Metropolitan Health Plan
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
51 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
Metropolitan Health Plan
Adult BMI Assessment
Data Elements
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Commercial
Medicare
Advantage
Measurement Year
Data Collection Methodology
Eligible Member Population
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
MA Expand
F& C
2013
H
893
79
NR
NR
NR
NR
8.85%
411
5.00%
432
35
8.10%
Number of Records Excluded Because of Valid
Data Errors
0
Number of administrative data records excluded
12
Number of medical record data records excluded
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
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
MN Care
NR
NR
NR
NR
NR
NR
0
411
32
359
95.13%
92.93%
97.34%
NR
NR
NR
NR
NR
Page 3
Effectiveness of Care
Metropolitan Health Plan
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
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 8:01 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
0
0
0
0
0
0
0
0
0
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
0.00%
0
0.00%
0
0
NR
0
NR
0
NR
0
0
NR
0
NR
0
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
0
0
0
0
0
0
0
0
0
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
Page 5
Effectiveness of Care
Metropolitan Health Plan
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Jul 8, 2015 8:01 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
BMI Percentile
Ages 3-11 Ages 12-17
Total
General
Counseling for Nutrition
Ages 3-11 Ages 12-17
Total
Counseling for Physical Activity
General
Ages 3-11 Ages 12Total
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
Page 6
Effectiveness of Care
Metropolitan Health Plan
Childhood Immunization Status
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Childhood Immunization Status
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Childhood Immunization Status
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
0
0
0
0
0
0
0
0
0
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Numerator Events by administrative Data
0
0
0
0
0
0
0
0
0
0
Numerator Events by Medical Record
0
0
0
0
0
0
0
0
0
0
Reported Rate
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Lower 95% Confidence Interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Upper 95% Confidence Interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Measurement Year
2013
Data Collection Methodology
H
Eligible Member Population
0
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
0
0
0
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
0
HEDIS 2014 (Reporting Year 2013)
Influenza
Page 9
Effectiveness of Care
Metropolitan Health Plan
Childhood Immunization Status
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
0
0
0
0
0
0
0
0
0
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Numerator Events by administrative Data
0
0
0
0
0
0
0
0
0
0
Numerator Events by Medical Record
0
0
0
0
0
0
0
0
0
0
Reported Rate
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Lower 95% Confidence Interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Upper 95% Confidence Interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Measurement Year
2013
Data Collection Methodology
H
Eligible Member Population
0
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
0
0
0
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
0
HEDIS 2014 (Reporting Year 2013)
Page 10
Effectiveness of Care
Metropolitan Health Plan
Childhood Immunization Status
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Minnesota Health Care Programs - Managed Care (MN Care)
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
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
HEDIS 2014 (Reporting Year 2013)
Page 11
Effectiveness of Care
Metropolitan Health Plan
Childhood Immunization Status
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Minnesota Health Care Programs - Managed Care (MN Care)
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
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
HEDIS 2014 (Reporting Year 2013)
Page 12
Effectiveness of Care
Metropolitan Health Plan
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Data Last Refreshed:
Jul 8, 2015 8:01 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
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
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
0
0
0
NA
NA
NA
0
NA
0
NA
0
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0.00%
0
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
0
Page 14
Effectiveness of Care
Metropolitan Health Plan
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Immunizations for Adolescents
Commercial
Minnesota Health Care Programs - Managed Care (MN Care)
General
Data Elements
Measure Data
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible
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 data records excluded
Number of employee/dependent medical 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)
Meningococcal
Tdap
Combo 1
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 15
Effectiveness of Care
Metropolitan Health Plan
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 8:01 AM
Commercial
NR
NR
NR
Medicare
Advantage
NR
NR
NR
MSHO
MA Expand
F& C
2013
A
93
57
61.29%
50.85%
71.73%
2013
A
55
41
74.55%
62.12%
86.97%
MN Care
NR
NR
NR
SNBC
SNP
SNBC
Non SNP
2013
A
45
34
75.56%
61.89%
89.22%
2013
A
85
62
72.94%
62.91%
82.97%
Page 16
Effectiveness of Care
Metropolitan Health Plan
Cervical Cancer Screening
Data Elements
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Commercial
MA Expand
F& C
Measurement Year
