2013
A
104
66
63.46%
53.73%
73.20%
2013
A
37
26
70.27%
54.19%
86.35%
2013
A
150
123
82.00%
75.52%
88.48%
2013
A
19
15
NA
NA
NA
Page 16
Effectiveness of Care
South Country Health Alliance
Cervical Cancer Screening
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MA Expand
F& C
MN Care
Measurement Year
Data Collection Methodology
Eligible Member Population
2013
H
1831
2013
H
332
Numerator Events by Admin Data on Eligible
Population (before exclusions)
1074
194
58.66%
411
5.00%
432
239
55.32%
0
0
15
58.43%
319
0.00%
319
195
61.13%
0
0
11
0
0
0
417
239
37
66.19%
61.53%
70.85%
0
308
195
23
70.78%
65.54%
76.02%
Data Elements
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical record data records excluded
Commercial
NR
NR
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
Page 17
Effectiveness of Care
South Country Health Alliance
Colorectal Cancer Screening
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare
Advantage
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
2013
H
342
SNBC
SNP
2013
H
303
Number of numerator events by administrative data in eligible population
(before exclusions)
179
203
52.34%
338
0.00%
338
180
53.25%
0
0
1
0
0
337
180
21
59.64%
54.26%
65.03%
67.00%
303
0.00%
303
207
68.32%
0
0
1
0
0
302
207
13
72.85%
67.67%
78.03%
Data Elements
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid data errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical records
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
Commercial
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
MSHO
SNBC
Non SNP
NR
NR
NR
NR
NR
Page 18
Effectiveness of Care
South Country Health Alliance
Chlamydia Screening in Women
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Ages 16-20
NR
NR
NR
Ages 21-24
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 19
Effectiveness of Care
South Country Health Alliance
Chlamydia Screening in Women
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F& C)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Ages 16-20
Ages 21-24
Total
207
73
35.27%
28.52%
42.02%
198
121
61.11%
54.07%
68.15%
405
194
47.90%
42.91%
52.89%
2013
A
Page 20
Effectiveness of Care
South Country Health Alliance
Chlamydia Screening in Women
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
General
Measurement Year
2013
Data Collection Methodology
A
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Ages 16-20
Ages 21-24
Total
30
9
30.00%
11.93%
48.07%
16
6
NA
NA
NA
46
15
32.61%
17.97%
47.24%
Page 21
Effectiveness of Care
South Country Health Alliance
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare
Advantage
NR
NR
NR
MSHO
2013
A
1126
849
75.40%
72.84%
77.96%
Page 22
Effectiveness of Care
South Country Health Alliance
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Human Papillomavirus Vaccine for Female Adolescents
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
MA Expand F & C
2013
H
136
MN Care
2013
H
12
30
2
NR
22.06%
16.67%
NR
136
0.00%
136
30
22.06%
12
0.00%
12
2
16.67%
Records Excluded because of Valid Data
Errors
0
0
Number of administrative data records
excluded
0
0
Number of medical record data records
excluded
0
0
Number of employee/dependent medical
records excluded
0
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
0
136
30
2
0
12
2
0
Numerator Events by Admin Data on
Eligible Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Reported Rate
NR
23.53%
NA
Lower 95% Confidence Interval
NR
16.03%
NA
Upper 95% Confidence Interval
NR
31.03%
NA
HEDIS 2014 (Reporting Year 2013)
Page 23
Effectiveness of Care
South Country Health Alliance
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Care for Older Adults
MSHO
Medication Review
Functional
Status
Assessment
Pain
Screening
371
1
0
0
26.29%
0.07%
0.00%
0.00%
117
27.08%
1
0.23%
0
0.00%
0
0.00%
117
138
1
356
0
293
0
405
Reported Rate
59.03%
82.64%
67.82%
93.75%
Lower 95% Confidence Interval
54.27%
78.95%
63.30%
91.35%
Upper 95% Confidence Interval
63.78%
86.33%
72.35%
96.15%
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General Measure
Data
2013
H
1411
Numerator Events by Admin Data on
Eligible Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
411
5.00%
432
Records Excluded because of Valid Data
Errors
0
Number of employee/dependent medical
records excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
HEDIS 2014 (Reporting Year 2013)
Advance Care
Planning
0
432
Page 24
Effectiveness of Care
South Country Health Alliance
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
NR
NR
NR
NR
NR
NR
Page 25
Effectiveness of Care
South Country Health Alliance
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
20
54.05%
36.64%
71.46%
32
86.49%
74.12%
98.85%
2013
A
37
Page 26
Effectiveness of Care
South Country Health Alliance
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-SNP
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
7
NA
NA
NA
12
NA
NA
NA
2013
A
15
Page 27
Effectiveness of Care
South Country Health Alliance
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-Non SNP
Data Elements
Measurement Year
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
8
NA
NA
NA
10
NA
NA
NA
2013
29
Page 28
Effectiveness of Care
South Country Health Alliance
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
SNBC
SNP
SNBC Non
SNP
2013
A
27
5
NA
NA
NA
2013
A
4
1
NA
NA
NA
2013
A
2
0
NA
NA
NA
Page 29
Effectiveness of Care
South Country Health Alliance
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Number of required exclusions
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Ages 5-11
NR
NR
NR
Ages 12-18
NR
NR
NR
Ages 19-50
NR
NR
NR
Ages 51-64
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
`
Page 30
Effectiveness of Care
South Country Health Alliance
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Number of required exclusions
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Ages 5-11
Ages 12-18
Ages 19-50
Ages 51-64
Total
35
30
2
85.71%
72.69%
98.74%
27
26
2
NA
NA
NA
46
36
18
78.26%
65.25%
91.27%
5
4
13
NA
NA
NA
113
96
35
84.96%
77.92%
91.99%
2013
A
Page 31
Effectiveness of Care
South Country Health Alliance
Use of Appropriate Medications for People with Asthma
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
General
Ages 5-11
Measurement Year
2013
Data Collection Methodology
A
6
Eligible Member Population
6
Numerator Events by Admin Data
0
Number of required exclusions
NA
Reported Rate
NA
Lower 95% Confidence Interval
NA
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Ages 12-18
Ages 19-50
Ages 51-64
Total
2
2
0
NA
NA
NA
5
5
2
NA
NA
NA
2
2
3
NA
NA
NA
15
15
5
NA
NA
NA
Page 32
Effectiveness of Care
South Country Health Alliance
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 33
Effectiveness of Care
South Country Health Alliance
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 34
Effectiveness of Care
South Country Health Alliance
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
11
0
68.75%
0.00%
11
0
68.75%
0.00%
11
0
0
5
NA
NA
NA
NA
NA
NA
2013
H
16
16
0.00%
16
0
0
0
16
Page 35
Effectiveness of Care
South Country Health Alliance
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
5
0
83.33%
0.00%
2013
H
6
6
0.00%
6
5
0
83.33%
0.00%
5
0
0
3
NA
NA
NA
NA
NA
NA
0
0
0
6
Page 36
Effectiveness of Care
South Country Health Alliance
Controlling High Blood Pressure
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare
Advantage
MSHO
SNBC-SNP
SNBC
Non SNP
MA Expand
F&C
MN Care
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2013
H
303
2013
H
105
2013
H
172
2013
H
254
2013
H
64
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
0
0
0
0
0.00%
242
0.00%
242
0.00%
95
0.00%
95
0.00%
146
0.00%
146
0.00%
238
0.00%
238
0.00%
61
0.00%
61
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
Records Excluded because of Valid Data
Errors
