UCare Minnesota
General Info
Disclaimers
HEDIS 2012 (Reporting Year 2011)
Page
Data Last Refreshed: 10/22/2012
2
Effectiveness of Care Measures
Code
Effectiveness of Care Measures
Code
Medication Management
Page
Prevention and Screening
ABA
Adult BMI Assessment
3
WCC
Weight Assessment and Counseling for Nutrition and Physical Activity for
Children/Adolescents
4
CIS
Childhood Immunization Status
6
IMA
Immunizations for Adolescents
10
Page
26 MPM
Annual Monitoring for Patients on Persistent Medications
48
27 MRP
Medication Reconciliation Post Discharge
53
Potentially Harmful Drug-Disease Interactions in the Elderly
54
Use of High Risk Medications in the Elderly
56
28
DDE
29 DAE
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
IET
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
65
GSO
Glaucoma Screening in Older Adults
17
33 PPC
Prenatal and Postpartum Care
70
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
ASM
Use of Appropriate Medications for People with Asthma
24
Cardiovascular
Access / Availability of Care Measures
Use of Services Measures
0 Code
Page
Page
34 W15
Well Child Visits in the First 15 Months of Life
72
35 W34
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
74
Adolescent Well-Care Visits
75
36
AWC
Ambulatory Care
76
38
IPU
Inpatient Utilization - General Hospital/Acute Care
81
IAD
37 AMB
CMC
Cholesterol Management for Patients with Cardiovascular Conditions
26
39
Identification of Alcohol and Other Drug Services
86
CBP
Controlling High Blood Pressure
29
40 MPT
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
91
PBH
Persistence of Beta Blocker Treatment After Heart Attack
30
41 PCR
Plan All-Cause Readmissions
96
Diabetes
CDC
Comprehensive Diabetes Care
41
31
Musculoskeletal
ART
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
36
OMW
Osteoporosis Management in Women Who had a Fracture
37
Behavioral Health
AMM
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
HEDIS 2012 (Reporting Year 2011)
0 Code
Health Plan Descriptive Information Measures
Page
42 BCR
Board Certification
99
43 ENP
Enrollment by Product Line (Age & Sex)
101
43
DISCLAIMERS
-1
( this page left blank intentionally )
0. Disclaimer Query located below
HEDIS 2012 (Reporting Year 2011)
Page 2
Effectiveness of Care
UCare Minnesota
Adult BMI Assessment
Data Elements
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Medicare
Advantage
2011
H
32867
MHCP-MC
2011
H
12580
1279
468
3.89%
411
5.00%
432
19
4.40%
3.72%
411
5.00%
432
19
4.40%
Number of Records Excluded Because of Valid
Data Errors
0
0
Number of administrative data records excluded
61
1927
Number of medical record data records excluded
0
0
Number of employee/dependent medical records
excluded
0
0
0
411
18
325
83.45%
79.74%
87.17%
0
411
19
311
80.29%
76.32%
84.26%
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 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 2012 (Reporting Year 2011)
NR
NR
NR
NR
NR
Page 3
Effectiveness of Care
UCare Minnesota
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
BMI Percentile
Data Elements
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Nutrition
Total
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Physical Activity
Total
General
Measure
Data
Ages 3-11
Ages 1217
Total
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Page 4
Effectiveness of Care
UCare Minnesota
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
BMI Percentile
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Total
2011
H
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
Ages 3-11 Ages 12-17
Counseling for Nutrition
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Physical Activity
Total
2011
H
General
Measure
Data
Total
15986
7944
23930
15986
7944
23930
15986
7944
23930
454
2.84%
218
2.74%
672
2.81%
159
0.99%
139
1.75%
298
1.25%
2
0.01%
3
0.04%
5
0.02%
0
0.00%
0
0.00%
0
0.00%
411
5.00%
411
5.00%
432
411
5.00%
432
11
2.55%
3
0.69%
14
3.24%
432
4
0.93%
4
0.93%
8
1.85%
0
0
0
Number of administrative data records
excluded
99
99
99
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 2012 (Reporting Year 2011)
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
272
139
411
272
139
411
272
139
411
11
130
51.84%
45.72%
57.96%
2
61
45.32%
36.69%
53.96%
13
191
49.64%
44.68%
54.59%
4
151
56.99%
50.92%
63.05%
4
52
40.29%
31.77%
48.80%
8
203
51.34%
46.38%
56.29%
0
127
46.69%
40.58%
52.80%
0
52
37.41%
29.01%
45.81%
0
179
43.55%
38.64%
48.47%
Page 5
Effectiveness of Care
UCare Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Data Elements
General
Measure
Data
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
IPV
MMR
HiB
Hepatitis B
VZV
Influenza
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 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 2012 (Reporting Year 2011)
Page 6
Effectiveness of Care
UCare Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Data Elements
General
Measure
Data
DTaP
Combo 2
Combo 3
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 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 2012 (Reporting Year 2011)
Page 7
Effectiveness of Care
UCare Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
1
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
HiB
Hepatitis B
VZV
Influenza
2073
78.73%
2357
89.52%
2342
88.95%
2370
90.01%
1616
61.37%
2341
88.91%
2034
77.25%
848
32.21%
1687
64.07%
1376
52.26%
332
76.85%
374
86.57%
387
89.58%
377
87.27%
211
48.84%
391
90.51%
332
76.85%
134
31.02%
277
64.12%
225
52.08%
319
33
85.64%
82.13%
89.16%
356
36
95.38%
93.23%
97.53%
374
12
93.92%
91.48%
96.35%
359
33
95.38%
93.23%
97.53%
201
162
88.32%
85.09%
91.55%
375
4
92.21%
89.50%
94.93%
316
32
84.67%
81.07%
88.28%
129
9
33.58%
28.89%
38.26%
268
23
70.80%
66.29%
75.32%
216
20
57.42%
52.52%
62.32%
432
0
Numerator Events by administrative Data
MMR
411
0.05
Number of Records Excluded Because of
Valid Data Errors
Denominator
IPV
2011
H
2633
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
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
411
Page 8
Effectiveness of Care
UCare Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
1
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
2073
78.73%
1318
50.06%
1241
47.13%
494
18.76%
985
37.41%
789
29.97%
422
16.03%
335
12.72%
661
25.10%
295
11.20%
332
76.85%
171
39.58%
164
37.96%
66
15.28%
139
32.18%
103
23.84%
57
13.19%
47
10.88%
89
20.60%
41
9.49%
319
33
85.64%
82.13%
89.16%
167
153
77.86%
73.72%
81.99%
160
142
73.48%
69.09%
77.87%
64
61
30.41%
25.84%
34.98%
135
116
61.07%
56.23%
65.91%
100
96
47.69%
42.74%
52.64%
55
52
26.03%
21.67%
30.40%
46
44
21.90%
17.78%
26.02%
86
78
39.90%
35.05%
44.76%
40
38
18.98%
15.07%
22.89%
432
0
Numerator Events by administrative Data
Combo 3
411
0.05
Number of Records Excluded Because of
Valid Data Errors
Denominator
Combo 2
2011
H
2633
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
DTaP
411
Page 9
Effectiveness of Care
UCare Minnesota
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Immunizations for Adolescents
