Blue Plus (HMO Minnesota)
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
Blue Plus (HMO Minnesota)
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 12:51 PM
Commercial
Medicare
Advantage
2012
A
11168
MHCP-MC
2011
H
19708
663
NR
NR
NR
NR
3.36%
380
5.00%
399
19
4.76%
0
Number of administrative data records excluded
0
Number of medical record data records excluded
0
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
0
244
2.18%
1.91%
2.46%
NR
NR
NR
0
399
19
284
75.94%
71.62%
80.26%
Page 3
Effectiveness of Care
Blue Plus (HMO Minnesota)
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Nov 15, 2013 12:51 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
A
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Physical Activity
Total
2012
A
General
Measure
Data
Ages 3-11
Ages 1217
Total
2012
A
1955
1576
3531
1955
1576
3531
1955
1576
3531
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
88
54
142
6
17
23
0
1
1
4.50%
3.56%
5.45%
3.43%
2.50%
4.36%
4.02%
3.36%
4.68%
0.31%
0.04%
0.58%
1.08%
0.54%
1.62%
0.65%
0.37%
0.93%
0.00%
0.00%
0.03%
0.06%
0.00%
0.22%
0.03%
0.00%
0.10%
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
Page 4
Effectiveness of Care
Blue Plus (HMO Minnesota)
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Nov 15, 2013 12:51 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
16752
8835
25587
16752
8835
25587
16752
8835
25587
230
1.37%
93
1.05%
323
1.26%
109
0.65%
112
1.27%
221
0.86%
0
0.00%
1
0.01%
1
0.00%
0
0.00%
0
0.00%
0
0.00%
270
0
103
38.15%
32.17%
44.13%
162
0
62
38.27%
30.48%
46.07%
432
0
165
38.19%
33.50%
42.89%
411
5.00%
432
411
5.00%
432
3
0.69%
3
0.69%
6
1.39%
411
5.00%
432
2
0.46%
6
1.39%
8
1.85%
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
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
270
3
166
62.59%
56.64%
68.55%
162
3
102
64.81%
57.15%
72.48%
432
6
268
63.43%
58.77%
68.08%
270
2
129
48.52%
42.37%
54.67%
162
6
52
35.80%
28.11%
43.49%
432
8
181
43.75%
38.96%
48.54%
Page 5
Effectiveness of Care
Blue Plus (HMO Minnesota)
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
General
Measure
Data
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
IPV
MMR
HiB
Hepatitis B
VZV
Influenza
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
177
193
191
195
166
188
179
175
163
151
87.19%
82.35%
92.04%
95.07%
91.85%
98.30%
94.09%
90.60%
97.58%
96.06%
93.14%
98.98%
81.77%
76.22%
87.33%
92.61%
88.77%
96.46%
88.18%
83.49%
92.87%
86.21%
81.22%
91.20%
80.30%
74.58%
86.01%
74.38%
68.13%
80.64%
2012
A
203
Number of administrative data records
excluded
Number of medical data records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by administrative Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
Page 6
Effectiveness of Care
Blue Plus (HMO Minnesota)
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
General
Measure
Data
DTaP
Combo 2
Combo 3
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
177
146
144
131
122
113
115
106
102
97
87.19%
82.35%
92.04%
71.92%
65.49%
78.35%
70.94%
64.44%
77.43%
64.53%
57.70%
71.36%
60.10%
53.12%
67.08%
55.67%
48.58%
62.75%
56.65%
49.59%
63.71%
52.22%
45.10%
59.33%
50.25%
43.12%
57.37%
47.78%
40.67%
54.90%
2012
A
203
Number of administrative data records
excluded
Number of medical data records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by administrative Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
Page 7
Effectiveness of Care
Blue Plus (HMO Minnesota)
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
General
Measure
Data
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
HEDIS 2013 (Reporting Year 2012)
HiB
Hepatitis B
VZV
Influenza
1711
80.48%
1944
91.44%
1912
89.93%
1954
91.91%
1808
85.04%
1872
88.05%
1747
82.17%
1498
70.46%
1407
66.18%
1187
55.83%
352
81.48%
393
90.97%
389
90.05%
395
91.44%
372
86.11%
379
87.73%
351
81.25%
292
67.59%
273
63.19%
243
56.25%
352
12
84.26%
80.71%
87.81%
393
6
92.36%
89.74%
94.98%
389
2
90.51%
87.63%
93.39%
395
5
92.59%
90.01%
95.18%
372
26
92.13%
89.47%
94.78%
379
2
88.19%
85.04%
91.35%
351
16
84.95%
81.47%
88.44%
292
7
69.21%
64.74%
73.68%
273
15
66.67%
62.11%
71.23%
243
9
58.33%
53.57%
63.10%
0
Number of medical data records excluded
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
MMR
411
0.05
432
0
Numerator Events by administrative Data
IPV
2012
H
2126
Number of administrative data records
excluded
Denominator
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
432
Page 8
Effectiveness of Care
Blue Plus (HMO Minnesota)
Childhood Immunization Status
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
General
Measure
Data
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
HEDIS 2013 (Reporting Year 2012)
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
1711
80.48%
1504
70.74%
1453
68.34%
1186
55.79%
1130
53.15%
969
45.58%
988
46.47%
822
38.66%
778
36.59%
696
32.74%
352
81.48%
312
72.22%
302
69.91%
244
56.48%
231
53.47%
203
46.99%
201
46.53%
172
39.81%
158
