Medica
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
Medica
Adult BMI Assessment
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
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Commercial
Medicare
Advantage
MHCP-MC
2012
H
136880
2012
H
11578
3120
568
2.28%
411
10.00%
453
10
2.21%
NR
NR
4.91%
411
10.00%
453
26
5.74%
0
0
Number of administrative data records excluded
6456
1375
Number of medical record data records excluded
0
0
0
0
0
411
7
323
80.29%
76.32%
84.26%
0
411
21
353
91.00%
88.11%
93.89%
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)
NR
NR
NR
Page 3
Effectiveness of Care
Medica
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Commercial
Counseling for Nutrition
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
Total
2011
H
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Physical Activity
Total
2012
H
General
Measure
Data
Total
27336
18205
45541
29842
20186
50028
29842
20186
50028
1530
5.60%
814
4.47%
2344
5.15%
136
0.46%
121
0.60%
257
0.51%
14
0.05%
14
0.07%
28
0.06%
0
0.00%
0
0.00%
0
0.00%
250
0
130
52.00%
45.61%
58.39%
161
0
87
54.04%
46.03%
62.05%
411
0
217
52.80%
47.85%
57.75%
411
10.00%
453
411
10.00%
453
16
3.53%
3
0.66%
19
4.19%
411
10.00%
453
0
0.00%
1
0.22%
1
0.22%
0
0
0
Number of administrative data records
excluded
59
54
54
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
264
15
177
72.73%
67.17%
78.29%
147
3
95
66.67%
58.71%
74.63%
411
18
272
70.56%
66.03%
75.09%
250
0
154
61.60%
55.37%
67.83%
161
1
73
45.96%
37.95%
53.97%
411
1
227
55.47%
50.55%
60.40%
Page 4
Effectiveness of Care
Medica
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Nov 15, 2013 1:18 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
Number of Records Excluded Because of
Valid Data Errors
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Nutrition
Total
2011
H
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Physical Activity
Total
2011
H
General
Measure
Data
10023
31509
21486
10023
31509
21486
10023
31509
947
4.41%
349
3.48%
1296
4.11%
231
1.08%
163
1.63%
394
1.25%
1
0.00%
2
0.02%
3
0.01%
0
0.00%
0
0.00%
0
0.00%
278
0
144
51.80%
45.74%
57.85%
133
0
76
57.14%
48.36%
65.93%
411
0
220
53.53%
48.58%
58.47%
411
10.00%
453
411
10.00%
453
17
3.75%
8
1.77%
25
5.52%
411
10.00%
453
2
0.44%
4
0.88%
6
1.32%
0
121
121
121
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)
Total
21486
0
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Ages 1217
2011
H
0
Number of administrative data records
excluded
Ages 3-11
278
15
208
80.22%
75.35%
85.08%
133
7
91
73.68%
65.82%
81.54%
411
22
299
78.10%
73.98%
82.22%
278
2
184
66.91%
61.20%
72.62%
133
4
70
55.64%
46.82%
64.46%
411
6
254
63.26%
58.48%
68.04%
Page 5
Effectiveness of Care
Medica
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 1:18 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
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
HiB
Hepatitis B
VZV
Influenza
2328
75.58%
2582
83.83%
2735
88.80%
2687
87.24%
2194
71.23%
2669
86.66%
2382
77.34%
1027
33.34%
2180
70.78%
2008
65.19%
345
76.16%
383
84.55%
395
87.20%
401
88.52%
314
69.32%
388
85.65%
347
76.60%
152
33.55%
331
73.07%
299
66.00%
310
346
356
363
281
351
310
140
298
268
45
86.37%
82.94%
89.81%
36
92.94%
90.35%
95.54%
15
90.27%
87.28%
93.25%
27
94.89%
92.64%
97.14%
79
87.59%
84.28%
90.90%
15
89.05%
85.91%
92.19%
45
86.37%
82.94%
89.81%
7
35.77%
31.01%
40.52%
31
80.05%
76.06%
84.03%
13
68.37%
63.75%
72.99%
0
Number of medical data records excluded
Numerator Events by Medical Record
MMR
411
10.00%
453
1
Numerator Events by administrative Data
IPV
2011
H
3080
Number of administrative data records
excluded
Denominator
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
411
Page 6
Effectiveness of Care
Medica
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 1:18 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
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
2328
75.58%
1870
60.71%
1793
58.21%
749
24.32%
1588
51.56%
1412
45.84%
681
22.11%
621
20.16%
1275
41.40%
568
18.44%
345
76.16%
272
60.04%
259
57.17%
115
25.39%
234
51.66%
209
46.14%
106
23.40%
101
22.30%
193
42.60%
93
20.53%
310
243
230
104
208
185
96
92
171
85
45
86.37%
82.94%
89.81%
75
77.37%
73.21%
81.54%
78
74.94%
70.63%
79.25%
28
32.12%
27.48%
36.75%
67
66.91%
62.24%
71.58%
55
58.39%
53.51%
63.28%
26
29.68%
25.15%
34.22%
21
27.49%
23.06%
31.93%
46
52.80%
47.85%
57.75%
20
25.55%
21.21%
29.89%
0
Number of medical data records excluded
Numerator Events by Medical Record
Combo 3
411
10.00%
453
1
Numerator Events by administrative Data
Combo 2
2011
H
3080
Number of administrative data records
excluded
Denominator
DTaP
411
Page 7
Effectiveness of Care
Medica
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 1:18 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
2280
72.59%
2651
84.40%
2727
86.82%
2731
86.95%
2352
74.88%
2720
86.60%
2352
74.88%
973
30.98%
2005
63.83%
1705
54.28%
349
77.04%
399
88.08%
403
88.96%
405
89.40%
350
77.26%
401
88.52%
344
75.94%
132
29.14%
291
64.24%
244
53.86%
323
30
85.89%
82.40%
89.38%
365
25
94.89%
92.64%
97.14%
370
7
91.73%
88.94%
94.51%
369
21
94.89%
92.64%
97.14%
321
60
92.70%
90.06%
95.34%
365
7
90.51%
87.56%
93.47%
318
34
85.64%
82.13%
89.16%
122
10
32.12%
27.48%
36.75%
265
34
72.75%
68.32%
77.18%
220
14
56.93%
52.03%
61.84%
0
Number of medical data records excluded
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
MMR
411
0.1
453
1
Numerator Events by administrative Data
IPV
2011
H
3141
Number of administrative data records
excluded
Denominator
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
411
Page 8
Effectiveness of Care
Medica
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 1:18 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
2280
72.59%
1915
60.97%
1827
58.17%
737
23.46%
1473
46.90%
1199
38.17%
643
20.47%
544
17.32%
1039
33.08%
485
15.44%
349
77.04%
293
64.68%
269
59.38%
90
19.87%
210
46.36%
173
38.19%
80
17.66%
74
16.34%
152
33.55%
67
14.79%
323
30
85.89%
82.40%
89.38%
272
55
79.56%
75.54%
83.58%
251
59
75.43%
71.14%
79.71%
83
36
28.95%
24.45%
33.46%
194
54
60.34%
55.49%
65.19%
158
46
49.64%
44.68%
54.59%
73
32
25.55%