0
0
0
0
0
Number of records excluded because of
false positive diagnoses
0
0
0
0
0
Number of administrative data records
excluded
2
0
1
0
0
Number of medical record data records
excluded
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
Records Added from the OverSample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
0
240
0
180
75.00%
69.31%
80.69%
0
95
0
69
72.63%
63.14%
82.12%
0
145
0
109
75.17%
67.80%
82.55%
0
238
0
161
67.65%
61.49%
73.80%
0
61
0
41
67.21%
54.61%
79.81%
Data Elements
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
HEDIS 2014 (Reporting Year 2013)
Commercial
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 37
Effectiveness of Care
South Country Health Alliance
Persistence of Beta Blocker Treatment After Heart Attack
Data Elements
Commercial
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare
Advantage
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
NR
NR
NR
MSHO
SNBC
SNP
SNBC
Non SNP
MA Expand
F&C
MN Care
2013
A
16
2013
A
0
2013
A
1
2013
A
1
2013
A
1
15
0
0
1
1
NA
NA
NA
NR
NR
NR
NA
NA
NA
NA
NA
NA
NA
NA
NA
Page 38
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Data Elements
HbA1c
Testing
Poor HbA1c
Control
(>9.0%)
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Number of HbA1c < 7 required administrative
data records excluded
Number of HbA1c < 7 required medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Page 39
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Page 40
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2013
H
163
2013
H
163
2013
H
163
2013
H
163
2013
H
163
2013
H
163
2013
H
163
0
0.00%
163
0%
163
0
0.00%
115
70.55%
163
0%
163
122
74.85%
126
77.30%
163
0%
163
128
78.53%
0
0.00%
163
0%
163
0
0.00%
149
91.41%
163
0%
163
149
91.41%
0
0.00%
163
0%
163
0
0.00%
0
0.00%
163
0%
163
0
0.00%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
163
149
4
93.87%
89.87%
97.86%
0
163
33
3
22.09%
15.41%
28.76%
0
163
0
115
70.55%
63.25%
77.86%
0
163
122
9
80.37%
73.96%
86.77%
0
163
128
7
82.82%
76.72%
88.92%
0
163
0
90
55.21%
47.27%
63.16%
0
163
149
2
92.64%
88.32%
96.95%
0
163
0
137
84.05%
78.12%
89.98%
0
163
0
120
73.62%
66.55%
80.69%
HbA1c
Testing
Poor HbA1c
Control
2013
H
163
2013
H
163
149
91.41%
163
0%
163
149
91.41%
163
100.00%
163
0%
163
163
100.00%
Number of Records Excluded Because of
Valid Data Errors
0
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Good HbA1c
Control
(<7.0%)
NR
NR
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
Page 41
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC - SNP
HbA1c
Testing
Poor HbA1c
Control
2013
H
140
2013
H
140
128
91.43%
140
0%
140
129
92.14%
139
99.29%
140
0%
140
139
99.29%
Number of Records Excluded Because of
Valid Data Errors
0
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2013
H
140
2013
H
140
2013
H
140
2013
H
140
2013
H
140
2013
H
140
2013
H
140
1
0.71%
140
0%
140
1
0.71%
103
73.57%
140
0%
140
109
77.86%
122
87.14%
140
0%
140
123
87.86%
1
0.71%
140
0%
140
1
0.71%
117
83.57%
140
0%
140
117
83.57%
0
0.00%
140
0%
140
0
0.00%
0
0.00%
140
0%
140
0
0.00%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
140
0
140
30
5
25.00%
17.47%
32.53%
0
140
1
94
67.86%
59.76%
75.95%
0
140
109
8
83.57%
77.08%
90.07%
0
140
123
4
90.71%
85.55%
95.88%
0
140
1
83
60.00%
51.53%
68.47%
0
140
117
4
86.43%
80.40%
92.46%
0
140
0
130
92.86%
88.23%
97.48%
0
140
0
107
76.43%
69.04%
83.82%
NR
NR
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
NR
NR
NR
Page 42
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC - Non SNP
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2013
H
196
2013
H
196
2013
H
196
2013
H
196
2013
H
196
2013
H
196
2013
H
196
3
1.53%
196
0%
196
3
1.53%
120
61.22%
196
0%
196
125
63.78%
157
80.10%
196
0%
196
163
83.16%
5
2.55%
196
0%
196
5
2.55%
141
71.94%
196
0%
196
143
72.96%
0
0.00%
196
0%
196
0
0.00%
0
0.00%
196
0%
196
0
0.00%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
196
181
3
93.88%
90.27%
97.49%
0
196
54
20
37.76%
30.71%
44.80%
0
196
3
105
55.10%
47.88%
62.32%
0
196
125
14
70.92%
64.31%
77.53%
0
196
163
6
86.22%
81.14%
91.30%
0
196
5
87
46.94%
39.70%
54.18%
0
196
143
23
84.69%
79.40%
89.99%
0
196
0
159
81.12%
75.39%
86.86%
0
196
0
123
62.76%
55.73%
69.78%
HbA1c
Testing
Poor HbA1c
Control
2013
H
196
2013
H
196
180
91.84%
196
0%
196
181
92.35%
190
96.94%
196
0%
196
190
96.94%
0
Good HbA1c
Control
(<7.0%)
NR
NR
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
Page 43
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
2013
H
217
2013
H
217
H
186
85.71%
205
0%
205
185
90.24%
216
99.54%
205
0%
205
204
99.51%
Number of Records Excluded Because of
Valid Data Errors
0
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2013
H
217
2013
H
217
2013
H
217
2013
H
217
2013
H
217
2013
H
217
2013
H
217
1
0.46%
205
0%
205
1
0.49%
106
48.85%
205
0%
205
106
51.71%
161
74.19%
205
0%
205
163
79.51%
1
0.46%
205
0%
205
1
0.49%
158
72.81%
205
0%
205
162
79.02%
0
0.00%
205
0%
205
0
0.00%
0
0.00%
205
0%
205
0
0.00%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
205
185
3
91.71%
87.69%
95.73%
0
205
37
33
34.15%
27.41%
40.88%
0
205
1
119
58.54%
51.55%
65.52%
0
205
106
25
63.90%
57.08%
70.72%
0
205
163
6
82.44%
76.99%
87.89%
0
205
1
83
40.98%
34.00%
47.95%
0
205
162
9
83.41%
78.08%
88.75%
0
205
0
165
80.49%
74.82%
86.16%
0
205
0
122
59.51%
52.55%
66.48%
NR
NR
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
Page 44
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
HbA1c
2013
Measurement Year
H
Data Collection Methodology
50
Eligible Member Population
43
Numerator events by admin data in eligible
86.00%
Current Year's Administrative Rate
49
Minimum Required Sample Size
0%
Oversampling Rate
49
Final Sample Size (FSS)
43
Numerator events by admin data in FSS
87.76%
Admin rate on FSS
0
Number of Records Excluded Because of
0
Number of administrative data records
0
Number of medical record data records
0
Number of employee/dependent medical
Number of Administrative required exclusions
Number of Hybrid required exclusions
0
Additional Records Added from the
49
Denominator
43
Numerator Events by Admin Data
1
Numerator Events by Medical Record
89.80%
Reported Rate
80.30%
Lower 95% Confidence Interval
99.29%
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Poor HbA1c
2013
H
50
50
100.00%
49
0%
49
49
100.00%
0
0
0
0
0
49
12
5
34.69%
20.35%
49.04%
Good HbA1c
H
NR
NR
NR
NR
NR
Adequate
2013
H
50
0
0.00%
49
0%
49
0
0.00%
0
0
0
0
Eye Exam
2013
H
50
24
48.00%
49
0%
49
25
51.02%
0
0
0
0
LDL-C
2013
H
50
41
82.00%
49
0%
49
42
85.71%
0
0
0
0
0
49
0
23
46.94%
31.94%
61.93%
0
49
25
6
63.27%
48.75%
77.78%
0
49
42
2
89.80%
80.30%
99.29%
LDL-C Level Monitoring for
2013
2013
H
H
50
50
0
37
0.00%
74.00%
49
49
0%
0%
49
49
0
37
0.00%
75.51%
0
0
0
0
0
0
0
0
0
49
0
21
42.86%
27.98%
57.73%
0
49
37
3
81.63%
69.77%
93.50%
Blood
2013
H
50
0
0.00%
49
0%
49
0
0.00%
0
0
0
0
Blood
2013
H
50
0
0.00%
49
0%
49
0
0.00%
0
0
0
0
0
49
0
40
81.63%
69.77%
93.50%
0
49
0
31
63.27%
48.75%
77.78%
Page 45
Effectiveness of Care
South Country Health Alliance
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare
Advantage
NR
NR
NR
Page 46
Effectiveness of Care
South Country Health Alliance
Osteoporosis Management in Women Who had a Fracture
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
2013
A
53
2
3.77%
0.00%
9.85%
Page 47
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
NR
NR
NR
NR
NR
NR
Page 48
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
NR
NR
NR
NR
NR
NR
Page 49
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
2013
A
36
29
80.56%
66.24%
94.87%
28
77.78%
62.81%
92.75%
Page 50
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-SNP
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
NR
NR
NR
NR
NR
NR
Page 51
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-Non SNP