Data Collection Methodology
Eligible Member Population
2013
H
493
Numerator Events by Admin Data on Eligible
Population (before exclusions)
196
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
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)
39.76%
411
5.00%
432
173
40.05%
11
8
1
MN Care
NR
NR
0
NR
NR
NR
12
411
169
54
54.26%
49.32%
59.20%
NR
NR
NR
Page 17
Effectiveness of Care
Metropolitan Health Plan
Colorectal Cancer Screening
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Data Elements
Commercial
Medicare
Advantage
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
Number of numerator events by administrative data in eligible population
(before exclusions)
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)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
2013
H
226
SNBC
SNP
2013
H
131
60
49
26.55%
225
0.00%
225
60
26.67%
0
0
0
0
0
225
60
55
51.11%
44.36%
57.87%
37.40%
130
0.00%
130
49
37.69%
0
0
0
0
0
130
49
20
53.08%
44.11%
62.04%
MSHO
SNBC
Non SNP
NR
NR
NR
NR
NR
Page 18
Effectiveness of Care
Metropolitan Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
0
NR
NR
NR
19
19
NA
NA
NA
19
19
NA
NA
NA
2013
A
Page 20
Effectiveness of Care
Metropolitan Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
General
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)
Ages 16-20
NR
NR
NR
Ages 21-24
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 21
Effectiveness of Care
Metropolitan Health Plan
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 8:01 AM
Medicare
Advantage
NR
NR
NR
MSHO
2013
A
518
388
74.90%
71.07%
78.73%
Page 22
Effectiveness of Care
Metropolitan Health Plan
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Human Papillomavirus Vaccine for Female Adolescents
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
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
MA Expand F & C
2013
H
0
MN Care
0
NR
NA
NR
NR
0
0.00%
0
0
NA
NR
Records Excluded because of Valid Data
Errors
0
Number of administrative data records
excluded
0
Number of medical record data records
excluded
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
0
0
0
0
Reported Rate
NR
NA
NR
Lower 95% Confidence Interval
NR
NA
NR
Upper 95% Confidence Interval
NR
NA
NR
HEDIS 2014 (Reporting Year 2013)
Page 23
Effectiveness of Care
Metropolitan Health Plan
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Care for Older Adults
MSHO
Medication Review
Functional
Status
Assessment
Pain
Screening
0
3
0
0
0.00%
0.52%
0.00%
0.00%
0
0.00%
1
0.23%
0
0.00%
0
0.00%
0
340
1
376
0
339
0
338
Reported Rate
82.73%
91.73%
82.48%
82.24%
Lower 95% Confidence Interval
78.95%
88.94%
78.69%
78.42%
Upper 95% Confidence Interval
86.50%
94.51%
86.28%
86.06%
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General Measure
Data
2013
H
582
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
411
Page 24
Effectiveness of Care
Metropolitan Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jul 8, 2015 8:01 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
9
NA
NA
NA
10
NA
NA
NA
2013
A
10
Page 26
Effectiveness of Care
Metropolitan Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jul 8, 2015 8:01 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
11
NA
NA
NA
11
NA
NA
NA
2013
A
11
Page 27
Effectiveness of Care
Metropolitan Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jul 8, 2015 8:01 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
35
71.43%
57.76%
85.10%
43
87.76%
77.56%
97.95%
2013
49
Page 28
Effectiveness of Care
Metropolitan Health Plan
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 8:01 AM
MSHO
SNBC
SNP
SNBC Non
SNP
2013
A
12
2
NA
NA
NA
2013
A
6
5
NA
NA
NA
2013
A
11
7
NA
NA
NA
Page 29
Effectiveness of Care
Metropolitan Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
0
0
NR
NR
NR
0
0
0
NR
NR
NR
31
28
13
90.32%
78.30%
100.00%
22
15
16
NA
NA
NA
53
43
29
81.13%
69.66%
92.61%
2013
A
Page 31
Effectiveness of Care
Metropolitan Health Plan
Use of Appropriate Medications for People with Asthma
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
General
Ages 5-11
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Number of required exclusions
NR
Reported Rate
NR
Lower 95% Confidence Interval
NR
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:01 AM
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 32
Effectiveness of Care
Metropolitan Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jul 8, 2015 8:01 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
20
0
74.07%
0.00%
19
0
73.08%
0.00%
19
3
0
14
NA
NA
NA
NA
NA
NA
2013
H
27
26
0.00%
26
0
0
0
26
Page 35
Effectiveness of Care
Metropolitan Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jul 8, 2015 8:01 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 36
Effectiveness of Care
Metropolitan Health Plan
Controlling High Blood Pressure
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Medicare
Advantage
MSHO
SNBC-SNP
SNBC
Non SNP
MA Expand
F&C
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2013
H
270
2013
H
103
2013
H
641
2013
H
449
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
0
0
0
0.00%
224
0.00%
224
0.00%
96
0.00%
96
0.00%
411
5.00%
432
0.00%
411
0.00%
432
0
0.00%
0
0.00%
0
0.00%
0
0.00%
Records Excluded because of Valid Data
Errors
0
0
0
0
Number of records excluded because of
false positive diagnoses
0
0
0
0
Number of administrative data records
excluded
47
7
69
9
Number of medical record data records
excluded
0
0
0
0
Number of employee/dependent medical
records excluded
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
224
0
162
72.32%
66.24%
78.40%
0
96
0
63
65.63%
55.60%
75.65%
0
411
0
268