36.57%
142
32.87%
352
12
84.26%
80.71%
87.81%
312
31
79.40%
75.47%
83.33%
302
35
78.01%
73.99%
82.03%
244
28
62.96%
58.29%
67.63%
231
29
60.19%
55.45%
64.92%
203
26
53.01%
48.19%
57.83%
201
23
51.85%
47.02%
56.68%
172
21
44.68%
39.87%
49.48%
158
24
42.13%
37.36%
46.90%
142
19
37.27%
32.59%
41.94%
0
Number of medical data records excluded
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Combo 3
411
0.05
432
0
Numerator Events by administrative Data
Combo 2
2012
H
2126
Number of administrative data records
excluded
Denominator
DTaP
432
Page 9
Effectiveness of Care
Blue Plus (HMO Minnesota)
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Immunizations for Adolescents
Commercial
Commercial
Data Elements
General
Measure Data
Meningococcal
Tdap
Combo 1
Current Year's Admin Rate
NR
NR
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
NR
NR
NR
Measurement Year
2012
Data Collection Methodology
A
Eligible Member Population
331
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
204
304
202
61.63%
91.84%
61.03%
Lower 95% Confidence Interval
56.24%
88.74%
55.62%
Upper 95% Confidence Interval
67.02%
94.94%
66.43%
HEDIS 2013 (Reporting Year 2012)
Page 10
Effectiveness of Care
Blue Plus (HMO Minnesota)
Data Last Refreshed:
Nov 15, 2013 12:51 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
1710
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
1
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
794
1402
780
46.43%
81.99%
45.61%
215
49.77%
355
82.18%
211
48.84%
215
7
51.51%
46.67%
56.34%
355
8
84.22%
80.67%
87.78%
211
9
51.04%
46.21%
55.88%
411
5.00%
432
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
431
Page 11
Effectiveness of Care
Blue Plus (HMO Minnesota)
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 12:51 PM
Commercial
2012
A
4774
3431
71.87%
70.58%
73.15%
Medicare
Advantage
NR
NR
NR
MSHO
2012
A
367
210
57.22%
52.02%
62.42%
SNBC
MHCP-MC
NR
NR
NR
2012
A
5606
3346
59.69%
58.39%
60.98%
Page 12
Effectiveness of Care
Blue Plus (HMO Minnesota)
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 12:51 PM
Commercial
2012
A
5923
MHCP-MC
2012
H
17871
11221
NR
NR
62.79%
288
5.00%
303
197
65.02%
0
0
7
0
4172
70.44%
69.27%
71.61%
0
296
197
11
70.27%
64.89%
75.65%
Page 13
Effectiveness of Care
Blue Plus (HMO Minnesota)
Colorectal Cancer Screening
Data Last Refreshed:
Nov 15, 2013 12:51 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
2012
A
5452
MSHO
SNBC
2012
H
2009
878
NR
NR
NR
NR
3727
68.36%
67.12%
69.60%
NR
NR
NR
43.70%
411
10.00%
453
253
55.85%
0
1
0
0
0
452
253
16
59.51%
54.88%
64.15%
NR
NR
NR
NR
NR
Page 14
Effectiveness of Care
Blue Plus (HMO Minnesota)
Chlamydia Screening in Women
Data Last Refreshed:
Nov 15, 2013 12:51 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
358
112
31.28%
26.34%
36.23%
468
220
47.01%
42.38%
51.64%
826
332
40.19%
36.79%
43.60%
2012
A
Page 15
Effectiveness of Care
Blue Plus (HMO Minnesota)
Chlamydia Screening in Women
Data Last Refreshed:
Nov 15, 2013 12:51 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
1887
841
44.57%
42.30%
46.84%
1473
789
53.56%
50.98%
56.15%
3360
1630
48.51%
46.81%
50.22%
2012
A
Page 16
Effectiveness of Care
Blue Plus (HMO Minnesota)
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 12:51 PM
Medicare
Advantage
NR
NR
NR
MSHO
2012
A
6757
4901
72.53%
71.46%
73.60%
Page 17
Effectiveness of Care
Blue Plus (HMO Minnesota)
Data Last Refreshed:
Nov 15, 2013 12:51 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
203
MHCP-MC
2012
H
2126
1646
NR
77.42%
NR
411
5.00%
432
322
74.54%
0
Number of administrative data records
excluded
0
Number of medical record data records
excluded
0
Number of employee/dependent medical
records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
66.01%
0
432
322
15
78.01%
Lower 95% Confidence Interval
59.25%
73.99%
Upper 95% Confidence Interval
72.77%
82.03%
HEDIS 2013 (Reporting Year 2012)
0
134
Page 18
Effectiveness of Care
Blue Plus (HMO Minnesota)
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Care for Older Adults
MSHO
Advance Care
Planning
Medication Review
Functional
Status
Assessment
Pain
Screening
119
0
0
0
1.47%
0.00%
0.00%
0.00%
7
1.55%
3
0.66%
0
0.00%
3
0.66%
7
267
60.49%
3
304
67.77%
0
436
96.25%
3
273
60.93%
Lower 95% Confidence Interval
55.87%
63.36%
94.39%
56.32%
Upper 95% Confidence Interval
65.10%
72.18%
98.11%
65.53%
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
8113
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data
Errors
Number of employee/dependent medical
records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
HEDIS 2013 (Reporting Year 2012)
411
10.00%
453
0
0
0
453
Page 19
Effectiveness of Care
Blue Plus (HMO Minnesota)
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Nov 15, 2013 12:51 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
158
70.54%
64.34%
76.73%
194
86.61%
81.92%
91.29%
2012
A
224
Page 21
Effectiveness of Care
Blue Plus (HMO Minnesota)
