HealthPartners / Group Health Plan, Inc.
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
HealthPartners / Group Health Plan, Inc.
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 2:08 PM
Commercial
Medicare
Advantage
MHCP-MC
2012
H
245752
2011
H
7413
66519
4568
27.07%
250
5.00%
263
69
26.24%
NR
NR
61.62%
240
5.00%
252
162
64.29%
0
0
Number of administrative data records excluded
0
0
Number of medical record data records excluded
0
0
0
0
0
250
66
148
85.60%
81.05%
90.15%
0
240
156
52
86.67%
82.16%
91.18%
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
HealthPartners / Group Health Plan, Inc.
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Nov 15, 2013 2:08 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
2012
H
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Physical Activity
Total
2012
H
General
Measure
Data
Total
47556
31959
79515
47566
31959
79525
47566
31959
79525
8832
18.57%
6081
19.03%
14913
18.75%
206
0.43%
266
0.83%
472
0.59%
20
0.04%
13
0.04%
33
0.04%
0
0.00%
0
0.00%
0
0.00%
250
0
130
52.00%
45.61%
58.39%
161
0
70
43.48%
35.51%
51.45%
411
0
200
48.66%
43.71%
53.62%
411
5.00%
432
411
5.00%
432
44
10.19%
38
8.80%
82
18.98%
411
5.00%
432
1
0.23%
1
0.23%
2
0.46%
0
0
0
Number of administrative data records
excluded
0
0
0
Number of medical records excluded
0
0
0
Number of employee/dependent records
excluded
0
0
0
Records Added from the Oversample List
0
0
0
HEDIS 2013 (Reporting Year 2012)
Ages 1217
2012
H
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Ages 3-11
250
40
152
76.80%
71.37%
82.23%
161
36
76
69.57%
62.15%
76.98%
411
76
228
73.97%
69.60%
78.33%
250
1
150
60.40%
54.14%
66.66%
161
1
65
40.99%
33.09%
48.90%
411
2
215
52.80%
47.85%
57.75%
Page 4
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Nov 15, 2013 2:08 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
BMI Percentile
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Nutrition
Total
2011
H
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Physical Activity
Total
2011
H
General
Measure
Data
Total
7564
3859
11423
7564
3859
11423
7564
3859
11423
3715
49.11%
1931
50.04%
5646
49.43%
53
0.70%
91
2.36%
144
1.26%
0
0.00%
1
0.03%
1
0.01%
0
0.00%
0
0.00%
0
0.00%
257
0
127
49.42%
43.11%
55.72%
135
0
71
52.59%
43.80%
61.39%
392
0
198
50.51%
45.43%
55.59%
392
5.00%
412
392
5.00%
412
138
33.50%
72
17.48%
210
50.97%
392
5.00%
412
2
0.49%
2
0.49%
4
0.97%
0
0
0
Number of administrative data records
excluded
1
1
1
Number of medical records excluded
0
0
0
Number of employee/dependent records
excluded
0
0
0
Records Added from the Oversample List
1
1
1
HEDIS 2013 (Reporting Year 2012)
Ages 1217
2011
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
257
129
79
80.93%
75.94%
85.93%
135
70
37
79.26%
72.05%
86.47%
392
199
116
80.36%
76.30%
84.42%
257
2
164
64.59%
58.55%
70.63%
135
2
65
49.63%
40.82%
58.43%
392
4
229
59.44%
54.45%
64.43%
Page 5
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 2:08 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
4335
85.40%
4636
91.33%
4687
92.34%
4705
92.69%
4276
84.24%
4586
90.35%
4303
84.77%
4192
82.58%
3896
76.75%
3698
72.85%
371
85.88%
398
92.13%
406
93.98%
402
93.06%
369
85.42%
393
90.97%
376
87.04%
346
80.09%
326
75.46%
311
71.99%
355
381
388
384
352
375
360
330
310
298
10
88.81%
85.64%
91.98%
9
94.89%
92.64%
97.14%
3
95.13%
92.93%
97.34%
8
95.38%
93.23%
97.53%
28
92.46%
89.78%
95.13%
4
92.21%
89.50%
94.93%
15
91.24%
88.39%
94.10%
3
81.02%
77.11%
84.93%
20
80.29%
76.32%
84.26%
6
73.97%
69.60%
78.33%
0
Number of medical data records excluded
Numerator Events by Medical Record
MMR
411
5.00%
432
0
Numerator Events by administrative Data
IPV
2012
H
5076
Number of administrative data records
excluded
Denominator
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
411
Page 6
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 2:08 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
4335
85.40%
3829
75.43%
3699
72.87%
3395
66.88%
3238
63.79%
3062
60.32%
3022
59.54%
2876
56.66%
2740
53.98%
2589
51.00%
371
85.88%
332
76.85%
320
74.07%
286
66.20%
275
63.66%
261
60.42%
256
59.26%
243
56.25%
233
53.94%
221
51.16%
355
317
305
272
261
249
243
231
221
209
10
88.81%
85.64%
91.98%
27
83.70%
80.01%
87.39%
34
82.48%
78.69%
86.28%
30
73.48%
69.09%
77.87%
35
72.02%
67.56%
76.48%
31
68.13%
63.50%
72.75%
34
67.40%
62.74%
72.05%
27
62.77%
57.98%
67.57%
29
60.83%
55.99%
65.67%
29
57.91%
53.01%
62.80%
0
Number of medical data records excluded
Numerator Events by Medical Record
Combo 3
411
5.00%
432
0
Numerator Events by administrative Data
Combo 2
2012
H
5076
Number of administrative data records
excluded
Denominator
DTaP
411
Page 7
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 2:08 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
1
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
1
HEDIS 2013 (Reporting Year 2012)
HiB
Hepatitis B
VZV
Influenza
872
80.82%
985
91.29%
993
92.03%
985
91.29%
944
87.49%
966
89.53%
864
80.07%
489
45.32%
771
71.46%
666
61.72%
351
81.25%
394
91.20%
398
92.13%
395
91.44%
380
87.96%
387
89.58%
352
81.48%
205
47.45%
321
74.31%
276
63.89%