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
2013
A
17
13
NA
NA
NA
12
NA
NA
NA
Page 52
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F& C)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
2013
A
252
129
51.19%
44.82%
57.56%
86
34.13%
28.07%
40.18%
Page 53
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
General
Measurement Year
2013
Data Collection Methodology
A
Eligible Member Population
22
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Effective Acute
Effective
9
NA
NA
NA
6
NA
NA
NA
Page 54
Effectiveness of Care
South Country Health Alliance
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
NR
NR
NR
NR
NR
NR
Page 55
Effectiveness of Care
South Country Health Alliance
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F& C)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
101
65
64.36%
54.52%
74.19%
36
23
63.89%
46.81%
80.97%
2013
A
Page 56
Effectiveness of Care
South Country Health Alliance
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
General
Measurement Year
2013
Data Collection Methodology
A
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Initiation
Continuation
8
6
NA
NA
NA
3
3
NA
NA
NA
Page 57
Effectiveness of Care
South Country Health Alliance
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
30 Days
7 Days
NR
NR
NR
NR
NR
NR
Page 58
Effectiveness of Care
South Country Health Alliance
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
30 Days
7 Days
6
NA
NA
NA
5
NA
NA
NA
2013
A
8
Page 59
Effectiveness of Care
South Country Health Alliance
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC - SNP
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
30 Days
7 Days
16
NA
NA
NA
12
NA
NA
NA
2013
A
18
Page 60
Effectiveness of Care
Follow-up After Hospitalization for Mental Illness
SNBC-Non SNP
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
30 Days
7 Days
18
NA
NA
NA
6
NA
NA
NA
2013
A
24
Page 61
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 62
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 63
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
592
552
93.24%
91.14%
95.35%
68
63
92.65%
85.71%
99.59%
670
637
95.07%
93.36%
96.79%
67
59
88.06%
79.55%
96.57%
1397
1311
93.84%
92.55%
95.14%
2013
A
Page 64
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-SNP
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
128
117
91.41%
86.16%
96.65%
6
6
NA
NA
NA
83
77
92.77%
86.60%
98.94%
112
79
70.54%
61.65%
79.43%
329
279
84.80%
80.77%
88.83%
2013
A
Page 65
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-Non SNP
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
68
53
77.94%
67.35%
88.53%
2
2
NA
NA
NA
57
48
84.21%
73.87%
94.55%
25
18
NA
NA
NA
152
121
79.61%
72.87%
86.34%
2013
A
Page 66
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
226
185
81.86%
76.61%
87.10%
3
3
NA
NA
NA
173
141
81.50%
75.43%
87.58%
26
15
NA
NA
NA
428
344
80.37%
76.49%
84.25%
2013
A
Page 67
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Minnesota Health Care Programs - Managed Care (MN Care)
General
Data Elements
Measure
Measurement Year
2013
Data Collection Methodology
A
Eligible Member Population
Numerator Events by Admin Data
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
ACE Inhibitors
71
62
78.88%
95.77%
Annual Monitoring for Members on
Digoxin
Diuretics
Anti-
1
1
NA
NA
51
47
83.80%
100.00%
13
6
NA
NA
Total
136
116
78.97%
91.61%
Page 68
Access/Availability of Care
South Country Health Alliance
Medication Reconciliation Post Discharge
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
H
Number of numerator events by administrative data in eligible
population (before exclusions)
Current year's administrative rate (before exclusions)
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
NR
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
Page 69
Effectiveness of Care
South Country Health Alliance
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Drug-Disease Interactions
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
History of Falls +
Dementia +
Tricyclic
Tricyclic
Antidepressants, Antidepressants
Antipsychotics or or Anticholinergic
Sleep Agents
Agents
NR
NR
NR
NR
NR
NR
Chronic Renal
Failure +
Nonaspirin
NSAIDs or Cox-2
Selective NSAIDs
Total
NR
NR
NR
NR
NR
NR
Page 70
Effectiveness of Care
South Country Health Alliance
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Drug-Disease Interactions
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
History of Falls +
Dementia +
Tricyclic
Tricyclic
Antidepressants, Antidepressants
Antipsychotics or or Anticholinergic
Sleep Agents
Agents
Chronic Renal
Failure +
Nonaspirin
NSAIDs or Cox-2
Selective NSAIDs
Total
48
2
4.17%
0.00%
10.86%
314
155
49.36%
43.67%
55.05%
2013
A
68
44
64.71%
52.61%
76.80%
198
109
55.05%
47.87%
62.23%
Page 71
Effectiveness of Care
South Country Health Alliance
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
At least 1
Prescription
At least 2
Prescriptions
NR
NR
NR
NR
NR
NR
Page 72
Effectiveness of Care
South Country Health Alliance
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
General
Measure
Data
2013
A
1411
At least 1
Prescription
At least 2
Prescriptions
263
18.64%
16.57%
20.71%
46
3.26%
2.30%
4.22%
Page 73
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
NR
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
NR
NR
NR
NR
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 74
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
NR
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
NR
NR
NR
NR
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 75
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
0
0
1426
1426
0
0
1402
NA
NA
NA
NA
NA
NA
98.32%
97.61%
99.02%
1402
98.32%
97.61%
99.02%
2013
A
Page 76
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-SNP
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
181
377
39
597
175
369
39
96.69%
93.80%
99.57%
97.88%
96.29%
99.47%
100.00%
98.72%
100.00%
583
97.65%
96.36%
98.95%
2013
A
Page 77
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-Non SNP
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
453
574
26
1053
427
544
25
94.26%
92.01%
96.51%
94.77%
92.87%
96.68%
NA
NA
NA
996
94.59%
93.17%
96.00%
2013
A
Page 78
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
2167
835
0
3002
1945
739
0
89.76%
88.46%
91.06%
88.50%
86.28%
90.73%
NA
NA
NA
2684
89.41%
88.29%
90.52%
2013
A
Page 79
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Minnesota Health Care Programs - Managed Care (MN Care)
General Measure
Data Elements
Measurement Year
2013
Data collection methodology
A
Eligible member population (i.e. members
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Ages 20-44
Ages 45-64
Ages 65+
Total
333
281
84.38%
80.34%
88.43%
260
235
90.38%
86.61%
94.16%
0
0
NA
NA
NA
593
516
87.02%
84.23%
89.80%
Page 80
Access/Availability of Care
South Country Health Alliance
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
General Measure
Data
12-24 months
25 months 6 yrs.
7-11 yrs.
12-19 yrs.
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 81
Access/Availability of Care
South Country Health Alliance
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
General Measure
Data
12-24 months
25 months 6 yrs.
7-11 yrs.
12-19 yrs.
504
488
1510
1331
1088
983
1181
1070
96.83%
95.20%
98.46%
88.15%
86.48%
89.81%
90.35%
88.55%
92.15%
90.60%
88.89%
92.31%
2013
A
Page 82
Access/Availability of Care
South Country Health Alliance
Children's and Adolescents' Access to Primary Care Practitioners
Minnesota Health Care Programs - Managed Care (MN Care)
General Measure
Data Elements
Measurement Year
2013
Data collection methodology (Administrative only)
A
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
12-24 months
25 months -
7-11 yrs.
12-19 yrs.