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
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 12:51 PM
MSHO
SNBC
2012
A
268
57
21.27%
16.18%
26.35%
NR
NR
NR
Page 23
Effectiveness of Care
Blue Plus (HMO Minnesota)
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Nov 15, 2013 12:51 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
37
37
0
100.00%
98.65%
100.00%
25
25
1
NA
NA
NA
101
92
12
91.09%
85.04%
97.14%
89
81
31
91.01%
84.51%
97.52%
252
235
44
93.25%
89.96%
96.55%
2012
A
`
Page 24
Effectiveness of Care
Blue Plus (HMO Minnesota)
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Nov 15, 2013 12:51 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
323
310
18
95.98%
93.68%
98.27%
218
187
8
85.78%
80.91%
90.65%
428
346
103
80.84%
77.00%
84.69%
143
110
222
76.92%
69.67%
84.18%
1112
953
351
85.70%
83.60%
87.80%
2012
A
Page 25
Effectiveness of Care
Blue Plus (HMO Minnesota)
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
150
0
88.76%
83.70%
93.82%
0.00%
0.00%
0.30%
2012
A
169
Page 26
Effectiveness of Care
Blue Plus (HMO Minnesota)
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Nov 15, 2013 12:51 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
232
85.93%
0
0.00%
232
85.93%
0
0.00%
232
5
87.78%
83.69%
91.87%
0
149
55.19%
49.07%
61.30%
2011
H
270
270
5.00%
270
0
0
0
270
Page 28
Effectiveness of Care
Blue Plus (HMO Minnesota)
Controlling High Blood Pressure
Data Last Refreshed:
Nov 15, 2013 12:51 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
1486
2012
H
1827
2012
H
3241
0
0
0
0.00%
411
10.00%
453
0
0.00%
NR
NR
0.00%
411
10.00%
453
0
0.00%
NR
NR
0.00%
411
10.00%
453
0
0.00%
5
3
8
Number of records excluded because of
false positive diagnoses
5
3
8
Number of administrative data records
excluded
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
448
0
324
72.32%
68.07%
76.58%
0
450
0
294
65.33%
60.83%
69.84%
0
445
0
287
64.49%
59.94%
69.05%
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
Blue Plus (HMO Minnesota)
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 12:51 PM
Medicare
Advantage
MSHO
SNBC
MHCP-MC
2012
A
10
2012
A
62
2012
A
45
9
57
37
NA
NA
NA
NR
NR
NR
91.94%
84.35%
99.52%
NR
NR
NR
82.22%
69.94%
94.50%
Page 30
Effectiveness of Care
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 12:51 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
A
791
Eye Exam
LDL-C
Screening
2012
A
791
2012
A
791
LDL-C Level
<100 mg/dL
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
2012
A
791
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
446
671
56.38%
52.87%
59.90%
84.83%
82.27%
87.39%
NR
NR
NR
NR
NR
NR
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Number of HbA1c < 7 required administrative
data records excluded
Number of HbA1c < 7 required medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
723
91.40%
89.39%
93.42%
NR
NR
NR
NR
NR
NR
NR
NR
NR
635
NR
NR
NR
80.28%
77.44%
83.11%
Page 31
Effectiveness of Care
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 12:51 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
874
2012
H
874
792
90.62%
411
10%
453
419
92.49%
863
98.74%
411
10%
453
449
99.12%
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
874
2012
H
874
2012
H
874
2012
H
874
2012
H
874
2012
H
874
2012
H
874
6
0.69%
411
10%
453
3
0.66%
570
65.22%
411
10%
453
298
65.78%
691
79.06%
411
10%
453
372
82.12%
13
1.49%
411
10%
453
4
0.88%
758
86.73%
411
10%
453
400
88.30%
17
1.95%
411
10%
453
4
0.88%
17
1.95%
411
10%
453
4
0.88%
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
453
419
5
93.60%
91.23%
95.96%
0
453
126
14
30.91%
26.54%
35.27%
0
453
3
281
62.69%
58.13%
67.26%
0
453
298
48
76.38%
72.36%
80.40%
0
453
372
8
83.89%
80.39%
87.38%
0
453
4
234
52.54%
47.83%
57.25%
0
453
400
7
89.85%
86.95%
92.74%
0
453
4
304
67.99%
63.58%
72.40%
0
453
4
272
60.93%
56.32%
65.53%
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
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
HbA1c
Testing
Poor HbA1c
Control
2011
H
2730
2011
H
2730
2419
88.61%
411
10%
453
408
90.07%
2724
99.78%
411
10%
453
451
99.56%
1
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2011
H
2730
2011
H
2730
2011
H
2730
2011
H
2730
2011
H
2730
2011
H
2730
2011
H
2730
5
0.18%
411
10%
453
2
0.44%
1513
55.42%
411
10%
453
253
55.85%
2118
77.58%
411
10%
453
356
78.59%
4
0.15%
411
10%
453
1
0.22%
2160
79.12%
411
10%
453
357
78.81%
6
0.22%
411
10%
453
1
0.22%
6
0.22%
411
10%
453
1
0.22%
1
1
1
1
1
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
452
408
6
91.59%
88.92%
94.26%
0
452
73
61
29.65%
25.33%
33.97%
0
452
2
265
59.07%
54.43%
63.71%
0
452
253
55
68.14%
63.74%
72.55%
0
452
356
14
81.86%
78.20%
85.52%
0
452
1
203
45.13%
40.43%
49.83%
0
452
357
17
82.74%
79.15%
86.34%
0
452
1
340
75.44%
71.36%
79.52%
0
452
1
257
57.08%
52.41%
61.75%
NR
NR
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
NR
NR
NR
Page 35
Effectiveness of Care
Blue Plus (HMO Minnesota)