65.21%
60.48%
69.93%
0
411
0
241
58.64%
53.75%
63.52%
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
MN Care
NR
NR
NR
NR
NR
Page 37
Effectiveness of Care
Metropolitan Health Plan
Persistence of Beta Blocker Treatment After Heart Attack
Data Elements
Commercial
Data Last Refreshed:
Jul 8, 2015 8:01 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
2013
A
0
2013
A
0
2013
A
0
2013
A
1
0
0
0
0
NR
NR
NR
NR
NR
NR
NR
NR
NR
NA
NA
NA
MN Care
NR
NR
NR
Page 38
Effectiveness of Care
Metropolitan Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jul 8, 2015 8:01 AM
MSHO
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2013
H
100
2013
H
100
2013
H
100
2013
H
100
2013
H
100
2013
H
100
2013
H
100
0
0.00%
98
0%
98
0
0.00%
61
61.00%
98
0%
98
60
61.22%
83
83.00%
98
0%
98
80
81.63%
0
0.00%
98
0%
98
0
0.00%
88
88.00%
98
0%
98
87
88.78%
0
0.00%
98
0%
98
0
0.00%
0
0.00%
98
0%
98
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
98
88
4
93.88%
88.62%
99.13%
0
98
11
12
23.47%
14.57%
32.37%
0
98
0
69
70.41%
60.86%
79.96%
0
98
60
13
74.49%
65.35%
83.63%
0
98
76
11
88.78%
82.02%
95.54%
0
98
0
60
61.22%
51.07%
71.38%
0
98
87
2
90.82%
84.59%
97.04%
0
98
0
76
77.55%
68.78%
86.32%
0
98
0
67
68.37%
58.65%
78.08%
HbA1c
Testing
Poor HbA1c
Control
2013
H
100
2013
H
100
91
91.00%
98
0%
98
91
92.86%
100
100.00%
98
0%
98
23
23.47%
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
Metropolitan Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jul 8, 2015 8:01 AM
SNBC - SNP
HbA1c
Testing
Poor HbA1c
Control
2013
H
81
2013
H
81
69
85.19%
80
0%
80
68
85.00%
81
100.00%
80
0%
80
28
35.00%
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%)
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
81
2013
H
81
2013
H
81
2013
H
81
2013
H
81
2013
H
81
2013
H
81
0
0.00%
80
0%
80
0
0.00%
44
54.32%
80
0%
80
44
55.00%
63
77.78%
80
0%
80
61
76.25%
0
0.00%
80
0%
80
0
0.00%
69
85.19%
80
0%
80
69
86.25%
0
0.00%
80
0%
80
0
0.00%
0
0.00%
80
0%
80
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
80
0
80
13
15
35.00%
23.92%
46.08%
0
80
0
47
58.75%
47.34%
70.16%
0
80
44
12
70.00%
59.33%
80.67%
0
80
57
9
82.50%
73.55%
91.45%
0
80
0
50
62.50%
51.27%
73.73%
0
80
69
0
86.25%
78.08%
94.42%
0
80
0
63
78.75%
69.16%
88.34%
0
80
0
46
57.50%
46.04%
68.96%
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
Metropolitan Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
466
2013
H
466
2013
H
466
2013
H
466
2013
H
466
2013
H
466
2013
H
466
0
0.00%
411
5%
432
0
0.00%
222
47.64%
411
5%
432
206
47.69%
299
64.16%
411
5%
432
269
62.27%
0
0.00%
411
5%
432
0
0.00%
341
73.18%
411
5%
432
321
74.31%
0
0.00%
411
5%
432
0
0.00%
0
0.00%
411
5%
432
0
0.00%
0
0
0
0
0
0
0
0
1
1
1
1
1
1
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
411
283
89
90.51%
87.56%
93.47%
8
411
63
79
34.55%
29.83%
39.27%
8
411
0
230
55.96%
51.04%
60.88%
8
411
195
49
59.37%
54.50%
64.24%
8
411
228
101
80.05%
76.06%
84.03%
8
411
0
202
49.15%
44.19%
54.10%
8
411
308
28
81.75%
77.90%
85.61%
8
411
0
303
73.72%
69.35%
78.10%
8
411
0
197
47.93%
42.98%
52.88%
HbA1c
Testing
Poor HbA1c
Control
2013
H
466
2013
H
466
365
78.33%
411
5%
432
340
78.70%
466
100.00%
411
5%
432
149
34.49%
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
Metropolitan Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
222
2013
H
222
H
197
88.74%
221
0%
221
196
88.69%
222
100.00%
221
0%
221
69
31.22%
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
222
2013
H
222
2013
H
222
2013
H
222
2013
H
222
2013
H
222
2013
H
222
0
0.00%
221
0%
221
0
0.00%
109
49.10%
221
0%
221
108
48.87%
160
72.07%
221
0%
221
156
70.59%
0
0.00%
221
0%
221
0
0.00%
185
83.33%
221
0%
221
185
83.71%
0
0.00%
221
0%
221
0
0.00%
0
0.00%
221
0%
221
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
221
189
13
91.40%
87.48%
95.32%
0
221
22
47
31.22%
24.89%
37.56%
0
221
0
124
56.11%
49.34%
62.88%
0
221
108
35
64.71%
58.18%
71.23%
0
221
146
28
78.73%
73.11%
84.35%
0
221
0
93
42.08%
35.35%
48.82%
0
221
185
5
85.97%
81.17%
90.78%
0
221
0
154
69.68%
63.40%
75.97%
0
221
0
88
39.82%
33.14%
46.50%
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
Metropolitan Health Plan
Comprehensive Diabetes Care
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
HbA1c
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
NR
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
NR
Admin rate on FSS
Number of Records Excluded Because of
Number of administrative data records
Number of medical record data records
Number of employee/dependent medical
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
NR
Reported Rate
NR
Lower 95% Confidence Interval
NR
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Poor HbA1c
Good HbA1c
Adequate
Eye Exam
LDL-C
LDL-C Level Monitoring for
Blood
Blood
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
Page 45
Effectiveness of Care
Metropolitan Health Plan
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 8:01 AM
Medicare
Advantage
NR
NR
NR
Page 46
Effectiveness of Care
Metropolitan Health Plan
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 8:01 AM
MSHO
2013
A
11
1
NA
NA
NA
Page 47
Effectiveness of Care
Metropolitan Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jul 8, 2015 8:01 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
10
8
NA
NA
NA
7
NA
NA
NA
Page 50
Effectiveness of Care
Metropolitan Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jul 8, 2015 8:01 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
160
78
48.75%
40.69%
56.81%
69
43.13%
35.14%
51.11%
Page 52
Effectiveness of Care
Metropolitan Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jul 8, 2015 8:01 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