19
18
NA
NA
NA
176
156
88.64%
83.66%
93.61%
78
69
88.46%
80.73%
96.19%
104
97
93.27%
87.97%
98.57%
Page 83
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 84
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
General
13-17 Year Olds
Initiation of Engagement
18+ Year Olds
Initiation of Engagement
Total
Initiation of Engagement
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 85
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
General
2013
A
13-17 Year Olds
Initiation of Engagement
18+ Year Olds
Initiation of Engagement
0
0
NA
NA
NA
Total
Initiation of Engagement
20
0
NA
NA
NA
7
NA
NA
NA
20
1
NA
NA
NA
7
NA
NA
NA
1
NA
NA
NA
Page 86
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-SNP
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
General
2013
A
13-17 Year Olds
Initiation of Engagement
18+ Year Olds
Initiation of Engagement
0
0
NA
NA
NA
Total
Initiation of Engagement
46
46
0
NA
NA
NA
17
36.96%
21.92%
51.99%
4
8.70%
0.00%
17.93%
17
36.96%
21.92%
51.99%
4
8.70%
0.00%
17.93%
Page 87
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-Non SNP
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
General
2013
A
13-17 Year Olds
Initiation of Engagement
18+ Year Olds
Initiation of Engagement
0
0
NA
NA
NA
Total
Initiation of Engagement
106
0
NA
NA
NA
37
34.91%
25.36%
44.45%
106
12
11.32%
4.82%
17.82%
37
34.91%
25.36%
44.45%
12
11.32%
4.82%
17.82%
Page 88
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
General
2013
A
13-17 Year Olds
Initiation of Engagement
18+ Year Olds
Initiation of Engagement
30
13
43.33%
23.93%
62.73%
Total
Initiation of Engagement
374
4
13.33%
0.00%
27.16%
128
34.22%
29.28%
39.17%
404
45
12.03%
8.60%
15.46%
141
34.90%
30.13%
39.67%
49
12.13%
8.82%
15.44%
Page 89
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
General
2013
A
13-17 Year Olds
Initiation of Engagement
18+ Year Olds
Initiation of Engagement
0
0
NA
NA
NA
Total
Initiation of Engagement
28
0
NA
NA
NA
11
NA
NA
NA
28
2
NA
NA
NA
11
NA
NA
NA
2
NA
NA
NA
Page 90
Access/Availability of Care
South Country Health Alliance
Prenatal and Postpartum Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
Current year's administrative rate (before exclusions)
NR
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
NR
NR
NR
NR
NR
NR
NR
NR
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
population (before exclusions)
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
Page 91
Access/Availability of Care
South Country Health Alliance
Prenatal and Postpartum Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
Timeliness of
Prenatal Care
Postpartum
Care
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
2013
H
710
2013
H
710
Number of numerator events by administrative data in eligible
population (before exclusions)
401
335
56.48%
411
5.00%
432
253
47.18%
411
5.00%
432
216
58.56%
50.00%
0
0
0
0
432
253
112
0
0
432
216
84.49%
80.96%
88.02%
50.00%
45.17%
54.83%
Data Elements
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
Page 92
Access/Availability of Care
South Country Health Alliance
Prenatal and Postpartum Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2014 (Reporting Year 2013)
Timeliness of
2013
H
17
12
70.59%
17
0.00%
17
12
70.59%
0
0
0
17
12
1
NA
NA
NA
Postpartum
2013
H
17
11
64.71%
17
0.00%
17
11
64.71%
0
0
0
17
11
2
NA
NA
NA
Page 93
Use of Services
South Country Health Alliance
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Data Elements
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of employee/dependent medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Page 94
Use of Services
South Country Health Alliance
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
0
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Oversample List
0
HEDIS 2014 (Reporting Year 2013)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
22
5.70%
12
3.11%
7
1.81%
23
5.96%
48
12.44%
93
24.09%
181
46.89%
22
5.70%
12
3.11%
7
1.81%
23
5.96%
48
12.44%
93
24.09%
181
46.89%
8
0
2.07%
0.52%
3.62%
7
2
2.33%
0.70%
3.97%
5
1
1.55%
0.19%
2.92%
16
4
5.18%
2.84%
7.52%
30
2
8.29%
5.41%
11.17%
56
10
17.10%
13.21%
20.98%
181
64
63.47%
58.54%
68.40%
386
0.00%
386
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
1 visit
2013
H
386
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Zero Visits
386
Page 95
Use of Services
South Country Health Alliance
Well Child Visits in the First 15 Months of Life
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
General
Zero Visits
Measurement Year
2013
Data Collection Methodology
H
Eligible Member Population
15
2
Numerator events by admin data in eligible
13.33%
Currect Year's Administrative Rate
Minimum Required Sample Size
15
Oversampling Rate
0.00%
Final sample size (FSS)
15
2
Numerator events by admin data in FSS
13.33%
Administrative rate on FSS
Number of Records Excluded Because of
0
Number of employee/dependent medical
0
Additional Records Added from the
0
Denominator
15
2
Numerator Events by Admin Data
0
Numerator Events by Medical Record
NA
Reported Rate
NA
Lower 95% Confidence Interval
NA
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
0
0.00%
2
13.33%
1
6.67%
0
0.00%
4
26.67%
6
40.00%
0
0.00%
2
13.33%
1
6.67%
0
0.00%
4
26.67%
6
40.00%
0
0
NA
NA
NA
1
0
NA
NA
NA
1
0
NA
NA
NA
0
0
NA
NA
NA
3
0
NA
NA
NA
6
2
NA
NA
NA
Page 96
Use of Services
South Country Health Alliance
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MA Expand
F&C
MN Care
Measurement Year
Data Collection Methodology
Eligible Member Population
2013
H
1243
2013
H
160
Numerator events by admin data in eligible
population
684
101
NR
55.03%
411
5.00%
432
247
63.13%
160
0.00%
160
105
NR
57.18%
0
65.63%
0
0
0
0
432
247
17
61.11%
56.40%
65.82%
0
160
105
3
67.50%
59.93%
75.07%
Data Elements
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
Commercial
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
Page 97
Use of Services
South Country Health Alliance
Adolescent Well-Care Visits
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MA Expand
F&C
MN Care
Measurement Year
Data Collection Methodology
Eligible Member Population
2013
H
1816
2013
H
190
Numerator events by admin data in eligible
population
542
62
NR
29.85%
411
5.00%
432
143
32.63%
190
0.00%
190
64
NR
33.10%
0
33.68%
0
0
0
0
432
143
37
41.67%
36.90%
46.43%
0
190
64
12
40.00%
32.77%
47.23%
Data Elements
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
Commercial
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
Page 98
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
NR
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 2014 (Reporting Year 2013)
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Emergency Room Visits
Visits
NR
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 99
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
NR
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 2014 (Reporting Year 2013)
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Emergency Room Visits
Visits
NR
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 100
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
0
0
3
5538
6222
8531
0
20294
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