335
19
86.13%
82.67%
89.59%
376
20
96.35%
94.42%
98.28%
381
1
92.94%
90.35%
95.54%
377
19
96.35%
94.42%
98.28%
363
25
94.40%
92.06%
96.75%
371
1
90.51%
87.56%
93.47%
338
19
86.86%
83.47%
90.25%
196
1
47.93%
42.98%
52.88%
304
21
79.08%
75.02%
83.13%
265
1
64.72%
59.98%
69.46%
0
Number of medical data records excluded
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
MMR
411
0.05
432
0
Numerator Events by administrative Data
IPV
2011
H
1079
Number of administrative data records
excluded
Denominator
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
411
Page 8
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 2:08 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
1
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
1
HEDIS 2013 (Reporting Year 2012)
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
872
80.82%
791
73.31%
772
71.55%
433
40.13%
645
59.78%
562
52.09%
381
35.31%
346
32.07%
491
45.51%
312
28.92%
351
81.25%
327
75.69%
321
74.31%
183
42.36%
277
64.12%
245
56.71%
164
37.96%
151
34.95%
214
49.54%
136
31.48%
335
19
86.13%
82.67%
89.59%
313
26
82.48%
78.69%
86.28%
307
27
81.27%
77.37%
85.16%
174
13
45.50%
40.56%
50.43%
263
27
70.56%
66.03%
75.09%
236
14
60.83%
55.99%
65.67%
155
14
41.12%
36.24%
46.00%
144
8
36.98%
32.19%
41.77%
205
18
54.26%
49.32%
59.20%
129
10
33.82%
29.12%
38.52%
0
Number of medical data records excluded
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Combo 3
411
0.05
432
0
Numerator Events by administrative Data
Combo 2
2011
H
1079
Number of administrative data records
excluded
Denominator
DTaP
411
Page 9
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Data Last Refreshed:
Nov 15, 2013 2:08 PM
Immunizations for Adolescents
Commercial
Commercial
Data Elements
Measurement Year
General
Measure Data
H
Eligible Member Population
6223
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Combo 1
3971
5548
3919
63.81%
89.15%
62.98%
269
64.35%
374
89.47%
263
62.92%
258
4
358
7
252
5
398
5.00%
418
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
398
65.83%
91.71%
64.57%
Lower 95% Confidence Interval
61.04%
88.87%
59.75%
Upper 95% Confidence Interval
70.61%
94.54%
69.40%
HEDIS 2013 (Reporting Year 2012)
Page 10
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Data Last Refreshed:
Nov 15, 2013 2:08 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
841
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
567
755
552
67.42%
89.77%
65.64%
277
68.56%
362
89.60%
270
66.83%
262
1
68.49%
63.71%
73.27%
346
2
90.63%
87.58%
93.67%
257
2
67.45%
62.63%
72.26%
384
5.00%
404
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
384
Page 11
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
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 2:08 PM
Commercial
2012
A
84633
63470
74.99%
74.70%
75.29%
Medicare
Advantage
NR
NR
NR
MSHO
2012
A
207
135
65.22%
58.49%
71.95%
SNBC
MHCP-MC
NR
NR
NR
2012
A
2103
1361
64.72%
62.65%
66.78%
Page 12
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
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 2:08 PM
Commercial
2012
A
104732
MHCP-MC
2012
H
10287
6838
NR
NR
66.47%
219
10.00%
241
151
62.66%
0
0
7
0
81165
77.50%
77.24%
77.75%
7
219
144
13
71.69%
65.49%
77.88%
Page 13
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Colorectal Cancer Screening
Data Last Refreshed:
Nov 15, 2013 2:08 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
2011
H
99415
2012
H
996
57326
592
57.66%
354
0.05
372
193
51.88%
0
0
0
0
0
354
183
62
69.21%
64.26%
74.16%
NR
NR
NR
NR
NR
59.44%
403
5.00%
424
237
55.90%
0
2
0
0
2
403
232
13
60.79%
55.90%
65.68%
SNBC
NR
NR
NR
NR
NR
Page 14
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Chlamydia Screening in Women
Data Last Refreshed:
Nov 15, 2013 2:08 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
7924
3569
45.04%
43.94%
46.14%
9053
5116
56.51%
55.48%
57.54%
16977
8685
51.16%
50.40%
51.91%
2012
A
Page 15
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Chlamydia Screening in Women
Data Last Refreshed:
Nov 15, 2013 2:08 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
1181
784
66.38%
63.65%
69.12%
890
666
74.83%
71.92%
77.74%
2071
1450
70.01%
68.02%
72.01%
2012
A
Page 16
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
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 2:08 PM
Medicare
Advantage
NR
NR
NR
MSHO
2012
A
2136
1715
80.29%
78.58%
82.00%
Page 17
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Data Last Refreshed:
Nov 15, 2013 2:08 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
Commercial
2012
A
5076
MHCP-MC
2012
A
1035
NR
NR
NR
NR
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
3574
954
70.41%
92.17%
Lower 95% Confidence Interval
69.14%
90.49%
Upper 95% Confidence Interval
71.68%
93.86%
HEDIS 2013 (Reporting Year 2012)
Page 18
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Data Last Refreshed:
Nov 15, 2013 2:08 PM
Care for Older Adults
MSHO
Advance Care
Planning
Medication Review
Functional
Status
Assessment
Pain
Screening
1203
0
1074
0
45.69%
0.00%
40.79%
0.00%
90
41.28%
0
0.00%
80
36.70%
0
0.00%
87
105
92.75%
0
199
96.14%
74