240
140
58.33%
51.89%
64.78%
97
40.42%
34.00%
46.83%
Page 53
Effectiveness of Care
Metropolitan Health Plan
Antidepressant Medication Management
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements
General
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 8:01 AM
Effective Acute
Effective
NR
NR
NR
NR
NR
NR
Page 54
Effectiveness of Care
Metropolitan Health Plan
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
0
NA
NA
NA
0
0
NA
NA
NA
2013
A
Page 56
Effectiveness of Care
Metropolitan Health Plan
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
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 8:01 AM
Initiation
Continuation
NR
NR
NR
NR
NR
NR
Page 57
Effectiveness of Care
Metropolitan Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jul 8, 2015 8:01 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
10
NA
NA
NA
6
NA
NA
NA
2013
A
11
Page 59
Effectiveness of Care
Metropolitan Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jul 8, 2015 8:01 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
15
NA
NA
NA
5
NA
NA
NA
2013
A
28
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
97
57.74%
49.97%
65.51%
43
25.60%
18.70%
32.49%
2013
A
168
Page 61
Effectiveness of Care
Metropolitan Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jul 8, 2015 8:01 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
293
272
92.83%
89.71%
95.96%
5
5
NA
NA
NA
239
229
95.82%
93.07%
98.56%
16
14
NA
NA
NA
553
520
94.03%
91.97%
96.10%
2013
A
Page 64
Effectiveness of Care
Metropolitan Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jul 8, 2015 8:01 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
82
74
90.24%
83.21%
97.28%
0
0
NA
NA
NA
76
73
96.05%
91.02%
100.00%
21
16
NA
NA
NA
179
163
91.06%
86.60%
95.52%
2013
A
Page 65
Effectiveness of Care
Metropolitan Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jul 8, 2015 8:01 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
317
292
92.11%
88.99%
95.24%
2
2
NA
NA
NA
298
272
91.28%
87.90%
94.65%
68
51
75.00%
63.97%
86.03%
685
617
90.07%
87.76%
92.39%
2013
A
Page 66
Effectiveness of Care
Metropolitan Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jul 8, 2015 8:01 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
271
231
85.24%
80.83%
89.65%
2
2
NA
NA
NA
243
207
85.19%
80.51%
89.86%
20
16
NA
NA
NA
536
456
85.07%
81.96%
88.18%
2013
A
Page 67
Effectiveness of Care
Metropolitan Health Plan
Annual Monitoring for Patients on Persistent Medications
Minnesota Health Care Programs - Managed Care (MN Care)
General
Data Elements
Measure
Measurement Year
Data Collection Methodology
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 8:01 AM
ACE Inhibitors
NR
NR
Annual Monitoring for Members on
Digoxin
Diuretics
Anti-
NR
NR
NR
NR
NR
NR
Total
NR
NR
Page 68
Access/Availability of Care
Metropolitan Health Plan
Medication Reconciliation Post Discharge
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jul 8, 2015 8:01 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
31
4
12.90%
0.00%
26.32%
103
40
38.83%
28.94%
48.73%
2013
A
6
4
NA
NA
NA
66
32
48.48%
35.67%
61.30%
Page 71
Effectiveness of Care
Metropolitan Health Plan
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jul 8, 2015 8:01 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
582
At least 1
Prescription
At least 2
Prescriptions
155
26.63%
22.96%
30.31%
35
6.01%
4.00%
8.03%
Page 73
Access/Availability of Care
Metropolitan Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
586
586
0
0
569
NA
NA
NA
NA
NA
NA
97.10%
95.65%
98.54%
569
97.10%
95.65%
98.54%
2013
A
Page 76
Access/Availability of Care
Metropolitan Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
62
234
13
309
59
229
13
95.16%
89.01%
100.00%
97.86%
95.80%
99.93%
NA
NA
NA
301
97.41%
95.48%
99.34%
2013
A
Page 77
Access/Availability of Care
Metropolitan Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
798
1408
65
2271
725
1347
63
90.85%
88.79%
92.92%
95.67%
94.57%
96.77%
96.92%
91.96%
100.00%
2135
94.01%
93.01%
95.01%
2013
A
Page 78
Access/Availability of Care
Metropolitan Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
897
1151
2
2050
703
994
1
78.37%
75.62%
81.12%
86.36%
84.33%
88.39%
NA
NA
NA
1698
82.83%
81.17%
84.49%
2013
A
Page 79
Access/Availability of Care
Metropolitan Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Minnesota Health Care Programs - Managed Care (MN Care)
General Measure
Data Elements
Measurement Year
Data collection methodology
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 8:01 AM
Ages 20-44
NR
NR
NR
Ages 45-64
NR
NR
NR
Ages 65+
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 80
Access/Availability of Care
Metropolitan Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jul 8, 2015 8:01 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.
0
0
0
0
0
0
0
0
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
2013
A
Page 82
Access/Availability of Care
Metropolitan Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Minnesota Health Care Programs - Managed Care (MN Care)
General Measure
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)
Data Last Refreshed:
Jul 8, 2015 8:01 AM
12-24 months
25 months -
7-11 yrs.
12-19 yrs.
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 83
Access/Availability of Care
Metropolitan Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:01 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
24
0
NA
NA
NA
5
NA
NA
NA
24
0
NA
NA
NA
5
NA
NA
NA
0
NA
NA
NA
Page 86
Access/Availability of Care
Metropolitan Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:01 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
100