21.21%
29.89%
67
28
23.11%
18.92%
27.31%
138
40
43.31%
38.40%
48.22%
60
25
20.68%
16.64%
24.72%
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
0.1
453
1
Numerator Events by administrative Data
Combo 2
2011
H
3141
Number of administrative data records
excluded
Denominator
DTaP
411
Page 9
Effectiveness of Care
Medica
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Immunizations for Adolescents
Commercial
Commercial
Data Elements
Measurement Year
General
Measure Data
H
Eligible Member Population
3576
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Combo 1
2178
3006
2118
60.91%
84.06%
59.23%
269
59.38%
367
81.02%
259
57.17%
245
6
337
17
237
12
411
10.00%
453
Records Excluded because of Valid Data Errors
0
Number of administrative data records excluded
0
Number of medical data records excluded
0
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Tdap
2012
Data Collection Methodology
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Meningococcal
0
411
61.07%
86.13%
60.58%
Lower 95% Confidence Interval
56.23%
82.67%
55.74%
Upper 95% Confidence Interval
65.91%
89.59%
65.43%
HEDIS 2013 (Reporting Year 2012)
Page 10
Effectiveness of Care
Medica
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Immunizations for Adolescents
Commercial
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Data Elements
Measure Data
Measurement Year
2012
Data Collection Methodology
H
Eligible Member Population
1488
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
878
1228
847
59.01%
82.53%
56.92%
257
56.73%
372
82.12%
250
55.19%
232
7
58.15%
53.26%
63.04%
338
8
84.18%
80.54%
87.83%
227
7
56.93%
52.03%
61.84%
411
10.00%
453
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
411
Page 11
Effectiveness of Care
Medica
Breast Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Commercial
2012
A
45046
31301
69.49%
69.06%
69.91%
Medicare
Advantage
NR
NR
NR
MSHO
SNBC
MHCP-MC
2012
A
614
351
57.17%
53.17%
61.16%
2012
A
741
339
45.75%
42.09%
49.40%
2012
A
3318
1958
59.01%
57.32%
60.70%
Page 12
Effectiveness of Care
Medica
Cervical Cancer Screening
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)
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Commercial
2012
A
52247
MHCP-MC
2012
A
12931
NR
NR
NR
NR
38986
8693
74.62%
74.24%
74.99%
67.23%
66.41%
68.04%
Page 13
Effectiveness of Care
Medica
Colorectal Cancer Screening
Data Last Refreshed:
Nov 15, 2013 1:18 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
MSHO
SNBC
2012
H
55057
2012
H
2784
2012
H
780
33359
1459
323
52.41%
411
10.00%
453
240
52.98%
0
13
1
0
1
411
217
24
58.64%
53.75%
63.52%
41.41%
411
10.00%
453
182
40.18%
0
2
0
0
0
411
171
82
61.56%
56.73%
66.38%
60.59%
411
0.1
453
291
64.24%
0
43
0
0
0
411
263
17
68.13%
63.50%
72.75%
NR
NR
NR
NR
NR
Page 14
Effectiveness of Care
Medica
Chlamydia Screening in Women
Data Last Refreshed:
Nov 15, 2013 1:18 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
Ages 21-24
Total
4898
1979
40.40%
39.02%
41.79%
5431
2753
50.69%
49.35%
52.03%
10329
4732
45.81%
44.85%
46.78%
2012
A
Page 15
Effectiveness of Care
Medica
Chlamydia Screening in Women
Data Last Refreshed:
Nov 15, 2013 1:18 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
1604
906
56.48%
54.03%
58.94%
1240
833
67.18%
64.52%
69.83%
2844
1739
61.15%
59.34%
62.96%
2012
A
Page 16
Effectiveness of Care
Medica
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Medicare
Advantage
NR
NR
NR
MSHO
2012
A
7564
5855
77.41%
76.46%
78.36%
Page 17
Effectiveness of Care
Medica
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Lead Screening in Children
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
Commercial
2012
A
2902
MHCP-MC
2012
A
1827
1937
66.75%
NR
NR
NR
0
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
2097
1937
1620
66.75%
88.67%
Lower 95% Confidence Interval
65.02%
87.19%
Upper 95% Confidence Interval
68.48%
90.15%
HEDIS 2013 (Reporting Year 2012)
Page 18
Effectiveness of Care
Medica
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Care for Older Adults
MSHO
Advance Care
Planning
Medication Review
Functional
Status
Assessment
Pain
Screening
4
0
0
0
0.05%
0.00%
0.00%
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
254
61.80%
0
370
90.02%
0
305
74.21%
0
274
66.67%
Lower 95% Confidence Interval
56.98%
87.01%
69.86%
61.99%
Upper 95% Confidence Interval
66.62%
93.04%
78.56%
71.35%
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
8774
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
10.00%
453
0
0
0
411
Page 19
Effectiveness of Care
Medica
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Nov 15, 2013 1:18 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
157
70.09%
63.87%
76.31%
200
89.29%
85.01%
93.56%
2012
A
224
Page 21
Effectiveness of Care
Medica
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Nov 15, 2013 1:18 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
69
36.70%
29.55%
43.86%
89
47.34%
39.94%
54.74%
2012
A
188
Page 22
Effectiveness of Care
Medica
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Nov 15, 2013 1:18 PM
MSHO
SNBC
2012
A
243
48
19.75%
14.54%
24.96%
2012
A
29
12
NA
NA
NA
Page 23
Effectiveness of Care
Medica
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Nov 15, 2013 1:18 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
Ages 12-18
Ages 19-50
Ages 51-64
Total
308
297
11
96.43%
94.19%
98.66%
265
240
12
90.57%
86.86%
94.27%
982
838
107
85.34%
83.07%
87.60%
551
500
254
90.74%
88.23%
93.25%
2106
1875
384
89.03%
87.67%
90.39%
2012
A
`
Page 24
Effectiveness of Care
Medica
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Nov 15, 2013 1:18 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
339
317
21
93.51%
90.74%
96.28%
252
216
14
85.71%
81.20%
90.23%
349
265
75
75.93%
71.30%
80.56%
103
86
112
83.50%
75.84%
91.15%
1043
884
222
84.76%
82.53%
86.98%
2012
A
Page 25
Effectiveness of Care
Medica
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Nov 15, 2013 1:18 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
1614
87.43%
40
2.17%
387
85.43%
11
2.43%
350
17
89.29%
86.18%
92.41%
11
266
67.40%
62.74%
72.05%
2012
H
1846
411
10.00%
453
0
0
0
411
Page 26
Effectiveness of Care