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 12:51 PM
Medicare
Advantage
NR
NR
NR
Page 36
Effectiveness of Care
Blue Plus (HMO Minnesota)
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 12:51 PM
MSHO
2012
A
363
32
8.82%
5.76%
11.87%
Page 37
Effectiveness of Care
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 12:51 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
196
152
77.55%
71.45%
83.65%
124
63.27%
56.26%
70.27%
Page 38
Effectiveness of Care
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 12:51 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
116
93
80.17%
72.49%
87.86%
85
73.28%
64.79%
81.76%
Page 40
Effectiveness of Care
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Nov 15, 2013 12:51 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
1247
761
61.03%
58.28%
63.77%
543
43.54%
40.75%
46.34%
Page 42
Effectiveness of Care
Blue Plus (HMO Minnesota)
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Nov 15, 2013 12:51 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
47
17
36.17%
21.37%
50.97%
18
6
NA
NA
NA
2012
A
Page 43
Effectiveness of Care
Blue Plus (HMO Minnesota)
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Nov 15, 2013 12:51 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
592
237
40.03%
36.00%
44.07%
157
75
47.77%
39.64%
55.90%
2012
A
Page 44
Effectiveness of Care
Blue Plus (HMO Minnesota)
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Nov 15, 2013 12:51 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
15
39.47%
22.62%
56.33%
8
21.05%
6.77%
35.33%
2012
A
38
Page 46
Effectiveness of Care
Blue Plus (HMO Minnesota)
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 12:51 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
1322
1070
80.94%
78.78%
83.09%
6
5
NA
NA
NA
1019
816
80.08%
77.58%
82.58%
63
45
71.43%
59.48%
83.38%
2410
1936
80.33%
78.72%
81.94%
2012
A
Page 48
Effectiveness of Care
Blue Plus (HMO Minnesota)
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 12:51 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
3372
3219
95.46%
94.75%
96.18%
372
361
97.04%
95.19%
98.90%
3702
3573
96.52%
95.91%
97.12%
408
359
87.99%
84.71%
91.27%
7854
7512
95.65%
95.19%
96.10%
2012
A
Page 50
Effectiveness of Care
Blue Plus (HMO Minnesota)
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Nov 15, 2013 12:51 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
2959
2503
84.59%
83.27%
85.91%
39
37
94.87%
86.67%
100.00%
2225
1879
84.45%
82.92%
85.98%
254
160
62.99%
56.86%
69.13%
5477
4579
83.60%
82.61%
84.59%
2012
A
Page 52
Access/Availability of Care
Blue Plus (HMO Minnesota)
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 12:51 PM
MSHO
2012
H
3902
0
0.00%
411
20.00%
494
0
0.00%
12
0
0
482
0
73
15.15%
11.84%
18.45%
Page 53
Effectiveness of Care
Blue Plus (HMO Minnesota)
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Nov 15, 2013 12:51 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
110
10
9.09%
3.26%
14.92%
2898
590
20.36%
18.88%
21.84%
2012
A
534
86
16.10%
12.89%
19.32%
2254
494
21.92%
20.19%
23.65%
Page 55
Effectiveness of Care
Blue Plus (HMO Minnesota)
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Nov 15, 2013 12:51 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
8113
At least 1
Prescription
At least 2
Prescriptions
1608
19.82%
18.95%
20.69%
454
5.60%
5.09%
6.10%
Page 57
Access/Availability of Care
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 12:51 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
4831
6734
277
11842
4540
93.98%
93.30%
94.66%
6432
95.52%
95.01%
96.02%
266
96.03%
93.55%
98.51%
11238
94.90%
94.50%
95.30%
2012
A
Page 58
Access/Availability of Care
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 12:51 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
8137
8137
0
NA
NA
NA
0
NA
NA
NA
7997
98.28%
97.99%
98.57%
7997
98.28%
97.99%
98.57%
2012
A
Page 60
Access/Availability of Care
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Nov 15, 2013 12:51 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
19058
12236
64
31358
16989
89.14%
88.70%
89.59%
11013
90.00%
89.47%
90.54%
58
90.63%
82.70%
98.55%
28060
89.48%
89.14%
89.82%
2012
A
Page 62
Access/Availability of Care
Blue Plus (HMO Minnesota)
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Nov 15, 2013 12:51 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.
255
235
92.16%
88.66%
95.65%
1163
1022
87.88%
85.96%
89.80%
1214
1082
89.13%
87.33%
90.92%
2206
1984
89.94%
88.66%
91.21%
2012
A
Page 63
Access/Availability of Care
Blue Plus (HMO Minnesota)
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Nov 15, 2013 12:51 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.
3205
3144
98.10%
97.61%
98.59%
10382
9426
90.79%
90.23%
91.35%
6532
6020
92.16%
91.50%
92.82%
8875
8250
92.96%
92.42%
93.50%
2012
A
Page 64
Access/Availability of Care
Blue Plus (HMO Minnesota)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 12:51 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