115
91.30%
0
169
81.64%
Lower 95% Confidence Interval
88.98%
93.27%
87.22%
76.13%
Upper 95% Confidence Interval
96.53%
99.00%
95.38%
87.16%
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
2633
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)
207
5.00%
218
0
0
0
207
Page 19
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Nov 15, 2013 2:08 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
38
77.55%
64.85%
90.25%
44
89.80%
80.30%
99.29%
2012
A
49
Page 21
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Nov 15, 2013 2:08 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
NR
NR
NR
NR
NR
NR
Page 22
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
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 2:08 PM
MSHO
SNBC
2012
A
53
14
26.42%
13.60%
39.23%
NR
NR
NR
Page 23
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Nov 15, 2013 2:08 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
607
586
38
96.54%
95.00%
98.08%
507
472
30
93.10%
90.79%
95.40%
1929
1751
191
90.77%
89.45%
92.09%
1285
1221
549
95.02%
93.79%
96.25%
4328
4030
808
93.11%
92.35%
93.88%
2012
A
`
Page 24
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Nov 15, 2013 2:08 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
202
187
10
92.57%
88.71%
96.44%
121
99
8
81.82%
74.53%
89.10%
211
173
54
81.99%
76.57%
87.41%
52
37
52
71.15%
57.88%
84.43%
586
496
124
84.64%
81.64%
87.65%
2012
A
Page 25
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Nov 15, 2013 2:08 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
3177
85.47%
947
25.48%
294
85.22%
92
26.67%
286
11
90.55%
87.23%
93.87%
91
151
73.78%
68.87%
78.69%
2012
H
3717
328
5.00%
345
1
0
1
328
Page 26
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Nov 15, 2013 2:08 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
75
81.52%
48
52.17%
75
81.52%
48
52.17%
73
3
82.61%
74.32%
90.90%
48
10
63.04%
52.64%
73.45%
2012
H
92
92
0.00%
92
0
0
0
92
Page 28
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Controlling High Blood Pressure
Data Last Refreshed:
Nov 15, 2013 2:08 PM
Data Elements
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
Commercial
Medicare
Advantage
MSHO
SNBC
MHCP-MC
2012
H
30924
2012
H
962
2012
H
2083
0
0
0
0.00%
270
5.00%
284
0
0.00%
NR
NR
0.00%
279
5.00%
293
0
0.00%
NR
NR
0.00%
321
5.00%
338
0
0.00%
0
0
0
Number of records excluded because of
false positive diagnoses
0
0
0
Number of administrative data records
excluded
4
13
8
Number of medical record data records
excluded
2
1
1
0
0
0
6
270
0
215
79.63%
74.64%
84.62%
14
279
0
203
72.76%
67.36%
78.16%
9
321
0
226
70.40%
65.26%
75.55%
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
NR
NR
NR
Page 29
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
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 2:08 PM
Medicare
Advantage
MSHO
SNBC
MHCP-MC
2012
A
207
2012
A
6
2012
A
18
187
6
17
90.34%
86.07%
94.60%
NR
NR
NR
NA
NA
NA
NR
NR
NR
NA
NA
NA
Page 30
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 2:08 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%)
2012
H
17092
2012
H
17092
2012
H
13210
15786
92.36%
548
10%
603
560
92.87%
12795
74.86%
548
10%
603
462
76.62%
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
17092
2011
H
16828
2012
H
17092
2012
H
17092
2012
H
17092
2012
H
17092
2012
H
17092
1717
13.00%
548
10%
464
50
10.78%
3689
21.58%
548
10%
603
121
20.07%
9281
55.15%
548
10%
603
329
54.56%
14801
86.60%
548
10%
603
523
86.73%
3501
20.48%
548
10%
603
115
19.07%
13785
80.65%
548
10%
603
489
81.09%
4492
26.28%
548
10%
603
151
25.04%
3129
18.31%
548
10%
603
104
17.25%
3
3
3
3
7
3
3
3
3
3
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
3
548
109
279
70.80%
66.90%
74.70%
7
548
303
58
65.88%
61.81%
69.94%
3
548
478
24
91.61%
89.19%
94.02%
3
548
110
232
62.41%
58.26%
66.56%
3
548
447
36
88.14%
85.34%
90.94%
3
548
113
347
83.94%
80.78%
87.11%
3
548
75
270
62.96%
58.82%
67.09%
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)
139
20
3
548
511
18
96.53%
94.91%
98.16%
3
548
86
11
17.70%
14.41%
20.99%
0
444
48
144
43.24%
38.52%
47.96%
Page 31
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 2:08 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
467
2012
H
467
436
93.36%
371
10%
409
381
93.15%
232
49.68%
371
10%
409
203
49.63%
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
467
2012
H
467
2012
H
467
2012
H
467
2012
H
467
2012
H
467
2012
H
467
203
43.47%
371
10%
409
177
43.28%
333
71.31%
371
10%
409
290
70.90%
396
84.80%
371
10%
409
345
84.35%
200
42.83%
371
10%
409
173
42.30%
415
88.87%
371
10%
409
364
89.00%
218
46.68%
371
10%
409
194
47.43%
192
41.11%
371
10%
409
169
41.32%
1
1
1
1
1
1
1
1
1
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
1
371
346
11
96.23%
94.15%
98.30%
1
371
36
3
10.51%
7.26%
13.77%
1
371
160
129
77.90%
73.54%
82.25%
1
371
251
39
78.17%
73.83%
82.51%
1
371
315
13
88.41%
85.02%
91.80%
1
371
158
106
71.16%
66.41%
75.90%
1
371
329
3
89.49%
86.23%
92.74%
1
371
160
131
78.44%
74.12%
82.76%
1
371
138
113
67.65%
62.76%
72.55%
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
HealthPartners / Group Health Plan, Inc.