Medica
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Nov 15, 2013 1:18 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
172
86.00%
5
2.50%
172
86.00%
5
2.50%
172
7
89.50%
85.00%
94.00%
5
123
64.00%
57.10%
70.90%
2011
H
200
200
0.00%
200
0
0
0
200
Page 28
Effectiveness of Care
Medica
Controlling High Blood Pressure
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Data Elements
Medicare
Advantage
MSHO
SNBC
MHCP-MC
2012
H
19408
2012
H
2571
2012
H
754
2012
H
2575
0
0
0
0
0.00%
411
15.00%
473
0
0.00%
0.00%
411
15.00%
473
0
0.00%
0.00%
411
15.00%
473
0
0.00%
0
2
4
2
0
0
0
0
Number of administrative data records
excluded
344
169
37
99
Number of medical record data records
excluded
0
2
2
1
0
0
0
0
0
411
0
305
74.21%
69.86%
78.56%
4
411
0
325
79.08%
75.02%
83.13%
6
411
0
318
77.37%
73.21%
81.54%
3
411
0
284
69.10%
64.51%
73.69%
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 records excluded because of
false positive diagnoses
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
0.00%
411
15.00%
473
0
0.00%
NR
NR
NR
NR
NR
Page 29
Effectiveness of Care
Medica
Persistence of Beta Blocker Treatment After Heart Attack
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
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Medicare
Advantage
MSHO
SNBC
MHCP-MC
2012
A
145
2012
A
42
2012
A
5
2012
A
25
128
41
4
21
97.62%
91.82%
100.00%
NA
NA
NA
NA
NA
NA
88.28%
82.69%
93.86%
NR
NR
NR
Page 30
Effectiveness of Care
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 1:18 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%)
2011
H
9351
2011
H
9351
2011
H
9351
8383
89.65%
548
10%
603
504
83.58%
9191
98.29%
548
10%
603
595
98.67%
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
2011
H
9351
2012
H
10350
2011
H
9351
2011
H
9351
2011
H
9351
2011
H
9351
2011
H
9351
119
1.27%
548
10%
603
3
0.50%
140
1.50%
548
10%
603
8
1.33%
5171
49.96%
548
10%
603
314
52.07%
7831
83.75%
548
10%
603
483
80.10%
182
1.95%
548
10%
603
11
1.82%
7564
80.89%
548
10%
603
499
82.75%
24
0.26%
548
10%
603
1
0.17%
21
0.22%
548
10%
603
1
0.17%
3
3
3
3
5
3
3
3
3
3
Number of administrative data records
excluded
110
110
110
110
116
110
110
110
110
110
Number of medical record data records
excluded
0
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
3
548
7
377
70.07%
66.15%
74.00%
5
548
288
71
65.51%
61.44%
69.58%
3
548
441
42
88.14%
85.34%
90.94%
3
548
10
294
55.47%
51.22%
59.73%
3
548
463
16
87.41%
84.54%
90.28%
3
548
1
424
77.55%
73.97%
81.14%
3
548
1
324
59.31%
55.10%
63.51%
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)
84
16
3
548
459
55
93.80%
91.68%
95.91%
3
548
55
45
18.25%
14.92%
21.57%
2
448
3
210
47.54%
42.81%
52.28%
Page 31
Effectiveness of Care
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 1:18 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
1267
2012
H
1267
1171
92.42%
411
10%
453
418
92.27%
1216
95.97%
411
10%
453
66
14.57%
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
1267
2012
H
1267
2012
H
1267
2012
H
1267
2012
H
1267
2012
H
1267
2012
H
1267
37
2.92%
411
10%
453
13
2.87%
847
66.85%
411
10%
453
298
65.78%
1032
81.45%
411
10%
453
369
81.46%
63
4.97%
411
10%
453
24
5.30%
1131
89.27%
411
10%
453
400
88.30%
41
3.24%
411
10%
453
6
1.32%
36
2.84%
411
10%
453
6
1.32%
3
3
3
3
3
3
3
3
3
Number of administrative data records
excluded
1
1
1
1
1
1
1
1
1
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
3
411
338
47
93.67%
91.20%
96.15%
3
411
33
25
14.11%
10.62%
17.60%
3
411
9
312
78.10%
73.98%
82.22%
3
411
277
34
75.67%
71.40%
79.94%
3
411
310
35
83.94%
80.27%
87.61%
3
411
22
235
62.53%
57.73%
67.33%
3
411
361
8
89.78%
86.73%
92.83%
3
411
6
337
83.45%
79.74%
87.17%
3
411
6
296
73.48%
69.09%
77.87%
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
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 1:18 PM
SNBC
HbA1c
Testing
Poor HbA1c
Control
2012
H
785
2012
H
785
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
568
72.36%
411
10%
453
323
71.30%
745
94.90%
411
10%
453
91
20.09%
Number of Records Excluded Because of
Valid Data Errors
3
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
785
2012
H
785
2012
H
785
2012
H
785
2012
H
785
2012
H
785
2012
H
785
28
3.57%
411
10%
453
15
3.31%
507
64.59%
411
10%
453
286
63.13%
444
56.56%
411
10%
453
263
58.06%
42
5.35%
411
10%
453
21
4.64%
446
56.82%
411
10%
453
248
54.75%
33
4.20%
411
10%
453
9
1.99%
27
3.44%
411
10%
453
7
1.55%
3
3
3
3
3
3
3
3
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
3
411
221
155
91.48%
88.66%
94.30%
3
411
43
39
19.95%
15.97%
23.94%
3
411
9
282
70.80%
66.29%
75.32%
3
411
265
48
76.16%
71.91%
80.40%
3
411
205
135
82.73%
78.95%
86.50%
3
411
19
205
54.50%
49.57%
59.44%
3
411
224
92
76.89%
72.69%
81.08%
3
411
9
321
80.29%
76.32%
84.26%
3
411
7
236
59.12%
54.25%
64.00%
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
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 1:18 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
2011
H
2546
2011
H
2546
2231
87.63%
411
10%
453
359
79.25%
2516
98.82%
411
10%
453
444
98.01%
13
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
2011
H
2546
2011
H
2546
2011
H
2546
2011
H
2546
2011
H
2546
2011
H
2546
2011
H
2546
20
0.79%
411
10%
453
3
0.66%
1349
52.99%
411
10%
453
251
55.41%
1960
76.98%
411
10%
453
330
72.85%
65
2.55%
411
10%
453
10
2.21%
1955
76.79%
411
10%
453
363
80.13%
11
0.43%
411
10%
453
1
0.22%
9
0.35%
411
10%
453
1
0.22%
13
13
13
13
13
13
13
13
69
69
69
69
69
69
69
69
69
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
13
411
337
51
94.40%
92.06%
96.75%
13
411
31
68
24.09%
19.83%
28.34%
13
411
2
257
63.02%
58.23%
67.81%
13
411
229
42
65.94%
61.23%
70.64%
13
411
309
37
84.18%
80.54%
87.83%
13
411
8
172
43.80%
38.88%
48.71%
13
411
338
8
84.18%
80.54%
87.83%
13
411
1
335
81.75%
77.90%
85.61%
13
411
1
246
60.10%
55.24%
64.95%
2011
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 35
Effectiveness of Care
Medica
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Medicare
Advantage
NR
NR
NR
Page 36
Effectiveness of Care
Medica
Osteoporosis Management in Women Who had a Fracture
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Nov 15, 2013 1:18 PM