14
204
218
6
3
73
30
NA
NA
NA
NA
NA
NA
35.78%
28.96%
42.61%
14.71%
9.60%
19.81%
79
36.24%
29.63%
42.85%
33
15.14%
10.15%
20.12%
Page 65
Access/Availability of Care
Blue Plus (HMO Minnesota)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 12:51 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
99
0
99
0
0
45
2
NA
NA
NA
NA
NA
NA
45.45%
35.14%
55.77%
2.02%
0.00%
5.30%
45
45.45%
35.14%
55.77%
2
2.02%
0.00%
5.30%
Page 67
Access/Availability of Care
Blue Plus (HMO Minnesota)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Nov 15, 2013 12:51 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
211
2520
2731
100
38
993
321
47.39%
40.42%
54.37%
18.01%
12.59%
23.43%
39.40%
37.48%
41.33%
12.74%
11.42%
14.06%
1093
40.02%
38.17%
41.88%
359
13.15%
11.86%
14.43%
Page 69
Access/Availability of Care
Blue Plus (HMO Minnesota)
Prenatal and Postpartum Care
Data Last Refreshed:
Nov 15, 2013 12:51 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
A
354
Postpartum
Care
2012
A
354
NR
NR
NR
NR
264
196
74.58%
69.90%
79.25%
55.37%
50.05%
60.69%
Page 70
Access/Availability of Care
Blue Plus (HMO Minnesota)
Prenatal and Postpartum Care
Data Last Refreshed:
Nov 15, 2013 12:51 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
3649
Postpartum
Care
2012
H
3649
2045
1944
56.04%
411
10.00%
453
242
53.42%
53.27%
411
10.00%
453
274
60.49%
1
1
0
0
452
242
140
84.51%
81.07%
87.96%
0
0
452
274
64
74.78%
70.66%
78.89%
Page 71
Use of Services
Blue Plus (HMO Minnesota)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Nov 15, 2013 12:51 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
16
2
1
4
11
23
155
7.55%
3.76%
11.34%
0.94%
0.00%
2.48%
0.47%
0.00%
1.63%
1.89%
0.00%
3.95%
5.19%
1.97%
8.41%
10.85%
6.43%
15.27%
73.11%
66.91%
79.32%
2012
A
212
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
Blue Plus (HMO Minnesota)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Nov 15, 2013 12:51 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
29
1.03%
54
1.92%
64
2.28%
121
4.31%
318
11.32%
573
20.41%
1649
58.73%
3
0.70%
6
1.40%
22
5.12%
20
4.65%
43
10.00%
87
20.23%
249
57.91%
1
0
0.23%
0.00%
0.80%
5
0
1.16%
0.03%
2.29%
14
0
3.26%
1.46%
5.05%
16
3
4.42%
2.36%
6.48%
32
3
8.14%
5.44%
10.84%
63
8
16.51%
12.89%
20.14%
251
34
66.28%
61.69%
70.86%
2011
H
2808
409
5.00%
430
0
0
0
430
Page 73
Use of Services
Blue Plus (HMO Minnesota)
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Commercial
2012
A
967
MHCP-MC
2012
A
8571
NR
NR
NR
NR
642
5549
66.39%
63.36%
69.42%
64.74%
63.72%
65.76%
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2013 (Reporting Year 2012)
Page 74
Use of Services
Blue Plus (HMO Minnesota)
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 12:51 PM
Commercial
2012
A
3393
MHCP-MC
2011
H
15430
4954
NR
NR
32.11%
411
5.00%
432
151
34.95%
0
0
1103
32.51%
30.92%
34.10%
0
432
151
23
40.28%
35.54%
45.02%
Page 75
Use of Services
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
3213
31854
45084
104799
115644
3512
163
32
0
304301
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
2712
8983
10288
25386
38791
1698
85
21
0
87964
HEDIS 2013 (Reporting Year 2012)
Visits/ 1,000
Member
Months
844.07
282.01
228.20
242.24
335.43
483.49
521.47
656.25
289.07
Emergency Room Visits
Visits
92
576
581
1413
1343
57
3
1
0
4066
Visits/ 1,000
Member
Months
28.63
18.08
12.89
13.48
11.61
16.23
18.40
31.25
13.36
Page 76
Use of Services
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 12:51 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
5
29820
36732
47458
0
114015
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
1
28046
34739
38506
0
101292
HEDIS 2013 (Reporting Year 2012)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
200.00
940.51
945.74
811.37
888.41
Emergency Room Visits
Visits
0
0
0
0
0
1647
1918
2277
0
5842
Visits/ 1,000
Member
Months
NA
NA
NA
NA
0.00
55.23
52.22
47.98
51.24
Page 78
Use of Services
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Nov 15, 2013 12:51 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
61015
378085
300107
461562
230283
418
49
30
0
1431549
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
51000
126508
86375
210132
125694
241
25
5
0
599980
HEDIS 2013 (Reporting Year 2012)
Visits/ 1,000
Member
Months
835.86
334.60
287.81
455.26
545.82
576.56
510.20
166.67
419.11
Emergency Room Visits
Visits
6090
17906
10824
30313
8669
20
3
2
0
73827
Visits/ 1,000
Member
Months
99.81
47.36
36.07
65.67
37.64
47.85
61.22
66.67
51.57
Page 80
Use of Services
Blue Plus (HMO Minnesota)
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 12:51 PM
Member Months
3213
31854
45084
104799
115644
3512
163
32
0
304301
Discharges
Discharges /
1,000 Member
Months
39
36
64
570
631
37
1
0
0
1378
12.14
1.13
1.42
5.44
5.46
10.54
6.13
0.00
34
26
31
89
236
7
1
0
0
424
10.58
0.82
0.69
0.85
2.04
1.99
6.13
0.00
5
10
22
99
394
30
0
0
0
560
1.56
0.31
0.49
0.94
3.41
8.54
0.00
0.00
11
382
0
0
393
0.24
3.65