100
0
NA
NA
NA
25
25.00%
16.01%
33.99%
7
7.00%
1.50%
12.50%
25
25.00%
16.01%
33.99%
7
7.00%
1.50%
12.50%
Page 87
Access/Availability of Care
Metropolitan Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:01 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
550
0
NA
NA
NA
150
27.27%
23.46%
31.09%
550
29
5.27%
3.31%
7.23%
150
27.27%
23.46%
31.09%
29
5.27%
3.31%
7.23%
Page 88
Access/Availability of Care
Metropolitan Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
0
NA
NA
NA
Total
Initiation of Engagement
755
0
NA
NA
NA
222
29.40%
26.09%
32.72%
755
58
7.68%
5.72%
9.65%
222
29.40%
26.09%
32.72%
58
7.68%
5.72%
9.65%
Page 89
Access/Availability of Care
Metropolitan Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jul 8, 2015 8:01 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
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 90
Access/Availability of Care
Metropolitan Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Minnesota Health Care Programs - Managed Care (MA Expand F&C)
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)
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)
Timeliness of
Prenatal Care
Postpartum
Care
2013
H
1
2013
H
1
0
0
0.00%
0
0.00%
0
0
0.00%
0
0.00%
0
0
NA
NA
0
0
0
0
1
0
0
0
0
1
0
NA
NA
NA
NA
NA
NA
Page 92
Access/Availability of Care
Metropolitan Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
Postpartum
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 93
Use of Services
Metropolitan Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
NR
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0.00%
0
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
0
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
0
Page 95
Use of Services
Metropolitan Health Plan
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
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
NR
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
NR
Administrative rate on FSS
Number of Records Excluded Because of
Number of employee/dependent medical
Additional Records Added from the
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
NR
Reported Rate
NR
Lower 95% Confidence Interval
NR
Upper 95% Confidence Interval
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:01 AM
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
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 96
Use of Services
Metropolitan Health Plan
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Commercial
Measurement Year
Data Collection Methodology
Eligible Member Population
HEDIS 2014 (Reporting Year 2013)
MN Care
0
NR
NA
0
0.00%
0
0
NR
NR
NA
0
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
MA Expand
F&C
2013
H
0
Numerator events by admin data in eligible
population
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
Data Last Refreshed:
Jul 8, 2015 8:01 AM
0
NR
NR
NR
0
0
0
0
NA
NA
NA
NR
NR
NR
Page 97
Use of Services
Metropolitan Health Plan
Adolescent Well-Care Visits
Data Elements
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Commercial
Measurement Year
Data Collection Methodology
Eligible Member Population
0
NR
NA
0
0.00%
0
0
NR
NR
NA
0
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)
MN Care
2013
H
0
Numerator events by admin data in eligible
population
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
MA Expand
F&C
0
NR
NR
NR
0
0
0
0
NA
NA
NA
NR
NR
NR
Page 98
Use of Services
Metropolitan Health Plan
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
3323
3186
1163
0
7672
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
0
2957
2955
855
0
6767
HEDIS 2014 (Reporting Year 2013)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
889.86
927.50
735.17
882.04
Emergency Room Visits
Visits
0
0
0
0
0
224
202
44
0
470
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
67.41
63.40
37.83
61.26
Page 101
Use of Services
Metropolitan Health Plan
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
854
2989
140
0
0
0
3983
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
516
2652
110
0
0
0
3278
HEDIS 2014 (Reporting Year 2013)
Visits/ 1,000
Member
Months
NA
NA
NA
604.22
887.25
785.71
NA
NA
823.00
Emergency Room Visits
Visits
0
0
0
178
405
19
0
0
0
602
Visits/ 1,000
Member
Months
NA
NA
NA
208.43
135.50
135.71
NA
NA
151.14
Page 102
Use of Services
Metropolitan Health Plan
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
401
13696
20793
706
0
0
0
35596
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
86
6437
15306
626
0
0
0
22455
HEDIS 2014 (Reporting Year 2013)
Visits/ 1,000
Member
Months
NA
NA
214.46
469.99
736.11
886.69
NA
NA
630.83
Emergency Room Visits
Visits
0
0
33
1916
2596
59
0
0
0
4604
Visits/ 1,000
Member
Months
NA
NA
82.29
139.89
124.85
83.57
NA
NA
129.34
Page 103
Use of Services
Metropolitan Health Plan
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
0
0
46286
27802
13
0
0
0
74101
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
12159
14731
11
0
0
0
26901
HEDIS 2014 (Reporting Year 2013)
Visits/ 1,000
Member
Months
NA
NA
NA
262.69
529.85
846.15
NA
NA
363.03
Emergency Room Visits
Visits
0
0
0
5468
2728
0
0
0
0
8196
Visits/ 1,000
Member
Months
NA
NA
NA
118.14
98.12
0.00
NA
NA
110.61
Page 104
Use of Services
Metropolitan Health Plan
Ambulatory Care
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Minnesota Health Care Programs - Managed Care (MN Care)
Member Months
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
NR
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
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2014 (Reporting Year 2013)
NR
Emergency Room Visits
Visits
Visits/ 1,000
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 105
