Prime West
General Info
Disclaimers
HEDIS 2013 (Reporting Year 2012)
Page
Data Last Refreshed: 11/15/2013
2
Effectiveness of Care Measures
Code
Effectiveness of Care Measures
Code
Prevention and Screening
Page
Medication Management
Page
26 MPM
Annual Monitoring for Patients on Persistent Medications
48
ABA
Adult BMI Assessment
3
27 MRP
Medication Reconciliation Post Discharge
53
WCC
Weight Assessment and Counseling for Nutrition and Physical Activity for
Children/Adolescents
4
DDE
Potentially Harmful Drug-Disease Interactions in the Elderly
54
CIS
Childhood Immunization Status
6
Use of High Risk Medications in the Elderly
56
IMA
Immunizations for Adolescents
10
28
29 DAE
Access / Availability of Care Measures
BCS
Breast Cancer Screening
12
0 Code
CCS
Cervical Cancer Screening
13
30 AAP
Adult's Access to Preventive/Ambulatory Health Services
58
COL
Colorectal Cancer Screening
14
31 CAP
Children's and Adolescents' Access to Primary Care Practitioners
63
CHL
Chlamydia Screening in Women
15
32
GSO
Glaucoma Screening in Older Adults
17
33 PPC
LSC
Lead Screening in Children
18
34
COA
Care for Older Adults
19
Respiratory Conditions
PCE
Pharmacotherapy Management of COPD Exacerbation
20
SPR
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
23
Use of Appropriate Medications for People with Asthma
24
ASM
Cardiovascular
IET
Page
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
65
Prenatal and Postpartum Care
70
Use of Services Measures
0 Code
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
74
Adolescent Well-Care Visits
75
36
AWC
72
Ambulatory Care
76
38
IPU
Inpatient Utilization - General Hospital/Acute Care
81
IAD
Identification of Alcohol and Other Drug Services
86
37 AMB
CMC
Cholesterol Management for Patients with Cardiovascular Conditions
26
39
CBP
Controlling High Blood Pressure
29
40 MPT
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services 91
Persistence of Beta Blocker Treatment After Heart Attack
30
41 PCR
Plan All-Cause Readmissions
PBH
Diabetes
CDC
Comprehensive Diabetes Care
31
Musculoskeletal
ART
OMW
0 Code
99
Enrollment by Product Line (Age & Sex)
101
43 ENP
Osteoporosis Management in Women Who had a Fracture
37
43
Behavioral Health
Antidepressant Medication Management
38
ADD
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
43
FUH
Follow-up After Hospitalization for Mental Illness
45
Page
Board Certification
36
AMM
Health Plan Descriptive Information Measures
42 BCR
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
HEDIS 2013 (Reporting Year 2012)
96
41
DISCLAIMERS
-1
( this page left blank intentionally )
0. Disclaimer Query located below
HEDIS 2013 (Reporting Year 2012)
Page 2
Effectiveness of Care
Prime West
Adult BMI Assessment
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Data Elements
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
Number of Records Excluded Because of Valid
Data Errors
Commercial
Medicare
Advantage
MHCP-MC
2012
H
1782
144
NR
NR
NR
NR
8.08%
411
5.00%
432
50
11.57%
0
Number of administrative data records excluded
0
Number of medical record data records excluded
0
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 2013 (Reporting Year 2012)
0
NR
NR
NR
NR
NR
NR
0
411
83
239
78.35%
74.24%
82.45%
Page 3
Effectiveness of Care
Prime West
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Commercial
Counseling for Nutrition
BMI Percentile
Data Elements
General
Measure
Data
Ages 3-11 Ages 12-17
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 2013 (Reporting Year 2012)
Page 4
Effectiveness of Care
Prime West
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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
Counseling for Nutrition
Total
2012
H
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Physical Activity
Total
2012
H
General
Measure
Data
Total
2481
1214
3695
2481
1214
3695
2481
1214
3695
10
0.40%
14
1.15%
24
0.65%
12
0.48%
11
0.91%
23
0.62%
0
0.00%
1
0.08%
1
0.03%
0
0.00%
0
0.00%
0
0.00%
282
0
92
32.62%
26.97%
38.27%
129
0
49
37.98%
29.22%
46.75%
411
0
141
34.31%
29.60%
39.02%
411
5.00%
432
411
5.00%
432
3
0.69%
1
0.23%
4
0.93%
411
5.00%
432
0
0.00%
2
0.46%
2
0.46%
0
0
0
Number of administrative data records
excluded
0
0
0
Number of medical records excluded
0
0
0
Number of employee/dependent records
excluded
0
0
0
Records Added from the Oversample List
0
0
0
HEDIS 2013 (Reporting Year 2012)
Ages 1217
2012
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
282
3
176
63.48%
57.68%
69.27%
129
0
79
61.24%
52.45%
70.04%
411
3
255
62.77%
57.98%
67.57%
282
0
130
46.10%
40.10%
52.09%
129
2
41
33.33%
24.81%
41.86%
411
2
171
42.09%
37.20%
46.99%
Page 5
Effectiveness of Care
Prime West
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Commercial
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
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
NR
NR
NR
NR
NR
NR
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 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
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
Page 6
Effectiveness of Care
Prime West
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Commercial
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
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
NR
NR
NR
NR
NR
NR
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 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
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
Page 7
Effectiveness of Care
Prime West
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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
General
Measure
Data
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
HEDIS 2013 (Reporting Year 2012)
HiB
Hepatitis B
VZV
Influenza
359
81.04%
409
92.33%
397
89.62%
407
91.87%
396
89.39%
384
86.68%
362
81.72%
203
45.82%
268
60.50%
204
46.05%
352
81.48%
400
92.59%
388
89.81%
398
92.13%
387
89.58%
375
86.81%
355
82.18%
198
45.83%
262
60.65%
199
46.06%
332
2
81.27%
77.37%
85.16%
380
2
92.94%
90.35%
95.54%
367
1
89.54%
86.46%
92.62%
378
4
92.94%
