Prime West
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
Prime West
Adult BMI Assessment
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Data Elements
Commercial
Medicare
Advantage
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
2011
H
1754
Numerator Events by Admin Data on Eligible
Population (before exclusions)
100
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
NR
NR
NR
NR
5.70%
411
5.00%
432
28
6.48%
Number of Records Excluded Because of Valid
Data Errors
0
Number of administrative data records excluded
0
Number of medical record data records excluded
0
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
NR
NR
NR
0
411
27
249
67.15%
62.49%
71.82%
Page 3
Effectiveness of Care
Prime West
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 22, 2012 9:50 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
2638
1206
3844
2638
1206
3844
2638
1206
3844
9
0.34%
3
0.25%
12
0.31%
14
0.53%
21
1.74%
35
0.91%
2
0.08%
1
0.08%
3
0.08%
0
0.00%
0
0.00%
0
0.00%
411
5.00%
411
5.00%
432
411
5.00%
432
3
0.69%
0
0.00%
3
0.69%
432
2
0.46%
1
0.23%
3
0.69%
0
0
0
Number of administrative data records
excluded
0
0
0
Number of medical records excluded
0
0
0
Number of employee/dependent records
excluded
0
0
0
Records Added from the Oversample List
0
0
0
HEDIS 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
273
138
411
273
138
411
273
138
411
3
136
50.92%
44.80%
57.03%
0
79
57.25%
48.63%
65.86%
3
215
53.04%
48.09%
57.99%
2
117
43.59%
37.52%
49.66%
1
64
47.10%
38.41%
55.79%
3
181
44.77%
39.84%
49.70%
0
98
35.90%
30.02%
41.77%
0
67
48.55%
39.85%
57.25%
0
165
40.15%
35.29%
45.01%
Page 5
Effectiveness of Care
Prime West
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:50 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
0
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
419
81.04%
477
92.26%
471
91.10%
479
92.65%
465
89.94%
469
90.72%
434
83.95%
71
13.73%
309
59.77%
223
43.13%
351
81.25%
400
92.59%
396
91.67%
403
93.29%
388
89.81%
393
90.97%
362
83.80%
60
13.89%
259
59.95%
185
42.82%
334
6
82.73%
78.95%
86.50%
382
4
93.92%
91.48%
96.35%
379
1
92.46%
89.78%
95.13%
385
2
94.16%
91.77%
96.55%
370
9
92.21%
89.50%
94.93%
376
1
91.73%
88.94%
94.51%
347
5
85.64%
82.13%
89.16%
58
4
15.09%
11.50%
18.67%
245
12
62.53%
57.73%
67.33%
174
32
50.12%
45.17%
55.08%
432
0
Numerator Events by administrative Data
MMR
411
0.05
Number of Records Excluded Because of
Valid Data Errors
Denominator
IPV
2011
H
517
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
Prime West
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:50 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
0
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
419
81.04%
400
77.37%
385
74.47%
63
12.19%
268
51.84%
192
37.14%
50
9.67%
42
8.12%
131
25.34%
36
6.96%
351
81.25%
334
77.31%
321
74.31%
52
12.04%
224
51.85%
158
36.57%
40
9.26%
35
8.10%
108
25.00%
29
6.71%
334
6
82.73%
78.95%
86.50%
317
10
79.56%
75.54%
83.58%
306
12
77.37%
73.21%
81.54%
50
9
14.36%
10.84%
17.87%
211
19
55.96%
51.04%
60.88%
148
34
44.28%
39.36%
49.21%
38
9
11.44%
8.24%
14.63%
34
8
10.22%
7.17%
13.27%
100
33
32.36%
27.72%
37.00%
28
8
8.76%
5.90%
11.61%
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
517
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
Prime West
Immunizations for Adolescents
Data Last Refreshed:
Oct 22, 2012 9:50 AM
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
Prime West
Immunizations for Adolescents
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Data Elements
Measure Data
Measurement Year
2011
Data Collection Methodology
H
Eligible Member Population
268
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
63
205
63
23.51%
76.49%
23.51%
63
23.51%
205
76.49%
63
23.51%
63
1
23.88%
18.59%
29.17%
205
5
78.36%
73.24%
83.48%