Commercial
Data Elements
General
Measure Data
Meningococcal
Tdap
Combo 1
Current Year's Admin Rate
NR
NR
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
NR
NR
NR
Reported Rate
NR
NR
NR
Lower 95% Confidence Interval
NR
NR
NR
Upper 95% Confidence Interval
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
HEDIS 2012 (Reporting Year 2011)
Page 10
Effectiveness of Care
UCare Minnesota
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Immunizations for Adolescents
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Data Elements
Measure Data
Measurement Year
2011
Data Collection Methodology
H
Eligible Member Population
1705
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
0
Number of administrative data records excluded
0
Number of medical data records excluded
0
Number of employee/dependent medical records
excluded
0
HEDIS 2012 (Reporting Year 2011)
Tdap
Combo 1
945
1366
881
55.43%
80.12%
51.67%
229
53.01%
334
77.31%
213
49.31%
218
4
54.01%
49.07%
58.95%
318
17
81.51%
77.63%
85.38%
203
6
50.85%
45.90%
55.81%
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
411
Page 11
Effectiveness of Care
UCare 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 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
NR
NR
NR
Medicare
Advantage
MSHO
SNBC
MHCP-MC
2011
A
8874
6843
77.11%
76.23%
77.99%
2011
A
659
349
52.96%
49.07%
56.85%
2011
A
390
201
51.54%
46.45%
56.63%
2011
A
3316
1852
55.85%
54.15%
57.56%
Page 12
Effectiveness of Care
UCare Minnesota
Cervical Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical record data records excluded
9404
NR
NR
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
MHCP-MC
2011
H
14383
65.38%
411
5.00%
432
288
66.67%
0
235
3
0
NR
NR
NR
3
411
274
24
72.51%
68.07%
76.94%
Page 13
Effectiveness of Care
UCare Minnesota
Colorectal Cancer Screening
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Data Elements
Commercial
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 2012 (Reporting Year 2011)
NR
NR
NR
NR
NR
Medicare
Advantage
2011
H
36359
MSHO
SNBC
2011
H
2710
2011
H
422
16297
1111
183
44.82%
411
0.05
432
189
43.75%
0
112
0
0
0
411
181
101
68.61%
64.00%
73.22%
41.00%
411
5.00%
432
161
37.27%
0
8
0
0
0
411
154
47
48.91%
43.95%
53.86%
43.36%
411
2.00%
421
158
37.53%
0
1
0
0
0
411
155
27
44.28%
39.36%
49.21%
Page 14
Effectiveness of Care
UCare Minnesota
Chlamydia Screening in Women
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure Data
Ages 16-20
NR
NR
NR
Ages 21-24
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 15
Effectiveness of Care
UCare Minnesota
Chlamydia Screening in Women
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
General
Measure Data
Ages 16-20
Ages 21-24
Total
1758
1039
59.10%
56.77%
61.43%
1667
1034
62.03%
59.67%
64.39%
3425
2073
60.53%
58.87%
62.18%
2011
A
Page 16
Effectiveness of Care
UCare 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 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare
Advantage
MSHO
2011
A
59849
46557
77.79%
77.46%
78.12%
2011
A
6391
4746
74.26%
73.18%
75.34%
Page 17
Effectiveness of Care
UCare Minnesota
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Lead Screening in Children
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
MHCP-MC
2011
A
2633
Current Year's Admin Rate
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
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 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
2279
Reported Rate
NR
86.56%
Lower 95% Confidence Interval
NR
85.23%
Upper 95% Confidence Interval
NR
87.88%
HEDIS 2012 (Reporting Year 2011)
Page 18
Effectiveness of Care
UCare Minnesota
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Care for Older Adults
MSHO
Medication Review
Functional
Status
Assessment
Pain
Screening
NR
NR
NR
NR
NR
NR
NR
NR
Reported Rate
NR
NR
NR
NR
Lower 95% Confidence Interval
NR
NR
NR
NR
Upper 95% Confidence Interval
NR
NR
NR
NR
Advance Care
Planning
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
Data Elements
General Measure
Data
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population (before exclusions)
Records Excluded because of Valid Data
Errors
Number of employee/dependent medical
records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
HEDIS 2012 (Reporting Year 2011)
Page 19
Effectiveness of Care
UCare Minnesota
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
368
75.10%
71.17%
79.03%
408
83.27%
79.86%
86.67%
2011
A
490
Page 20
Effectiveness of Care
UCare Minnesota
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
127
77.91%
71.24%
84.59%
141
86.50%
80.95%
92.06%
2011
A
163
Page 21
Effectiveness of Care
UCare Minnesota
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
12
NA
NA
NA
17
NA
NA
NA
2011
A
21
Page 22
Effectiveness of Care
UCare 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 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare
Advantage
MSHO
SNBC
2011
A
1263
524
41.49%
38.73%
44.25%
2011
A
223
52
23.32%
17.54%
29.09%
2011
A
13
5
NA
NA
NA
Page 23
Effectiveness of Care
UCare Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Number of required exclusions
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure Data
Ages 5-11
NR
NR
NR
Ages 12-18
NR
NR
NR
Ages 19-50
NR
NR
NR
Ages 51-64
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
`
Page 24
Effectiveness of Care
UCare Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
General
Measure Data
Ages 5-11
Ages 12-18
Ages 19-50
Ages 51-64
Total
330
311
13
94.24%
91.58%
96.91%
183
161
8
87.98%
82.99%
92.96%
376
316
61
84.04%
80.21%
87.88%
104
89
86
85.58%
78.34%
92.81%
993
877
168
88.32%
86.27%
90.37%
2011
A
Page 25
Effectiveness of Care
UCare Minnesota
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 26
Effectiveness of Care
UCare Minnesota
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
3185
731
89.62%
20.57%
392
61
90.74%
14.12%
372
4
58
208
91.48%
88.66%
94.30%
64.72%
59.98%
69.46%
2011
H
3554
411
5.00%
432
1
0
1
411
Page 27
Effectiveness of Care
UCare Minnesota
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
151
98
90.42%
58.68%
143
15
85.63%
8.98%
143
8
15
83
90.42%
85.66%
95.18%
58.68%
50.91%
66.45%
2011
H
167
167
0.00%
167
0
0
0
167
Page 28
Effectiveness of Care
UCare Minnesota
Controlling High Blood Pressure
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare
Advantage
MSHO
SNBC
MHCP-MC
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2011
H
25976
2011
H
2518
2011
H
462
2011
H
2532
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
0
0
0
0.00%
411
10.00%
453
0.00%
411
10.00%
453
0.00%
411
0.00%
412
0.00%
411
10.00%
453
0
0.00%
0
0.00%
0
0.00%
0
0.00%
Records Excluded because of Valid Data
Errors
0
0
0
0
Number of records excluded because of
false positive diagnoses
6
3
7
5
Number of administrative data records
excluded
1651
311
52
113
Number of medical record data records
excluded
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