90.35%
95.54%
367
5
90.51%
87.56%
93.47%
354
1
86.37%
82.94%
89.81%
337
5
83.21%
79.48%
86.95%
188
22
51.09%
46.14%
56.05%
246
4
60.83%
55.99%
65.67%
190
29
53.28%
48.34%
58.23%
0
Number of medical data records excluded
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
MMR
411
0.05
432
0
Numerator Events by administrative Data
IPV
2012
H
443
Number of administrative data records
excluded
Denominator
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
411
Page 8
Effectiveness of Care
Prime West
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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
General
Measure
Data
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
HEDIS 2013 (Reporting Year 2012)
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
359
81.04%
337
76.07%
320
72.23%
177
39.95%
229
51.69%
180
40.63%
141
31.83%
122
27.54%
135
30.47%
98
22.12%
352
81.48%
330
76.39%
313
72.45%
172
39.81%
223
51.62%
175
40.51%
136
31.48%
118
27.31%
131
30.32%
94
21.76%
332
2
81.27%
77.37%
85.16%
310
4
76.40%
72.17%
80.63%
295
8
73.72%
69.35%
78.10%
163
24
45.50%
40.56%
50.43%
209
10
53.28%
48.34%
58.23%
167
28
47.45%
42.50%
52.39%
127
23
36.50%
31.72%
41.27%
112
25
33.33%
28.65%
38.01%
125
28
37.23%
32.43%
42.02%
88
26
27.74%
23.29%
32.19%
0
Number of medical data records excluded
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Combo 3
411
0.05
432
0
Numerator Events by administrative Data
Combo 2
2012
H
443
Number of administrative data records
excluded
Denominator
DTaP
411
Page 9
Effectiveness of Care
Prime West
Immunizations for Adolescents
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
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
HEDIS 2013 (Reporting Year 2012)
Page 10
Effectiveness of Care
Prime West
Immunizations for Adolescents
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Commercial
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Data Elements
Measure Data
Measurement Year
2012
Data Collection Methodology
H
Eligible Member Population
290
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 2013 (Reporting Year 2012)
Tdap
Combo 1
89
220
87
30.69%
75.86%
30.00%
89
30.69%
220
75.86%
87
30.00%
89
0
30.69%
25.21%
36.17%
220
11
79.66%
74.85%
84.46%
87
2
30.69%
25.21%
36.17%
290
5.00%
290
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
290
Page 11
Effectiveness of Care
Prime West
Breast Cancer Screening
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
Commercial
NR
NR
NR
Medicare
Advantage
NR
NR
NR
MSHO
SNBC
MHCP-MC
2012
A
94
57
60.64%
50.23%
71.05%
2012
A
108
78
72.22%
63.31%
81.13%
2012
A
400
198
49.50%
44.48%
54.52%
Page 12
Effectiveness of Care
Prime West
Cervical Cancer Screening
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Data Elements
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
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 Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
Commercial
MHCP-MC
2012
H
2259
1384
NR
NR
61.27%
411
5.00%
432
266
61.57%
0
4
15
0
NR
NR
NR
19
411
266
23
70.32%
65.78%
74.85%
Page 13
Effectiveness of Care
Prime West
Colorectal Cancer Screening
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Data Elements
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 2013 (Reporting Year 2012)
Commercial
Medicare
Advantage
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
MSHO
SNBC
2012
H
390
2012
H
120
191
56
48.97%
388
5.00%
388
191
49.23%
0
0
0
0
0
388
191
54
63.14%
58.22%
68.07%
46.67%
120
5.00%
120
56
46.67%
0
0
0
0
0
120
56
24
66.67%
57.82%
75.52%
Page 14
Effectiveness of Care
Prime West
Chlamydia Screening in Women
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure Data
Ages 16-20
NR
NR
NR
Ages 21-24
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 15
Effectiveness of Care
Prime West
Chlamydia Screening in Women
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 2013 (Reporting Year 2012)
General
Measure Data
Ages 16-20
Ages 21-24
Total
278
107
38.49%
32.59%
44.39%
292
128
43.84%
37.97%
49.70%
570
235
41.23%
37.10%
45.36%
2012
A
Page 16
Effectiveness of Care
Prime West
Glaucoma Screening in Older Adults
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
Medicare
Advantage
NR
NR
NR
MSHO
2012
A
1376
1027
74.64%
72.30%
76.97%
Page 17
Effectiveness of Care
Prime West
Lead Screening in Children
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Data Elements
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
Records Excluded because of Valid Data
Errors
Commercial
MHCP-MC
2012
A
443
NR
NR
NR
NR
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 Admin Data
Numerator Events by Medical Record
Reported Rate
NR
87.13%
Lower 95% Confidence Interval
NR
83.90%
Upper 95% Confidence Interval
NR
90.36%
HEDIS 2013 (Reporting Year 2012)
386
Page 18
Effectiveness of Care
Prime West
Care for Older Adults
Data Last Refreshed:
Nov 15, 2013 2:03 PM
MSHO
Advance Care
Planning
Medication Review
Functional
Status
Assessment
Pain
Screening
0
0
0
0
0.00%
0.00%
0.00%
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
354
86.13%
0
325
79.08%
0
338
82.24%
0
314
76.40%
Lower 95% Confidence Interval
82.67%
75.02%
78.42%
72.17%
Upper 95% Confidence Interval
89.59%
83.13%
86.06%
80.63%
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population (before exclusions)
General Measure
Data
2012
H
1715
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
HEDIS 2013 (Reporting Year 2012)
411
5.00%
432
0
0
0
411
Page 19
Effectiveness of Care
Prime West
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
NR
NR
NR
NR
NR
NR
Page 20
Effectiveness of Care
Prime West
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
29
67.44%
52.27%
82.61%
40
93.02%
84.25%
100.00%
2012
A
43
Page 21
Effectiveness of Care
Prime West
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Nov 15, 2013 2:03 PM
SNBC
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 2013 (Reporting Year 2012)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
7
NA
NA
NA
8
NA
NA
NA
2012
A
8
Page 22
Effectiveness of Care