MSHO
2012
A
268
26
9.70%
5.97%
13.43%
Page 37
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 1:18 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
2012
A
1914
1447
75.60%
73.65%
77.55%
1159
60.55%
58.34%
62.77%
Page 38
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 1:18 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
101
78
77.23%
68.55%
85.90%
66
65.35%
55.57%
75.12%
Page 40
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 1:18 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
27
19
NA
NA
NA
14
NA
NA
NA
Page 41
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 1:18 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
1130
615
54.42%
51.48%
57.37%
444
39.29%
36.40%
42.18%
Page 42
Effectiveness of Care
Medica
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Nov 15, 2013 1:18 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
455
172
37.80%
33.24%
42.37%
133
57
42.86%
34.07%
51.64%
2012
A
Page 43
Effectiveness of Care
Medica
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Nov 15, 2013 1:18 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
633
314
49.61%
45.63%
53.58%
114
61
53.51%
43.91%
63.10%
2012
A
Page 44
Effectiveness of Care
Medica
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Nov 15, 2013 1:18 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
31
75.61%
61.25%
89.97%
22
53.66%
37.18%
70.14%
2012
A
41
Page 46
Effectiveness of Care
Medica
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Nov 15, 2013 1:18 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
470
80.48%
77.18%
83.78%
354
60.62%
56.57%
64.66%
2012
A
584
Page 47
Effectiveness of Care
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 1:18 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
14931
12239
81.97%
81.35%
82.59%
141
123
87.23%
81.37%
93.10%
11115
9088
81.76%
81.04%
82.49%
617
429
69.53%
65.82%
73.24%
26804
21879
81.63%
81.16%
82.09%
2012
A
Page 48
Effectiveness of Care
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 1:18 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
3598
3352
93.16%
92.32%
94.00%
261
246
94.25%
91.24%
97.27%
3455
3272
94.70%
93.94%
95.46%
495
388
78.38%
74.66%
82.11%
7809
7258
92.94%
92.37%
93.52%
2012
A
Page 50
Effectiveness of Care
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 1:18 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
286
255
89.16%
85.38%
92.94%
6
6
NA
NA
NA
245
227
92.65%
89.18%
96.12%
127
92
72.44%
64.28%
80.61%
664
580
87.35%
84.75%
89.95%
2012
A
Page 51
Effectiveness of Care
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 1:18 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
1937
1670
86.22%
84.65%
87.78%
20
16
NA
NA
NA
1530
1320
86.27%
84.52%
88.03%
197
140
71.07%
64.48%
77.65%
3684
3146
85.40%
84.24%
86.55%
2012
A
Page 52
Access/Availability of Care
Medica
Medication Reconciliation Post Discharge
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)
Data Last Refreshed:
Nov 15, 2013 1:18 PM
MSHO
2012
H
3077
0
0.00%
411
40.00%
575
0
0.00%
121
0
121
411
0
201
48.91%
43.95%
53.86%
Page 53
Effectiveness of Care
Medica
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Nov 15, 2013 1:18 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
132
10
7.58%
2.68%
12.47%
2876
627
21.80%
20.27%
23.33%
2012
A
574
122
21.25%
17.82%
24.69%
2170
495
22.81%
21.02%
24.60%
Page 55
Effectiveness of Care
Medica
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Nov 15, 2013 1:18 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
8458
At least 1
Prescription
At least 2
Prescriptions
1894
22.39%
21.50%
23.29%
639
7.55%
6.99%
8.12%
Page 57
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Commercial
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
54127
61480
3709
119316
50977
94.18%
93.98%
94.38%
59191
96.28%
96.13%
96.43%
3647
98.33%
97.90%
98.75%
113815
95.39%
95.27%
95.51%
2012
A
Page 58
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 1:18 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
8816
8816
0
NA
NA
NA
0
NA
NA
NA
8631
97.90%
97.60%
98.21%
8631
97.90%
97.60%
98.21%
2012
A
Page 60
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 1:18 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
1356
2276
74
3706
1292
95.28%
94.11%
96.45%
2194
96.40%
95.61%
97.18%
72
97.30%
92.93%
100.00%
3558
96.01%
95.36%
96.65%
2012
A
Page 61
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 1:18 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
14929
8182
32
23143
13241
88.69%
88.18%
89.20%
7331
89.60%
88.93%
90.27%
29
90.63%
78.96%
100.00%
20601
89.02%
88.61%
89.42%
2012
A
Page 62
Access/Availability of Care
Medica
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Nov 15, 2013 1:18 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.
3757
3682
98.00%
97.54%
98.46%
18746
17167
91.58%
91.18%
91.98%
13985
12872
92.04%
91.59%
92.49%
24351
22145
90.94%
90.58%
91.30%
2012
A
Page 63
Access/Availability of Care
Medica
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Nov 15, 2013 1:18 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.
3002
2933
97.70%
97.15%
98.25%
9486
8626
90.93%
90.35%
91.52%
5652
5235
92.62%
91.93%
93.31%
6887
6324
91.83%
91.17%
92.48%
2012
A
Page 64
Access/Availability of Care
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Commercial
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
214
3193
3407
90
53
997
511
42.06%
35.21%
48.90%
24.77%
18.75%
30.78%
31.22%
29.60%
32.85%
16.00%
14.72%
17.29%
1087
31.90%
30.33%
33.48%
564
16.55%
15.29%
17.82%
Page 65
Access/Availability of Care
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 1:18 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
155
0
155
0
0
62
4
NA
NA
NA
NA
NA
NA
40.00%
31.96%
48.04%
2.58%
0.00%
5.40%
62
40.00%
31.96%
48.04%
4
2.58%
0.00%
5.40%
Page 67
Access/Availability of Care
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 1:18 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
975
975
0
0
308
84
NA
NA
NA
NA
NA
NA
31.59%
28.62%
34.56%
8.62%
6.80%
10.43%
308
31.59%
28.62%
34.56%
84
8.62%
6.80%
10.43%
Page 68
Access/Availability of Care