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 2:08 PM
SNBC
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 34
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 2:08 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
2011
H
1145
2011
H
1145
2011
H
1019
1053
91.97%
548
10%
603
553
91.71%
662
57.82%
548
10%
603
353
58.54%
22
Eye Exam
2011
H
1145
2011
H
1145
2011
H
1145
2011
H
1145
2011
H
1145
2011
H
1145
2011
H
1145
210
20.61%
548
10%
533
106
19.89%
365
31.88%
548
10%
603
192
31.84%
650
56.77%
548
10%
603
337
55.89%
939
82.01%
548
10%
603
488
80.93%
312
27.25%
548
10%
603
150
24.88%
958
83.67%
548
10%
603
504
83.58%
582
50.83%
548
10%
603
305
50.58%
460
40.17%
548
10%
603
248
41.13%
22
0
22
22
22
22
22
22
22
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
22
548
173
150
58.94%
54.73%
63.15%
22
548
313
73
70.44%
66.53%
74.35%
22
548
453
16
85.58%
82.55%
88.62%
22
548
145
138
51.64%
47.37%
55.92%
22
548
469
11
87.59%
84.74%
90.44%
22
548
269
173
80.66%
77.26%
84.06%
22
548
221
126
63.32%
59.19%
67.45%
70
Number of Hybrid required exclusions
HEDIS 2013 (Reporting Year 2012)
Blood
Pressure
<140/80
mm Hg
LDL-C Level
<100 mg/dL
Number of Administrative required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
LDL-C
Screening
36
22
548
510
5
93.98%
91.90%
96.06%
22
548
137
6
26.09%
22.33%
29.86%
106
497
96
91
37.63%
33.27%
41.99%
Page 35
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
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 2:08 PM
Medicare
Advantage
NR
NR
NR
Page 36
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
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 2:08 PM
MSHO
2012
A
46
4
8.70%
0.00%
17.93%
Page 37
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 2:08 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
3814
3036
79.60%
78.31%
80.89%
2417
63.37%
61.83%
64.91%
Page 38
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 2:08 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
43
27
62.79%
47.18%
78.40%
21
48.84%
32.73%
64.94%
Page 40
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 2:08 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
NR
NR
NR
NR
NR
NR
Page 41
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 2:08 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
712
384
53.93%
50.20%
57.66%
286
40.17%
36.50%
43.84%
Page 42
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Nov 15, 2013 2:08 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
827
381
46.07%
42.61%
49.53%
294
152
51.70%
45.82%
57.58%
2012
A
Page 43
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Nov 15, 2013 2:08 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
236
115
48.73%
42.14%
55.32%
58
35
60.34%
46.89%
73.80%
2012
A
Page 44
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Nov 15, 2013 2:08 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
4
NA
NA
NA
1
NA
NA
NA
2012
A
5
Page 46
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Nov 15, 2013 2:08 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
NR
NR
NR
NR
NR
NR
Page 47
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 2:08 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
23102
19403
83.99%
83.51%
84.46%
259
222
85.71%
81.26%
90.17%
18715
15650
83.62%
83.09%
84.16%
967
674
69.70%
66.75%
72.65%
43043
35949
83.52%
83.17%
83.87%
2012
A
Page 48
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 2:08 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
975
926
94.97%
93.55%
96.40%
57
55
96.49%
90.84%
100.00%
897
862
96.10%
94.78%
97.42%
129
111
86.05%
79.68%
92.41%
2058
1954
94.95%
93.98%
95.92%
2012
A
Page 50
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 2:08 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 51
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 2:08 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
1386
1226
88.46%
86.74%
90.17%
11
8
NA
NA
NA
1169
1034
88.45%
86.58%
90.33%
148
112
75.68%
68.43%
82.93%
2714
2380
87.69%
86.44%
88.95%
2012
A
Page 52
Access/Availability of Care
HealthPartners / Group Health Plan, Inc.
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 2:08 PM
MSHO
2012
H
325
0
0.00%
229
5.00%
241
0
0.00%
0
0
0
229
0
181
79.04%
73.55%
84.53%
Page 53
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Nov 15, 2013 2:08 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
56
3
5.36%
0.00%
12.15%
818
148
18.09%
15.39%
20.79%
2012
A
195
31
15.90%
10.51%
21.29%
567
114
20.11%
16.72%
23.49%
Page 55
Effectiveness of Care
HealthPartners / Group Health Plan, Inc.
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Nov 15, 2013 2:08 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
2629
At least 1
Prescription
At least 2
Prescriptions
520
19.78%
18.24%
21.32%
151
5.74%
4.84%
6.65%
Page 57
Access/Availability of Care
HealthPartners / Group Health Plan, Inc.
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 2:08 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
100520
121446
8998
230964
95543
95.05%
94.91%
95.18%
117844
97.03%
96.94%
97.13%
8836
98.20%
97.92%
98.48%
222223
96.22%
96.14%
96.29%
2012
A
Page 58
Access/Availability of Care
HealthPartners / Group Health Plan, Inc.
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 2:08 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
2660
2660
0
NA
NA
NA
0
NA
NA
NA
2614
98.27%
97.76%
98.78%
2614
98.27%
97.76%
98.78%
2012
A
Page 60
Access/Availability of Care
HealthPartners / Group Health Plan, Inc.
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 2:08 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 61
Access/Availability of Care
HealthPartners / Group Health Plan, Inc.
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 2:08 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
12255
6583
46
18884
10709
87.38%
86.79%
87.98%
5850
88.87%
88.10%
89.63%
45
97.83%
92.52%
100.00%
16604
87.93%
87.46%
88.39%
2012
A
Page 62
Access/Availability of Care
HealthPartners / Group Health Plan, Inc.
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Nov 15, 2013 2:08 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.
6007
5949
99.03%
98.78%
99.29%
30030
28003
93.25%
92.96%
93.54%
26726
24897
93.16%
92.85%
93.46%
47579
44080
92.65%
92.41%
92.88%
2012
A
Page 63
Access/Availability of Care
HealthPartners / Group Health Plan, Inc.
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Nov 15, 2013 2:08 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.
1901
1867
98.21%
97.59%
98.83%
6165
5633
91.37%
90.66%
92.08%
3272
3003
91.78%
90.82%
92.74%
4402
4075
92.57%
91.79%
93.36%
2012
A
Page 64
Access/Availability of Care
HealthPartners / Group Health Plan, Inc.
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 2:08 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
356
4508
4864
144
84
1644
723
40.45%
35.21%
45.69%
23.60%
19.04%
28.15%
36.47%
35.05%
37.88%
16.04%
14.96%
17.12%
1788
36.76%
35.39%
38.13%
807
16.59%
15.54%
17.65%
Page 65
Access/Availability of Care
HealthPartners / Group Health Plan, Inc.
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 2:08 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
34
0
34
0
0
15
0
NA
NA
NA
NA
NA
NA
44.12%
25.96%
62.28%
0.00%
0.00%
1.47%
15
44.12%
25.96%
62.28%
0
0.00%
0.00%
1.47%
Page 67
Access/Availability of Care
HealthPartners / Group Health Plan, Inc.
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 2:08 PM
SNBC
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Total
Engagement
of AOD
Treatment
Initiation of
AOD
Treatment
NR
NR
NR
NR
NR
NR
NR
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2013 (Reporting Year 2012)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 68
Access/Availability of Care
HealthPartners / Group Health Plan, Inc.
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 2:08 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
169
2053
2222
68
48
747
331
40.24%
32.55%
47.93%
28.40%
21.31%
35.50%
36.39%
34.28%
38.49%
16.12%
14.51%
17.74%
815
36.68%
34.65%
38.71%
379
17.06%
15.47%
18.64%
Page 69
Access/Availability of Care
HealthPartners / Group Health Plan, Inc.
Prenatal and Postpartum Care
Data Last Refreshed:
Nov 15, 2013 2:08 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
6100
Postpartum
Care
2012
H
6100
4851
3517
79.52%
229
5.00%
241
189
78.42%
57.66%
229
5.00%
241
132
54.77%
0
0
0
0
229
95
123
95.20%
92.21%
98.18%
0
0
229
95
101
85.59%
80.82%
90.36%
Page 70
Access/Availability of Care
HealthPartners / Group Health Plan, Inc.