Prime West
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
Medicare
Advantage
NR
NR
NR
MSHO
SNBC
2012
A
57
5
8.77%
0.55%
16.99%
2012
A
6
1
NA
NA
NA
Page 23
Effectiveness of Care
Prime West
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
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 24
Effectiveness of Care
Prime West
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 2013 (Reporting Year 2012)
General
Measure Data
Ages 5-11
Ages 12-18
Ages 19-50
Ages 51-64
Total
74
62
4
83.78%
74.71%
92.86%
68
52
2
76.47%
65.65%
87.29%
80
55
12
68.75%
57.97%
79.53%
14
14
13
NA
NA
NA
236
183
31
77.54%
72.01%
83.08%
2012
A
Page 25
Effectiveness of Care
Prime West
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 26
Effectiveness of Care
Prime West
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 27
Effectiveness of Care
Prime West
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 2013 (Reporting Year 2012)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
11
73.33%
0
0.00%
11
73.33%
0
0.00%
11
0
NA
NA
NA
0
8
NA
NA
NA
2012
H
15
15
5.00%
15
0
0
0
15
Page 28
Effectiveness of Care
Prime West
Controlling High Blood Pressure
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Data Elements
Medicare
Advantage
MSHO
SNBC
MHCP-MC
2012
H
384
2012
H
108
2012
H
361
0
0
0
0.00%
289
5.00%
289
0
0.00%
0.00%
99
5.00%
99
0
0.00%
0.00%
349
5.00%
349
0
0.00%
0
0
1
Number of records excluded because of
false positive diagnoses
0
0
1
Number of administrative data records
excluded
2
0
1
Number of medical record data records
excluded
0
0
0
0
0
0
0
287
0
202
70.38%
64.93%
75.84%
0
99
0
72
72.73%
63.45%
82.01%
0
347
0
222
63.98%
58.78%
69.17%
Measurement Year
Data Collection Methodology (Hybrid)
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
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 2013 (Reporting Year 2012)
Commercial
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 29
Effectiveness of Care
Prime West
Persistence of Beta Blocker Treatment After Heart Attack
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Data Elements
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 2013 (Reporting Year 2012)
Commercial
NR
NR
NR
Medicare
Advantage
NR
NR
NR
MSHO
SNBC
MHCP-MC
2012
A
14
2012
A
2
2012
A
5
14
2
4
NA
NA
NA
NA
NA
NA
NA
NA
NA
Page 30
Effectiveness of Care
Prime West
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Commercial
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
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
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 2013 (Reporting Year 2012)
Page 31
Effectiveness of Care
Prime West
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
Page 32
Effectiveness of Care
Prime West
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
MSHO
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
HbA1c
Testing
Poor HbA1c
Control
2012
H
192
2012
H
192
170
88.54%
192
5%
192
170
88.54%
194
NR
192
5%
192
192
100.00%
Good HbA1c
Control
(<7.0%)
NR
NR
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
2012
H
192
2012
H
192
2012
H
192
2012
H
192
2012
H
192
2012
H
192
2012
H
192
0
0.00%
192
5%
192
0
0.00%
140
72.92%
192
5%
192
140
72.92%
147
76.56%
192
5%
192
146
76.04%
0
0.00%
192
5%
192
0
0.00%
159
82.81%
192
5%
192
157
81.77%
1
0.52%
192
5%
192
0
0.00%
1
0.52%
192
5%
192
0
0.00%
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
192
170
10
93.75%
90.07%
97.43%
0
192
32
2
17.71%
12.05%
23.37%
0
192
0
145
75.52%
69.18%
81.86%
0
192
140
9
77.60%
71.45%
83.76%
0
192
146
4
78.13%
72.02%
84.23%
0
192
0
93
48.44%
41.11%
55.77%
0
192
157
2
82.81%
77.22%
88.41%
0
192
0
154
80.21%
74.31%
86.10%
0
192
0
131
68.23%
61.38%
75.08%
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 2013 (Reporting Year 2012)
NR
NR
NR
Page 33
Effectiveness of Care
Prime West
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
SNBC
HbA1c
Testing
Poor HbA1c
Control
2012
H
127
2012
H
127
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
105
82.68%
126
5%
126
105
83.33%
127
100.00%
126
5%
126
126
100.00%
Number of Records Excluded Because of
Valid Data Errors
0
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
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
2012
H
127
2012
H
127
2012
H
127
2012
H
127
2012
H
127
2012
H
127
2012
H
127
0
0.00%
126
5%
126
0
0.00%
81
63.78%
126
5%
126
81
64.29%
103
81.10%
126
5%
126
103
81.75%
1
0.79%
126
5%
126
1
0.79%
101
79.53%
126
5%
126
101
80.16%
2
1.57%
126
5%
126
0
0.00%
1
0.79%
126
5%
126
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
126
105
4
86.51%
80.15%
92.87%
0
126
21
18
30.95%
22.48%
39.42%
0
126
0
75
59.52%
50.56%
68.49%
0
126
81
2
65.87%
57.20%
74.55%
0
126
103
7
87.30%
81.09%
93.51%
0
126
1
36
29.37%
21.02%
37.71%
0
126
101
1
80.95%
73.70%
88.21%
0
126
0
101
80.16%
72.80%
87.52%
0
126
0
80
63.49%
54.69%
72.30%
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 2013 (Reporting Year 2012)
NR
NR
NR
Page 34
Effectiveness of Care
Prime West
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
2012
H
280
2012
H
280
2012
H
244
219
78.21%
271
5%
271
215
79.34%
280
100.00%
271
5%
271
271
100.00%
0
Eye Exam
2012
H
280
2012
H
280
2012
H
280
2012
H
280
2012
H
280
2012
H
280
2012
H
280
0
0.00%
271
5%
271
0
0.00%
0
0.00%
271
5%
271
0
0.00%
156
55.71%
271
5%
271
153
56.46%
189
67.50%
271
5%
271
189
69.74%
1
0.36%
271
5%
271
0
0.00%
196
70.00%
271
5%
271
196
72.32%
0
0.00%
271
5%
271
0
0.00%
0
0.00%
271
5%
271
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
0
0
0
0
271
0
147
54.24%
48.13%
60.36%
0
271
153
17
62.73%
56.79%
68.67%
0
271
189
5
71.59%
66.03%
77.14%
0
271
0
108
39.85%
33.84%
45.87%
0
271
196
12
76.75%
71.54%
81.97%
0
271
0
200
73.80%
68.38%
79.22%
0
271
0
149
54.98%
48.87%
61.09%
36
Number of Hybrid required exclusions
HEDIS 2013 (Reporting Year 2012)
Blood
Pressure
<140/80
mm Hg
LDL-C Level
<100 mg/dL
Number of Administrative 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
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
LDL-C
Screening
12
0