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 1:18 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
254
2845
3099
100
59
816
410
39.37%
33.16%
45.58%
23.23%
17.84%
28.62%
28.68%
27.00%
30.36%
14.41%
13.10%
15.72%
916
29.56%
27.94%
31.18%
469
15.13%
13.86%
16.41%
Page 69
Access/Availability of Care
Medica
Prenatal and Postpartum Care
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Commercial
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
3986
Postpartum
Care
2012
H
3986
2915
2074
73.13%
411
10.00%
453
329
72.63%
52.03%
411
10.00%
453
227
50.11%
1
1
0
1
411
303
88
95.13%
92.93%
97.34%
0
1
411
212
121
81.02%
77.11%
84.93%
Page 70
Access/Availability of Care
Medica
Prenatal and Postpartum Care
Data Last Refreshed:
Nov 15, 2013 1:18 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
3541
Postpartum
Care
2012
H
3541
2278
1946
64.33%
411
10.00%
453
272
60.04%
54.96%
411
10.00%
453
250
55.19%
0
0
0
0
411
245
123
89.54%
86.46%
92.62%
0
0
411
224
71
71.78%
67.30%
76.25%
Page 71
Use of Services
Medica
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Nov 15, 2013 1:18 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
36
22
21
51
124
334
2028
1.38%
0.91%
1.84%
0.84%
0.47%
1.21%
0.80%
0.44%
1.16%
1.95%
1.40%
2.50%
4.74%
3.91%
5.57%
12.77%
11.47%
14.07%
77.52%
75.90%
79.14%
2012
A
2616
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
Medica
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Nov 15, 2013 1:18 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
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
52
53
85
124
284
512
1410
2.06%
1.49%
2.64%
2.10%
1.52%
2.68%
3.37%
2.65%
4.10%
4.92%
4.06%
5.78%
11.27%
10.02%
12.52%
20.32%
18.73%
21.91%
55.95%
53.99%
57.91%
2012
A
2520
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 73
Use of Services
Medica
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Commercial
2012
A
15498
MHCP-MC
2012
A
7902
NR
NR
NR
NR
11041
5588
71.24%
70.53%
71.96%
70.72%
69.71%
71.73%
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)
Page 74
Use of Services
Medica
Adolescent Well-Care Visits
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)
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Commercial
2012
A
43608
MHCP-MC
2012
A
11999
NR
NR
NR
NR
14931
4511
34.24%
33.79%
34.69%
37.59%
36.72%
38.47%
Page 75
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
50505
500708
600062
1672526
1416839
65118
5643
1266
0
4312667
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
42307
144078
134246
389467
464156
32618
3900
924
0
1211696
HEDIS 2013 (Reporting Year 2012)
Visits/ 1,000
Member
Months
837.68
287.75
223.72
232.86
327.60
500.91
691.12
729.86
280.96
Emergency Room Visits
Visits
1639
7933
7764
23205
17789
1142
166
85
0
59723
Visits/ 1,000
Member
Months
32.45
15.84
12.94
13.87
12.56
17.54
29.42
67.14
13.85
Page 76
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 1:18 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
6
38707
37240
34256
0
110209
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
8
36696
36318
28911
0
101933
HEDIS 2013 (Reporting Year 2012)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
1333.33
948.05
975.24
843.97
924.91
Emergency Room Visits
Visits
0
0
0
0
1
2713
2655
1797
0
7166
Visits/ 1,000
Member
Months
NA
NA
NA
NA
166.67
70.09
71.29
52.46
65.02
Page 78
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 1:18 PM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
1907
53456
88230
1122
0
0
0
144715
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
683
33309
74495
927
0
0
0
109414
HEDIS 2013 (Reporting Year 2012)
Visits/ 1,000
Member
Months
NA
NA
358.15
623.11
844.33
826.20
NA
NA
756.07
Emergency Room Visits
Visits
0
0
154
7328
11104
96
0
0
0
18682
Visits/ 1,000
Member
Months
NA
NA
80.76
137.08
125.85
85.56
NA
NA
129.10
Page 79
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 1:18 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
60483
390881
293904
352994
139961
299
88
6
0
1238616
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
47125
124377
78135
192102
98216
229
97
4
1
540286
HEDIS 2013 (Reporting Year 2012)
Visits/ 1,000
Member
Months
779.14
318.20
265.85
544.21
701.74
765.89
1102.27
666.67
436.20
Emergency Room Visits
Visits
7483
22136
12544
38267
9231
12
1
0
0
89674
Visits/ 1,000
Member
Months
123.72
56.63
42.68
108.41
65.95
40.13
11.36
0.00
72.40
Page 80
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
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
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Member Months
50505
500708
600062
1672526
1416839
65118
5643
1266
0
4312667
Discharges
Discharges /
1,000 Member
Months
424
619
784
7632
7190
714
81
37
0
17481
8.40
1.24
1.31
4.56
5.07
10.96
14.35
29.23
358
437
425
1542
3241
351
51
28
0
6433
7.09
0.87
0.71
0.92
2.29
5.39
9.04
22.12
65
182
263
1433
3938
363
30
9
0
6283
1.29
0.36
0.44
0.86
2.78
5.57
5.32
7.11
96
4656
10
0
4762
0.16
2.78
0.01
HEDIS 2013 (Reporting Year 2012)
4.05
1.49
1.46
1.29
Days
Days / 1,000
Member
Months
2786
1906
2669
21626
27408
2894
355
116
0
59760
55.16
3.81
4.45
12.93
19.34
44.44
62.91
91.63
2138
1158
1397
4992
12690
1385
199
81
0
24040
42.33
2.31
2.33
2.98
8.96
21.27
35.26
63.98
647
748
1030
4648
14689
1509
156
35
0
23462
12.81
1.49
1.72
2.78
10.37
23.17
27.64
27.65
242
11974
27
0
12243
0.40
7.16
0.02
13.86
5.57
5.44
3.32
Average
Length of Stay
6.57
3.08
3.40
2.83
3.81
4.05
4.38
3.14
NA
3.42
5.97
2.65
3.29
3.24
3.92
3.95
3.90
2.89
NA
3.74
9.95
4.11
3.92
3.24
3.73
4.16
5.20
3.89
NA
3.73
2.52
2.57
2.70
NA
2.57
Page 81
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Inpatient Utilization - General Hospital/Acute Care
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
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Member Months
0
0
0
0
6
38707
37240
34256
0
110209
Discharges
0
0
0
0
0
1374
1560
1219
0
4153
0
0
0
0
0
1019
1273
1036
0
3328
Discharges /
1,000 Member
Months
NA
NA
NA
NA
0.00
35.50
41.89
35.59
37.68
NA
NA
NA
NA
0.00
26.33
34.18
30.24
30.20
0
0
0
0
0
355
287
183
0
825
NA
NA
NA
NA
0.00
9.17
7.71
5.34
0
0
0
0
0
NA
NA
0.00
HEDIS 2013 (Reporting Year 2012)
7.49
0.00
Days
0
0
0
0
0
7081
7383
5160
0
19624