Use of Services
Metropolitan Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
3323
3186
1163
0
7672
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
128
126
39
0
293
NA
NA
NA
NA
NA
38.52
39.55
33.53
0
0
0
0
0
113
110
37
0
260
NA
NA
NA
NA
NA
34.01
34.53
31.81
0
0
0
0
0
15
16
2
0
33
NA
NA
NA
NA
NA
4.51
5.02
1.72
0
0
0
0
0
NA
NA
NA
HEDIS 2014 (Reporting Year 2013)
38.19
33.89
4.30
NA
Days
0
0
0
0
0
617
697
209
0
1523
0
0
0
0
0
509
492
195
0
1196
Days / 1,000
Member
Months
NA
NA
NA
NA
NA
185.68
218.77
179.71
198.51
NA
NA
NA
NA
NA
153.17
154.43
167.67
155.89
0
0
0
0
0
108
205
14
0
327
NA
NA
NA
NA
NA
32.50
64.34
12.04
0
0
0
0
0
NA
NA
NA
42.62
NA
Average
Length of Stay
NA
NA
NA
NA
NA
4.82
5.53
5.36
NA
5.20
NA
NA
NA
NA
NA
4.50
4.47
5.27
NA
4.60
NA
NA
NA
NA
NA
7.20
12.81
7.00
NA
9.91
NA
NA
NA
NA
NA
Page 108
Use of Services
Metropolitan Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
854
2989
140
0
0
0
3983
Discharges
Discharges /
1,000 Member
Months
0
0
0
20
90
5
0
0
0
115
NA
NA
NA
23.42
30.11
35.71
NA
NA
0
0
0
18
63
5
0
0
0
86
NA
NA
NA
21.08
21.08
35.71
NA
NA
0
0
0
2
27
0
0
0
0
29
NA
NA
NA
2.34
9.03
0.00
NA
NA
0
0
0
0
0
NA
0.00
0.00
HEDIS 2014 (Reporting Year 2013)
28.87
21.59
7.28
0.00
Days
Days / 1,000
Member
Months
0
0
0
119
392
11
0
0
0
522
NA
NA
NA
139.34
131.15
78.57
NA
NA
0
0
0
108
261
11
0
0
0
380
NA
NA
NA
126.46
87.32
78.57
NA
NA
0
0
0
11
131
0
0
0
0
142
NA
NA
NA
12.88
43.83
0.00
NA
NA
0
0
0
0
0
NA
0.00
0.00
131.06
95.41
35.65
0.00
Average
Length of Stay
NA
NA
NA
5.95
4.36
2.20
NA
NA
NA
4.54
NA
NA
NA
6.00
4.14
2.20
NA
NA
NA
4.42
NA
NA
NA
5.50
4.85
NA
NA
NA
NA
4.90
NA
NA
NA
NA
NA
Page 109
Use of Services
Metropolitan Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
401
13696
20793
706
0
0
0
35596
Discharges
Discharges /
1,000 Member
Months
0
0
1
221
545
20
0
0
0
787
NA
NA
2.49
16.14
26.21
28.33
NA
NA
0
0
0
149
395
16
0
0
0
560
NA
NA
0.00
10.88
19.00
22.66
NA
NA
0
0
0
37
148
4
0
0
0
189
NA
NA
0.00
2.70
7.12
5.67
NA
NA
1
35
2
0
38
2.49
2.56
0.10
HEDIS 2014 (Reporting Year 2013)
22.11
15.73
5.31
1.09
Days
Days / 1,000
Member
Months
0
0
1
918
2269
60
0
0
0
3248
NA
NA
2.49
67.03
109.12
84.99
NA
NA
0
0
0
594
1340
41
0
0
0
1975
NA
NA
0.00
43.37
64.44
58.07
NA
NA
0
0
0
211
925
19
0
0
0
1155
NA
NA
0.00
15.41
44.49
26.91
NA
NA
1
113
4
0
118
2.49
8.25
0.19
91.25
55.48
32.45
3.38
Average
Length of Stay
NA
NA
1.00
4.15
4.16
3.00
NA
NA
NA
4.13
NA
NA
NA
3.99
3.39
2.56
NA
NA
NA
3.53
NA
NA
NA
5.70
6.25
4.75
NA
NA
NA
6.11
1.00
3.23
2.00
NA
3.11
Page 110
Use of Services
Metropolitan Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
0
0
46286
27802
13
0
0
0
74101
Discharges
Discharges /
1,000 Member
Months
0
0
0
362
423
1
0
0
0
786
NA
NA
NA
7.82
15.21
76.92
NA
NA
0
0
0
266
296
1
0
0
0
563
NA
NA
NA
5.75
10.65
76.92
NA
NA
0
0
0
75
123
0
0
0
0
198
NA
NA
NA
1.62
4.42
0.00
NA
NA
0
21
4
0
25
NA
0.45
0.14
HEDIS 2014 (Reporting Year 2013)
10.61
7.60
2.67
0.34
Days
Days / 1,000
Member
Months
0
0
0
1317
1906
3
0
0
0
3226
NA
NA
NA
28.45
68.56
230.77
NA
NA
0
0
0
824
1089
3
0
0
0
1916
NA
NA
NA
17.80
39.17
230.77
NA
NA
0
0
0
446
799
0
0
0
0
1245
NA
NA
NA
9.64
28.74
0.00
NA
NA
0
47
18
0
65
NA
1.02
0.65
43.54
25.86
16.80
0.88
Average
Length of Stay
NA
NA
NA
3.64
4.51
3.00
NA
NA
NA
4.10
NA
NA
NA
3.10
3.68
3.00
NA
NA
NA
3.40
NA
NA
NA
5.95
6.50
NA
NA
NA
NA
6.29
NA
2.24
4.50
NA
2.60
Page 111
Use of Services
Metropolitan Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Minnesota Health Care Programs - Managed Care (MN Care)
Age
Member Months
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
NR
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
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
NR
Average
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Days / 1,000
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 112
Use of Services
Metropolitan Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
2988
0
2988
0
0
0
0
0
4684
0
4684
0
0
0
0
0
7672
0
7672
0
0
0
0
0
2988
0
2988
0
0
0
0
0
4684
0
4684
0
0
0
0
0
7672
0
7672
0
0
0
0
0
2988
0
2988
0
0
0
0
0
4684
0
4684
0
0
0
0
0
7672
0
7672
0
0
0
0
0
2988
0
2988
0
0
0
0
0
4684
0
4684
0
0
0
0
0
7672
0
7672
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
35
16
51
0
0
0
35
16
51
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
14.06%
4.10%
7.98%
NA
NA
NA
14.06%
4.10%
7.98%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
5
19
0
0
0
14
5
19
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
5.62%
1.28%
2.97%
NA
NA
NA
5.62%
1.28%
2.97%
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
NA
NA
NA
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
28
14
42
0
0
0
28
14
42
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
11.24%
3.59%
6.57%
NA
NA
NA
11.24%
3.59%
6.57%
HEDIS 2014 (Reporting Year 2013)
Page 115
Use of Services
Metropolitan Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
155
2087
92
0
2334
0
0
22
146
1433
48
0
1649
0
0
22
301
3520
140
0
3983
0
0
0
155
2087
92
0
2334
0
0
22
146
1433
48
0
1649
0
0
22
301
3520
140
0
3983
0
0
0
155
2087
92
0
2334
0
0
22
146
1433
48
0
1649
0
0
22
301
3520
140
0
3983
0
0
0
155
2087
92
0
2334
0
0
22
146
1433
48
0
1649
0
0
22
301
3520
140
0
3983
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
7
5
12
94
40
134
2
1
3
0
0
0
103
46
149
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
54.19%
41.10%
47.84%
54.05%
33.50%
45.68%
26.09%
25.00%
25.71%
NA
NA
NA
52.96%
33.47%
44.89%
0
0
0
0
0
0
0
0
0
4
1
5
26
3
29
2
0
2
0
0
0
32
4
36
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
30.97%
8.22%
19.93%
14.95%
2.51%
9.89%
26.09%
0.00%
17.14%
NA
NA
NA
16.45%
2.91%
10.85%
0
0
0
0
0