0
0
4
5399
6203
7074
0
18680
HEDIS 2014 (Reporting Year 2013)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
1333.33
974.90
996.95
829.21
920.47
Emergency Room Visits
Visits
0
0
0
0
0
388
361
463
0
1212
Visits/ 1,000
Member
Months
NA
NA
NA
NA
0.00
70.06
58.02
54.27
59.72
Page 101
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-SNP
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
0
2380
4705
406
0
0
0
7491
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
0
1777
4352
296
0
0
0
6425
HEDIS 2014 (Reporting Year 2013)
Visits/ 1,000
Member
Months
NA
NA
NA
746.64
924.97
729.06
NA
NA
857.70
Emergency Room Visits
Visits
0
0
0
233
356
32
0
0
0
621
Visits/ 1,000
Member
Months
NA
NA
NA
97.90
75.66
78.82
NA
NA
82.90
Page 102
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-Non SNP
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
256
7984
9213
326
0
0
0
17779
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
115
3498
6083
232
0
0
0
9928
HEDIS 2014 (Reporting Year 2013)
Visits/ 1,000
Member
Months
NA
NA
449.22
438.13
660.26
711.66
NA
NA
558.41
Emergency Room Visits
Visits
0
0
15
616
674
27
0
0
0
1332
Visits/ 1,000
Member
Months
NA
NA
58.59
77.15
73.16
82.82
NA
NA
74.92
Page 103
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
10528
65699
48251
62161
18066
10
0
0
0
204715
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
8101
21336
13000
32293
10025
2
0
0
0
84757
HEDIS 2014 (Reporting Year 2013)
Visits/ 1,000
Member
Months
769.47
324.75
269.42
519.51
554.91
200.00
NA
NA
414.02
Emergency Room Visits
Visits
1026
3210
1825
5515
837
0
0
0
0
12413
Visits/ 1,000
Member
Months
97.45
48.86
37.82
88.72
46.33
0.00
NA
NA
60.64
Page 104
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MN Care)
Member Months
Age
<1
171
1-9
4424
10-19
3202
20-44
7443
45-64
4772
65-74
12
75-84
0
85+
0
Unknown
0
20024
Total
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Outpatient Visits (Excludes
Visits
Visits/ 1,000
146
853.80
1402
316.91
970
302.94
3028
406.83
2832
593.46
0
0.00
0
NA
0
NA
0
8378
418.40
HEDIS 2014 (Reporting Year 2013)
Emergency Room Visits
Visits
Visits/ 1,000
12
70.18
136
30.74
100
31.23
336
45.14
204
42.75
1
83.33
0
NA
0
NA
0
789
39.40
Page 105
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Member Months
NR
Discharges
Discharges /
1,000 Member
Months
Days
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Days / 1,000
Member
Months
NR
NR
NR
NR
NR
NR
Average
Length of Stay
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 106
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Member Months
NR
Discharges
Discharges /
1,000 Member
Months
Days
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2014 (Reporting Year 2013)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Days / 1,000
Member
Months
NR
NR
NR
NR
NR
NR
Average
Length of Stay
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 107
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Member Months
0
0
0
0
3
5538
6222
8531
0
20294
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
198
244
324
0
766
NA
NA
NA
NA
0.00
35.75
39.22
37.98
0
0
0
0
0
149
202
286
0
637
NA
NA
NA
NA
0.00
26.91
32.47
33.52
0
0
0
0
0
49
42
38
0
129
NA
NA
NA
NA
0.00
8.85
6.75
4.45
0
0
0
0
0
HEDIS 2014 (Reporting Year 2013)
37.75
31.39
6.36
NA
NA
0.00
0.00
Days
Days / 1,000
Member
Months
0
0
0
0
0
892
1013
1375
0
3280
NA
NA
NA
NA
0.00
161.07
162.81
161.18
0
0
0
0
0
667
757
1137
0
2561
NA
NA
NA
NA
0.00
120.44
121.67
133.28
0
0
0
0
0
225
256
238
0
719
NA
NA
NA
NA
0.00
40.63
41.14
27.90
0
0
0
0
0
161.62
126.19
35.43
NA
NA
0.00
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
4.51
4.15
4.24
NA
4.28
NA
NA
NA
NA
NA
4.48
3.75
3.98
NA
4.02
NA
NA
NA
NA
NA
4.59
6.10
6.26
NA
5.57
NA
NA
NA
NA
NA
Page 108
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-SNP
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Member Months
0
0
0
2380
4705
406
0
0
0
7491
Discharges
Discharges /
1,000 Member
Months
0
0
0
27
96
11
0
0
0
134
NA
NA
NA
11.34
20.40
27.09
NA
NA
0
0
0
14
67
8
0
0
0
89
NA
NA
NA
5.88
14.24
19.70
NA
NA
0
0
0
12
29
3
0
0
0
44
NA
NA
NA
5.04
6.16
7.39
NA
NA
0
1
0
0
1
NA
0.42
0.00
HEDIS 2014 (Reporting Year 2013)
17.89
11.88
5.87
0.14
Days
Days / 1,000
Member
Months
0
0
0
168
366
42
0
0
0
576
NA
NA
NA
70.59
77.79
103.45
NA
NA
0
0
0
50
227
35
0
0
0
312
NA
NA
NA
21.01
48.25
86.21
NA
NA
0
0
0
115
139
7
0
0
0
261
NA
NA
NA
48.32
29.54
17.24
NA
NA
0
3
0
0
3
NA
1.26
0.00
76.89
41.65
34.84
0.42
Average
Length of Stay
NA
NA
NA
6.22
3.81
3.82
NA
NA
NA
4.30
NA
NA
NA
3.57
3.39
4.38
NA
NA
NA
3.51
NA
NA
NA
9.58
4.79
2.33
NA
NA
NA
5.93
NA
3.00
NA
NA
3.00
Page 109
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-Non SNP
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Member Months
0
0
256
7984
9213
326
0
0
0
17779
Discharges
Discharges /
1,000 Member
Months
0
0
1
97
219
13
0
0
0
330
NA
NA
3.91
12.15
23.77
39.88
NA
NA
0
0
1
57
164
10
0
0
0
232
NA
NA
3.91
7.14
17.80
30.67
NA
NA
0
0
0
31
55
3
0
0
0
89
NA
NA
0.00
3.88
5.97
9.20
NA
NA
0
9
0
0
9
0.00
1.13
0.00
HEDIS 2014 (Reporting Year 2013)
18.56
13.05
5.01
0.52
Days
Days / 1,000
Member
Months
0
0
2
341
1007
79
0
0
0
1429
NA
NA
7.81
42.71
109.30
242.33
NA
NA
0
0
2
228
642
56
0
0
0
928
NA
NA
7.81
28.56
69.68
171.78
NA
NA
0
0
0
87
365
23
0
0
0
475
NA
NA
0.00
10.90
39.62
70.55
NA
NA
0
26
0
0
26
0.00
3.26
0.00
80.38
52.20
26.72
1.49
Average
Length of Stay
NA
NA
2.00
3.52
4.60
6.08
NA
NA
NA
4.33
NA
NA
2.00
4.00
3.91
5.60
NA
NA
NA
4.00
NA
NA
NA
2.81
6.64
7.67
NA
NA
NA
5.34
NA
2.89
NA
NA
2.89
Page 110
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Member Months
10528
65699
48251
62161
18066
10
0
0
0
204715
Discharges
Discharges /
1,000 Member
Months
74
91
119
1116
196
0
0
0
0
1596
7.03
1.39
2.47
17.95
10.85
0.00
NA
NA
60
75
32
196
102
0
0
0
0
465
5.70
1.14
0.66
3.15
5.65
0.00
NA
NA
14
16
17
139
93
0
0
0
0
279
1.33
0.24
0.35
2.24
5.15
0.00
NA
NA
70
781
1
0
852
1.45
12.56
0.06
HEDIS 2014 (Reporting Year 2013)
7.80
2.27
1.36
6.63
Days
Days / 1,000
Member
Months
307
329
322
2998
681
0
0
0
0
4637
29.16
5.01
6.67
48.23
37.70
0.00
NA
NA
175
205
74
542
329
0
0
0
0
1325
16.62
3.12
1.53
8.72
18.21
0.00
NA
NA
132
124
44
503
349
0
0
0
0
1152
12.54
1.89
0.91
8.09
19.32
0.00
NA
NA
204
1953
3
0
2160
4.23
31.42
0.17
22.65
6.47
5.63
16.81
Average
Length of Stay
4.15
3.62
2.71
2.69
3.47
NA
NA
NA
NA
2.91
2.92
2.73
2.31
2.77
3.23
NA
NA
NA
NA
2.85
9.43
7.75
2.59
3.62
3.75
NA
NA
NA
NA
4.13
2.91
2.50
3.00
NA
2.54
Page 111
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MN Care)
Age
Member Months
<1
171
1-9
4424
10-19
3202
20-44
7443
45-64
4772
65-74
12
75-84
0
85+
0
Unknown
0
20024
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Discharges
Discharges /
Days
Days / 1,000
Average
0
4
6
31
13
0
0
0
0
54
0.00
0.90
1.87
4.16
2.72
0.00
NA
NA
0
6
8
62
24
0
0
0
0
100
0.00
1.36
2.50
8.33
5.03
0.00
NA
NA
NA
1.50
1.33
2.00
1.85
NA
NA
NA
NA
1.85
0
4
4
8
5
0
0
0
0
21
0.00
0.90
1.25
1.07
1.05
0.00
NA
NA
0
6
6
11
8
0
0
0
0
31
0.00
1.36
1.87
1.48
1.68
0.00
NA
NA
0
0
2
5
8
0
0
0
0
15
0.00
0.00
0.62
0.67
1.68
0.00
NA
NA
0
0
2
9
16
0
0
0
0
27
0.00
0.00
0.62
1.21
3.35
0.00
NA