0
0
0
0
0
4828
5600
4093
0
14521
Days / 1,000
Member
Months
NA
NA
NA
NA
0.00
182.94
198.25
150.63
178.06
NA
NA
NA
NA
0.00
124.73
150.38
119.48
131.76
0
0
0
0
0
2253
1783
1067
0
5103
NA
NA
NA
NA
0.00
58.21
47.88
31.15
0
0
0
0
0
NA
NA
0.00
46.30
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
5.15
4.73
4.23
NA
4.73
NA
NA
NA
NA
NA
4.74
4.40
3.95
NA
4.36
NA
NA
NA
NA
NA
6.35
6.21
5.83
NA
6.19
NA
NA
NA
NA
NA
Page 83
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
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
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Member Months
0
0
1907
53456
88230
1122
0
0
0
144715
Discharges
Discharges /
1,000 Member
Months
0
0
13
824
2148
25
0
0
0
3010
NA
NA
6.82
15.41
24.35
22.28
NA
NA
0
0
9
554
1583
17
0
0
0
2163
NA
NA
4.72
10.36
17.94
15.15
NA
NA
0
0
2
208
564
8
0
0
0
782
NA
NA
1.05
3.89
6.39
7.13
NA
NA
2
62
1
0
65
1.05
1.16
0.01
HEDIS 2013 (Reporting Year 2012)
20.80
14.95
5.40
0.45
Days
Days / 1,000
Member
Months
0
0
40
3731
10098
111
0
0
0
13980
NA
NA
20.98
69.80
114.45
98.93
NA
NA
0
0
33
2173
6983
60
0
0
0
9249
NA
NA
17.30
40.65
79.15
53.48
NA
NA
0
0
2
1282
3113
51
0
0
0
4448
NA
NA
1.05
23.98
35.28
45.45
NA
NA
5
276
2
0
283
2.62
5.16
0.02
96.60
63.91
30.74
1.97
Average
Length of Stay
NA
NA
3.08
4.53
4.70
4.44
NA
NA
NA
4.64
NA
NA
3.67
3.92
4.41
3.53
NA
NA
NA
4.28
NA
NA
1.00
6.16
5.52
6.38
NA
NA
NA
5.69
2.50
4.45
2.00
NA
4.35
Page 84
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
<1
60483
1-9
390881
10-19
293904
20-44
352994
45-64
139961
65-74
299
75-84
88
85+
6
Unknown
0
1238616
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
707
792
1009
6426
1720
1
0
0
0
10655
11.69
2.03
3.43
18.20
12.29
3.34
0.00
0.00
617
652
350
1401
1021
1
0
0
0
4042
10.20
1.67
1.19
3.97
7.29
3.34
0.00
0.00
90
140
159
806
690
0
0
0
0
1885
1.49
0.36
0.54
2.28
4.93
0.00
0.00
0.00
500
4219
9
0
4728
1.70
11.95
0.06
HEDIS 2013 (Reporting Year 2012)
8.60
3.26
1.52
6.01
Days
Days / 1,000
Member
Months
3876
2433
3303
18461
6460
6
0
0
0
34539
64.08
6.22
11.24
52.30
46.16
20.07
0.00
0.00
2867
1855
1345
4540
3706
6
0
0
0
14319
47.40
4.75
4.58
12.86
26.48
20.07
0.00
0.00
1009
578
625
3139
2718
0
0
0
0
8069
16.68
1.48
2.13
8.89
19.42
0.00
0.00
0.00
1333
10782
36
0
12151
4.54
30.54
0.26
27.89
11.56
6.51
15.44
Average
Length of Stay
5.48
3.07
3.27
2.87
3.76
6.00
NA
NA
NA
3.24
4.65
2.85
3.84
3.24
3.63
6.00
NA
NA
NA
3.54
11.21
4.13
3.93
3.89
3.94
NA
NA
NA
NA
4.28
2.67
2.56
4.00
NA
2.57
Page 85
Use of Services
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Commercial
Member Months
(Inpatient)
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
370161
154919
223633
337074
1062285
41211
0
2189283
Female
356404
148001
213484
327705
1046465
30809
0
2122868
Total
726565
302920
437117
664779
2108750
72020
0
4312151
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
8
1
9
220
157
377
728
354
1082
721
357
1078
1822
1052
2874
55
16
71
0
0
0
3554
1937
5491
HEDIS 2013 (Reporting Year 2012)
Male
370161
154919
223633
337074
1062285
41211
0
2189283
Female
356404
148001
213484
327705
1046465
30809
0
2122868
Total
726565
302920
437117
664779
2108750
72020
0
4312151
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
0.03%
0.00%
0.01%
1.70%
1.27%
1.49%
3.91%
1.99%
2.97%
2.57%
1.31%
1.95%
2.06%
1.21%
1.64%
1.60%
0.62%
1.18%
NA
NA
NA
1.95%
1.09%
1.53%
Number
0
1
1
67
51
118
154
81
235
118
63
181
421
263
684
20
7
27
0
0
0
780
466
1246
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
370161
356404
726565
154919
148001
302920
223633
213484
437117
337074
327705
664779
1062285
1046465
2108750
41211
30809
72020
0
0
0
2189283
2122868
4312151
Percent
0.00%
0.00%
0.00%
0.52%
0.41%
0.47%
0.83%
0.46%
0.65%
0.42%
0.23%
0.33%
0.48%
0.30%
0.39%
0.58%
0.27%
0.45%
NA
NA
NA
0.43%
0.26%
0.35%
Number
0
0
0
27
29
56
69
43
112
62
24
86
107
63
170
0
0
0
0
0
0
265
159
424
Percent
0.00%
0.00%
0.00%
0.21%
0.24%
0.22%
0.37%
0.24%
0.31%
0.22%
0.09%
0.16%
0.12%
0.07%
0.10%
0.00%
0.00%
0.00%
NA
NA
NA
0.15%
0.09%
0.12%
Member Months
(Outpatient/ED)
Male
370161
154919
223633
337074
1062285
41211
0
2189283
Female
356404
148001
213484
327705
1046465
30809
0
2122868
Total
726565
302920
437117
664779
2108750
72020
0
4312151
Outpatient/ED
Number
8
0
8
206
145
351
674
318
992
669
341
1010
1683
973
2656
49
14
63
0
0
0
3289
1791
5080
Percent
0.03%
0.00%
0.01%
1.60%
1.18%
1.39%
3.62%
1.79%
2.72%
2.38%
1.25%
1.82%
1.90%
1.12%
1.51%
1.43%
0.55%
1.05%
NA
NA
NA
1.80%
1.01%
1.41%
Page 86
Use of Services
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 1:18 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
30889
0
30890
Female
0
0
0
0
5
79295
0
79300
Member Months
(Inpatient)
Total
0
0
0
0
6
110184
0
110190
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
147
165
312
0
0
0
147
165
312
HEDIS 2013 (Reporting Year 2012)
Male
0
0
0
0
1
30889
0
30890
Female
0
0
0
0
5
79295
0
79300
Total
0
0
0
0
6
110184
0
110190
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
5.71%
2.50%
3.40%
NA
NA
NA
5.71%
2.50%
3.40%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
76
65
141
0
0
0
76
65
141
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
0
0
0
0
0
0
0
0
0
0
1
5
6
30889
79295
110184
0
0
0
30890
79300
110190
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
2.95%
0.98%
1.54%
NA
NA
NA
2.95%
0.98%
1.54%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
3
0
0
0
1
2
3
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.04%
0.03%
0.03%
NA
NA
NA
0.04%
0.03%
0.03%
Member Months
(Outpatient/ED)
Male
0
0
0
0
1
30889
0
30890
Female
0
0
0
0
5
79295
0
79300
Total
0
0
0
0
6
110184
0
110190
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
116
127
243
0
0
0
116
127
243
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
4.51%
1.92%
2.65%
NA
NA
NA
4.51%
1.92%
2.65%
Page 88
Use of Services
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 1:18 PM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
5710
10508
49324
337
0
65879
Female
0
0
3945
9381
64725
785
0
78836
Member Months
(Inpatient)
Total
0
0
9655
19889
114049
1122
0
144715
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
54
46
100
177
166
343
1158
1181
2339