0.00
HEDIS 2013 (Reporting Year 2012)
4.53
1.39
1.84
1.48
Days
Days / 1,000
Member
Months
190
76
267
1431
2134
150
6
0
0
4254
59.13
2.39
5.92
13.65
18.45
42.71
36.81
0.00
161
50
150
241
786
20
6
0
0
1414
50.11
1.57
3.33
2.30
6.80
5.69
36.81
0.00
29
26
67
242
1342
130
0
0
0
1836
9.03
0.82
1.49
2.31
11.60
37.02
0.00
0.00
50
948
0
0
998
1.11
9.05
0.00
13.98
4.65
6.03
3.76
Average
Length of Stay
4.87
2.11
4.17
2.51
3.38
4.05
6.00
NA
NA
3.09
4.74
1.92
4.84
2.71
3.33
2.86
6.00
NA
NA
3.33
5.80
2.60
3.05
2.44
3.41
4.33
NA
NA
NA
3.28
4.55
2.48
NA
NA
2.54
Page 81
Use of Services
Blue Plus (HMO Minnesota)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
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 12:51 PM
Member Months
0
0
0
0
5
29820
36732
47458
0
114015
Discharges
0
0
0
0
0
1191
1621
1826
0
4638
Discharges /
1,000 Member
Months
NA
NA
NA
NA
0.00
39.94
44.13
38.48
40.68
0
0
0
0
0
925
1346
1567
0
3838
NA
NA
NA
NA
0.00
31.02
36.64
33.02
0
0
0
0
0
266
275
256
0
797
NA
NA
NA
NA
0.00
8.92
7.49
5.39
0
0
0
0
0
NA
NA
0.00
HEDIS 2013 (Reporting Year 2012)
33.66
6.99
0.00
Days
0
0
0
0
0
5584
7514
7495
0
20593
Days / 1,000
Member
Months
NA
NA
NA
NA
0.00
187.26
204.56
157.93
180.62
0
0
0
0
0
3962
5692
6050
0
15704
NA
NA
NA
NA
0.00
132.86
154.96
127.48
0
0
0
0
0
1622
1822
1437
0
4881
NA
NA
NA
NA
0.00
54.39
49.60
30.28
0
0
0
0
0
NA
NA
0.00
137.74
42.81
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
4.69
4.64
4.10
NA
4.44
NA
NA
NA
NA
NA
4.28
4.23
3.86
NA
4.09
NA
NA
NA
NA
NA
6.10
6.63
5.61
NA
6.12
NA
NA
NA
NA
NA
Page 83
Use of Services
Blue Plus (HMO Minnesota)
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 12:51 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
Blue Plus (HMO Minnesota)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
<1
61015
1-9
378085
10-19
300107
20-44
461562
45-64
230283
65-74
418
75-84
49
85+
30
Unknown
0
1431549
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
664
648
878
6155
1469
1
0
0
0
9815
10.88
1.71
2.93
13.34
6.38
2.39
0.00
0.00
564
518
298
1311
837
0
0
0
0
3528
9.24
1.37
0.99
2.84
3.63
0.00
0.00
0.00
100
130
156
746
631
1
0
0
0
1764
1.64
0.34
0.52
1.62
2.74
2.39
0.00
0.00
424
4097
1
0
4522
1.41
8.88
0.00
HEDIS 2013 (Reporting Year 2012)
6.86
2.46
1.23
4.56
Days
Days / 1,000
Member
Months
2935
1733
2432
16356
5785
2
0
0
0
29243
48.10
4.58
8.10
35.44
25.12
4.78
0.00
0.00
2355
1188
759
3937
3005
0
0
0
0
11244
38.60
3.14
2.53
8.53
13.05
0.00
0.00
0.00
580
545
528
2339
2778
2
0
0
0
6772
9.51
1.44
1.76
5.07
12.06
4.78
0.00
0.00
1145
10077
2
0
11224
3.82
21.83
0.01
20.43
7.85
4.73
11.32
Average
Length of Stay
4.42
2.67
2.77
2.66
3.94
2.00
NA
NA
NA
2.98
4.18
2.29
2.55
3.00
3.59
NA
NA
NA
NA
3.19
5.80
4.19
3.38
3.14
4.40
2.00
NA
NA
NA
3.84
2.70
2.46
2.00
NA
2.48
Page 85
Use of Services
Blue Plus (HMO Minnesota)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Commercial
Member Months
(Inpatient)
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
24912
11785
16331
15108
68182
1852
0
138170
Female
22647
11113
17475
21158
91883
1855
0
166131
Total
47559
22898
33806
36266
160065
3707
0
304301
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
1
1
17
8
25
53
24
77
26
17
43
99
64
163
2
0
2
0
0
0
197
114
311
HEDIS 2013 (Reporting Year 2012)
Male
24912
11785
16331
15108
68182
1852
0
138170
Female
22647
11113
17475
21158
91883
1855
0
166131
Total
47559
22898
33806
36266
160065
3707
0
304301
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
0.00%
0.05%
0.03%
1.73%
0.86%
1.31%
3.89%
1.65%
2.73%
2.07%
0.96%
1.42%
1.74%
0.84%
1.22%
1.30%
0.00%
0.65%
NA
NA
NA
1.71%
0.82%
1.23%
Number
0
0
0
7
3
10
18
5
23
8
2
10
23
14
37
0
0
0
0
0
0
56
24
80
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
24912
22647
47559
11785
11113
22898
16331
17475
33806
15108
21158
36266
68182
91883
160065
1852
1855
3707
0
0
0
138170
166131
304301
Percent
0.00%
0.00%
0.00%
0.71%
0.32%
0.52%
1.32%
0.34%
0.82%
0.64%
0.11%
0.33%
0.40%
0.18%
0.28%
0.00%
0.00%
0.00%
NA
NA
NA
0.49%
0.17%
0.32%
Number
0
0
0
1
1
2
1
0
1
0
0
0
2
2
4
0
0
0
0
0
0
4
3
7
Percent
0.00%
0.00%
0.00%
0.10%
0.11%
0.10%
0.07%
0.00%
0.04%
0.00%
0.00%
0.00%
0.04%
0.03%
0.03%
0.00%
0.00%
0.00%
NA
NA
NA
0.03%
0.02%
0.03%
Member Months
(Outpatient/ED)
Male
24912
11785
16331
15108
68182
1852
0
138170
Female
22647
11113
17475
21158
91883
1855
0
166131
Total
47559
22898
33806
36266
160065
3707
0
304301
Outpatient/ED
Number
0
1
1
15
8
23
50
24
74
25
17
42
91
61
152
2
0
2
0
0
0
183
111
294
Percent
0.00%
0.05%
0.03%
1.53%
0.86%
1.21%
3.67%
1.65%
2.63%
1.99%
0.96%
1.39%
1.60%
0.80%
1.14%
1.30%
0.00%
0.65%
NA
NA
NA
1.59%
0.80%
1.16%
Page 86
Use of Services
Blue Plus (HMO Minnesota)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 12:51 PM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
0
3
29097
0
29100
Female
0
0
0
0
2
84913
0
84915
Member Months
(Inpatient)
Total
0
0
0
0
5
114010
0
114015
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
92
88
180
0
0