NA
0
18
0
0
18
0.00
2.42
0.00
0
42
0
0
42
0.00
5.64
0.00
HEDIS 2014 (Reporting Year 2013)
2.70
1.05
0.75
1.17
4.99
1.55
1.35
2.72
NA
1.50
1.50
1.38
1.60
NA
NA
NA
NA
1.48
NA
NA
1.00
1.80
2.00
NA
NA
NA
NA
1.80
NA
2.33
NA
NA
2.33
Page 112
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2014 (Reporting Year 2013)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
Male
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Outpatient/ED
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 113
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2014 (Reporting Year 2013)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
Male
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Outpatient/ED
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 114
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
13-17
18-24
25-34
35-64
65+
Unknown
Total
Member Months
(Outpatient/ED)
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
0
0
0
0
1
5251
0
5252
0
0
0
0
2
15040
0
15042
0
0
0
0
3
20291
0
20294
0
0
0
0
1
5251
0
5252
0
0
0
0
2
15040
0
15042
0
0
0
0
3
20291
0
20294
0
0
0
0
1
5251
0
5252
0
0
0
0
2
15040
0
15042
0
0
0
0
3
20291
0
20294
0
0
0
0
1
5251
0
5252
0
0
0
0
2
15040
0
15042
0
0
0
0
3
20291
0
20294
Any Services
Age
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Intensive Outpatient/Partial
Hospitalization
Inpatient
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
20
21
41
0
0
0
20
21
41
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
4.57%
1.68%
2.42%
NA
NA
NA
4.57%
1.68%
2.42%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
6
14
0
0
0
8
6
14
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
1.83%
0.48%
0.83%
NA
NA
NA
1.83%
0.48%
0.83%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
16
31
0
0
0
15
16
31
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.43%
1.28%
1.83%
NA
NA
NA
3.43%
1.28%
1.83%
HEDIS 2014 (Reporting Year 2013)
Page 115
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-SNP
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
13-17
18-24
25-34
35-64
65+
Unknown
Total
Member Months
(Outpatient/ED)
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
0
0
87
453
2583
163
0
3286
0
0
23
498
3441
243
0
4205
0
0
110
951
6024
406
0
7491
0
0
87
453
2583
163
0
3286
0
0
23
498
3441
243
0
4205
0
0
110
951
6024
406
0
7491
0
0
87
453
2583
163
0
3286
0
0
23
498
3441
243
0
4205
0
0
110
951
6024
406
0
7491
0
0
87
453
2583
163
0
3286
0
0
23
498
3441
243
0
4205
0
0
110
951
6024
406
0
7491
Any Services
Age
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Intensive Outpatient/Partial
Hospitalization
Inpatient
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
0
0
0
5
4
9
41
44
85
1
0
1
0
0
0
47
48
95
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
13.25%
9.64%
11.36%
19.05%
15.34%
16.93%
7.36%
0.00%
2.96%
NA
NA
NA
17.16%
13.70%
15.22%
0
0
0
0
0
0
0
0
0
0
2
2
6
11
17
0
0
0
0
0
0
6
13
19
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
4.82%
2.52%
2.79%
3.84%
3.39%
0.00%
0.00%
0.00%
NA
NA
NA
2.19%
3.71%
3.04%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
0
0
0
0
0
0
0
0
0
5
4
9
40
41
81
1
0
1
0
0
0
46
45
91
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
13.25%
9.64%
11.36%
18.58%
14.30%
16.14%
7.36%
0.00%
2.96%
NA
NA
NA
16.80%
12.84%
14.58%
HEDIS 2014 (Reporting Year 2013)
Page 116
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-Non SNP
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
13-17
18-24
25-34
35-64
65+
Unknown
Total
Member Months
(Outpatient/ED)
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
0
0
1006
1887
5504
73
0
8470
0
0
619
1718
6719
253
0
9309
0
0
1625
3605
12223
326
0
17779
0
0
1006
1887
5504
73
0
8470
0
0
619
1718
6719
253
0
9309
0
0
1625
3605
12223
326
0
17779
0
0
1006
1887
5504
73
0
8470
0
0
619
1718
6719
253
0
9309
0
0
1625
3605
12223
326
0
17779
0
0
1006
1887
5504
73
0
8470
0
0
619
1718
6719
253
0
9309
0
0
1625
3605
12223
326
0
17779
Any Services
Age
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Intensive Outpatient/Partial
Hospitalization
Inpatient
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
11
3
14
29
16
45
94
83
177
0
0
0
0
0
0
134
102
236
NA
NA
NA
NA
NA
NA
13.12%
5.82%
10.34%
18.44%
11.18%
14.98%
20.49%
14.82%
17.38%
0.00%
0.00%
0.00%
NA
NA
NA
18.98%
13.15%
15.93%
0
0
0
0
0
0
2
0
2
9
5
14
21
23
44
0
0
0
0
0
0
32
28
60
NA
NA
NA
NA
NA
NA
2.39%
0.00%
1.48%
5.72%
3.49%
4.66%
4.58%
4.11%
4.32%
0.00%
0.00%
0.00%
NA
NA
NA
4.53%
3.61%
4.05%
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
1
0
1
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.22%
0.00%
0.10%
0.00%
0.00%
0.00%
NA
NA
NA
0.14%
0.00%
0.07%
0
0
0
0
0
0
11
3
14
26
15
41
88
74
162
0
0
0
0
0
0
125
92
217
NA
NA
NA
NA
NA
NA
13.12%
5.82%
10.34%
16.53%
10.48%
13.65%
19.19%
13.22%
15.90%
0.00%
0.00%
0.00%
NA
NA
NA
17.71%
11.86%
14.65%
HEDIS 2014 (Reporting Year 2013)
Page 117
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Total
13-17
18-24
25-34
35-64
65+
Unknown
Total
Member Months
(Outpatient/ED)
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
48697
11947
6301
8619
16132
6
91702
45570
12435
12902
21435
20667
4
113013
94267
24382
19203
30054
36799
10
204715
48697
11947
6301
8619
16132
6
91702
45570
12435
12902
21435
20667
4
113013
94267
24382
19203
30054
36799
10
204715
48697
11947
6301
8619
16132
6
91702
45570
12435
12902
21435
20667
4
113013
94267
24382
19203
30054
36799
10
204715
48697
11947
6301
8619
16132
6
91702
45570
12435
12902
21435
20667
4
113013
94267
24382
19203
30054
36799
10
204715
Any Services
Age
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Sex
M
Total
M
Total
M
Total
M
Total
M
Total
M
Total
M
Total
M
F
Total
Intensive Outpatient/Partial
Hospitalization
Inpatient
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
49
49
111
111
201
201
312
312
0
0
0
0
673
NR
673
0.00%
0.00%
4.92%
2.41%
21.14%
6.94%
27.98%
8.03%
23.21%
10.17%
0.00%
0.00%
NR
NR
8.81%
NR
3.94%
0
0
5
5
17
17
17
17
49
49
0
0
0
0
88
NR
88
0.00%
0.00%
0.50%
0.25%
3.24%
1.06%
2.37%
0.68%
3.64%
1.60%
0.00%
0.00%
NR
NR
1.15%
NR
0.52%
0
0
1
1
0
0
2
2
1
1
0
0
0
0
4
NR
4
0.00%
0.00%
0.10%
0.05%
0.00%
0.00%
0.28%
0.08%
0.07%
0.03%
0.00%
0.00%
NR
NR
0.05%
NR
0.02%
0
0
48
48
105
105
197
197
294
294
0
0
0
0
644
NR
644
0.00%
0.00%
4.82%
2.36%
20.00%
6.56%
27.43%
7.87%
21.87%
9.59%
0.00%
0.00%
NR
NR
8.43%
NR
3.78%
HEDIS 2014 (Reporting Year 2013)
Page 118
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MN Care)
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
2970
708
859
1427
3029
0
0
8993
Female
2790
644
1149
2041
4395
12
0
11031
Member Months
(Inpatient)
Total
5760
1352
2008
3468
7424
12
0
20024
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
2
0
2
14
5
19
14
5
19
16
17
33
0
0
0
0
0
0
46
27
73
HEDIS 2014 (Reporting Year 2013)
Male
2970
708
859
1427
3029
0
0
8993
Female
2790
644
1149
2041
4395
12
0
11031
Total
5760
1352
2008
3468
7424
12
0
20024
Inpatient
Percent
0.00%
0.00%
0.00%
3.39%
0.00%
1.78%
19.56%
5.22%
11.35%
11.77%
2.94%
6.57%
6.34%
4.64%
5.33%
NA
0.00%
0.00%
NA
NA
NA
6.14%
2.94%
4.37%
Number
0
0
0
0
0
0
3
0
3
0
1
1
2
0
2
0
0
0
0
0
0
5
1
6
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