Prenatal and Postpartum Care
Data Last Refreshed:
Nov 15, 2013 2:08 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
2321
Postpartum
Care
2012
H
2321
1739
1215
74.92%
360
5.00%
378
272
71.96%
52.35%
360
5.00%
378
191
50.53%
0
0
0
0
360
150
183
92.50%
89.64%
95.36%
0
0
360
150
91
66.94%
61.95%
71.94%
Page 71
Use of Services
HealthPartners / Group Health Plan, Inc.
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Nov 15, 2013 2:08 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
23
25
28
81
164
474
4007
0.48%
0.27%
0.68%
0.52%
0.31%
0.73%
0.58%
0.36%
0.81%
1.69%
1.31%
2.06%
3.42%
2.89%
3.94%
9.87%
9.02%
10.72%
83.44%
82.38%
84.51%
2012
A
4802
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
HealthPartners / Group Health Plan, Inc.
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Nov 15, 2013 2:08 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of employee/dependent medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
11
0.71%
26
1.68%
30
1.94%
82
5.30%
130
8.41%
272
17.59%
995
64.36%
3
0.85%
6
1.70%
11
3.13%
14
3.98%
25
7.10%
66
18.75%
227
64.49%
0
2
0.60%
0.00%
1.57%
0
4
1.19%
0.00%
2.51%
0
11
3.28%
1.23%
5.34%
0
9
2.69%
0.81%
4.57%
0
18
5.37%
2.81%
7.94%
0
49
14.63%
10.69%
18.56%
216
26
72.24%
67.29%
77.18%
2011
H
1546
335
5.00%
352
0
0
0
335
Page 73
Use of Services
HealthPartners / Group Health Plan, Inc.
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
2012
A
24831
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
HEDIS 2013 (Reporting Year 2012)
MHCP-MC
2011
H
4288
3132
NR
NR
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Data Last Refreshed:
Nov 15, 2013 2:08 PM
73.04%
260
5.00%
273
202
73.99%
0
0
18579
74.82%
74.28%
75.36%
0
260
192
15
79.62%
74.53%
84.70%
Page 74
Use of Services
HealthPartners / Group Health Plan, Inc.
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 2:08 PM
Commercial
2012
A
70303
MHCP-MC
2011
H
7106
2802
NR
NR
39.43%
407
5.00%
428
167
39.02%
0
0
25296
35.98%
35.63%
36.34%
0
407
158
56
52.58%
47.61%
57.55%
Page 75
Use of Services
HealthPartners / Group Health Plan, Inc.
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 2:08 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
76037
753652
909685
2238642
1968699
104112
18440
7555
0
6076822
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
66821
221181
205271
544018
707957
64936
20497
8129
0
1838810
HEDIS 2013 (Reporting Year 2012)
Visits/ 1,000
Member
Months
878.80
293.48
225.65
243.01
359.61
623.71
1111.55
1075.98
302.59
Emergency Room Visits
Visits
1988
10363
10390
26832
20963
1841
717
413
0
73507
Visits/ 1,000
Member
Months
26.15
13.75
11.42
11.99
10.65
17.68
38.88
54.67
12.10
Page 76
Use of Services
HealthPartners / Group Health Plan, Inc.
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 2:08 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
2
15166
12557
8699
0
36424
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
2
12713
10664
7693
0
31072
HEDIS 2013 (Reporting Year 2012)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
1000.00
838.26
849.25
884.35
853.06
Emergency Room Visits
Visits
0
0
0
0
0
552
511
283
0
1346
Visits/ 1,000
Member
Months
NA
NA
NA
NA
0.00
36.40
40.69
32.53
36.95
Page 78
Use of Services
HealthPartners / Group Health Plan, Inc.
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 2:08 PM
SNBC
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 79
Use of Services
HealthPartners / Group Health Plan, Inc.
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 2:08 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
40086
246371
200773
328659
134304
523
106
30
0
950852
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
27828
67117
46063
129142
67638
314
73
14
0
338189
HEDIS 2013 (Reporting Year 2012)
Visits/ 1,000
Member
Months
694.21
272.42
229.43
392.94
503.62
600.38
688.68
466.67
355.67
Emergency Room Visits
Visits
3643
10770
5746
20949
5304
4
5
0
0
46421
Visits/ 1,000
Member
Months
90.88
43.71
28.62
63.74
39.49
7.65
47.17
0.00
48.82
Page 80
Use of Services
HealthPartners / Group Health Plan, Inc.
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 2:08 PM
Member Months
76037
753652
909685
2238642
1968699
104112
18440
7555
0
6076822
Discharges
Discharges /
1,000 Member
Months
677
910
1150
11035
10986
1402
558
267
0
26985
8.90
1.21
1.26
4.93
5.58
13.47
30.26
35.34
561
687
585
2028
4880
675
356
215
0
9987
7.38
0.91
0.64
0.91
2.48
6.48
19.31
28.46
113
223
416
2052
6092
727
202
52
0
9877
1.49
0.30
0.46
0.92
3.09
6.98
10.95
6.88
149
6955
14
0
7118
0.16
3.11
0.01
HEDIS 2013 (Reporting Year 2012)
4.44
1.64
1.63
1.39
Days
Days / 1,000
Member
Months
4018
2726
4011
30456
37911
5792
2312
1112
0
88338
52.84
3.62
4.41
13.60
19.26
55.63
125.38
147.19
2605
1827
1956
6396
16614
2639
1308
860
0
34205
34.26
2.42
2.15
2.86
8.44
25.35
70.93
113.83
1410
899
1616
6085
21263
3153
1004
252
0
35682
18.54
1.19
1.78
2.72
10.80
30.28
54.45
33.36
439
17975
34
0
18448
0.48
8.03
0.02
14.54
5.63
5.87
3.61
Average
Length of Stay
5.94
3.00
3.49
2.76
3.45
4.13
4.14
4.16
NA
3.27
4.64
2.66
3.34
3.15
3.40
3.91
3.67
4.00
NA
3.42
12.48
4.03
3.88
2.97
3.49
4.34
4.97
4.85
NA
3.61
2.95
2.58
2.43
NA
2.59
Page 81
Use of Services
HealthPartners / Group Health Plan, Inc.