Records Added from the OverSample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
6
411
0
308
74.94%
70.63%
79.25%
3
411
0
280
68.13%
63.50%
72.75%
1
405
0
275
67.90%
63.23%
72.57%
5
411
0
283
68.86%
64.26%
73.46%
Data Elements
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
HEDIS 2012 (Reporting Year 2011)
Commercial
NR
NR
NR
NR
NR
Page 29
Effectiveness of Care
UCare Minnesota
Persistence of Beta Blocker Treatment After Heart Attack
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare
Advantage
MSHO
SNBC
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
2011
A
265
2011
A
52
2011
A
1
2011
A
31
Numerator Events by Admin Data on
Eligible Population
232
44
1
28
87.55%
83.38%
91.71%
84.62%
73.85%
95.38%
NA
NA
NA
90.32%
78.30%
100.00%
Data Elements
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Commercial
NR
NR
NR
Page 30
Effectiveness of Care
UCare Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Data Elements
HbA1c
Testing
Poor HbA1c
Control
(>9.0%)
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Number of HbA1c < 7 required administrative
data records excluded
Number of HbA1c < 7 required medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Page 31
Effectiveness of Care
UCare Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
2011
H
8993
2011
H
8993
2011
H
8993
2011
H
8993
2011
H
8993
2011
H
8993
1759
19.56%
411
5%
432
67
15.51%
6175
68.66%
411
5%
432
297
68.75%
8105
90.13%
411
5%
432
394
91.20%
1579
17.56%
411
5%
432
68
15.74%
8055
89.57%
411
5%
432
381
88.19%
72
0.80%
411
5%
432
1
0.23%
66
0.73%
411
5%
432
1
0.23%
1
1
1
1
1
1
1
1
5
5
5
5
5
5
5
5
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
411
386
7
95.62%
93.52%
97.72%
1
411
64
0
15.57%
11.94%
19.20%
1
411
65
266
80.54%
76.59%
84.48%
1
411
282
27
75.18%
70.88%
79.48%
1
411
375
3
91.97%
89.22%
94.72%
1
411
65
212
67.40%
62.74%
72.05%
1
411
366
11
91.73%
88.94%
94.51%
1
411
1
337
82.24%
78.42%
86.06%
1
411
1
304
74.21%
69.86%
78.56%
8449
93.95%
411
5%
432
407
94.21%
7068
78.59%
411
5%
432
68
15.74%
Number of Records Excluded Because of
Valid Data Errors
1
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Blood
Pressure
<140/80
mm Hg
2011
H
8993
2011
H
8993
Numerator events by admin data in eligible
population
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Eye Exam
2011
H
8993
Measurement Year
Data Collection Methodology
Eligible Member Population
Adequate
HbA1c
Control
(<8.0%)
LDL-C Level
<100 mg/dL
Poor HbA1c
Control
Data Elements
Good HbA1c
Control
(<7.0%)
LDL-C
Screening
HbA1c
Testing
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 2012 (Reporting Year 2011)
NR
NR
NR
Page 32
Effectiveness of Care
UCare Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
LDL-C
Screening
LDL-C Level
<100 mg/dL
2011
H
1250
2011
H
1250
2011
H
1250
2011
H
1250
2011
H
1250
2011
H
1250
2011
H
1250
358
28.64%
411
5%
432
34
7.87%
826
66.08%
411
5%
432
279
64.58%
1043
83.44%
411
5%
432
357
82.64%
339
27.12%
411
5%
432
25
5.79%
1100
88.00%
411
5%
432
379
87.73%
13
1.04%
411
5%
432
3
0.69%
13
1.04%
411
5%
432
3
0.69%
0
0
0
0
0
0
0
0
1
1
1
1
1
1
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
411
377
6
93.19%
90.63%
95.74%
0
411
89
0
21.65%
17.55%
25.76%
0
411
33
269
73.48%
69.09%
77.87%
0
411
264
43
74.70%
70.37%
79.02%
0
411
343
9
85.64%
82.13%
89.16%
0
411
23
199
54.01%
49.07%
58.95%
0
411
359
8
89.29%
86.18%
92.41%
0
411
3
300
73.72%
69.35%
78.10%
0
411
3
267
65.69%
60.98%
70.40%
2011
H
1250
2011
H
1250
1150
92.00%
411
5%
432
397
91.90%
845
67.60%
411
5%
432
95
21.99%
Number of Records Excluded Because of
Valid Data Errors
0
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Blood
Pressure
<140/80
mm Hg
Eye Exam
Poor HbA1c
Control
Measurement Year
Data Collection Methodology
Eligible Member Population
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Adequate
HbA1c
Control
(<8.0%)
HbA1c
Testing
Data Elements
Good HbA1c
Control
(<7.0%)
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 2012 (Reporting Year 2011)
NR
NR
NR
Page 33
Effectiveness of Care
UCare Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
SNBC
2011
H
489
2011
H
489
2011
H
489
2011
H
489
2011
H
489
2011
H
489
261
53.37%
411
5%
432
23
5.32%
320
65.44%
411
5%
432
283
65.51%
409
83.64%
411
5%
432
357
82.64%
211
43.15%
411
5%
432
22
5.09%
395
80.78%
411
5%
432
348
80.56%
8
1.64%
411
5%
432
8
1.85%
8
1.64%
411
5%
432
8
1.85%
0
0
0
0
0
0
0
0
3
3
3
3
3
3
3
3
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
411
376
10
93.92%
91.48%
96.35%
0
411
115
0
27.98%
23.52%
32.44%
0
411
22
238
63.26%
58.48%
68.04%
0
411
270
38
74.94%
70.63%
79.25%
0
411
338
7
83.94%
80.27%
87.61%
0
411
20
185
49.88%
44.92%
54.83%
0
411
333
12
83.94%
80.27%
87.61%
0
411
8
307
76.64%
72.43%
80.85%
0
411
8
244
61.31%
56.48%
66.14%
459
93.87%
411
5%
432
394
91.20%
174
35.58%
411
5%
432
124
28.70%
Number of Records Excluded Because of
Valid Data Errors
0
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Blood
Pressure
<140/80
mm Hg
2011
H
489
2011
H
489
Numerator events by admin data in eligible
population
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Eye Exam
2011
H
489
Measurement Year
Data Collection Methodology
Eligible Member Population
Adequate
HbA1c
Control
(<8.0%)
LDL-C Level
<100 mg/dL
Poor HbA1c
Control
Data Elements
Good HbA1c
Control
(<7.0%)
LDL-C
Screening
HbA1c
Testing
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 2012 (Reporting Year 2011)
NR
NR
NR
Page 34
Effectiveness of Care
UCare Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2011
H
2095
2011
H
2095
2011
H
2095
2011
H
2095
2011
H
2095
2011
H
2095
2011
H
2095
2011
H
2095
2011
H
2095
2011
H
2095
1883
89.88%
548
5%
576
530
92.01%
1351
64.49%
548
5%
576
173
30.03%
440
21.00%
462
5%
485
32
6.60%
626
29.88%
548
5%
576
52
9.03%
1160
55.37%
548
5%
576
326
56.60%
1686
80.48%
548
5%
576
478
82.99%
496
23.68%
548
5%
576
43
7.47%
1612
76.95%
548
5%
576
449
77.95%
4
0.19%
548
5%
576
1
0.17%
2
0.10%
548
5%
576
1
0.17%
2
2
2
2
2
2
2
2
2
2
58
58
58
58
58
58
58
58
58
58
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
548
51
285
61.31%
57.14%
65.48%
2
548
313
39
64.23%
60.13%
68.34%
2
548
455
7
84.31%
81.17%
87.44%
2
548
43
207
45.62%
41.36%
49.88%
2
548
429
11
80.29%
76.87%
83.71%
2
548
1
440
80.47%
77.06%
83.88%
2
548
1
321
58.76%
54.55%
62.97%
86
Number of Hybrid required exclusions
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Blood
Pressure
<140/80
mm Hg
Poor HbA1c
Control
Number of Administrative required exclusions
Additional Records Added from the
Oversample List
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
HbA1c
Testing
0
2
548
505
7
93.43%
91.27%
95.60%
2
548
162
1
29.74%
25.83%
33.66%
2
462
31
170
43.51%
38.88%
48.14%
Page 35
Effectiveness of Care
UCare 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 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare
Advantage
2011
A
902
758
84.04%
81.59%
86.48%
Page 36
Effectiveness of Care