271
215
22
87.45%
83.33%
91.58%
0
271
52
41
34.32%
28.48%
40.15%
0
223
0
90
40.36%
33.70%
47.02%
Page 35
Effectiveness of Care
Prime West
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
Medicare
Advantage
NR
NR
NR
Page 36
Effectiveness of Care
Prime West
Osteoporosis Management in Women Who had a Fracture
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
Medicare
Advantage
NR
NR
NR
MSHO
2012
A
66
13
19.70%
9.34%
30.05%
Page 37
Effectiveness of Care
Prime West
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
NR
NR
NR
NR
NR
NR
Page 38
Effectiveness of Care
Prime West
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
NR
NR
NR
NR
NR
NR
Page 39
Effectiveness of Care
Prime West
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
2012
A
36
33
91.67%
81.25%
100.00%
30
83.33%
69.77%
96.90%
Page 40
Effectiveness of Care
Prime West
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 2:03 PM
SNBC
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 2013 (Reporting Year 2012)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
2012
A
8
7
NA
NA
NA
6
NA
NA
NA
Page 41
Effectiveness of Care
Prime West
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 2013 (Reporting Year 2012)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
2012
A
193
150
77.72%
71.59%
83.85%
124
64.25%
57.23%
71.27%
Page 42
Effectiveness of Care
Prime West
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
NR
NR
NR
NR
NR
NR
Page 43
Effectiveness of Care
Prime West
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 2013 (Reporting Year 2012)
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
127
42
33.07%
24.49%
41.65%
37
17
45.95%
28.54%
63.36%
2012
A
Page 44
Effectiveness of Care
Prime West
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure
Data
30 Days
7 Days
NR
NR
NR
NR
NR
NR
Page 45
Effectiveness of Care
Prime West
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure
Data
30 Days
7 Days
5
NA
NA
NA
2
NA
NA
NA
2012
A
8
Page 46
Effectiveness of Care
Prime West
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Nov 15, 2013 2:03 PM
SNBC
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 2013 (Reporting Year 2012)
General
Measure
Data
30 Days
7 Days
21
NA
NA
NA
17
NA
NA
NA
2012
A
27
Page 47
Effectiveness of Care
Prime West
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
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 48
Effectiveness of Care
Prime West
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
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 49
Effectiveness of Care
Prime West
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
741
712
96.09%
94.62%
97.55%
111
108
97.30%
93.83%
100.00%
874
849
97.14%
95.98%
98.30%
96
87
90.63%
84.27%
96.98%
1822
1756
96.38%
95.49%
97.26%
2012
A
Page 50
Effectiveness of Care
Prime West
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 2:03 PM
SNBC
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 2013 (Reporting Year 2012)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
123
111
90.24%
84.59%
95.89%
2
2
NA
NA
NA
88
83
94.32%
88.91%
99.72%
61
46
75.41%
63.78%
87.04%
274
242
88.32%
84.34%
92.31%
2012
A
Page 51
Effectiveness of Care
Prime West
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 2013 (Reporting Year 2012)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
356
292
82.02%
77.89%
86.15%
6
6
NA
NA
NA
247
214
86.64%
82.19%
91.09%
41
29
70.73%
55.58%
85.88%
650
541
83.23%
80.28%
86.18%
2012
A
Page 52
Access/Availability of Care
Prime West
Medication Reconciliation Post Discharge
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
MSHO
2012
H
453
0
0.00%
411
5.00%
432
0
0.00%
1
0
1
411
0
78
18.98%
15.07%
22.89%
Page 53
Effectiveness of Care
Prime West
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
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 54
Effectiveness of Care
Prime West
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
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
21
3
NA
NA
NA
565
112
19.82%
16.45%
23.20%
2012
A
56
9
16.07%
5.56%
26.58%
488
100
20.49%
16.81%
24.18%
Page 55
Effectiveness of Care
Prime West
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure
Data
At least 1
Prescription
At least 2
Prescriptions
NR
NR
NR
NR
NR
NR
Page 56
Effectiveness of Care
Prime West
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General
Measure
Data
2012
A
1711
At least 1
Prescription
At least 2
Prescriptions
428
25.01%
22.93%
27.10%
158
9.23%
7.83%
10.64%
Page 57
Access/Availability of Care
Prime West
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2013 (Reporting Year 2012)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 58
Access/Availability of Care
Prime West
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2013 (Reporting Year 2012)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 59
Access/Availability of Care
Prime West
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
0
0
1721
1721
0
NA
NA
NA
0
NA
NA
NA
1689
98.14%
97.47%
98.81%
1689
98.14%
97.47%
98.81%
2012
A
Page 60
Access/Availability of Care
Prime West
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
SNBC
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 2013 (Reporting Year 2012)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
188
347
9
544
172
91.49%
87.23%
95.74%
338
97.41%
95.59%
99.22%
9
NA
NA
NA
519
95.40%
93.55%
97.26%
2012
A
Page 61
Access/Availability of Care
Prime West
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 2013 (Reporting Year 2012)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
2661
1177
1
3839
2418
90.87%
89.75%
91.98%
1057
89.80%
88.03%
91.58%
1
NA
NA
NA
3476
90.54%
89.61%
91.48%
2012
A
Page 62
Access/Availability of Care
Prime West
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
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 63
Access/Availability of Care
Prime West
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 2013 (Reporting Year 2012)
General Measure
Data
12-24 months
25 months 6 yrs.
7-11 yrs.
12-19 yrs.