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
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 2:08 PM
Member Months
0
0
0
0
2
15166
12557
8699
0
36424
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
452
408
313
0
1173
NA
NA
NA
NA
0.00
29.80
32.49
35.98
0
0
0
0
0
340
342
286
0
968
NA
NA
NA
NA
0.00
22.42
27.24
32.88
0
0
0
0
0
112
66
27
0
205
NA
NA
NA
NA
0.00
7.38
5.26
3.10
0
0
0
0
0
NA
NA
0.00
HEDIS 2013 (Reporting Year 2012)
32.20
26.58
5.63
0.00
Days
Days / 1,000
Member
Months
0
0
0
0
0
2071
1832
1242
0
5145
NA
NA
NA
NA
0.00
136.56
145.89
142.78
0
0
0
0
0
1337
1411
1086
0
3834
NA
NA
NA
NA
0.00
88.16
112.37
124.84
0
0
0
0
0
734
421
156
0
1311
NA
NA
NA
NA
0.00
48.40
33.53
17.93
0
0
0
0
0
NA
NA
0.00
141.25
105.26
35.99
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
4.58
4.49
3.97
NA
4.39
NA
NA
NA
NA
NA
3.93
4.13
3.80
NA
3.96
NA
NA
NA
NA
NA
6.55
6.38
5.78
NA
6.40
NA
NA
NA
NA
NA
Page 83
Use of Services
HealthPartners / Group Health Plan, Inc.
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 2:08 PM
Member Months
NR
Discharges
Discharges /
1,000 Member
Months
Days
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2013 (Reporting Year 2012)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Days / 1,000
Member
Months
NR
NR
NR
NR
NR
NR
Average
Length of Stay
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 84
Use of Services
HealthPartners / Group Health Plan, Inc.
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Nov 15, 2013 2:08 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
<1
40086
1-9
246371
10-19
200773
20-44
328659
45-64
134304
65-74
523
75-84
106
85+
30
Unknown
0
950852
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
362
383
521
4624
1293
5
0
0
0
7188
9.03
1.55
2.59
14.07
9.63
9.56
0.00
0.00
320
317
183
1048
740
3
0
0
0
2611
7.98
1.29
0.91
3.19
5.51
5.74
0.00
0.00
42
66
75
577
549
2
0
0
0
1311
1.05
0.27
0.37
1.76
4.09
3.82
0.00
0.00
263
2999
4
0
3266
1.31
9.12
0.03
HEDIS 2013 (Reporting Year 2012)
7.56
2.75
1.38
4.92
Days
Days / 1,000
Member
Months
1940
1013
1697
13090
4794
47
0
0
0
22581
48.40
4.11
8.45
39.83
35.70
89.87
0.00
0.00
1463
865
701
3098
2557
4
0
0
0
8688
36.50
3.51
3.49
9.43
19.04
7.65
0.00
0.00
477
148
338
2213
2218
43
0
0
0
5437
11.90
0.60
1.68
6.73
16.51
82.22
0.00
0.00
658
7779
19
0
8456
3.28
23.67
0.14
23.75
9.14
5.72
12.74
Average
Length of Stay
5.36
2.64
3.26
2.83
3.71
9.40
NA
NA
NA
3.14
4.57
2.73
3.83
2.96
3.46
1.33
NA
NA
NA
3.33
11.36
2.24
4.51
3.84
4.04
21.50
NA
NA
NA
4.15
2.50
2.59
4.75
NA
2.59
Page 85
Use of Services
HealthPartners / Group Health Plan, Inc.
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 2:08 PM
Commercial
Member Months
(Inpatient)
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
558982
235993
325987
391529
1369831
68331
0
2950653
Female
532830
222623
320710
464601
1523629
61776
0
3126169
Total
1091812
458616
646697
856130
2893460
130107
0
6076822
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
16
10
26
470
235
705
1222
637
1859
791
510
1301
2446
1686
4132
119
57
176
0
0
0
5064
3135
8199
HEDIS 2013 (Reporting Year 2012)
Male
558982
235993
325987
391529
1369831
68331
0
2950653
Female
532830
222623
320710
464601
1523629
61776
0
3126169
Total
1091812
458616
646697
856130
2893460
130107
0
6076822
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
0.03%
0.02%
0.03%
2.39%
1.27%
1.84%
4.50%
2.38%
3.45%
2.42%
1.32%
1.82%
2.14%
1.33%
1.71%
2.09%
1.11%
1.62%
NA
NA
NA
2.06%
1.20%
1.62%
Number
7
5
12
122
84
206
385
200
585
206
116
322
697
446
1143
59
27
86
0
0
0
1476
878
2354
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
558982
532830
1091812
235993
222623
458616
325987
320710
646697
391529
464601
856130
1369831
1523629
2893460
68331
61776
130107
0
0
0
2950653
3126169
6076822
Percent
0.02%
0.01%
0.01%
0.62%
0.45%
0.54%
1.42%
0.75%
1.09%
0.63%
0.30%
0.45%
0.61%
0.35%
0.47%
1.04%
0.52%
0.79%
NA
NA
NA
0.60%
0.34%
0.46%
Number
0
0
0
22
22
44
60
33
93
28
19
47
58
51
109
1
1
2
0
0
0
169
126
295
Percent
0.00%
0.00%
0.00%
0.11%
0.12%
0.12%
0.22%
0.12%
0.17%
0.09%
0.05%
0.07%
0.05%
0.04%
0.05%
0.02%
0.02%
0.02%
NA
NA
NA
0.07%
0.05%
0.06%
Member Months
(Outpatient/ED)
Male
558982
235993
325987
391529
1369831
68331
0
2950653
Female
532830
222623
320710
464601
1523629
61776
0
3126169
Total
1091812
458616
646697
856130
2893460
130107
0
6076822
Outpatient/ED
Number
12
5
17
419
187
606
1050
552
1602
701
446
1147
2057
1426
3483
80
36
116
0
0
0
4319
2652
6971
Percent
0.03%
0.01%
0.02%
2.13%
1.01%
1.59%
3.87%
2.07%
2.97%
2.15%
1.15%
1.61%
1.80%
1.12%
1.44%
1.40%
0.70%
1.07%
NA
NA
NA
1.76%
1.02%
1.38%
Page 86
Use of Services
HealthPartners / Group Health Plan, Inc.