UCare 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 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare
Advantage
MSHO
2011
A
1196
205
17.14%
14.96%
19.32%
2011
A
276
26
9.42%
5.79%
13.05%
Page 37
Effectiveness of Care
UCare Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
NR
NR
NR
NR
NR
NR
Page 38
Effectiveness of Care
UCare Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
2011
A
903
734
81.28%
78.69%
83.88%
619
68.55%
65.47%
71.63%
Page 39
Effectiveness of Care
UCare Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
2011
A
111
74
66.67%
57.45%
75.89%
62
55.86%
46.17%
65.54%
Page 40
Effectiveness of Care
UCare Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
2011
A
27
17
NA
NA
NA
15
NA
NA
NA
Page 41
Effectiveness of Care
UCare Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
2011
A
901
446
49.50%
46.18%
52.82%
301
33.41%
30.27%
36.54%
Page 42
Effectiveness of Care
UCare Minnesota
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
NR
NR
NR
NR
NR
NR
Page 43
Effectiveness of Care
UCare Minnesota
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
390
150
38.46%
33.50%
43.42%
105
51
48.57%
38.54%
58.61%
2011
A
Page 44
Effectiveness of Care
UCare Minnesota
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
30 Days
7 Days
158
69.91%
63.71%
76.11%
112
49.56%
42.82%
56.30%
2011
A
226
Page 45
Effectiveness of Care
UCare Minnesota
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
30 Days
7 Days
31
55.36%
41.44%
69.27%
20
35.71%
22.27%
49.16%
2011
A
56
Page 46
Effectiveness of Care
UCare Minnesota
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
General
Measure
Data
30 Days
7 Days
75
84.27%
76.14%
92.40%
55
61.80%
51.14%
72.45%
2011
A
89
Page 47
Effectiveness of Care
UCare Minnesota
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 48
Effectiveness of Care
UCare Minnesota
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
25971
23840
91.79%
91.46%
92.13%
1183
1088
91.97%
90.38%
93.56%
23755
21930
92.32%
91.98%
92.66%
805
585
72.67%
69.53%
75.81%
51714
47443
91.74%
91.50%
91.98%
2011
A
Page 49
Effectiveness of Care
UCare Minnesota
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
3071
2883
93.88%
93.01%
94.74%
263
248
94.30%
91.30%
97.29%
3007
2832
94.18%
93.33%
95.03%
354
289
81.64%
77.46%
85.81%
6695
6252
93.38%
92.78%
93.99%
2011
A
Page 50
Effectiveness of Care
UCare Minnesota
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
400
366
91.50%
88.64%
94.36%
6
5
NA
NA
NA
304
273
89.80%
86.24%
93.37%
138
103
74.64%
67.02%
82.26%
848
747
88.09%
85.85%
90.33%
2011
A
Page 51
Effectiveness of Care
UCare Minnesota
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
1923
1655
86.06%
84.49%
87.64%
32
28
87.50%
74.48%
100.00%
1462
1245
85.16%
83.30%
87.01%
166
114
68.67%
61.32%
76.03%
3583
3042
84.90%
83.71%
86.09%
2011
A
Page 52
Access/Availability of Care
UCare Minnesota
Medication Reconciliation Post Discharge
Data Elements
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
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)
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
NR
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
Page 53
Effectiveness of Care
UCare Minnesota
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
Drug-Disease Interactions
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
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
343
13
3.79%
1.62%
5.96%
7462
948
12.70%
11.94%
13.47%
2011
A
3539
390
11.02%
9.97%
12.07%
3580
545
15.22%
14.03%
16.41%
Page 54
Effectiveness of Care
UCare Minnesota
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
Drug-Disease Interactions
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
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
127
17
13.39%
7.07%
19.70%
2628
594
22.60%
20.98%
24.22%
2011
A
624
116
18.59%
15.46%
21.72%
1877
461
24.56%
22.59%
26.53%
Page 55
Effectiveness of Care
UCare Minnesota
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
2011
A
70084
At least 1
Prescription
At least 2
Prescriptions
6578
9.39%
9.17%
9.60%
666
0.95%
0.88%
1.02%
Page 56
Effectiveness of Care
UCare Minnesota
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
2011
A
8120
At least 1
Prescription
At least 2
Prescriptions
1341
16.51%
15.70%
17.33%
206
2.54%
2.19%
2.89%
Page 57
Access/Availability of Care
UCare Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
NR
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
NR
NR
NR
NR
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 58
Access/Availability of Care
UCare Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
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 2012 (Reporting Year 2011)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
435
2765
74889
78089
420
2684
72220
96.55%
94.72%
98.38%
97.07%
96.42%
97.72%
96.44%
96.30%
96.57%
75324
96.46%
96.33%
96.59%
2011
A
Page 59
Access/Availability of Care
UCare Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2012 (Reporting Year 2011)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
0
0
8120
8120
0
0
7973
NA
NA
NA
NA
NA
NA
98.19%
97.89%
98.49%
7973
98.19%
97.89%
98.49%
2011
A
Page 60
Access/Availability of Care
UCare Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
627
1239
34
1900
611
1225
34
97.45%
96.13%
98.76%
98.87%
98.24%
99.50%
100.00%
98.53%
100.00%
1870
98.42%
97.83%
99.01%
2011
A
Page 61
Access/Availability of Care
UCare Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
17158
8100
27
25285
15188
7324
25
88.52%
88.04%
89.00%
90.42%
89.77%
91.07%
NA
NA
NA
22537
89.13%
88.75%
89.52%
2011
A
Page 62
Access/Availability of Care
UCare Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2012 (Reporting Year 2011)
General Measure
Data
12-24 months
25 months 6 yrs.
7-11 yrs.
12-19 yrs.
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 63
Access/Availability of Care
UCare Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
General Measure
Data
12-24 months
25 months 6 yrs.
7-11 yrs.
12-19 yrs.
3732
3660
11814
10610
6600
5949
8920
7902
98.07%
97.62%
98.53%
89.81%
89.26%
90.36%
90.14%
89.41%
90.86%
88.59%
87.92%
89.25%
2011
A
Page 64
Access/Availability of Care
UCare Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 65
Access/Availability of Care
UCare Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
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 2012 (Reporting Year 2011)
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
2011
A
0
1008
1008
0
0
407
47
407
47
NA
NA
NA
NA
NA
NA
40.38%
37.30%
43.46%
4.66%
3.31%
6.01%
40.38%
37.30%
43.46%
4.66%
3.31%
6.01%
Page 66
Access/Availability of Care
UCare Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
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
2011
A
209
0
209
0
0
77
4
77
4
NA
NA
NA
NA
NA
NA
36.84%
30.06%
43.62%
1.91%
0.00%
4.01%
36.84%
30.06%
43.62%
1.91%
0.00%
4.01%
Page 67
Access/Availability of Care
UCare Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 10:02 AM
SNBC
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