4.19%
0.00%
1.79%
0.00%
0.59%
0.35%
0.79%
0.00%
0.32%
NA
0.00%
0.00%
NA
NA
NA
0.67%
0.11%
0.36%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
2970
2790
5760
708
644
1352
859
1149
2008
1427
2041
3468
3029
4395
7424
0
12
12
0
0
0
8993
11031
20024
Intensive Outpatient/Partial
Hospitalization
Number
Percent
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
NA
0
0.00%
0
0.00%
0
NA
0
NA
0
NA
0
0.00%
0
0.00%
0
0.00%
Member Months
(Outpatient/ED)
Male
2970
708
859
1427
3029
0
0
8993
Female
2790
644
1149
2041
4395
12
0
11031
Total
5760
1352
2008
3468
7424
12
0
20024
Outpatient/ED
Number
0
0
0
2
0
2
12
5
17
14
5
19
16
17
33
0
0
0
0
0
0
44
27
71
Percent
0.00%
0.00%
0.00%
3.39%
0.00%
1.78%
16.76%
5.22%
10.16%
11.77%
2.94%
6.57%
6.34%
4.64%
5.33%
NA
0.00%
0.00%
NA
NA
NA
5.87%
2.94%
4.25%
Page 119
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
Member Months
(Inpatient)
Female
Total
NR
NR
NR
NR
NR
NR
NR
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2014 (Reporting Year 2013)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
Outpatient/ED
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 120
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
Member Months
(Inpatient)
Female
Total
NR
NR
NR
NR
NR
NR
NR
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2014 (Reporting Year 2013)
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
Age
0-12
Male
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
Outpatient/ED
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 121
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
1
5251
0
5252
0
0
2
15040
0
15042
0
0
3
20291
0
20294
0
0
1
5251
0
5252
0
0
2
15040
0
15042
0
0
3
20291
0
20294
0
0
1
5251
0
5252
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
0
0
2
15040
0
15042
0
0
3
20291
0
20294
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
0
0
1
5251
0
5252
0
0
2
15040
0
15042
0
0
3
20291
0
20294
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
0
0
0
50
163
213
0
0
0
50
163
213
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
11.43%
13.01%
12.60%
NA
NA
NA
11.42%
13.00%
12.59%
0
0
0
0
0
0
0
0
0
16
53
69
0
0
0
16
53
69
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.66%
4.23%
4.08%
NA
NA
NA
3.66%
4.23%
4.08%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
0
0
0
0
0
0
0
0
0
37
117
154
0
0
0
37
117
154
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
8.46%
9.34%
9.11%
NA
NA
NA
8.45%
9.33%
9.11%
HEDIS 2014 (Reporting Year 2013)
Page 122
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-SNP
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
3123
163
0
3286
0
0
3962
243
0
4205
0
0
7085
406
0
7491
0
0
3123
163
0
3286
0
0
3962
243
0
4205
0
0
7085
406
0
7491
0
0
3123
163
0
3286
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
0
0
3962
243
0
4205
0
0
7085
406
0
7491
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
0
0
3123
163
0
3286
0
0
3962
243
0
4205
0
0
7085
406
0
7491
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
140
173
313
4
10
14
0
0
0
144
183
327
NA
NA
NA
NA
NA
NA
53.79%
52.40%
53.01%
29.45%
49.38%
41.38%
NA
NA
NA
52.59%
52.22%
52.38%
0
0
0
0
0
0
5
20
25
0
0
0
0
0
0
5
20
25
NA
NA
NA
NA
NA
NA
1.92%
6.06%
4.23%
0.00%
0.00%
0.00%
NA
NA
NA
1.83%
5.71%
4.00%
0
0
0
0
0
0
1
1
2
0
0
0
0
0
0
1
1
2
NA
NA
NA
NA
NA
NA
0.38%
0.30%
0.34%
0.00%
0.00%
0.00%
NA
NA
NA
0.37%
0.29%
0.32%
0
0
0
0
0
0
139
172
311
4
10
14
0
0
0
143
182
325
NA
NA
NA
NA
NA
NA
53.41%
52.09%
52.67%
29.45%
49.38%
41.38%
NA
NA
NA
52.22%
51.94%
52.06%
HEDIS 2014 (Reporting Year 2013)
Page 123
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-Non SNP
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
8397
73
0
8470
0
0
9056
253
0
9309
0
0
17453
326
0
17779
0
0
8397
73
0
8470
0
0
9056
253
0
9309
0
0
17453
326
0
17779
0
0
8397
73
0
8470
Member Months
(Inpatient)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
0
0
9056
253
0
9309
0
0
17453
326
0
17779
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
0
0
8397
73
0
8470
0
0
9056
253
0
9309
0
0
17453
326
0
17779
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
291
339
630
1
5
6
0
0
0
292
344
636
NA
NA
NA
NA
NA
NA
41.59%
44.92%
43.32%
16.44%
23.72%
22.09%
NA
NA
NA
41.37%
44.34%
42.93%
0
0
0
0
0
0
19
21
40
0
0
0
0
0
0
19
21
40
NA
NA
NA
NA
NA
NA
2.72%
2.78%
2.75%
0.00%
0.00%
0.00%
NA
NA
NA
2.69%
2.71%
2.70%
0
0
0
0
0
0
11
6
17
0
0
0
0
0
0
11
6
17
NA
NA
NA
NA
NA
NA
1.57%
0.80%
1.17%
0.00%
0.00%
0.00%
NA
NA
NA
1.56%
0.77%
1.15%
0
0
0
0
0
0
285
335
620
1
5
6
0
0
0
286
340
626
NA
NA
NA
NA
NA
NA
40.73%
44.39%
42.63%
16.44%
23.72%
22.09%
NA
NA
NA
40.52%
43.83%
42.25%
HEDIS 2014 (Reporting Year 2013)
Page 124
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care(MA Expand F&C)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Male
Female
Total
Male
Female
Total
48697
11947
31052
6
0
91702
45570
12435
55004
4
0
113013
94267
24382
86056
10
0
204715
48697
11947
31052
6
0
91702
45570
12435
55004
4
0
113013
94267
24382
86056
10
0
204715
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
Male
Female
Total
48697
11947
31052
6
0
91702
48697
11947
31052
6
0
91702
45570
12435
55004
4
0
113013
94267
24382
86056
10
0
204715
45570
12435
55004
4
0
113013
94267
24382
86056
10
0
204715
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
657
455
1112
219
278
497
589
1171
1760
0
0
0
0
0
0
1465
1904
3369
16.19%
11.98%
14.16%
22.00%
26.83%
24.46%
22.76%
25.55%
24.54%
0.00%
0.00%
0.00%
NA
NA
NA
19.17%
20.22%
19.75%
8
11
19
11
27
38
47
60
107
0
0
0
0
0
0
66
98
164
0.20%
0.29%
0.24%
1.10%
2.61%
1.87%
1.82%
1.31%
1.49%
0.00%
0.00%
0.00%
NA
NA
NA
0.86%
1.04%
0.96%
7
4
11
4
10
14
20
37
57
0
0
0
0
0
0
31
51
82
0.17%
0.11%
0.14%
0.40%
0.97%
0.69%
0.77%
0.81%
0.79%
0.00%
0.00%
0.00%
NA
NA
NA
0.41%
0.54%
0.48%
657
455
1112
216
273
489
576
1153
1729
0
0
0
0
0
0
1449
1881
3330
16.19%
11.98%
14.16%
21.70%
26.34%
24.07%
22.26%
25.15%
24.11%
0.00%
0.00%
0.00%
NA
NA
NA
18.96%
19.97%
19.52%
HEDIS 2014 (Reporting Year 2013)
Page 125
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care(MN Care)
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
2970
708
5315
0
0
8993
2790
644
7585
12
0
11031
5760
1352
12900
12
0
20024
2970
708
5315
0
0
8993
2790
644
7585
12
0
11031
5760
1352
12900
12
0
20024
2970
708
5315
0
0
8993
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
2790
644
7585
12
0
11031
5760
1352
12900
12
0
20024
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
2970
708
5315
0
0
8993
2790
644
7585
12
0
11031
5760
1352
12900
12
0
20024
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
27
19
46
10
13
23
56
105
161
0
0
0
0
0
0
93
137
230
10.91%
8.17%
9.58%
16.95%
24.22%
20.41%
12.64%
16.61%
14.98%
NA
0.00%
0.00%
NA
NA
NA
12.41%
14.90%
13.78%
0
0
0
0
0
0
2
1
3
0
0
0
0
0
0
2
1
3
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.45%
0.16%
0.28%
NA
0.00%
0.00%
NA
NA
NA
0.27%
0.11%
0.18%
0
0
0
0
2
2
0
1
1
0
0
0
0
0
0
0
3
3
0.00%
0.00%
0.00%
0.00%
3.73%
1.78%
0.00%
0.16%
0.09%
NA
0.00%
0.00%
NA
NA
NA
0.00%
0.33%
0.18%
27
19
46
10
12
22
56
103
159
0
0
0
0
0
0
93
134
227
10.91%
8.17%
9.58%
16.95%
22.36%
19.53%
12.64%
16.30%
14.79%
NA
0.00%
0.00%