0
0
0
0
0
0
0
1
2
3
0
0
0
0
0
0
1
2
3
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.57%
1.67%
1.02%
0.00%
0.00%
0.00%
NA
NA
NA
0.51%
1.46%
0.90%
0
0
0
0
0
0
0
0
0
5
5
10
87
38
125
1
1
2
0
0
0
93
44
137
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
38.71%
41.10%
39.87%
50.02%
31.82%
42.61%
13.04%
25.00%
17.14%
NA
NA
NA
47.81%
32.02%
41.28%
HEDIS 2014 (Reporting Year 2013)
Page 116
Use of Services
Metropolitan Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
1494
2959
14690
420
0
19563
0
0
984
2567
12196
286
0
16033
0
0
2478
5526
26886
706
0
35596
0
0
1494
2959
14690
420
0
19563
0
0
984
2567
12196
286
0
16033
0
0
2478
5526
26886
706
0
35596
0
0
1494
2959
14690
420
0
19563
0
0
984
2567
12196
286
0
16033
0
0
2478
5526
26886
706
0
35596
0
0
1494
2959
14690
420
0
19563
0
0
984
2567
12196
286
0
16033
0
0
2478
5526
26886
706
0
35596
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
24
14
38
65
34
99
504
249
753
9
2
11
0
0
0
602
299
901
NA
NA
NA
NA
NA
NA
19.28%
17.07%
18.40%
26.36%
15.89%
21.50%
41.17%
24.50%
33.61%
25.71%
8.39%
18.70%
NA
NA
NA
36.93%
22.38%
30.37%
0
0
0
0
0
0
6
3
9
24
16
40
142
70
212
3
1
4
0
0
0
175
90
265
NA
NA
NA
NA
NA
NA
4.82%
3.66%
4.36%
9.73%
7.48%
8.69%
11.60%
6.89%
9.46%
8.57%
4.20%
6.80%
NA
NA
NA
10.73%
6.74%
8.93%
0
0
0
0
0
0
0
0
0
1
0
1
7
8
15
1
0
1
0
0
0
9
8
17
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.41%
0.00%
0.22%
0.57%
0.79%
0.67%
2.86%
0.00%
1.70%
NA
NA
NA
0.55%
0.60%
0.57%
0
0
0
0
0
0
18
12
30
49
31
80
469
227
696
8
1
9
0
0
0
544
271
815
NA
NA
NA
NA
NA
NA
14.46%
14.63%
14.53%
19.87%
14.49%
17.37%
38.31%
22.34%
31.06%
22.86%
4.20%
15.30%
NA
NA
NA
33.37%
20.28%
27.47%
HEDIS 2014 (Reporting Year 2013)
Page 117
Use of Services
Metropolitan Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
0
6750
17294
31805
12
55861
0
0
2673
5019
10547
1
18240
0
0
9423
22313
42352
13
74101
0
0
6750
17294
31805
12
55861
0
0
2673
5019
10547
1
18240
0
0
9423
22313
42352
13
74101
0
0
6750
17294
31805
12
55861
0
0
2673
5019
10547
1
18240
0
0
9423
22313
42352
13
74101
0
0
6750
17294
31805
12
55861
0
0
2673
5019
10547
1
18240
0
0
9423
22313
42352
13
74101
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
0
0
150
150
508
508
1159
1159
0
0
0
0
1817
NR
1817
NA
NA
NA
NA
26.67%
19.10%
35.25%
27.32%
43.73%
32.84%
0.00%
0.00%
NR
NR
39.03%
NR
29.42%
0
0
0
0
22
22
81
81
233
233
0
0
0
0
336
NR
336
NA
NA
NA
NA
3.91%
2.80%
5.62%
4.36%
8.79%
6.60%
0.00%
0.00%
NR
NR
7.22%
NR
5.44%
0
0
0
0
1
1
6
6
17
17
0
0
0
0
24
NR
24
NA
NA
NA
NA
0.18%
0.13%
0.42%
0.32%
0.64%
0.48%
0.00%
0.00%
NR
NR
0.52%
NR
0.39%
0
0
0
0
139
139
483
483
1095
1095
0
0
0
0
1717
NR
1717
NA
NA
NA
NA
24.71%
17.70%
33.51%
25.98%
41.31%
31.03%
0.00%
0.00%
NR
NR
36.88%
NR
27.81%
HEDIS 2014 (Reporting Year 2013)
Page 118
Use of Services
Metropolitan Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
Female
NR
NR
Member Months
(Inpatient)
Total
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)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Inpatient
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
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Number
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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
Female
NR
NR
Total
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 119
Use of Services
Metropolitan Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:01 AM
MSHO
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
0
2988
0
2988
0
0
0
4684
0
4684
0
0
0
7672
0
7672
0
0
0
2988
0
2988
0
0
0
4684
0
4684
0
0
0
7672
0
7672
0
0
0
2988
0
2988
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
0
4684
0
4684
0
0
0
7672
0
7672
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
0
0
0
2988
0
2988
0
0
0
4684
0
4684
0
0
0
7672
0
7672
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
0
0
0
38
82
120
0
0
0
38
82
120
NA
NA
NA
NA
NA
NA
NA
NA
NA
15.26%
21.01%
18.77%
NA
NA
NA
15.26%
21.01%
18.77%
0
0
0
0
0
0
0
0
0
5
15
20
0
0
0
5
15
20
NA
NA
NA
NA
NA
NA
NA
NA
NA
2.01%
3.84%
3.13%
NA
NA
NA
2.01%
3.84%
3.13%
0
0
0
0
0
0
0
0
0
1
2
3
0
0
0
1
2
3
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.40%
0.51%
0.47%
NA
NA
NA
0.40%
0.51%
0.47%
0
0
0
0
0
0
0
0
0
36
75
111
0
0
0
36
75
111
NA
NA
NA
NA
NA
NA
NA
NA
NA
14.46%
19.21%
17.36%
NA
NA
NA
14.46%
19.21%
17.36%
HEDIS 2014 (Reporting Year 2013)
Page 122
Use of Services
Metropolitan Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:01 AM
SNBC-SNP
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
2242
92
0
2334
0
0
1601
48
0
1649
0
0
3843
140
0
3983
0
0
2242
92
0
2334
0
0
1601
48
0
1649
0
0
3843
140
0
3983
0
0
2242
92
0
2334
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
1601
48
0
1649
0
0
3843
140
0
3983
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
0
0
2242
92
0
2334
0
0
1601
48
0
1649
0
0
3843
140
0
3983
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
113
95
208
2
1
3
0
0
0
115
96
211
NA
NA
NA
NA
NA
NA
60.48%
71.21%
64.95%
26.09%
25.00%
25.71%
NA
NA
NA
59.13%
69.86%
63.57%
0
0
0
0
0
0
21
5
26
0
0
0
0
0
0
21
5
26
NA
NA
NA
NA
NA
NA
11.24%
3.75%
8.12%
0.00%
0.00%
0.00%
NA
NA
NA
10.80%
3.64%
7.83%
0
0
0
0
0
0
6
7
13
0
0
0
0
0
0
6
7
13
NA
NA
NA
NA
NA
NA
3.21%
5.25%
4.06%
0.00%
0.00%
0.00%
NA
NA
NA
3.08%
5.09%
3.92%
0
0
0
0
0
0
107
95
202
2
1
3
0
0
0
109
96
205
NA
NA
NA
NA
NA
NA
57.27%
71.21%
63.08%
26.09%
25.00%
25.71%
NA
NA
NA
56.04%
69.86%
61.76%
HEDIS 2014 (Reporting Year 2013)
Page 123
Use of Services
Metropolitan Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:01 AM
SNBC-Non SNP
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
19143
420
0
19563
0
0
15747
286
0
16033
0