2011
A
0
168
168
0
0
54
19
54
19
NA
NA
NA
NA
NA
NA
32.14%
24.78%
39.50%
11.31%
6.22%
16.40%
32.14%
24.78%
39.50%
11.31%
6.22%
16.40%
Page 68
Access/Availability of Care
UCare Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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 2012 (Reporting Year 2011)
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
2011
A
199
2740
2541
89
54
817
387
906
441
44.72%
37.56%
51.88%
27.14%
20.71%
33.57%
32.15%
30.32%
33.99%
15.23%
13.81%
16.65%
33.07%
31.29%
34.85%
16.09%
14.70%
17.49%
Page 69
Access/Availability of Care
UCare Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
Current year's administrative rate (before exclusions)
NR
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
NR
NR
NR
NR
NR
NR
NR
NR
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
population (before exclusions)
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2012 (Reporting Year 2011)
Page 70
Access/Availability of Care
UCare Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Timeliness of
Prenatal Care
Postpartum
Care
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
2011
H
4301
2011
H
4301
Number of numerator events by administrative data in eligible
population (before exclusions)
2254
2207
52.41%
411
5.00%
432
211
51.31%
411
5.00%
432
212
48.84%
49.07%
0
0
0
0
411
202
142
0
0
411
205
53
83.70%
80.01%
87.39%
62.77%
57.98%
67.57%
Data Elements
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 2012 (Reporting Year 2011)
Page 71
Use of Services
UCare Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Data Elements
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of employee/dependent medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Page 72
Use of Services
UCare Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
0
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Oversample List
0
HEDIS 2012 (Reporting Year 2011)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
49
1.45%
64
1.89%
119
3.52%
216
6.39%
388
11.48%
748
22.12%
1797
53.15%
2
0.46%
4
0.93%
10
2.31%
19
4.40%
54
12.50%
85
19.68%
217
50.23%
2
0
0.49%
0.00%
1.28%
4
0
0.97%
0.00%
2.04%
9
0
2.19%
0.65%
3.73%
19
0
4.62%
2.47%
6.77%
51
0
12.41%
9.10%
15.72%
79
0
19.22%
15.29%
23.15%
207
40
60.10%
55.24%
64.95%
411
5.00%
432
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
1 visit
2011
H
3381
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Zero Visits
411
Page 73
Use of Services
UCare Minnesota
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
HEDIS 2012 (Reporting Year 2011)
MHCP-MC
2011
H
9503
6302
NR
66.32%
411
5.00%
432
278
NR
64.35%
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
Data Last Refreshed:
Oct 22, 2012 10:02 AM
0
NR
NR
NR
0
411
262
18
68.13%
63.50%
72.75%
Page 74
Use of Services
UCare Minnesota
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
5282
NR
35.49%
411
5.00%
432
146
NR
33.80%
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 2012 (Reporting Year 2011)
MHCP-MC
2011
H
14884
0
NR
NR
NR
0
411
138
38
42.82%
37.92%
47.73%
Page 75
Use of Services
UCare Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
NR
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Emergency Room Visits
Visits
NR
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 76
Use of Services
UCare Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
0
6210
41215
550174
283282
109151
0
990032
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
4893
34739
314129
207489
85944
0
647194
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
NA
NA
NA
787.92
842.87
570.96
732.45
787.39
653.71
Emergency Room Visits
Visits
0
0
0
567
1944
8458
6204
3322
0
20495
Visits/ 1,000
Member
Months
NA
NA
NA
91.30
47.17
15.37
21.90
30.43
20.70
Page 77
Use of Services
UCare Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
0
0
3
42657
36797
30691
0
110148
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
0
0
3
37880
33041
24331
0
95255
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
1000.00
888.01
897.93
792.77
864.79
Emergency Room Visits
Visits
0
0
0
0
2
1969
1509
1151
0
4631
Visits/ 1,000
Member
Months
NA
NA
NA
NA
666.67
46.16
41.01
37.50
42.04
Page 78
Use of Services
UCare Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
34
9332
18467
352
0
0
0
28185
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
10
7281
18826
323
0
0
0
26440
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
NA
NA
294.12
780.22
1019.44
917.61
NA
NA
938.09
Emergency Room Visits
Visits
0
0
1
1008
1609
22
0
0
0
2640
Visits/ 1,000
Member
Months
NA
NA
29.41
108.02
87.13
62.50
NA
NA
93.67
Page 79
Use of Services
UCare Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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
72527
417867
318535
437641
168565
402
31
0
0
1415568
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
55654
139417
79783
200940
98922
300
27
0
0
575043
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
767.36
333.64
250.47
459.14
586.85
746.27
870.97
NA
406.23
Emergency Room Visits
Visits
7402
22157
10497
32215
7594
10
1
0
0
79876
Visits/ 1,000
Member
Months
102.06
53.02
32.95
73.61
45.05
24.88
32.26
NA
56.43
Page 80
Use of Services
UCare Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Member Months
NR
Discharges
Discharges /
1,000 Member
Months
Days
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Days / 1,000
Member
Months
NR
NR
NR
NR
NR
NR
Average
Length of Stay
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 81
Use of Services
UCare Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Member Months
0
0
0
6210
41215
550174
283282
109151
0
990032
Discharges
0
0
0
180
1157
8038
6964
3944
0
20283
0
0
0
130
747
4270
4421
3103
0
12671
0
0
0
42
410
3768
2543
840
0
7603
0
8
0
0
8
HEDIS 2012 (Reporting Year 2011)
Discharges /
1,000 Member
Months
NA
NA
NA
28.99
28.07
14.61
24.58
36.13
20.49
NA
NA
NA
20.93
18.12
7.76
15.61
28.43
12.80
NA
NA
NA
6.76
9.95
6.85
8.98
7.70
7.68
NA
1.29
0.00
0.17
Days
Days / 1,000
Member
Months
0
0
0
729
5553
33800
30697
15859
0
86638
NA
NA
NA
117.39
134.73
61.44
108.36
145.29
0
0
0
556
3329
17650
18103
11568
0
51206
NA
NA
NA
89.53
80.77
32.08
63.90
105.98
0
0
0
153
2224
16150
12594
4287
0
35408
NA
NA
NA
24.64
53.96
29.35
44.46
39.28
0
20
0
0
20
87.51
51.72
35.76
NA
3.22
0.00
0.42
Average
Length of Stay
NA
NA
NA
4.05
4.80
4.21
4.41
4.02
NA
4.27
NA
NA
NA
4.28
4.46
4.13
4.09
3.73
NA
4.04
NA
NA
NA
3.64
5.42
4.29
4.95
5.10
NA
4.66
NA
2.50
NA
NA
2.50
Page 82
Use of Services
UCare Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Member Months
0
0
0
0
3
42657
36797
30691
0
110148
Discharges
0
0
0
0
0
1455
1459
1184
0
4098
0
0
0
0
0
1127
1172
1050
0
3349
0
0
0
0
0
328
287
134
0
749
0
0
0
0
0
HEDIS 2012 (Reporting Year 2011)
Discharges /
1,000 Member
Months
NA
NA
NA
NA
0.00
34.11
39.65
38.58
37.20
NA
NA
NA
NA
0.00
26.42
31.85
34.21
30.40
NA
NA
NA
NA
0.00
7.69
7.80
4.37
6.80
NA
NA
0.00
0.00
Days
0
0
0
0
0
6313
6635
4969
0
17917
0
0
0