0
92
88
180
HEDIS 2013 (Reporting Year 2012)
Male
0
0
0
0
3
29097
0
29100
Female
0
0
0
0
2
84913
0
84915
Total
0
0
0
0
5
114010
0
114015
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.79%
1.24%
1.89%
NA
NA
NA
3.79%
1.24%
1.89%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
29
36
65
0
0
0
29
36
65
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
0
0
0
0
0
0
0
0
0
0
3
2
5
29097
84913
114010
0
0
0
29100
84915
114015
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
1.20%
0.51%
0.68%
NA
NA
NA
1.20%
0.51%
0.68%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
1
0
1
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.04%
0.00%
0.01%
NA
NA
NA
0.04%
0.00%
0.01%
Member Months
(Outpatient/ED)
Male
0
0
0
0
3
29097
0
29100
Female
0
0
0
0
2
84913
0
84915
Total
0
0
0
0
5
114010
0
114015
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
82
69
151
0
0
0
82
69
151
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.38%
0.98%
1.59%
NA
NA
NA
3.38%
0.98%
1.59%
Page 88
Use of Services
Blue Plus (HMO Minnesota)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Nov 15, 2013 12:51 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
276115
74493
55852
74137
160638
234
0
641469
Female
265726
73457
95309
138204
217121
263
0
790080
Total
541841
147950
151161
212341
377759
497
0
1431549
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
14
3
17
351
188
539
737
650
1387
1338
1165
2503
2097
1571
3668
1
0
1
0
0
0
4538
3577
8115
HEDIS 2013 (Reporting Year 2012)
Total
541841
147950
151161
212341
377759
497
0
1431549
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
276115
265726
541841
74493
73457
147950
55852
95309
151161
74137
138204
212341
160638
217121
377759
234
263
497
0
0
0
641469
790080
1431549
Percent
0.00%
0.00%
0.00%
1.84%
1.09%
1.47%
5.05%
2.63%
3.52%
5.78%
2.79%
3.83%
4.56%
2.00%
3.09%
0.00%
0.00%
0.00%
NA
NA
NA
2.46%
1.46%
1.91%
Intensive Outpatient/Partial
Hospitalization
Percent
Number
0
0.00%
0
0.00%
0
0.00%
18
0.29%
20
0.33%
38
0.31%
10
0.21%
7
0.09%
17
0.13%
14
0.23%
18
0.16%
32
0.18%
23
0.17%
22
0.12%
45
0.14%
0
0.00%
0
0.00%
0
0.00%
0
NA
0
NA
0
NA
65
0.12%
67
0.10%
132
0.11%
Member Months
(Inpatient)
Male
276115
74493
55852
74137
160638
234
0
641469
Female
265726
73457
95309
138204
217121
263
0
790080
Inpatient
Percent
0.06%
0.01%
0.04%
5.65%
3.07%
4.37%
15.83%
8.18%
11.01%
21.66%
10.12%
14.15%
15.67%
8.68%
11.65%
5.13%
0.00%
2.41%
NA
NA
NA
8.49%
5.43%
6.80%
Number
1
0
1
114
67
181
235
209
444
357
321
678
610
362
972
0
0
0
0
0
0
1317
959
2276
Member Months
(Outpatient/ED)
Male
276115
74493
55852
74137
160638
234
0
641469
Female
265726
73457
95309
138204
217121
263
0
790080
Total
541841
147950
151161
212341
377759
497
0
1431549
Outpatient/ED
Number
13
3
16
340
173
513
716
606
1322
1301
1118
2419
2031
1524
3555
1
0
1
0
0
0
4402
3424
7826
Percent
0.06%
0.01%
0.04%
5.48%
2.83%
4.16%
15.38%
7.63%
10.49%
21.06%
9.71%
13.67%
15.17%
8.42%
11.29%
5.13%
0.00%
2.41%
NA
NA
NA
8.23%
5.20%
6.56%
Page 90
Use of Services
Blue Plus (HMO Minnesota)
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Commercial
Member Months
(Inpatient)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
24912
11785
99621
1852
0
138170
Female
22647
11113
130516
1855
0
166131
Total
47559
22898
230137
3707
0
304301
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
157
81
238
119
128
247
529
1059
1588
4
9
13
0
0
0
809
1277
2086
HEDIS 2013 (Reporting Year 2012)
Male
24912
11785
99621
1852
0
138170
Female
22647
11113
130516
1855
0
166131
Total
47559
22898
230137
3707
0
304301
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
7.56%
4.29%
6.01%
12.12%
13.82%
12.94%
6.37%
9.74%
8.28%
2.59%
5.82%
4.21%
NA
NA
NA
7.03%
9.22%
8.23%
Number
1
1
2
7
7
14
20
15
35
0
0
0
0
0
0
28
23
51
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
24912
22647
47559
11785
11113
22898
99621
130516
230137
1852
1855
3707
0
0
0
138170
166131
304301
Percent
0.05%
0.05%
0.05%
0.71%
0.76%
0.73%
0.24%
0.14%
0.18%
0.00%
0.00%
0.00%
NA
NA
NA
0.24%
0.17%
0.20%
Number
3
2
5
4
5
9
5
10
15
0
0
0
0
0
0
12
17
29
Percent
0.14%
0.11%
0.13%
0.41%
0.54%
0.47%
0.06%
0.09%
0.08%
0.00%
0.00%
0.00%
NA
NA
NA
0.10%
0.12%
0.11%
Member Months
(Outpatient/ED)
Male
24912
11785
99621
1852
0
138170
Total
47559
22898
230137
3707
0
304301
Female
22647
11113
130516
1855
0
166131
Outpatient/ED
Number
157
80
237
119
127
246
524
1058
1582
4
9
13
0
0
0
804
1274
2078
Percent
7.56%
4.24%
5.98%
12.12%
13.71%
12.89%
6.31%
9.73%
8.25%
2.59%
5.82%
4.21%
NA
NA
NA
6.98%
9.20%
8.19%
Page 91
Use of Services
Blue Plus (HMO Minnesota)
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 12:51 PM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
3
29097
0
29100
Female
0
0
2
84913
0
84915
Member Months
(Inpatient)
Total
0
0
5
114010
0
114015
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
1
0
1
319
934
1253
0
0
0
320
934
1254
HEDIS 2013 (Reporting Year 2012)
Male
0
0
3
29097
0
29100
Female
0
0