4
3
7
0
0
0
1393
1396
2789
HEDIS 2013 (Reporting Year 2012)
Male
0
0
5710
10508
49324
337
0
65879
Female
0
0
3945
9381
64725
785
0
78836
Total
0
0
9655
19889
114049
1122
0
144715
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
11.35%
13.99%
12.43%
20.21%
21.23%
20.69%
28.17%
21.90%
24.61%
14.24%
4.59%
7.49%
NA
NA
NA
25.37%
21.25%
23.13%
Number
0
0
0
0
0
0
21
14
35
53
40
93
308
280
588
3
0
3
0
0
0
385
334
719
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
0
0
0
0
5710
3945
9655
10508
9381
19889
49324
64725
114049
337
785
1122
0
0
0
65879
78836
144715
Percent
NA
NA
NA
NA
NA
NA
4.41%
4.26%
4.35%
6.05%
5.12%
5.61%
7.49%
5.19%
6.19%
10.68%
0.00%
3.21%
NA
NA
NA
7.01%
5.08%
5.96%
Number
0
0
0
0
0
0
2
6
8
15
17
32
83
85
168
0
0
0
0
0
0
100
108
208
Percent
NA
NA
NA
NA
NA
NA
0.42%
1.83%
0.99%
1.71%
2.17%
1.93%
2.02%
1.58%
1.77%
0.00%
0.00%
0.00%
NA
NA
NA
1.82%
1.64%
1.72%
Member Months
(Outpatient/ED)
Male
0
0
5710
10508
49324
337
0
65879
Female
0
0
3945
9381
64725
785
0
78836
Total
0
0
9655
19889
114049
1122
0
144715
Outpatient/ED
Number
0
0
0
0
0
0
51
42
93
158
151
309
1085
1095
2180
3
3
6
0
0
0
1297
1291
2588
Percent
NA
NA
NA
NA
NA
NA
10.72%
12.78%
11.56%
18.04%
19.32%
18.64%
26.40%
20.30%
22.94%
10.68%
4.59%
6.42%
NA
NA
NA
23.63%
19.65%
21.46%
Page 89
Use of Services
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 1:18 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
280489
69922
48248
52343
107993
166
0
559161
Female
275503
72882
77173
105028
148642
227
0
679455
Total
555992
142804
125421
157371
256635
393
0
1238616
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
21
12
33
327
233
560
748
739
1487
1297
1494
2791
2262
1787
4049
0
1
1
0
0
0
4655
4266
8921
HEDIS 2013 (Reporting Year 2012)
Total
555992
142804
125421
157371
256635
393
0
1238616
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
280489
275503
555992
69922
72882
142804
48248
77173
125421
52343
105028
157371
107993
148642
256635
166
227
393
0
0
0
559161
679455
1238616
Percent
0.03%
0.02%
0.02%
1.03%
0.92%
0.97%
2.93%
2.53%
2.69%
4.54%
3.34%
3.74%
5.34%
3.00%
3.99%
0.00%
5.29%
3.05%
NA
NA
NA
1.85%
1.57%
1.70%
Intensive Outpatient/Partial
Hospitalization
Percent
Number
2
0.01%
1
0.00%
3
0.01%
51
0.88%
40
0.66%
91
0.76%
61
1.52%
64
1.00%
125
1.20%
137
3.14%
168
1.92%
305
2.33%
169
1.88%
153
1.24%
322
1.51%
0
0.00%
0
0.00%
0
0.00%
0
NA
0
NA
0
NA
420
0.90%
426
0.75%
846
0.82%
Member Months
(Inpatient)
Male
280489
69922
48248
52343
107993
166
0
559161
Female
275503
72882
77173
105028
148642
227
0
679455
Inpatient
Percent
0.09%
0.05%
0.07%
5.61%
3.84%
4.71%
18.60%
11.49%
14.23%
29.73%
17.07%
21.28%
25.13%
14.43%
18.93%
0.00%
5.29%
3.05%
NA
NA
NA
9.99%
7.53%
8.64%
Number
6
5
11
60
56
116
118
163
281
198
292
490
481
372
853
0
1
1
0
0
0
863
889
1752
Member Months
(Outpatient/ED)
Male
280489
69922
48248
52343
107993
166
0
559161
Female
275503
72882
77173
105028
148642
227
0
679455
Total
555992
142804
125421
157371
256635
393
0
1238616
Outpatient/ED
Number
19
11
30
311
210
521
699
677
1376
1238
1412
2650
2176
1689
3865
0
1
1
0
0
0
4443
4000
8443
Percent
0.08%
0.05%
0.06%
5.34%
3.46%
4.38%
17.39%
10.53%
13.17%
28.38%
16.13%
20.21%
24.18%
13.64%
18.07%
0.00%
5.29%
3.05%
NA
NA
NA
9.53%
7.06%
8.18%
Page 90
Use of Services
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Commercial
Member Months
(Inpatient)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
370161
154919
1622992
41211
0
2189283
Female
356404
148001
1587654
30809
0
2122868
Total
726565
302920
3210646
72020
0
4312151
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
2264
1337
3601
1612
1800
3412
8579
14495
23074
150
158
308
0
0
0
12605
17790
30395
HEDIS 2013 (Reporting Year 2012)
Male
370161
154919
1622992
41211
0
2189283
Female
356404
148001
1587654
30809
0
2122868
Total
726565
302920
3210646
72020
0
4312151
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
7.34%
4.50%
5.95%
12.49%
14.59%
13.52%
6.34%
10.96%
8.62%
4.37%
6.15%
5.13%
NA
NA
NA
6.91%
10.06%
8.46%
Number
29
23
52
107
167
274
319
357
676
5
3
8
0
0
0
460
550
1010
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
370161
356404
726565
154919
148001
302920
1622992
1587654
3210646
41211
30809
72020
0
0
0
2189283
2122868
4312151
Percent
0.09%
0.08%
0.09%
0.83%
1.35%
1.09%
0.24%
0.27%
0.25%
0.15%
0.12%
0.13%
NA
NA
NA
0.25%
0.31%
0.28%
Number
159
83
242
136
183
319
310
590
900
2
2
4
0
0
0
607
858
1465
Percent
0.52%
0.28%
0.40%
1.05%
1.48%
1.26%
0.23%
0.45%
0.34%
0.06%
0.08%
0.07%
NA
NA
NA
0.33%
0.49%
0.41%
Member Months
(Outpatient/ED)
Male
370161
154919
1622992
41211
0
2189283
Total
726565
302920
3210646
72020
0
4312151
Female
356404
148001
1587654
30809
0
2122868
Outpatient/ED
Number
2259
1334
3593
1607
1794
3401
8546
14461
23007
150
157
307
0
0
0
12562
17746
30308
Percent
7.32%
4.49%
5.93%
12.45%
14.55%
13.47%
6.32%
10.93%
8.60%
4.37%
6.12%
5.12%
NA
NA
NA
6.89%
10.03%
8.43%
Page 91
Use of Services
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 1:18 PM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
1
30889
0
30890
Female
0
0
5
79295
0
79300
Member Months
(Inpatient)
Total
0
0
6
110184
0
110190
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
2
2
382
1070
1452
0
0
0
382
1072
1454
HEDIS 2013 (Reporting Year 2012)
Male
0
0
1
30889
0
30890
Female
0
0
5
79295
0
79300
Total
0
0
6
110184
0
110190
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
0.00%
480.00%
400.00%
14.84%
16.19%
15.81%
NA
NA
NA
14.84%
16.22%
15.83%
Number
0
0
0
0
0
0
0
0
0
72
201
273
0
0
0
72
201
273
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
0
0
0
0
1
5
6
30889
79295
110184
0
0
0
30890
79300
110190
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
2.80%
3.04%
2.97%
NA
NA
NA
2.80%
3.04%
2.97%
Number
0
0
0
0
0
0
0
1
1
35
74
109
0
0
0
35
75
110
Percent
NA
NA
NA
NA
NA
NA
0.00%
240.00%
200.00%
1.36%
1.12%
1.19%
NA
NA
NA
1.36%
1.13%
1.20%
Member Months
(Outpatient/ED)
Male
0
0
1
30889
0
30890
Total
0
0
6
110184
0
110190
Female
0
0
5
79295
0
79300
Outpatient/ED
Number
0
0
0
0
0
0
0
2
2
338
954
1292
0
0
0
338
956
1294
Percent
NA
NA
NA
NA
NA
NA
0.00%
480.00%
400.00%
13.13%
14.44%
14.07%
NA
NA
NA
13.13%
14.47%