0
0
4542
4819
4219
0
13580
0
0
0
0
0
1771
1816
750
0
4337
0
0
0
0
0
Days / 1,000
Member
Months
NA
NA
NA
NA
0.00
147.99
180.31
161.90
162.66
NA
NA
NA
NA
0.00
106.48
130.96
137.47
123.29
NA
NA
NA
NA
0.00
41.52
49.35
24.44
39.37
NA
NA
0.00
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
4.34
4.55
4.20
NA
4.37
NA
NA
NA
NA
NA
4.03
4.11
4.02
NA
4.05
NA
NA
NA
NA
NA
5.40
6.33
5.60
NA
5.79
NA
NA
NA
NA
NA
Page 83
Use of Services
UCare Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Member Months
0
0
34
9332
18467
352
0
0
0
28185
Discharges
0
0
0
219
598
7
0
0
0
824
0
0
0
143
449
5
0
0
0
597
0
0
0
58
146
2
0
0
0
206
0
18
3
0
21
HEDIS 2012 (Reporting Year 2011)
Discharges /
1,000 Member
Months
NA
NA
0.00
23.47
32.38
19.89
NA
NA
29.24
NA
NA
0.00
15.32
24.31
14.20
NA
NA
21.18
NA
NA
0.00
6.22
7.91
5.68
NA
NA
7.31
0.00
1.93
0.16
0.75
Days
0
0
0
929
2838
34
0
0
0
3801
Days / 1,000
Member
Months
NA
NA
0.00
99.55
153.68
96.59
NA
NA
134.86
0
0
0
617
1994
27
0
0
0
2638
NA
NA
0.00
66.12
107.98
76.70
NA
NA
0
0
0
268
838
7
0
0
0
1113
NA
NA
0.00
28.72
45.38
19.89
NA
NA
0
44
6
0
50
93.60
39.49
0.00
4.71
0.32
1.80
Average
Length of Stay
NA
NA
NA
4.24
4.75
4.86
NA
NA
NA
4.61
NA
NA
NA
4.31
4.44
5.40
NA
NA
NA
4.42
NA
NA
NA
4.62
5.74
3.50
NA
NA
NA
5.40
NA
2.44
2.00
NA
2.38
Page 84
Use of Services
UCare Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Member Months
72527
417867
318535
437641
168565
402
31
0
0
1415568
Discharges
Discharges /
1,000 Member
Months
1815
869
962
6862
1617
2
0
0
0
12127
25.03
2.08
3.02
15.68
9.59
4.98
0.00
NA
1721
699
386
2079
952
0
0
0
0
5837
23.73
1.67
1.21
4.75
5.65
0.00
0.00
NA
94
170
148
840
650
2
0
0
0
1904
1.30
0.41
0.46
1.92
3.86
4.98
0.00
NA
428
3942
15
0
4385
HEDIS 2012 (Reporting Year 2011)
8.57
4.12
1.35
1.34
9.01
0.09
4.74
Days
Days / 1,000
Member
Months
6661
2477
2831
18237
5590
7
0
0
0
35803
91.84
5.93
8.89
41.67
33.16
17.41
0.00
NA
5688
1778
1247
5735
3021
0
0
0
0
17469
78.43
4.25
3.91
13.10
17.92
0.00
0.00
NA
25.29
12.34
973
699
527
2774
2538
7
0
0
0
7518
13.42
1.67
1.65
6.34
15.06
17.41
0.00
NA
1057
9727
31
0
10815
3.32
22.23
0.18
5.31
11.70
Average
Length of Stay
3.67
2.85
2.94
2.66
3.46
3.50
NA
NA
NA
2.95
3.31
2.54
3.23
2.76
3.17
NA
NA
NA
NA
2.99
10.35
4.11
3.56
3.30
3.90
3.50
NA
NA
NA
3.95
2.47
2.47
2.07
NA
2.47
Page 85
Use of Services
UCare Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2012 (Reporting Year 2011)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Inpatient
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 86
Use of Services
UCare Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
13-17
18-24
25-34
35-64
65+
Unknown
Total
Member Months
(Outpatient/ED)
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
0
0
123
1041
20642
403294
0
425100
0
0
186
1092
24341
539313
0
564932
0
0
309
2133
44983
942607
0
990032
0
0
123
1041
20642
403294
0
425100
0
0
186
1092
24341
539313
0
564932
0
0
309
2133
44983
942607
0
990032
0
0
123
1041
20642
403294
0
425100
0
0
186
1092
24341
539313
0
564932
0
0
309
2133
44983
942607
0
990032
0
0
123
1041
20642
403294
0
425100
0
0
186
1092
24341
539313
0
564932
0
0
309
2133
44983
942607
0
990032
Inpatient
Any Services
Age
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
1
1
2
12
18
30
209
194
403
601
470
1071
0
0
0
823
683
1506
NA
NA
NA
NA
NA
NA
9.76%
6.45%
7.77%
13.83%
19.78%
16.88%
12.15%
9.56%
10.75%
1.79%
1.05%
1.36%
NA
NA
NA
2.32%
1.45%
1.83%
0
0
0
0
0
0
0
1
1
4
7
11
83
70
153
269
208
477
0
0
0
356
286
642
NA
NA
NA
NA
NA
NA
0.00%
6.45%
3.88%
4.61%
7.69%
6.19%
4.83%
3.45%
4.08%
0.80%
0.46%
0.61%
NA
NA
NA
1.00%
0.61%
0.78%
0
0
0
0
0
0
0
0
0
0
1
1
8
6
14
3
4
7
0
0
0
11
11
22
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
1.10%
0.56%
0.47%
0.30%
0.37%
0.01%
0.01%
0.01%
NA
NA
NA
0.03%
0.02%
0.03%
0
0
0
0
0
0
1
0
1
9
14
23
172
160
332
406
315
721
0
0
0
588
489
1077
NA
NA
NA
NA
NA
NA
9.76%
0.00%
3.88%
10.37%
15.38%
12.94%
10.00%
7.89%
8.86%
1.21%
0.70%
0.92%
NA
NA
NA
1.66%
1.04%
1.31%
HEDIS 2012 (Reporting Year 2011)
Page 87
Use of Services
UCare Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
13-17
18-24
25-34
35-64
65+
Unknown
Total
Member Months
(Outpatient/ED)
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
0
0
0
0
1
32763
0
32764
0
0
0
0
2
77382
0
77384
0
0
0
0
3
110145
0
110148
0
0
0
0
1
32763
0
32764
0
0
0
0
2
77382
0
77384
0
0
0
0
3
110145
0
110148
0
0
0
0
1
32763
0
32764
0
0
0
0
2
77382
0
77384
0
0
0
0
3
110145
0
110148
0
0
0
0
1
32763
0
32764
0
0
0
0
2
77382
0
77384
0
0
0
0
3
110145
0
110148
Inpatient
Any Services
Age
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
180
144
324
0
0
0
180
144
324
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
6.59%
2.23%
3.53%
NA
NA
NA
6.59%
2.23%
3.53%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
75
55
130
0
0
0
75
55
130
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
2.75%
0.85%
1.42%
NA
NA
NA
2.75%
0.85%
1.42%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
1
0
1
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%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
142
111
253
0
0
0
142
111
253
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
5.20%
1.72%
2.76%
NA
NA
NA
5.20%
1.72%
2.76%
HEDIS 2012 (Reporting Year 2011)
Page 88
Use of Services
UCare Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
13-17
18-24
25-34
35-64
65+
Unknown
Total
Member Months
(Outpatient/ED)
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
0
0
413
1589
8564
93
0
10659
0
0
516
1813
14938
259
0
17526
0
0
929
3402
23502
352
0
28185
0
0
413
1589
8564
93
0
10659
0
0
516
1813
14938
259
0
17526
0
0
929
3402
23502
352
0
28185
0
0
413
1589
8564
93
0
10659
0
0
516
1813
14938
259
0
17526
0
0
929
3402
23502
352
0
28185
0
0
413
1589
8564
93
0
10659
0
0
516
1813
14938
259
0
17526
0
0
929
3402
23502
352
0
28185
Any Services
Age
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Inpatient
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
1
2
3
29
30
59
154
164
318
0
0
0
0
0
0
184
196
380
NA
NA
NA
NA
NA
NA
2.91%
4.65%
3.88%
21.90%
19.86%
20.81%
21.58%
13.17%
16.24%
0.00%
0.00%
0.00%
NA
NA
NA
20.71%
13.42%
16.18%
0
0
0
0
0
0
1
1
2
11
9
20
47
51
98
0
0
0
0
0
0
59
61
120
NA
NA
NA
NA
NA
NA
2.91%
2.33%
2.58%
8.31%
5.96%
7.05%
6.59%
4.10%
5.00%
0.00%
0.00%
0.00%
NA
NA
NA
6.64%
4.18%
5.11%
0
0
0
0
0
0
0
0
0
1
3
4
4
5
9
0
0
0
0
0
0
5
8
13
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.76%
1.99%
1.41%
0.56%
0.40%
0.46%
0.00%
0.00%
0.00%
NA
NA
NA
0.56%
0.55%
0.55%
0
0
0
0
0
0
1
1
2
23
24
47
146
144
290
0
0
0
0
0
0
170
169
339
NA
NA
NA
NA
NA
NA
2.91%
2.33%
2.58%
17.37%
15.89%
16.58%
20.46%
11.57%
14.81%
0.00%
0.00%
0.00%
NA
NA
NA
19.14%
11.57%
14.43%
HEDIS 2012 (Reporting Year 2011)
Page 89
Use of Services
UCare Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
13-17
18-24
25-34
35-64
65+
Unknown
Total
Member Months
(Outpatient/ED)
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
302030
77687
63146
65032
130904
163
0
638962
293488
80004