0
34890
706
0
35596
0
0
19143
420
0
19563
0
0
15747
286
0
16033
0
0
34890
706
0
35596
0
0
19143
420
0
19563
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
15747
286
0
16033
0
0
34890
706
0
35596
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
0
0
19143
420
0
19563
0
0
15747
286
0
16033
0
0
34890
706
0
35596
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
800
688
1488
9
7
16
0
0
0
809
695
1504
NA
NA
NA
NA
NA
NA
50.15%
52.43%
51.18%
25.71%
29.37%
27.20%
NA
NA
NA
49.62%
52.02%
50.70%
0
0
0
0
0
0
108
61
169
0
0
0
0
0
0
108
61
169
NA
NA
NA
NA
NA
NA
6.77%
4.65%
5.81%
0.00%
0.00%
0.00%
NA
NA
NA
6.62%
4.57%
5.70%
0
0
0
0
0
0
44
51
95
1
0
1
0
0
0
45
51
96
NA
NA
NA
NA
NA
NA
2.76%
3.89%
3.27%
2.86%
0.00%
1.70%
NA
NA
NA
2.76%
3.82%
3.24%
0
0
0
0
0
0
785
679
1464
9
7
16
0
0
0
794
686
1480
NA
NA
NA
NA
NA
NA
49.21%
51.74%
50.35%
25.71%
29.37%
27.20%
NA
NA
NA
48.70%
51.34%
49.89%
HEDIS 2014 (Reporting Year 2013)
Page 124
Use of Services
Metropolitan Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Minnesota Health Care Programs - Managed Care(MA Expand F&C)
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
55849
12
0
55861
0
0
18239
1
0
18240
0
0
74088
13
0
74101
0
0
55849
12
0
55861
0
0
18239
1
0
18240
0
0
74088
13
0
74101
0
0
55849
12
0
55861
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
18239
1
0
18240
0
0
74088
13
0
74101
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
0
0
55849
12
0
55861
0
0
18239
1
0
18240
0
0
74088
13
0
74101
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
1538
693
2231
0
0
0
0
0
0
1538
693
2231
NA
NA
NA
NA
NA
NA
33.05%
45.59%
36.14%
0.00%
0.00%
0.00%
NA
NA
NA
33.04%
45.59%
36.13%
0
0
0
0
0
0
138
46
184
0
0
0
0
0
0
138
46
184
NA
NA
NA
NA
NA
NA
2.97%
3.03%
2.98%
0.00%
0.00%
0.00%
NA
NA
NA
2.96%
3.03%
2.98%
0
0
0
0
0
0
86
61
147
0
0
0
0
0
0
86
61
147
NA
NA
NA
NA
NA
NA
1.85%
4.01%
2.38%
0.00%
0.00%
0.00%
NA
NA
NA
1.85%
4.01%
2.38%
0
0
0
0
0
0
1492
671
2163
0
0
0
0
0
0
1492
671
2163
NA
NA
NA
NA
NA
NA
32.06%
44.15%
35.03%
0.00%
0.00%
0.00%
NA
NA
NA
32.05%
44.14%
35.03%
HEDIS 2014 (Reporting Year 2013)
Page 125
Use of Services
Metropolitan Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jul 8, 2015 8:01 AM
Minnesota Health Care Programs - Managed Care(MN Care)
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 126
Use of Services
Metropolitan Health Plan
Plan All-Cause Readmissions
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Plan All-Cause Readmissions
Data Last Refreshed:
Jul 8, 2015 8:01 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)
36
33
69
32
66
98
9
20
29
77
119
196
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)
10
6
16
5
14
19
1
4
5
16
24
40
Observed
Readmission
(Num/Den)
27.78%
18.18%
23.19%
15.63%
21.21%
19.39%
11.11%
20.00%
17.24%
20.78%
20.17%
20.41%
Average Adjusted
Probability
Total Variance
19.54%
15.93%
17.82%
15.03%
17.41%
16.63%
16.41%
14.92%
15.38%
17.30%
16.58%
16.86%
520.35%
418.17%
938.52%
389.88%
909.68%
1299.56%
122.10%
250.48%
372.58%
1032.33%
1578.33%
2610.66%
Page 128
Use of Services
Metropolitan Health Plan
Plan All-Cause Readmissions
Data Last Refreshed:
Jul 8, 2015 8:01 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)
3
0
3
0
0
0
0
0
0
3
0
3
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
66.67%
NA
66.67%
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
Metropolitan Health Plan
Plan All-Cause Readmissions
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jul 8, 2015 8:01 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
0
0
0.00%
0
0
0
0
0
0.00%
0
0.00%
692
857
622
552
206
59
0
0.00%
884
890
1097
915
563
335
0
0.00%
2988
100.00%
0
4684
100.00%
0
7672
100.00%
2988
4684
HEDIS 2014 (Reporting Year 2013)
0
0
0
0
0
0
0
0
0
1576
1747
1719
1467
769
394
0
7672
Page 136
Health Plan Descriptive Information
Metropolitan Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jul 8, 2015 8:01 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%
0
82
73
60
212
0
0.00%
22
45
101
132
127
0
0.00%
427
18.29%
467
607
446
295
427
25.89%
293
357
348
176
854
21.44%
1815
77.76%
92
0
0
0
0
0
1174
71.19%
48
0
0
0
0
0
2989
75.04%
92
3.94%
0
48
2.91%
0
140
3.51%
2334
1649
HEDIS 2014 (Reporting Year 2013)
22
127
174
192
339
760
964
794
471
140
0
0
0
0
0
0
3983
Page 137
Health Plan Descriptive Information
Metropolitan Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jul 8, 2015 8:01 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
Metropolitan Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jul 8, 2015 8:01 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
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%
6750
9729
7565
5412
6192
0
0.00%
2673
3148
1871
1275
1671
0
0.00%
35648
63.82%
7004
6938
4188
2071
10638
58.32%
2197
2436
1900
1068
46286
62.46%
20201
36.16%
12
0
0
0
0
0
7601
41.67%
1
0
0
0
0
0
27802
37.52%
12
0.02%
0
1
0.01%
0
13
0.02%
55861
18240
HEDIS 2014 (Reporting Year 2013)
9423
12877
9436
6687
7863
9201
9374
6088
3139
13
0
0
0
0
0
0
74101
Page 139
Health Plan Descriptive Information
Metropolitan Health Plan
Enrollment by Product Line (Age & Sex)
Minnesota Health Care Programs - Managed Care (MN Care)
Member Months
Male
Female
<1
1-4
5-9
10-14
15-17
18-19
NR
NR
0-19 Subtotal
NR
NR
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
NR
NR
20-44 Subtotal
NR
NR
20-44 Subtotal: %
45-49
50-54
55-59
60-64
NR
NR
45-64 Subtotal
NR
NR
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
NR
NR
>=65 Subtotal
NR
NR
>=65 Subtotal: %
Age Unknown
NR
NR
Total
HEDIS 2014 (Reporting Year 2013)
Data Last Refreshed:
Jul 8, 2015 8:01 AM
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
Page 140