637
610
95.76%
94.12%
97.40%
1787
1560
87.30%
85.73%
88.87%
1146
1049
91.54%
89.88%
93.19%
1274
1185
93.01%
91.58%
94.45%
2012
A
Page 64
Access/Availability of Care
Prime West
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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
Total
Engagement
of AOD
Treatment
Initiation of
AOD
Treatment
NR
NR
NR
NR
NR
NR
NR
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 2013 (Reporting Year 2012)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 65
Access/Availability of Care
Prime West
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Medicare Advantage
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 2013 (Reporting Year 2012)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 66
Access/Availability of Care
Prime West
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 2:03 PM
MSHO
13-17 Year Olds
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 2013 (Reporting Year 2012)
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
2012
A
31
0
31
0
0
12
2
NA
NA
NA
NA
NA
NA
38.71%
19.95%
57.47%
6.45%
0.00%
16.71%
12
38.71%
19.95%
57.47%
2
6.45%
0.00%
16.71%
Page 67
Access/Availability of Care
Prime West
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 2:03 PM
SNBC
13-17 Year Olds
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 2013 (Reporting Year 2012)
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
2012
A
0
56
56
0
0
25
5
NA
NA
NA
NA
NA
NA
44.64%
30.73%
58.56%
8.93%
0.57%
17.29%
25
44.64%
30.73%
58.56%
5
8.93%
0.57%
17.29%
Page 68
Access/Availability of Care
Prime West
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
13-17 Year Olds
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 2013 (Reporting Year 2012)
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
2012
A
41
484
525
16
4
179
60
39.02%
22.87%
55.18%
9.76%
0.00%
20.06%
36.98%
32.58%
41.39%
12.40%
9.36%
15.44%
195
37.14%
32.91%
41.37%
64
12.19%
9.30%
15.08%
Page 69
Access/Availability of Care
Prime West
Prenatal and Postpartum Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Commercial
Data Elements
Timeliness of
Prenatal Care
Postpartum
Care
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
NR
NR
NR
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
NR
NR
NR
NR
NR
NR
HEDIS 2013 (Reporting Year 2012)
Page 70
Access/Availability of Care
Prime West
Prenatal and Postpartum Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 2013 (Reporting Year 2012)
Timeliness of
Prenatal Care
2012
H
752
Postpartum
Care
2012
H
752
395
386
52.53%
411
5.00%
432
224
51.85%
51.33%
411
5.00%
432
239
55.32%
1
1
0
1
411
216
145
87.83%
84.55%
91.12%
0
1
411
224
63
69.83%
65.27%
74.39%
Page 71
Use of Services
Prime West
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Commercial
Data Elements
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
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
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 2013 (Reporting Year 2012)
Page 72
Use of Services
Prime West
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
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 2013 (Reporting Year 2012)
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
14
2.53%
16
2.89%
15
2.71%
31
5.60%
62
11.19%
99
17.87%
317
57.22%
11
2.55%
13
3.01%
11
2.55%
21
4.86%
45
10.42%
77
17.82%
254
58.80%
7
0
1.70%
0.33%
3.08%
4
1
1.22%
0.04%
2.40%
7
2
2.19%
0.65%
3.73%
12
1
3.16%
1.35%
4.98%
23
6
7.06%
4.46%
9.65%
60
14
18.00%
14.17%
21.84%
244
30
66.67%
61.99%
71.35%
2012
H
554
411
5.00%
432
0
0
0
411
Page 73
Use of Services
Prime West
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
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
732
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 2013 (Reporting Year 2012)
MHCP-MC
2012
H
1443
50.73%
411
5.00%
432
250
57.87%
0
0
NR
NR
NR
0
411
239
10
60.58%
55.74%
65.43%
Page 74
Use of Services
Prime West
Adolescent Well-Care Visits
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
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
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 2013 (Reporting Year 2012)
Commercial
MHCP-MC
2012
H
1992
567
NR
NR
28.46%
411
5.00%
432
140
32.41%
0
0
NR
NR
NR
0
411
132
30
39.42%
34.57%
44.26%
Page 75
Use of Services
Prime West
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
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 76
Use of Services
Prime West
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
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 77
Use of Services
Prime West
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
0
0
4
6449
7748
10800
0
25001
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
3
5454
7121
8353
0
20931
HEDIS 2013 (Reporting Year 2012)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
750.00
845.71
919.08
773.43
837.21
Emergency Room Visits
Visits
0
0
0
0
0
299
359
439
0
1097
Visits/ 1,000
Member
Months
NA
NA
NA
NA
0.00
46.36
46.33
40.65
43.88
Page 78
Use of Services
Prime West
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
59
3161
4816
109
0
0
0
8145
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
15
1984
4075
113
0
0
0
6187
HEDIS 2013 (Reporting Year 2012)
Visits/ 1,000
Member
Months
NA
NA
254.24
627.65
846.14
1036.70
NA
NA
759.61
Emergency Room Visits
Visits
0
0
1
318
487
8
0
0
0
814
Visits/ 1,000
Member
Months
NA
NA
16.95
100.60
101.12
73.39
NA
NA
99.94
Page 79
Use of Services
Prime West
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
13468
72846
48022
74722
24162
20
0
0
0
233240
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
10411
23305
14032
34852
13245
8
0
0
0
95853
HEDIS 2013 (Reporting Year 2012)
Visits/ 1,000
Member
Months
773.02
319.92
292.20
466.42
548.17
400.00
NA
NA
410.96
Emergency Room Visits
Visits
1344
3648