105494
132184
165166
270
0
776606
595518
157691
168640
197216
296070
433
0
1415568
302030
77687
63146
65032
130904
163
0
638962
293488
80004
105494
132184
165166
270
0
776606
595518
157691
168640
197216
296070
433
0
1415568
302030
77687
63146
65032
130904
163
0
638962
293488
80004
105494
132184
165166
270
0
776606
595518
157691
168640
197216
296070
433
0
1415568
302030
77687
63146
65032
130904
163
0
638962
293488
80004
105494
132184
165166
270
0
776606
595518
157691
168640
197216
296070
433
0
1415568
Any Services
Age
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Inpatient
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
16
11
27
261
163
424
633
641
1274
1177
1185
2362
2261
1474
3735
0
0
0
0
0
0
4348
3474
7822
0.06%
0.04%
0.05%
4.03%
2.44%
3.23%
12.03%
7.29%
9.07%
21.72%
10.76%
14.37%
20.73%
10.71%
15.14%
0.00%
0.00%
0.00%
NA
NA
NA
8.17%
5.37%
6.63%
7
6
13
85
53
138
168
208
376
292
332
624
602
348
950
0
0
0
0
0
0
1154
947
2101
0.03%
0.02%
0.03%
1.31%
0.79%
1.05%
3.19%
2.37%
2.68%
5.39%
3.01%
3.80%
5.52%
2.53%
3.85%
0.00%
0.00%
0.00%
NA
NA
NA
2.17%
1.46%
1.78%
0
0
0
8
12
20
21
34
55
51
59
110
83
69
152
0
0
0
0
0
0
163
174
337
0.00%
0.00%
0.00%
0.12%
0.18%
0.15%
0.40%
0.39%
0.39%
0.94%
0.54%
0.67%
0.76%
0.50%
0.62%
0.00%
0.00%
0.00%
NA
NA
NA
0.31%
0.27%
0.29%
11
6
17
241
145
386
565
541
1106
1032
1071
2103
2025
1356
3381
0
0
0
0
0
0
3874
3119
6993
0.04%
0.02%
0.03%
3.72%
2.17%
2.94%
10.74%
6.15%
7.87%
19.04%
9.72%
12.80%
18.56%
9.85%
13.70%
0.00%
0.00%
0.00%
NA
NA
NA
7.28%
4.82%
5.93%
HEDIS 2012 (Reporting Year 2011)
Page 90
Use of Services
UCare Minnesota
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
Member Months
(Inpatient)
Female
Total
NR
NR
NR
NR
NR
NR
NR
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 2012 (Reporting Year 2011)
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
Age
0-12
Male
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
Outpatient/ED
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 91
Use of Services
UCare Minnesota
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Male
Female
Total
Male
Female
Total
0
0
21806
403294
0
425100
0
0
25619
539313
0
564932
0
0
47425
942607
0
990032
0
0
21806
403294
0
425100
0
0
25619
539313
0
564932
0
0
47425
942607
0
990032
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
0
0
21806
403294
0
425100
0
0
25619
539313
0
564932
0
0
47425
942607
0
990032
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
Member Months
(Outpatient/ED)
Male
Female
Total
0
0
21806
403294
0
425100
0
0
25619
539313
0
564932
0
0
47425
942607
0
990032
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
475
872
1347
894
1789
2683
0
0
0
1369
2661
4030
NA
NA
NA
NA
NA
NA
26.14%
40.84%
34.08%
2.66%
3.98%
3.42%
NA
NA
NA
3.86%
5.65%
4.88%
0
0
0
0
0
0
45
74
119
110
169
279
0
0
0
155
243
398
NA
NA
NA
NA
NA
NA
2.48%
3.47%
3.01%
0.33%
0.38%
0.36%
NA
NA
NA
0.44%
0.52%
0.48%
0
0
0
0
0
0
67
95
162
31
85
116
0
0
0
98
180
278
NA
NA
NA
NA
NA
NA
3.69%
4.45%
4.10%
0.09%
0.19%
0.15%
NA
NA
NA
0.28%
0.38%
0.34%
0
0
0
0
0
0
467
864
1331
814
1694
2508
0
0
0
1281
2558
3839
NA
NA
NA
NA
NA
NA
25.70%
40.47%
33.68%
2.42%
3.77%
3.19%
NA
NA
NA
3.62%
5.43%
4.65%
HEDIS 2012 (Reporting Year 2011)
Page 92
Use of Services
UCare Minnesota
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Male
Female
Total
Male
Female
Total
0
0
1
32763
0
32764
0
0
2
77382
0
77384
0
0
3
110145
0
110148
0
0
1
32763
0
32764
0
0
2
77382
0
77384
0
0
3
110145
0
110148
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
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
Male
Female
Total
0
0
1
32763
0
32764
0
0
1
32763
0
32764
0
0
2
77382
0
77384
0
0
3
110145
0
110148
0
0
2
77382
0
77384
0
0
3
110145
0
110148
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
0
0
0
410
891
1301
0
0
0
410
891
1301
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
15.02%
13.82%
14.17%
NA
NA
NA
15.02%
13.82%
14.17%
0
0
0
0
0
0
0
0
0
47
148
195
0
0
0
47
148
195
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
1.72%
2.30%
2.12%
NA
NA
NA
1.72%
2.30%
2.12%
0
0
0
0
0
0
0
0
0
28
57
85
0
0
0
28
57
85
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
1.03%
0.88%
0.93%
NA
NA
NA
1.03%
0.88%
0.93%
0
0
0
0
0
0
0
0
0
377
788
1165
0
0
0
377
788
1165
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
13.81%
12.22%
12.69%
NA
NA
NA
13.81%
12.22%
12.69%
HEDIS 2012 (Reporting Year 2011)
Page 93
Use of Services
UCare Minnesota
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
SNBC
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
10566
93
0
10659
0
0
17267
259
0
17526
0
0
27833
352
0
28185
0
0
10566
93
0
10659
0
0
17267
259
0
17526
0
0
27833
352
0
28185
0
0
10566
93
0
10659
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
0
0
17267
259
0
17526
0
0
27833
352
0
28185
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
0
0
10566
93
0
10659
0
0
17267
259
0
17526
0
0
27833
352
0
28185
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
500
966
1466
2
9
11
0
0
0
502
975
1477
NA
NA
NA
NA
NA
NA
56.79%
67.13%
63.21%
25.81%
41.70%
37.50%
NA
NA
NA
56.52%
66.76%
62.88%
0
0
0
0
0
0
39
56
95
0
0
0
0
0
0
39
56
95
NA
NA
NA
NA
NA
NA
4.43%
3.89%
4.10%
0.00%
0.00%
0.00%
NA
NA
NA
4.39%
3.83%
4.04%
0
0
0
0
0
0
61
101
162
0
2
2
0
0
0
61
103
164
NA
NA
NA
NA
NA
NA
6.93%
7.02%
6.98%
0.00%
9.27%
6.82%
NA
NA
NA
6.87%
7.05%
6.98%
0
0
0
0
0
0
497
959
1456
2
9
11
0
0
0
499
968
1467
NA
NA
NA
NA
NA
NA
56.45%
66.65%
62.77%
25.81%
41.70%
37.50%
NA
NA
NA
56.18%
66.28%
62.46%
HEDIS 2012 (Reporting Year 2011)
Page 94
Use of Services
UCare Minnesota
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 10:02 AM
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
Female
Total
Male
Female
Total
302030
77687
259082
163
0
638962
293488
80004
402844
270
0
776606
595518
157691
661926
433
0
1415568
302030
77687
259082
163
0
638962
293488
80004
402844
270
0
776606
595518
157691
661926
433
0
1415568
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
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
302030
77687
259082
163
0
638962
293488
80004
402844
270
0
776606
595518
157691
661926
433
0
1415568
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
302030
77687
259082
163
0
638962
293488
80004
402844
270
0
776606
595518
157691
661926
433
0
1415568
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
2420
1647
4067
1043
1145
2188
4854
8796
13650
1
4
5
0
0
0
8318
11592
19910
9.61%
6.73%
8.20%
16.11%
17.17%
16.65%
22.48%
26.20%
24.75%
7.36%
17.78%
13.86%
NA
NA
NA
15.62%
17.91%
16.88%
48
28
76
78
107
185
306
398
704
0
0
0
0
0
0
432
533
965
0.19%
0.11%
0.15%
1.20%
1.60%
1.41%
1.42%
1.19%
1.28%
0.00%
0.00%
0.00%
NA
NA
NA
0.81%
0.82%
0.82%
247
176
423
135
166
301
682
1005
1687
0
0
0
0
0
0
1064
1347
2411
0.98%
0.72%
0.85%
2.09%
2.49%
2.29%
3.16%
2.99%
3.06%
0.00%
0.00%
0.00%
NA
NA
NA
2.00%
2.08%
2.04%
2416
1641
4057
1034
1135
2169
4759
8694
13453
1
4
5
0
0
0
8210
11474
19684
9.60%
6.71%
8.18%
15.97%
17.02%
16.51%
22.04%
25.90%