14.09%
Page 93
Use of Services
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 1:18 PM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
65542
337
0
65879
Female
0
0
78051
785
0
78836
Member Months
(Inpatient)
Total
0
0
143593
1122
0
144715
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
3627
4902
8529
4
13
17
0
0
0
3631
4915
8546
HEDIS 2013 (Reporting Year 2012)
Male
0
0
65542
337
0
65879
Female
0
0
78051
785
0
78836
Total
0
0
143593
1122
0
144715
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
66.41%
75.37%
71.28%
14.24%
19.87%
18.18%
NA
NA
NA
66.14%
74.81%
70.86%
Number
0
0
0
0
0
0
291
347
638
0
0
0
0
0
0
291
347
638
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
0
0
0
0
65542
78051
143593
337
785
1122
0
0
0
65879
78836
144715
Percent
NA
NA
NA
NA
NA
NA
5.33%
5.33%
5.33%
0.00%
0.00%
0.00%
NA
NA
NA
5.30%
5.28%
5.29%
Number
0
0
0
0
0
0
559
744
1303
0
2
2
0
0
0
559
746
1305
Percent
NA
NA
NA
NA
NA
NA
10.23%
11.44%
10.89%
0.00%
3.06%
2.14%
NA
NA
NA
10.18%
11.36%
10.82%
Member Months
(Outpatient/ED)
Male
0
0
65542
337
0
65879
Female
0
0
78051
785
0
78836
Total
0
0
143593
1122
0
144715
Outpatient/ED
Number
0
0
0
0
0
0
3605
4881
8486
4
13
17
0
0
0
3609
4894
8503
Percent
NA
NA
NA
NA
NA
NA
66.00%
75.04%
70.92%
14.24%
19.87%
18.18%
NA
NA
NA
65.74%
74.49%
70.51%
Page 94
Use of Services
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 1:18 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
280489
69922
208584
166
0
559161
Female
275503
72882
330843
227
0
679455
Total
555992
142804
539427
393
0
1238616
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
3277
2235
5512
1390
1688
3078
5111
9601
14712
1
3
4
0
0
0
9779
13527
23306
HEDIS 2013 (Reporting Year 2012)
Male
280489
69922
208584
166
0
559161
Female
275503
72882
330843
227
0
679455
Total
555992
142804
539427
393
0
1238616
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
14.02%
9.73%
11.90%
23.86%
27.79%
25.86%
29.40%
34.82%
32.73%
7.23%
15.86%
12.21%
NA
NA
NA
20.99%
23.89%
22.58%
Number
65
49
114
87
152
239
356
478
834
0
0
0
0
0
0
508
679
1187
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
280489
275503
555992
69922
72882
142804
208584
330843
539427
166
227
393
0
0
0
559161
679455
1238616
Percent
0.28%
0.21%
0.25%
1.49%
2.50%
2.01%
2.05%
1.73%
1.86%
0.00%
0.00%
0.00%
NA
NA
NA
1.09%
1.20%
1.15%
Number
617
382
999
259
320
579
644
1307
1951
0
1
1
0
0
0
1520
2010
3530
Percent
2.64%
1.66%
2.16%
4.44%
5.27%
4.87%
3.70%
4.74%
4.34%
0.00%
5.29%
3.05%
NA
NA
NA
3.26%
3.55%
3.42%
Member Months
(Outpatient/ED)
Male
280489
69922
208584
166
0
559161
Female
275503
72882
330843
227
0
679455
Total
555992
142804
539427
393
0
1238616
Outpatient/ED
Number
3269
2234
5503
1386
1683
3069
5067
9537
14604
1
3
4
0
0
0
9723
13457
23180
Percent
13.99%
9.73%
11.88%
23.79%
27.71%
25.79%
29.15%
34.59%
32.49%
7.23%
15.86%
12.21%
NA
NA
NA
20.87%
23.77%
22.46%
Page 95
Use of Services
Medica
Plan All-Cause Readmissions
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Plan All-Cause Readmissions
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Plan All-Cause Readmissions
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Board Certification
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
Medica
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Board Certification
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
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Commercial
<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
25904
109213
144939
151591
93476
61396
Member Months
Female
24601
103433
143123
143869
89442
60288
586519
26.79%
162242
158177
178941
167270
185721
564756
26.60%
153201
155564
172159
158746
180505
852351
38.93%
201257
207142
176469
124641
820175
38.63%
196927
209290
174637
126476
709509
32.40%
29098
8062
2475
976
315
292
707330
33.32%
22949
5009
1600
592
367
292
41218
1.88%
0
2189597
30809
1.45%
0
2123070
HEDIS 2013 (Reporting Year 2012)
Total
50505
212646
288062
295460
182918
121684
1151275
26.70%
315443
313741
351100
326016
366226
1672526
38.78%
398184
416432
351106
251117
1416839
32.85%
52047
13071
4075
1568
682
584
72027
1.67%
0
4312667
Page 101
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 1:18 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
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 1:18 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
5
1
0.00%
6238
7399
6243
5059
3645
2305
5
0.01%
11556
13514
13011
12927
13143
15163
30889
100.00%
0
30890
79314
99.99%
0
79319
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
6
6
0.01%
17794
20913
19254
17986
16788
17468
110203
99.99%
0
110209
Page 103
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 1:18 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
1232
Member Months
Female
0
0
0
0
0
675
1232
1.87%
4478
5631
4877
4955
6584
675
0.86%
3270
4336
5045
5870
8410
26525
40.26%
8991
11438
10103
7253
26931
34.16%
11591
14621
13098
11135
37785
57.36%
337
0
0
0
0
0
50445
63.99%
777
8
0
0
0
0
337
0.51%
0
65879
785
1.00%
0
78836
HEDIS 2013 (Reporting Year 2012)
Total
0
0
0
0
0
1907
1907
1.32%
7748
9967
9922
10825
14994
53456
36.94%
20582
26059
23201
18388
88230
60.97%
1114
8
0
0
0
0
1122
0.78%
0
144715
Page 104
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Member Months
Male
Female
31355
29128
<1
92412
91610
1-4
105092
101767
5-9
81343
84424
10-14
40209
41456
15-17
20994
25478
18-19
0-19 Subtotal
371405
373863
0-19 Subtotal: %
66.42%
55.02%
27254
51695
20-24
25396
54872
25-29
26947
50156
30-34
21700
38928
35-39
22613
33433
40-44
20-44 Subtotal
123910
229084
20-44 Subtotal: %
22.16%
33.72%
21409
26730
45-49
19419
22502
50-54
14483
15775
55-59
8369
11274
60-64
45-64 Subtotal
63680
76281
45-64 Subtotal: %
11.39%
11.23%
84
127
65-69
37
51
70-74
20
31
75-79
20
17
80-84
2
1
85-89
3
0
>=90
>=65 Subtotal
166
227
>=65 Subtotal: %
0.03%
0.03%
0
0
Age Unknown
Total
559161
679455
HEDIS 2013 (Reporting Year 2012)
Data Last Refreshed:
Nov 15, 2013 1:18 PM
Total
60483
184022
206859
165767
81665
46472
745268
60.17%
78949
80268
77103
60628
56046
352994
28.50%
48139
41921
30258
19643
139961
11.30%
211
88
51
37
3
3
393
0.03%
0
1238616
Page 105