1948
5959
1155
1
0
0
0
14055
Visits/ 1,000
Member
Months
99.79
50.08
40.56
79.75
47.80
50.00
NA
NA
60.26
Page 80
Use of Services
Prime West
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 81
Use of Services
Prime West
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Medicare Advantage
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 /
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 2013 (Reporting Year 2012)
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 82
Use of Services
Prime West
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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
4
6449
7748
10800
0
25001
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
222
322
416
0
960
NA
NA
NA
NA
0.00
34.42
41.56
38.52
0
0
0
0
0
169
252
368
0
789
NA
NA
NA
NA
0.00
26.21
32.52
34.07
0
0
0
0
0
53
70
48
0
171
NA
NA
NA
NA
0.00
8.22
9.03
4.44
0
0
0
0
0
HEDIS 2013 (Reporting Year 2012)
38.40
31.56
6.84
NA
NA
0.00
0.00
Days
Days / 1,000
Member
Months
0
0
0
0
0
1083
1501
1816
0
4400
NA
NA
NA
NA
0.00
167.93
193.73
168.15
0
0
0
0
0
757
1131
1572
0
3460
NA
NA
NA
NA
0.00
117.38
145.97
145.56
0
0
0
0
0
326
370
244
0
940
NA
NA
NA
NA
0.00
50.55
47.75
22.59
0
0
0
0
0
175.99
138.39
37.60
NA
NA
0.00
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
4.88
4.66
4.37
NA
4.58
NA
NA
NA
NA
NA
4.48
4.49
4.27
NA
4.39
NA
NA
NA
NA
NA
6.15
5.29
5.08
NA
5.50
NA
NA
NA
NA
NA
Page 83
Use of Services
Prime West
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
SNBC
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
59
3161
4816
109
0
0
0
8145
Discharges
Discharges /
1,000 Member
Months
0
0
0
50
124
6
0
0
0
180
NA
NA
0.00
15.82
25.75
55.05
NA
NA
0
0
0
33
91
4
0
0
0
128
NA
NA
0.00
10.44
18.90
36.70
NA
NA
0
0
0
13
33
2
0
0
0
48
NA
NA
0.00
4.11
6.85
18.35
NA
NA
0
4
0
0
4
0.00
1.27
0.00
HEDIS 2013 (Reporting Year 2012)
22.10
15.72
5.89
0.50
Days
Days / 1,000
Member
Months
0
0
0
184
594
54
0
0
0
832
NA
NA
0.00
58.21
123.34
495.41
NA
NA
0
0
0
130
448
42
0
0
0
620
NA
NA
0.00
41.13
93.02
385.32
NA
NA
0
0
0
43
146
12
0
0
0
201
NA
NA
0.00
13.60
30.32
110.09
NA
NA
0
11
0
0
11
0.00
3.48
0.00
102.15
76.12
24.68
1.37
Average
Length of Stay
NA
NA
NA
3.68
4.79
9.00
NA
NA
NA
4.62
NA
NA
NA
3.94
4.92
10.50
NA
NA
NA
4.84
NA
NA
NA
3.31
4.42
6.00
NA
NA
NA
4.19
NA
2.75
NA
NA
2.75
Page 84
Use of Services
Prime West
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
<1
13468
1-9
72846
10-19
48022
20-44
74722
45-64
24162
65-74
20
75-84
0
85+
0
Unknown
0
233240
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 /
1,000 Member
Months
127
116
156
1221
238
0
0
0
0
1858
9.43
1.59
3.25
16.34
9.85
0.00
NA
NA
116
95
41
217
113
0
0
0
0
582
8.61
1.30
0.85
2.90
4.68
0.00
NA
NA
11
21
20
170
124
0
0
0
0
346
0.82
0.29
0.42
2.28
5.13
0.00
NA
NA
95
834
1
0
930
1.98
11.16
0.04
HEDIS 2013 (Reporting Year 2012)
7.97
2.50
1.48
6.33
Days
Days / 1,000
Member
Months
730
396
580
3210
1255
0
0
0
0
6171
54.20
5.44
12.08
42.96
51.94
0.00
NA
NA
469
290
213
813
614
0
0
0
0
2399
34.82
3.98
4.44
10.88
25.41
0.00
NA
NA
261
106
103
436
637
0
0
0
0
1543
19.38
1.46
2.14
5.83
26.36
0.00
NA
NA
264
1961
4
0
2229
5.50
26.24
0.17
26.46
10.29
6.62
15.17
Average
Length of Stay
5.75
3.41
3.72
2.63
5.27
NA
NA
NA
NA
3.32
4.04
3.05
5.20
3.75
5.43
NA
NA
NA
NA
4.12
23.73
5.05
5.15
2.56
5.14
NA
NA
NA
NA
4.46
2.78
2.35
4.00
NA
2.40
Page 85
Use of Services
Prime West
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Commercial
Member Months
(Inpatient)
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
Female
NR
NR
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 2013 (Reporting Year 2012)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
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
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
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
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
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 86
Use of Services
Prime West
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Medicare Advantage
Member Months
(Inpatient)
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
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 2013 (Reporting Year 2012)
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
Age
0-12
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
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
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
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
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 87
Use of Services
Prime West
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
0
1
6647
0
6648
Female
0
0
0
0
3
18350
0
18353
Member Months
(Inpatient)
Total
0
0
0
0
4
24997
0
25001
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
29
18
47
0
0
0
29
18
47
HEDIS 2013 (Reporting Year 2012)
Male
0
0
0
0
1
6647
0
6648
Female
0
0
0
0
3
18350
0
18353
Total
0
0
0
0
4
24997
0
25001
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
5.24%
1.18%
2.26%
NA
NA
NA
5.23%
1.18%
2.26%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
11
10
21
0
0
0
11
10
21
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
0
0
0
0
0
0
0
0
0
0
1
3
4
6647
18350
24997
0
0
0
6648
18353
25001
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
1.99%
0.65%
1.01%
NA
NA
NA
1.99%
0.65%
1.01%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Member Months
(Outpatient/ED)
Male
0
0
0
0
1
6647
0
6648
Female
0
0
0
0
3
18350
0
18353
Total
0
0
0
0
4
24997
0
25001
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
28
12
40
0
0
0
28
12
40
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
5.05%
0.78%
1.92%
NA
NA
NA
5.05%
0.78%
1.92%
Page 88
Use of Services
Prime West
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
356
718
2581
51
0
3706
Female
0
0