63
1
23.88%
18.59%
29.17%
268
5.00%
268
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
268
Page 11
Effectiveness of Care
Prime West
Breast Cancer Screening
Data Last Refreshed:
Oct 22, 2012 9:50 AM
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)
Commercial
NR
NR
NR
Medicare
Advantage
NR
NR
NR
MSHO
SNBC
MHCP-MC
2011
A
88
52
59.09%
48.25%
69.93%
2011
A
104
76
73.08%
64.07%
82.08%
2011
A
364
184
50.55%
45.28%
55.82%
Page 12
Effectiveness of Care
Prime West
Cervical Cancer Screening
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
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
1315
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
2010
H
1937
67.89%
411
5.00%
432
300
69.44%
0
0
6
0
NR
NR
NR
0
411
287
21
74.94%
70.63%
79.25%
Page 13
Effectiveness of Care
Prime West
Colorectal Cancer Screening
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Data Elements
Medicare
Advantage
MSHO
SNBC
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
2011
H
388
2011
H
113
Number of numerator events by administrative data in eligible population
(before exclusions)
155
40
39.95%
386
5.00%
386
155
40.16%
0
0
0
0
0
386
155
68
57.77%
52.72%
62.83%
35.40%
112
5.00%
112
40
35.71%
0
0
0
0
0
112
40
33
65.18%
55.91%
74.45%
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)
Commercial
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 14
Effectiveness of Care
Prime West
Chlamydia Screening in Women
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Chlamydia Screening in Women
Data Last Refreshed:
Oct 22, 2012 9:50 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
264
93
35.23%
29.28%
41.18%
285
100
35.09%
29.37%
40.80%
549
193
35.15%
31.07%
39.24%
2011
A
Page 16
Effectiveness of Care
Prime West
Glaucoma Screening in Older Adults
Data Last Refreshed:
Oct 22, 2012 9:50 AM
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)
Medicare
Advantage
NR
NR
NR
MSHO
2011
A
1422
1053
74.05%
71.74%
76.36%
Page 17
Effectiveness of Care
Prime West
Lead Screening in Children
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
MHCP-MC
2011
A
517
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
457
Reported Rate
NR
88.39%
Lower 95% Confidence Interval
NR
85.54%
Upper 95% Confidence Interval
NR
91.25%
HEDIS 2012 (Reporting Year 2011)
Page 18
Effectiveness of Care
Prime West
Care for Older Adults
Data Last Refreshed:
Oct 22, 2012 9:50 AM
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
Prime West
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 9:50 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
NR
NR
NR
NR
NR
NR
Page 20
Effectiveness of Care
Prime West
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 9:50 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
29
67.44%
52.27%
82.61%
37
86.05%
74.53%
97.57%
2011
A
43
Page 21
Effectiveness of Care
Prime West
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 9:50 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
3
NA
NA
NA
3
NA
NA
NA
2011
A
3
Page 22
Effectiveness of Care
Prime West
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Last Refreshed:
Oct 22, 2012 9:50 AM
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)
Medicare
Advantage
NR
NR
NR
MSHO
SNBC
2011
A
59
14
23.73%
12.03%
35.43%
2011
A
4
2
NA
NA
NA
Page 23
Effectiveness of Care
Prime West
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 22, 2012 9:50 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
52
49
2
94.23%
86.93%
100.00%
39
38
3
97.44%
91.19%
100.00%
51
39
10
76.47%
63.85%
89.09%
12
10
8
NA
NA
NA
154
136
23
88.31%
82.91%
93.71%
2011
A
Page 25
Effectiveness of Care
Prime West
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 9:50 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 27
Effectiveness of Care
Prime West