NA
NA
NA
12.41%
14.58%
13.60%
HEDIS 2014 (Reporting Year 2013)
Page 126
Use of Services
South Country Health Alliance
Plan All-Cause Readmissions
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Age
18-44
45-54
55-64
Total
Age
65-74
75-84
85+
Total
Count of Index Stays
(Denominator)
Count of 30-Day
Readmissions
(Numerator)
Observed
Readmission
(Num/Den)
Average Adjusted
Probability
Total Variance
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Count of Index Stays
(Denominator)
Count of 30-Day
Readmissions
(Numerator)
Observed
Readmission
(Num/Den)
Average Adjusted
Probability
Total Variance
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2014 (Reporting Year 2013)
Page 127
Use of Services
South Country Health Alliance
Plan All-Cause Readmissions
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
Count of Index Stays
(Denominator)
Age
18-44
45-54
55-64
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
0
0
0
0
0
0
0
0
0
0
0
0
Count of Index Stays
(Denominator)
Age
65-74
75-84
85+
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2014 (Reporting Year 2013)
30
89
119
43
99
142
30
136
166
103
324
427
Count of 30-Day
Readmissions
(Numerator)
0
0
0
0
0
0
0
0
0
0
0
0
Observed
Readmission
(Num/Den)
0.00%
0.00%
NA
0.00%
0.00%
NA
0.00%
0.00%
NA
0
0
0
Average Adjusted
Probability
Total Variance
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
Count of 30-Day
Readmissions
(Numerator)
4
14
18
6
19
25
3
15
18
13
48
61
Observed
Readmission
(Num/Den)
13.33%
15.73%
15.13%
13.95%
19.19%
17.61%
10.00%
11.03%
10.84%
12.62%
14.81%
14.29%
Average Adjusted
Probability
Total Variance
18.63%
15.43%
16.23%
19.72%
15.81%
17.00%
17.24%
17.31%
17.30%
18.68%
16.34%
16.90%
430.83%
1131.73%
1562.56%
639.79%
1271.99%
1911.78%
415.36%
1904.90%
2320.26%
1485.98%
4308.62%
5794.60%
Page 128
Use of Services
South Country Health Alliance
Plan All-Cause Readmissions
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-SNP
Count of Index Stays
(Denominator)
Age
18-44
45-54
55-64
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
0
0
0
0
0
0
0
0
0
0
0
0
Count of Index Stays
(Denominator)
Age
65-74
75-84
85+
Sex
M
F
Total
M
F
Total
M
F
Total
M
Total
HEDIS 2014 (Reporting Year 2013)
2
6
8
0
0
0
0
0
0
2
6
8
Count of 30-Day
Readmissions
(Numerator)
0
Average Adjusted
Probability
Total Variance
NA
0
0
0
0
0
0
0
0
0
Observed
Readmission
(Num/Den)
0.00%
0.00%
NA
0.00%
0.00%
NA
0.00%
0.00%
NA
50.00%
0.00%
12.50%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
Count of 30-Day
Readmissions
(Numerator)
Observed
Readmission
(Num/Den)
Average Adjusted
Probability
Total Variance
NR
NA
NR
NR
NR
NA
NR
NR
NR
NR
NR
NR
NA
NA
NA
NA
NR
NR
NR
NR
NR
NR
NR
NR
Page 129
Use of Services
South Country Health Alliance
Plan All-Cause Readmissions
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-Non SNP
Age
18-44
45-54
55-64
Total
Age
65-74
75-84
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Count of Index Stays
(Denominator)
Count of 30-Day
Readmissions
Observed
Readmission
Average Adjusted
Probability
Total Variance
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Count of Index Stays
(Denominator)
Count of 30-Day
Readmissions
(Numerator)
Observed
Readmission
(Num/Den)
Average Adjusted
Probability
Total Variance
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Sex
M
F
Total
M
F
Total
M
F
85+
Total
M
Total
HEDIS 2014 (Reporting Year 2013)
Page 130
Health Plan Descriptive Information
South Country Health Alliance
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Board Certification
MSHO
MSHO
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2014 (Reporting Year 2013)
SNBC
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
706
246
25
6170
691
237
23
5371
97.88%
96.34%
92.00%
87.05%
Page 131
Health Plan Descriptive Information
South Country Health Alliance
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Board Certification
MSHO
SNBC-SNP
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2014 (Reporting Year 2013)
SNBC
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
NR
NR
NR
NR
Page 132
Health Plan Descriptive Information
South Country Health Alliance
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Board Certification
MSHO
SNBC-Non SNP
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2014 (Reporting Year 2013)
SNBC
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
NR
NR
NR
NR
Page 133
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Commercial
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2014 (Reporting Year 2013)
Page 134
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Medicare Advantage
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2014 (Reporting Year 2013)
Page 135
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
MSHO
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0.00%
0
0
0
1
0
0.00%
0
0
0
2
0
0.00%
1
0.02%
901
979
1039
862
768
702
2
0.01%
1826
1832
2014
2307
2871
4190
3
0.01%
5251
99.98%
0
15040
99.99%
0
20291
99.99%
5252
15042
HEDIS 2014 (Reporting Year 2013)
0
0
0
0
0
0
0
0
3
2727
2811
3053
3169
3639
4892
0
20294
Page 136
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-SNP
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
87
189
264
195
360
0
0.00%
23
203
295
357
407
0
0.00%
1095
33.32%
459
705
506
358
1285
30.56%
567
647
852
611
2380
31.77%
2028
61.72%
147
16
0
0
0
0
2677
63.66%
218
25
0
0
0
0
4705
62.81%
163
4.96%
0
243
5.78%
0
406
5.42%
3286
4205
HEDIS 2014 (Reporting Year 2013)
110
392
559
552
767
1026
1352
1358
969
365
41
0
0
0
0
0
7491
Page 137
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
SNBC-Non SNP
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2014 (Reporting Year 2013)
Page 138
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
5308
15846
18046
14943
6501
2600
Member Months
Female
5220
14101
17706
14017
6961
3229
Total
10528
29947
35752
28960
13462
5829
63244
68.97%
3701
4190
4429
3457
3367
61234
54.18%
9673
11401
10034
6818
5091
124478
60.81%
19144
20.88%
2925
2995
2205
1183
43017
38.06%
3324
2701
1660
1073
62161
30.36%
9308
10.15%
6
0
0
0
0
0
8758
7.75%
4
0
0
0
0
0
18066
8.82%
6
0.01%
0
4
0.00%
0
10
0.00%
91702
113013
HEDIS 2014 (Reporting Year 2013)
13374
15591
14463
10275
8458
6249
5696
3865
2256
10
0
0
0
0
0
0
204715
Page 139
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Minnesota Health Care Programs - Managed Care (MN Care)
Member Months
Male
Female
70
101
<1
1234
742
1-4
1187
1261
5-9
801
976
10-14
386
354
15-17
303
382
18-19
3981
3816
0-19 Subtotal
44.27%
34.59%
0-19 Subtotal: %
556
767
20-24
676
1201
25-29
751
840
30-34
652
706
35-39
473
821
40-44
3108
4335
20-44 Subtotal
34.56%
39.30%
20-44 Subtotal: %
541
840
45-49
451
746
50-54
517
740
55-59
395
542
60-64
1904
2868
45-64 Subtotal
21.17%
26.00%
45-64 Subtotal: %
0
6
65-69
0
6
70-74
0
0
75-79
0
0
80-84
0
0
85-89
0
0
>=90
0
12
>=65 Subtotal
0.00%
0.11%
>=65 Subtotal: %
0
0
Age Unknown
8993
11031
Total
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:17 AM
Total
171
1976
2448
1777
740
685
7797
38.94%
1323
1877
1591
1358
1294
7443
37.17%
1381
1197
1257
937
4772
23.83%
6
6
0
0
0
0
12
0.06%
0
20024
Page 140