203
578
3600
58
0
4439
Member Months
(Inpatient)
Total
0
0
559
1296
6181
109
0
8145
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
0
0
0
1
1
2
12
14
26
50
62
112
0
0
0
0
0
0
63
77
140
HEDIS 2013 (Reporting Year 2012)
Male
0
0
356
718
2581
51
0
3706
Female
0
0
203
578
3600
58
0
4439
Total
0
0
559
1296
6181
109
0
8145
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
3.37%
5.91%
4.29%
20.06%
29.07%
24.07%
23.25%
20.67%
21.74%
0.00%
0.00%
0.00%
NA
NA
NA
20.40%
20.82%
20.63%
Number
0
0
0
0
0
0
0
1
1
4
3
7
12
23
35
0
0
0
0
0
0
16
27
43
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
0
0
0
0
356
203
559
718
578
1296
2581
3600
6181
51
58
109
0
0
0
3706
4439
8145
Percent
NA
NA
NA
NA
NA
NA
0.00%
5.91%
2.15%
6.69%
6.23%
6.48%
5.58%
7.67%
6.80%
0.00%
0.00%
0.00%
NA
NA
NA
5.18%
7.30%
6.34%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Member Months
(Outpatient/ED)
Male
0
0
356
718
2581
51
0
3706
Female
0
0
203
578
3600
58
0
4439
Total
0
0
559
1296
6181
109
0
8145
Outpatient/ED
Number
0
0
0
0
0
0
1
0
1
10
13
23
47
57
104
0
0
0
0
0
0
58
70
128
Percent
NA
NA
NA
NA
NA
NA
3.37%
0.00%
2.15%
16.71%
26.99%
21.30%
21.85%
19.00%
20.19%
0.00%
0.00%
0.00%
NA
NA
NA
18.78%
18.92%
18.86%
Page 89
Use of Services
Prime West
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
52734
11585
8402
11338
19230
12
0
103301
Female
50981
12024
17238
24493
25195
8
0
129939
Total
103715
23609
25640
35831
44425
20
0
233240
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
6
2
8
42
48
90
131
163
294
263
274
537
315
282
597
0
0
0
0
0
0
757
769
1526
HEDIS 2013 (Reporting Year 2012)
Total
103715
23609
25640
35831
44425
20
0
233240
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
52734
50981
103715
11585
12024
23609
8402
17238
25640
11338
24493
35831
19230
25195
44425
12
8
20
0
0
0
103301
129939
233240
Percent
0.02%
0.00%
0.01%
1.76%
1.10%
1.42%
5.14%
5.01%
5.05%
7.41%
4.41%
5.36%
5.05%
2.86%
3.81%
0.00%
0.00%
0.00%
NA
NA
NA
2.38%
2.15%
2.25%
Intensive Outpatient/Partial
Hospitalization
Percent
Number
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
1
0.14%
1
0.07%
2
0.09%
1
0.11%
1
0.05%
2
0.07%
1
0.06%
0
0.00%
1
0.03%
0
0.00%
0
0.00%
0
0.00%
0
NA
0
NA
0
NA
3
0.03%
2
0.02%
5
0.03%
Member Months
(Inpatient)
Male
52734
11585
8402
11338
19230
12
0
103301
Female
50981
12024
17238
24493
25195
8
0
129939
Inpatient
Percent
0.14%
0.05%
0.09%
4.35%
4.79%
4.57%
18.71%
11.35%
13.76%
27.84%
13.42%
17.98%
19.66%
13.43%
16.13%
0.00%
0.00%
0.00%
NA
NA
NA
8.79%
7.10%
7.85%
Number
1
0
1
17
11
28
36
72
108
70
90
160
81
60
141
0
0
0
0
0
0
205
233
438
Member Months
(Outpatient/ED)
Male
52734
11585
8402
11338
19230
12
0
103301
Female
50981
12024
17238
24493
25195
8
0
129939
Total
103715
23609
25640
35831
44425
20
0
233240
Outpatient/ED
Number
5
2
7
38
42
80
127
131
258
254
252
506
300
274
574
0
0
0
0
0
0
724
701
1425
Percent
0.11%
0.05%
0.08%
3.94%
4.19%
4.07%
18.14%
9.12%
12.07%
26.88%
12.35%
16.95%
18.72%
13.05%
15.50%
0.00%
0.00%
0.00%
NA
NA
NA
8.41%
6.47%
7.33%
Page 90
Use of Services
Prime West
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Commercial
Member Months
(Inpatient)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
NR
NR
Total
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 2013 (Reporting Year 2012)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
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
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
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
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
Female
NR
NR
Total
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 91
Use of Services
Prime West
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Medicare Advantage
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
NR
NR
Member Months
(Inpatient)
Total
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 2013 (Reporting Year 2012)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
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
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
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
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
Female
NR
NR
Total
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 92
Use of Services
Prime West
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
1
6647
0
6648
Female
0
0
3
18350
0
18353
Member Months
(Inpatient)
Total
0
0
4
24997
0
25001
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
0
0
0
0
0
0
0
0
0
65
169
234
0
0
0
65
169
234
HEDIS 2013 (Reporting Year 2012)
Male
0
0
1
6647
0
6648
Female
0
0
3
18350
0
18353
Total
0
0
4
24997
0
25001
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
11.73%
11.05%
11.23%
NA
NA
NA
11.73%
11.05%
11.23%
Number
0
0
0
0
0
0
0
0
0
23
59
82
0
0
0
23
59
82
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
0
0
0
0
1
3
4
6647
18350
24997
0
0
0
6648
18353
25001
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
4.15%
3.86%
3.94%
NA
NA
NA
4.15%
3.86%
3.94%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Member Months
(Outpatient/ED)
Male
0
0
1
6647
0
6648
Total
0
0
4
24997
0
25001
Female
0
0
3
18350
0
18353
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
49
119
168
0
0
0
49
119
168
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
8.85%
7.78%
8.06%
NA
NA
NA
8.84%
7.78%
8.06%
Page 93
Use of Services
Prime West
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
3655
51
0
3706
Female
0
0
4381
58
0
4439
Member Months
(Inpatient)
Total
0
0
8036
109
0
8145
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
0
0
0
0
0
0
152
224
376
1
2
3
0
0
0
153
226
379
HEDIS 2013 (Reporting Year 2012)
Male
0
0
3655
51
0
3706
Female
0
0
4381
58
0
4439
Total
0
0
8036
109
0
8145
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
49.90%
61.36%