24.39%
7.36%
17.78%
13.86%
NA
NA
NA
15.42%
17.73%
16.69%
HEDIS 2012 (Reporting Year 2011)
Page 95
Use of Services
UCare Minnesota
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
Count of Index Stays
(Denominator)
Age
18-44
45-54
55-64
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
34
34
68
77
73
150
169
250
419
280
357
637
Count of Index Stays
(Denominator)
Age
65-74
75-84
85+
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2012 (Reporting Year 2011)
2287
2679
4966
1959
2496
4455
800
1622
2422
5046
6797
11843
Count of 30-Day
Readmissions
(Numerator)
7
5
12
23
8
31
28
51
79
58
64
122
Observed
Readmission
(Num/Den)
20.59%
14.71%
17.65%
29.87%
10.96%
20.67%
16.57%
20.40%
18.85%
20.71%
17.93%
19.15%
Average Adjusted
Probability
Total Variance
21.14%
16.13%
18.63%
20.04%
14.85%
17.52%
18.27%
15.38%
16.55%
19.11%
15.35%
17.00%
536.61%
446.35%
982.96%
1138.68%
871.21%
2009.89%
2319.16%
3039.49%
5358.65%
3994.45%
4357.05%
8351.50%
Count of 30-Day
Readmissions
(Numerator)
280
274
554
268
317
585
110
227
337
658
818
1476
Observed
Readmission
(Num/Den)
12.24%
10.23%
11.16%
13.68%
12.70%
13.13%
13.75%
14.00%
13.91%
13.04%
12.03%
12.46%
Average Adjusted
Probability
Total Variance
13.44%
11.47%
12.38%
14.99%
13.62%
14.22%
16.59%
14.34%
15.09%
14.54%
12.95%
13.63%
24960.40%
25807.60%
50768.00%
23752.40%
27963.60%
51716.00%
10622.50%
19375.20%
29997.70%
59335.30%
73146.40%
132481.70%
Page 96
Use of Services
UCare Minnesota
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
Count of Index Stays
(Denominator)
Age
18-44
45-54
55-64
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
0
0
0
0
0
0
0
0
0
0
0
0
Count of Index Stays
(Denominator)
Age
65-74
75-84
85+
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2012 (Reporting Year 2011)
285
501
786
261
562
823
148
462
610
694
1525
2219
Count of 30-Day
Readmissions
(Numerator)
0
0
0
0
0
0
0
0
0
0
0
0
Observed
Readmission
(Num/Den)
Count of 30-Day
Readmissions
(Numerator)
53
95
148
52
88
140
24
80
104
129
263
392
Observed
Readmission
(Num/Den)
18.60%
18.96%
18.83%
19.92%
15.66%
17.01%
16.22%
17.32%
17.05%
18.59%
17.25%
17.67%
NA
NA
NA
NA
NA
NA
Average Adjusted
Probability
Total Variance
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
Average Adjusted
Probability
Total Variance
17.32%
16.74%
16.95%
19.12%
16.85%
17.57%
17.87%
16.41%
16.77%
18.12%
16.68%
17.13%
3887.92%
6530.17%
10418.09%
3814.73%
7504.12%
11318.85%
2088.77%
6098.72%
8187.49%
9791.42%
20133.01%
29924.43%
Page 97
Use of Services
UCare Minnesota
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 10:02 AM
SNBC
Count of Index Stays
(Denominator)
Age
18-44
45-54
55-64
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
44
37
81
56
70
126
39
70
109
139
177
316
Count of Index Stays
(Denominator)
Age
65-74
75-84
85+
Sex
M
F
Total
M
F
Total
M
F
Total
M
Total
HEDIS 2012 (Reporting Year 2011)
1
3
4
0
0
0
0
0
0
1
3
4
Count of 30-Day
Readmissions
(Numerator)
8
5
13
15
12
27
7
16
23
30
33
63
Observed
Readmission
(Num/Den)
18.18%
13.51%
16.05%
26.79%
17.14%
21.43%
17.95%
22.86%
21.10%
21.58%
18.64%
19.94%
Average Adjusted
Probability
Total Variance
18.03%
16.19%
17.19%
22.60%
20.65%
21.51%
17.34%
16.03%
16.50%
19.67%
17.89%
18.68%
624.74%
490.81%
1115.55%
895.16%
1060.66%
1955.82%
541.36%
899.59%
1440.95%
2061.27%
2451.06%
4512.33%
Count of 30-Day
Readmissions
(Numerator)
0
1
1
0
0
0
0
0
0
0
1
1
Observed
Readmission
(Num/Den)
0.00%
33.33%
25.00%
Average Adjusted
Probability
Total Variance
25.29%
10.02%
13.84%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
25.29%
10.02%
13.84%
18.89%
26.86%
45.76%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
18.89%
26.86%
45.76%
NA
NA
0.00%
33.33%
25.00%
Page 98
Health Plan Descriptive Information
UCare Minnesota
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Board Certification
MSHO
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2012 (Reporting Year 2011)
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
2829
2994
145
6483
2667
2787
126
5949
94.27%
93.09%
86.90%
91.76%
Page 99
Health Plan Descriptive Information
UCare Minnesota
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Board Certification
SNBC
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2012 (Reporting Year 2011)
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
3071
3029
157
6482
2902
2816
138
5957
94.50%
92.97%
87.90%
91.90%
Page 100
Health Plan Descriptive Information
UCare Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Commercial
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2012 (Reporting Year 2011)
Page 101
Health Plan Descriptive Information
UCare Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Medicare Advantage
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
123
514
527
745
1039
0
0.00%
186
428
664
776
1208
0
0.00%
2948
0.69%
1969
3477
5177
8235
3262
0.58%
2125
3659
6037
10536
6210
0.63%
18858
4.44%
131177
113241
76140
47011
25740
9985
22357
3.96%
172181
133575
92315
67816
45058
28368
41215
4.16%
403294
94.87%
0
539313
95.47%
0
425100
564932
HEDIS 2012 (Reporting Year 2011)
309
942
1191
1521
2247
4094
7136
11214
18771
303358
246816
168455
114827
70798
38353
942607
95.21%
0
990032
Page 102
Health Plan Descriptive Information
UCare Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 10:02 AM
MSHO
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0.00%
0
0
0
1
0
0.00%
0
0
0
2
0
0.00%
1
0.00%
7834
7826
6305
5134
3355
2309
2
0.00%
13642
13355
12950
12408
11532
13495
3
0.00%
32763
100.00%
0
77382
100.00%
0
110145
100.00%
32764
77384
HEDIS 2012 (Reporting Year 2011)
0
0
0
0
0
0
0
0
3
21476
21181
19255
17542
14887
15804
0
110148
Page 103
Health Plan Descriptive Information
UCare Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 10:02 AM
SNBC
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
20
Member Months
Female
0
0
0
0
0
14
Total
0
0
0
0
0
34
20
0.19%
393
788
801
842
1084
14
0.08%
502
889
924
1344
1765
34
0.12%
3908
36.66%
1617
1641
1836
1544
5424
30.95%
2225
3202
3311
3091
9332
33.11%
6638
62.28%
93
0
0
0
0
0
11829
67.49%
247
12
0
0
0
0
18467
65.52%
93
0.87%
0
259
1.48%
0
352
1.25%
10659
17526
HEDIS 2012 (Reporting Year 2011)
895
1677
1725
2186
2849
3842
4843
5147
4635
340
12
0
0
0
0
0
28185
Page 104
Health Plan Descriptive Information
UCare Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
<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
36325
108740
103976
84425
46251
25506
Member Months
Female
36202
104624
100527
84732
47407
30214
Total
72527
213364
204503
169157
93658
55720
405223
63.42%
37640
33884
31148
25266
26725
403706
51.98%
75280
75324
56860
40960
34554
808929
57.15%
154663
24.21%
27016
24048
16933
10916
282978
36.44%
30315
26470
18298
14569
437641
30.92%
78913
12.35%
121
26
16
0
0
0
89652
11.54%
195
60
15
0
0
0
168565
11.91%
163
0.03%
0
270
0.03%
0
433
0.03%
638962
776606
HEDIS 2012 (Reporting Year 2011)
112920
109208
88008
66226
61279
57331
50518
35231
25485
316
86
31
0
0
0
0
1415568
Page 105