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 2:08 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
11108
0
11109
Female
0
0
0
0
1
25314
0
25315
Member Months
(Inpatient)
Total
0
0
0
0
2
36422
0
36424
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
76
52
128
0
0
0
76
52
128
HEDIS 2013 (Reporting Year 2012)
Male
0
0
0
0
1
11108
0
11109
Female
0
0
0
0
1
25314
0
25315
Total
0
0
0
0
2
36422
0
36424
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
8.21%
2.47%
4.22%
NA
NA
NA
8.21%
2.46%
4.22%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
51
34
85
0
0
0
51
34
85
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
0
0
0
0
0
0
0
0
0
0
1
1
2
11108
25314
36422
0
0
0
11109
25315
36424
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
5.51%
1.61%
2.80%
NA
NA
NA
5.51%
1.61%
2.80%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Member Months
(Outpatient/ED)
Male
0
0
0
0
1
11108
0
11109
Female
0
0
0
0
1
25314
0
25315
Total
0
0
0
0
2
36422
0
36424
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
35
20
55
0
0
0
35
20
55
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.78%
0.95%
1.81%
NA
NA
NA
3.78%
0.95%
1.81%
Page 88
Use of Services
HealthPartners / Group Health Plan, Inc.
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 2:08 PM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
Female
NR
NR
Member Months
(Inpatient)
Total
NR
NR
NR
NR
NR
NR
NR
NR
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2013 (Reporting Year 2012)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Outpatient/ED
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 89
Use of Services
HealthPartners / Group Health Plan, Inc.
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 2:08 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
178853
49886
39055
55139
111855
292
0
435080
Female
176197
50213
61539
99704
127752
367
0
515772
Total
355050
100099
100594
154843
239607
659
0
950852
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
16
15
31
261
177
438
505
451
956
1216
1072
2288
2042
1350
3392
0
0
0
0
0
0
4040
3065
7105
HEDIS 2013 (Reporting Year 2012)
Total
355050
100099
100594
154843
239607
659
0
950852
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
178853
176197
355050
49886
50213
100099
39055
61539
100594
55139
99704
154843
111855
127752
239607
292
367
659
0
0
0
435080
515772
950852
Percent
0.06%
0.03%
0.04%
1.27%
1.17%
1.22%
4.06%
2.79%
3.28%
6.18%
3.13%
4.22%
5.85%
3.19%
4.43%
0.00%
0.00%
0.00%
NA
NA
NA
2.82%
1.85%
2.30%
Intensive Outpatient/Partial
Hospitalization
Percent
Number
0
0.00%
1
0.01%
1
0.00%
18
0.43%
11
0.26%
29
0.35%
4
0.12%
6
0.12%
10
0.12%
18
0.39%
14
0.17%
32
0.25%
21
0.23%
25
0.23%
46
0.23%
0
0.00%
0
0.00%
0
0.00%
0
NA
0
NA
0
NA
61
0.17%
57
0.13%
118
0.15%
Member Months
(Inpatient)
Male
178853
49886
39055
55139
111855
292
0
435080
Female
176197
50213
61539
99704
127752
367
0
515772
Inpatient
Percent
0.11%
0.10%
0.10%
6.28%
4.23%
5.25%
15.52%
8.79%
11.40%
26.46%
12.90%
17.73%
21.91%
12.68%
16.99%
0.00%
0.00%
0.00%
NA
NA
NA
11.14%
7.13%
8.97%
Number
9
4
13
53
49
102
132
143
275
284
260
544
545
340
885
0
0
0
0
0
0
1023
796
1819
Member Months
(Outpatient/ED)
Male
178853
49886
39055
55139
111855
292
0
435080
Female
176197
50213
61539
99704
127752
367
0
515772
Total
355050
100099
100594
154843
239607
659
0
950852
Outpatient/ED
Number
9
10
19
243
153
396
452
369
821
1104
962
2066
1837
1214
3051
0
0
0
0
0
0
3645
2708
6353
Percent
0.06%
0.07%
0.06%
5.85%
3.66%
4.75%
13.89%
7.20%
9.79%
24.03%
11.58%
16.01%
19.71%
11.40%
15.28%
0.00%
0.00%
0.00%
NA
NA
NA
10.05%
6.30%
8.02%
Page 90
Use of Services
HealthPartners / Group Health Plan, Inc.
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 2:08 PM
Commercial
Member Months
(Inpatient)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
558982
235993
2087347
68331
0
2950653
Female
532830
222623
2308940
61776
0
3126169
Total
1091812
458616
4396287
130107
0
6076822
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
3290
2145
5435
2525
2931
5456
12039
22608
34647
304
342
646
0
0
0
18158
28026
46184
HEDIS 2013 (Reporting Year 2012)
Male
558982
235993
2087347
68331
0
2950653
Female
532830
222623
2308940
61776
0
3126169
Total
1091812
458616
4396287
130107
0
6076822
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
7.06%
4.83%
5.97%
12.84%
15.80%
14.28%
6.92%
11.75%
9.46%
5.34%
6.64%
5.96%
NA
NA
NA
7.38%
10.76%
9.12%
Number
38
18
56
157
225
382
396
578
974
11
12
23
0
0
0
602
833
1435
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
558982
532830
1091812
235993
222623
458616
2087347
2308940
4396287
68331
61776
130107
0
0
0
2950653
3126169
6076822
Percent
0.08%
0.04%
0.06%
0.80%
1.21%
1.00%
0.23%
0.30%
0.27%
0.19%
0.23%
0.21%
NA
NA
NA
0.24%
0.32%
0.28%
Number
219
135
354
215
292
507
398
883
1281
6
10
16
0
0
0
838
1320
2158
Percent
0.47%
0.30%
0.39%
1.09%
1.57%
1.33%
0.23%
0.46%
0.35%
0.11%
0.19%
0.15%
NA
NA
NA
0.34%
0.51%
0.43%
Member Months
(Outpatient/ED)
Male
558982
235993
2087347
68331
0
2950653
Total
1091812
458616
4396287
130107
0
6076822
Female
532830
222623
2308940
61776
0
3126169
Outpatient/ED
Number
3217
2100
5317
2463
2848
5311
11838
22265
34103
293
336
629
0
0
0
17811
27549
45360
Percent
6.91%
4.73%
5.84%
12.52%
15.35%
13.90%
6.81%
11.57%
9.31%
5.15%
6.53%
5.80%
NA
NA
NA
7.24%
10.57%
8.96%
Page 91
Use of Services
HealthPartners / Group Health Plan, Inc.