56.15%
23.53%
41.38%
33.03%
NA
NA
NA
49.54%
61.09%
55.84%
Number
0
0
0
0
0
0
10
27
37
0
1
1
0
0
0
10
28
38
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
0
0
0
0
3655
4381
8036
51
58
109
0
0
0
3706
4439
8145
Percent
NA
NA
NA
NA
NA
NA
3.28%
7.40%
5.53%
0.00%
20.69%
11.01%
NA
NA
NA
3.24%
7.57%
5.60%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Member Months
(Outpatient/ED)
Male
0
0
3655
51
0
3706
Female
0
0
4381
58
0
4439
Total
0
0
8036
109
0
8145
Outpatient/ED
Number
0
0
0
0
0
0
151
223
374
1
2
3
0
0
0
152
225
377
Percent
NA
NA
NA
NA
NA
NA
49.58%
61.08%
55.85%
23.53%
41.38%
33.03%
NA
NA
NA
49.22%
60.82%
55.54%
Page 94
Use of Services
Prime West
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care(MHCP-MC)
Member Months
(Inpatient)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
52734
11585
38970
12
0
103301
Female
50981
12024
66926
8
0
129939
Total
103715
23609
105896
20
0
233240
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
701
530
1231
278
311
589
779
1611
2390
0
0
0
0
0
0
1758
2452
4210
HEDIS 2013 (Reporting Year 2012)
Male
52734
11585
38970
12
0
103301
Female
50981
12024
66926
8
0
129939
Total
103715
23609
105896
20
0
233240
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
15.95%
12.48%
14.24%
28.80%
31.04%
29.94%
23.99%
28.89%
27.08%
0.00%
0.00%
0.00%
NA
NA
NA
20.42%
22.64%
21.66%
Number
8
13
21
15
27
42
62
89
151
0
0
0
0
0
0
85
129
214
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
52734
50981
103715
11585
12024
23609
38970
66926
105896
12
8
20
0
0
0
103301
129939
233240
Percent
0.18%
0.31%
0.24%
1.55%
2.69%
2.13%
1.91%
1.60%
1.71%
0.00%
0.00%
0.00%
NA
NA
NA
0.99%
1.19%
1.10%
Number
8
3
11
1
7
8
7
24
31
0
0
0
0
0
0
16
34
50
Percent
0.18%
0.07%
0.13%
0.10%
0.70%
0.41%
0.22%
0.43%
0.35%
0.00%
0.00%
0.00%
NA
NA
NA
0.19%
0.31%
0.26%
Member Months
(Outpatient/ED)
Male
52734
11585
38970
12
0
103301
Female
50981
12024
66926
8
0
129939
Total
103715
23609
105896
20
0
233240
Outpatient/ED
Number
700
530
1230
278
310
588
765
1592
2357
0
0
0
0
0
0
1743
2432
4175
Percent
15.93%
12.48%
14.23%
28.80%
30.94%
29.89%
23.56%
28.54%
26.71%
0.00%
0.00%
0.00%
NA
NA
NA
20.25%
22.46%
21.48%
Page 95
Use of Services
Prime West
Plan All-Cause Readmissions
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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 2013 (Reporting Year 2012)
Page 96
Use of Services
Prime West
Plan All-Cause Readmissions
Data Last Refreshed:
Nov 15, 2013 2:03 PM
MSHO
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 2013 (Reporting Year 2012)
Page 97
Use of Services
Prime West
Plan All-Cause Readmissions
Data Last Refreshed:
Nov 15, 2013 2:03 PM
SNBC
Age
18-44
45-54
55-64
Total
Age
65-74
75-84
85+
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
Total
HEDIS 2013 (Reporting Year 2012)
Page 98
Health Plan Descriptive Information
Prime West
Board Certification
Data Last Refreshed:
Nov 15, 2013 2:03 PM
MSHO
MSHO
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2013 (Reporting Year 2012)
SNBC
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
NR
NR
NR
NR
Page 99
Health Plan Descriptive Information
Prime West
Board Certification
Data Last Refreshed:
Nov 15, 2013 2:03 PM
MSHO
SNBC
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2013 (Reporting Year 2012)
SNBC
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
NR
NR
NR
NR
Page 100
Health Plan Descriptive Information
Prime West
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2013 (Reporting Year 2012)
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 101
Health Plan Descriptive Information
Prime West
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2013 (Reporting Year 2012)
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 102
Health Plan Descriptive Information
Prime West
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 2:03 PM
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
0
0.00%
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0
0
1
0
0.00%
0
0
0
3
1
0.02%
943
1158
1140
1231
1085
1090
3
0.02%
2120
2228
2294
3083
3498
5127
6647
99.98%
0
6648
18350
99.98%
0
18353
HEDIS 2013 (Reporting Year 2012)
Total
0
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0
0
4
4
0.02%
3063
3386
3434
4314
4583
6217
24997
99.98%
0
25001
Page 103
Health Plan Descriptive Information
Prime West
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 2:03 PM
SNBC
<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
36
Member Months
Female
0
0
0
0
0
23
36
0.97%
320
353
365
286
305
23
0.52%
180
235
343
285
489
1629
43.96%
457
535
517
481
1532
34.51%
658
796
816
556
1990
53.70%
51
0
0
0
0
0
2826
63.66%
58
0
0
0
0
0
51
1.38%
0
3706
58
1.31%
0
4439
HEDIS 2013 (Reporting Year 2012)
Total
0
0
0
0
0
59
59
0.72%
500
588
708
571
794
3161
38.81%
1115
1331
1333
1037
4816
59.13%
109
0
0
0
0
0
109
1.34%
0
8145
Page 104
Health Plan Descriptive Information
Prime West
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 2:03 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Member Months
Male
Female
6896
6572
<1
18457
17223
1-4
18789
18377
5-9
13376
14260
10-14
6801
6573
15-17
2890
4122
18-19
0-19 Subtotal
67209
67127
0-19 Subtotal: %
65.06%
51.66%
5512
13116
20-24
5634
13452
25-29
5704
11041
30-34
4350
6607
35-39
3658
5648
40-44
20-44 Subtotal
24858
49864
20-44 Subtotal: %
24.06%
38.37%
3697
4906
45-49
3636
3950
50-54
2539
2480
55-59
1350
1604
60-64
45-64 Subtotal
11222
12940
45-64 Subtotal: %
10.86%
9.96%
12
2
65-69
0
6
70-74
0
0
75-79
0
0
80-84
0
0
85-89
0
0
>=90
>=65 Subtotal
12
8
>=65 Subtotal: %
0.01%
0.01%
0
0
Age Unknown
Total
103301
129939
HEDIS 2013 (Reporting Year 2012)
Total
13468
35680
37166
27636
13374
7012
134336
57.60%
18628
19086
16745
10957
9306
74722
32.04%
8603
7586
5019
2954
24162
10.36%
14
6
0
0
0
0
20
0.01%
0
233240
Page 105