2
84913
0
84915
Total
0
0
5
114010
0
114015
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
400.00%
0.00%
240.00%
13.16%
13.20%
13.19%
NA
NA
NA
13.20%
13.20%
13.20%
Number
0
0
0
0
0
0
0
0
0
89
248
337
0
0
0
89
248
337
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
0
0
0
0
0
0
3
2
5
29097
84913
114010
0
0
0
29100
84915
114015
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.67%
3.50%
3.55%
NA
NA
NA
3.67%
3.50%
3.55%
Number
0
0
0
0
0
0
0
0
0
3
2
5
0
0
0
3
2
5
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.12%
0.03%
0.05%
NA
NA
NA
0.12%
0.03%
0.05%
Member Months
(Outpatient/ED)
Male
0
0
3
29097
0
29100
Total
0
0
5
114010
0
114015
Female
0
0
2
84913
0
84915
Outpatient/ED
Number
0
0
0
0
0
0
1
0
1
254
748
1002
0
0
0
255
748
1003
Percent
NA
NA
NA
NA
NA
NA
400.00%
0.00%
240.00%
10.48%
10.57%
10.55%
NA
NA
NA
10.52%
10.57%
10.56%
Page 93
Use of Services
Blue Plus (HMO Minnesota)
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Nov 15, 2013 12:51 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
276115
74493
290627
234
0
641469
Female
265726
73457
450634
263
0
790080
Total
541841
147950
741261
497
0
1431549
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
3358
2329
5687
1461
1607
3068
5237
10043
15280
2
1
3
0
0
0
10058
13980
24038
HEDIS 2013 (Reporting Year 2012)
Male
276115
74493
290627
234
0
641469
Female
265726
73457
450634
263
0
790080
Total
541841
147950
741261
497
0
1431549
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
14.59%
10.52%
12.59%
23.54%
26.25%
24.88%
21.62%
26.74%
24.74%
10.26%
4.56%
7.24%
NA
NA
NA
18.82%
21.23%
20.15%
Number
66
32
98
103
204
307
342
449
791
0
0
0
0
0
0
511
685
1196
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
276115
265726
541841
74493
73457
147950
290627
450634
741261
234
263
497
0
0
0
641469
790080
1431549
Percent
0.29%
0.14%
0.22%
1.66%
3.33%
2.49%
1.41%
1.20%
1.28%
0.00%
0.00%
0.00%
NA
NA
NA
0.96%
1.04%
1.00%
Number
123
61
184
71
80
151
111
246
357
0
0
0
0
0
0
305
387
692
Percent
0.53%
0.28%
0.41%
1.14%
1.31%
1.22%
0.46%
0.66%
0.58%
0.00%
0.00%
0.00%
NA
NA
NA
0.57%
0.59%
0.58%
Member Months
(Outpatient/ED)
Male
276115
74493
290627
234
0
641469
Female
265726
73457
450634
263
0
790080
Total
541841
147950
741261
497
0
1431549
Outpatient/ED
Number
3346
2324
5670
1456
1591
3047
5184
9988
15172
2
1
3
0
0
0
9988
13904
23892
Percent
14.54%
10.50%
12.56%
23.45%
25.99%
24.71%
21.40%
26.60%
24.56%
10.26%
4.56%
7.24%
NA
NA
NA
18.68%
21.12%
20.03%
Page 95
Use of Services
Blue Plus (HMO Minnesota)
Plan All-Cause Readmissions
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Plan All-Cause Readmissions
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Plan All-Cause Readmissions
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 12:51 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
1697
6552
10107
11131
7210
4995
Member Months
Female
1516
6102
9093
10200
6849
4699
41692
30.17%
11336
7023
8085
8716
11026
38459
23.15%
12776
10350
10808
10862
13817
46186
33.43%
11403
13060
12703
11274
58613
35.28%
15636
16541
18421
16606
48440
35.06%
1317
423
100
0
12
0
67204
40.45%
1525
247
27
36
0
20
1852
1.34%
0
138170
1855
1.12%
0
166131
HEDIS 2013 (Reporting Year 2012)
Total
3213
12654
19200
21331
14059
9694
80151
26.34%
24112
17373
18893
19578
24843
104799
34.44%
27039
29601
31124
27880
115644
38.00%
2842
670
127
36
12
20
3707
1.22%
0
304301
Page 101
Health Plan Descriptive Information
Blue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 12:51 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
3
0
0.00%
0
0
0
2
3
0.01%
4779
5688
5598
5159
4287
3586
2
0.00%
8200
11153
11418
14557
16665
22920
29097
99.99%
0
29100
84913
100.00%
0
84915
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
5
5
0.00%
12979
16841
17016
19716
20952
26506
114010
100.00%
0
114015
Page 103
Health Plan Descriptive Information
Blue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Nov 15, 2013 12:51 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
Blue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Member Months
Male
Female
31135
29880
<1
92843
87825
1-4
99755
97662
5-9
83469
81212
10-14
43406
42604
15-17
22235
27181
18-19
0-19 Subtotal
372843
366364
0-19 Subtotal: %
58.12%
46.37%
33617
68128
20-24
35805
72858
25-29
38332
65346
30-34
29143
46773
35-39
29727
41833
40-44
20-44 Subtotal
166624
294938
20-44 Subtotal: %
25.98%
37.33%
31627
40805
45-49
30610
38197
50-54
23559
28649
55-59
15972
20864
60-64
45-64 Subtotal
101768
128515
45-64 Subtotal: %
15.86%
16.27%
153
176
65-69
31
58
70-74
22
14
75-79
11
2
80-84
12
13
85-89
5
0
>=90
>=65 Subtotal
234
263
>=65 Subtotal: %
0.04%
0.03%
0
0
Age Unknown
Total
641469
790080
HEDIS 2013 (Reporting Year 2012)
Data Last Refreshed:
Nov 15, 2013 12:51 PM
Total
61015
180668
197417
164681
86010
49416
739207
51.64%
101745
108663
103678
75916
71560
461562
32.24%
72432
68807
52208
36836
230283
16.09%
329
89
36
13
25
5
497
0.03%
0
1431549
Page 105