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 2:08 PM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
1
11108
0
11109
Female
0
0
1
25314
0
25315
Member Months
(Inpatient)
Total
0
0
2
36422
0
36424
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
0
0
0
0
0
0
94
274
368
0
0
0
94
274
368
HEDIS 2013 (Reporting Year 2012)
Male
0
0
1
11108
0
11109
Female
0
0
1
25314
0
25315
Total
0
0
2
36422
0
36424
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
10.15%
12.99%
12.12%
NA
NA
NA
10.15%
12.99%
12.12%
Number
0
0
0
0
0
0
0
0
0
16
37
53
0
0
0
16
37
53
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
0
0
0
0
1
1
2
11108
25314
36422
0
0
0
11109
25315
36424
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
1.73%
1.75%
1.75%
NA
NA
NA
1.73%
1.75%
1.75%
Number
0
0
0
0
0
0
0
0
0
4
14
18
0
0
0
4
14
18
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.43%
0.66%
0.59%
NA
NA
NA
0.43%
0.66%
0.59%
Member Months
(Outpatient/ED)
Male
0
0
1
11108
0
11109
Total
0
0
2
36422
0
36424
Female
0
0
1
25314
0
25315
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
79
237
316
0
0
0
79
237
316
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
8.53%
11.23%
10.41%
NA
NA
NA
8.53%
11.23%
10.41%
Page 93
Use of Services
HealthPartners / Group Health Plan, Inc.
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 2:08 PM
SNBC
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)
Male
Female
Total
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 94
Use of Services
HealthPartners / Group Health Plan, Inc.
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 2:08 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
178853
49886
206049
292
0
435080
Female
176197
50213
288995
367
0
515772
Total
355050
100099
495044
659
0
950852
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
1679
1150
2829
838
1089
1927
4005
6773
10778
2
3
5
0
0
0
6524
9015
15539
HEDIS 2013 (Reporting Year 2012)
Male
178853
49886
206049
292
0
435080
Female
176197
50213
288995
367
0
515772
Total
355050
100099
495044
659
0
950852
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
11.27%
7.83%
9.56%
20.16%
26.03%
23.10%
23.32%
28.12%
26.13%
8.22%
9.81%
9.10%
NA
NA
NA
17.99%
20.97%
19.61%
Number
27
17
44
73
112
185
248
250
498
0
0
0
0
0
0
348
379
727
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
178853
176197
355050
49886
50213
100099
206049
288995
495044
292
367
659
0
0
0
435080
515772
950852
Percent
0.18%
0.12%
0.15%
1.76%
2.68%
2.22%
1.44%
1.04%
1.21%
0.00%
0.00%
0.00%
NA
NA
NA
0.96%
0.88%
0.92%
Number
122
58
180
90
127
217
265
412
677
0
0
0
0
0
0
477
597
1074
Percent
0.82%
0.40%
0.61%
2.16%
3.04%
2.60%
1.54%
1.71%
1.64%
0.00%
0.00%
0.00%
NA
NA
NA
1.32%
1.39%
1.36%
Member Months
(Outpatient/ED)
Male
178853
49886
206049
292
0
435080
Female
176197
50213
288995
367
0
515772
Total
355050
100099
495044
659
0
950852
Outpatient/ED
Number
1639
1131
2770
806
1044
1850
3849
6580
10429
2
3
5
0
0
0
6296
8758
15054
Percent
11.00%
7.70%
9.36%
19.39%
24.95%
22.18%
22.42%
27.32%
25.28%
8.22%
9.81%
9.10%
NA
NA
NA
17.37%
20.38%
19.00%
Page 95
Use of Services
HealthPartners / Group Health Plan, Inc.
Plan All-Cause Readmissions
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Plan All-Cause Readmissions
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Plan All-Cause Readmissions
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 2:08 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
39545
164541
221420
226148
143321
96811
Member Months
Female
36492
157081
210610
215785
135485
92135
891786
30.22%
229176
181519
210010
207639
237092
847588
27.11%
228575
216050
248551
225178
254852
1065436
36.11%
250091
268246
233610
173153
1173206
37.53%
276831
300490
269586
196692
925100
31.35%
44318
12691
5314
3215
2008
785
1043599
33.38%
37091
10012
5697
4214
3143
1619
68331
2.32%
0
2950653
61776
1.98%
0
3126169
HEDIS 2013 (Reporting Year 2012)
Total
76037
321622
432030
441933
278806
188946
1739374
28.62%
457751
397569
458561
432817
491944
2238642
36.84%
526922
568736
503196
369845
1968699
32.40%
81409
22703
11011
7429
5151
2404
130107
2.14%
0
6076822
Page 101
Health Plan Descriptive Information
HealthPartners / Group Health Plan, Inc.
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 2:08 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
HealthPartners / Group Health Plan, Inc.
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 2:08 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
1
1
0.01%
2792
2717
2375
1765
804
655
1
0.00%
4270
5387
4543
3874
3786
3454
11108
99.99%
0
11109
25314
100.00%
0
25315
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
2
2
0.01%
7062
8104
6918
5639
4590
4109
36422
99.99%
0
36424
Page 103
Health Plan Descriptive Information
HealthPartners / Group Health Plan, Inc.
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 2:08 PM
SNBC
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 104
Health Plan Descriptive Information
HealthPartners / Group Health Plan, Inc.
Enrollment by Product Line (Age & Sex)
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Member Months
Male
Female
20502
19584
<1
57563
57642
1-4
66085
65081
5-9
55440
55083
10-14
29149
29020
15-17
15174
16907
18-19
0-19 Subtotal
243913
243317
0-19 Subtotal: %
56.06%
47.18%
23881
44632
20-24
28013
52925
25-29
27126
46779
30-34
22563
32348
35-39
22686
27706
40-44
20-44 Subtotal
124269
204390
20-44 Subtotal: %
28.56%
39.63%
21919
22139
45-49
20611
20050
50-54
15249
14431
55-59
8827
11078
60-64
45-64 Subtotal
66606
67698
45-64 Subtotal: %
15.31%
13.13%
206
173
65-69
42
102
70-74
38
41
75-79
0
27
80-84
6
16
85-89
0
8
>=90
>=65 Subtotal
292
367
>=65 Subtotal: %
0.07%
0.07%
0
0
Age Unknown
Total
435080
515772
HEDIS 2013 (Reporting Year 2012)
Data Last Refreshed:
Nov 15, 2013 2:08 PM
Total
40086
115205
131166
110523
58169
32081
487230
51.24%
68513
80938
73905
54911
50392
328659
34.56%
44058
40661
29680
19905
134304
14.12%
379
144
79
27
22
8
659
0.07%
0
950852
Page 105