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 9:50 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
12
0
80.00%
0.00%
12
0
80.00%
0.00%
12
0
0
8
NA
NA
NA
NA
NA
NA
2011
H
15
15
5.00%
15
0
0
0
15
Page 28
Effectiveness of Care
Prime West
Controlling High Blood Pressure
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Data Elements
Medicare
Advantage
MSHO
SNBC
MHCP-MC
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2011
H
359
2011
H
58
2010
H
213
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
0
0
0.00%
261
5.00%
261
0.00%
45
5.00%
45
0.00%
197
5.00%
197
0
0.00%
0
0.00%
0
0.00%
Records Excluded because of Valid Data
Errors
1
0
0
Number of records excluded because of
false positive diagnoses
1
0
0
Number of administrative data records
excluded
1
0
1
Number of medical record data records
excluded
0
0
0
Number of employee/dependent medical
records excluded
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
0
259
0
167
64.48%
58.46%
70.50%
0
45
0
34
75.56%
61.89%
89.22%
0
196
0
127
64.80%
57.85%
71.74%
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
NR
NR
NR
NR
NR
Page 29
Effectiveness of Care
Prime West
Persistence of Beta Blocker Treatment After Heart Attack
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Data Elements
Commercial
Medicare
Advantage
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
NR
NR
NR
MSHO
SNBC
MHCP-MC
2011
A
16
2011
A
0
2011
A
4
15
0
4
NA
NA
NA
NR
NR
NR
NA
NA
NA
Page 30
Effectiveness of Care
Prime West
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Medicare Advantage
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Page 32
Effectiveness of Care
Prime West
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:50 AM
MSHO
LDL-C
Screening
LDL-C Level
<100 mg/dL
2011
H
193
2011
H
193
2011
H
193
2011
H
193
2011
H
193
2011
H
193
2011
H
193
1
0.52%
193
5%
193
1
0.52%
137
70.98%
193
5%
193
137
70.98%
149
77.20%
193
5%
193
149
77.20%
2
1.04%
193
5%
193
2
1.04%
162
83.94%
193
5%
193
162
83.94%
1
0.52%
193
5%
193
1
0.52%
1
0.52%
193
5%
193
1
0.52%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
193
162
11
89.64%
85.08%
94.20%
0
193
68
2
36.27%
29.23%
43.31%
0
193
1
112
58.55%
51.34%
65.76%
0
193
137
10
76.17%
69.90%
82.44%
0
193
149
3
78.76%
72.73%
84.79%
0
193
2
72
38.34%
31.22%
45.46%
0
193
162
1
84.46%
79.09%
89.83%
0
193
1
113
59.07%
51.87%
66.26%
0
193
1
98
51.30%
43.98%
58.61%
2011
H
193
2011
H
193
162
83.94%
193
5%
193
162
83.94%
191
98.96%
193
5%
193
191
98.96%
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
Prime West
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:50 AM
SNBC
2011
H
71
2011
H
71
2011
H
71
2011
H
71
2011
H
71
2011
H
71
1
1.41%
71
5%
71
1
1.41%
51
71.83%
71
5%
71
51
71.83%
63
88.73%
71
5%
71
63
88.73%
1
1.41%
71
5%
71
1
1.41%
51
71.83%
71
5%
71
51
71.83%
1
1.41%
71
5%
71
0
0.00%
1
1.41%
71
5%
71
0
0.00%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
71
63
0
88.73%
80.67%
96.79%
0
71
17
4
29.58%
18.26%
40.90%
0
71
1
45
64.79%
52.97%
76.60%
0
71
51
3
76.06%
65.43%
86.69%
0
71
63
0
88.73%
80.67%
96.79%
0
71
1
30
43.66%
31.42%
55.90%
0
71
51
1
73.24%
62.24%
84.24%
0
71
0
50
70.42%
59.10%
81.74%
0
71
0
35
49.30%
36.96%
61.63%
63
88.73%
71
5%
71
63
88.73%
70
98.59%
71
5%
71
70
98.59%
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
71
2011
H
71
Numerator events by admin data in eligible
population
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Eye Exam
2011
H
71
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
Prime West
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:50 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
224
2011
H
224
2011
H
195
2011
H
224
2011
H
224
2011
H
224
2011
H
224
2011
H
224
2011
H
224
2011
H
224
171
76.34%
216
5%
216
171
79.17%
223
99.55%
216
5%
216
215
99.54%
0
0.00%
216
5%
216
0
0.00%
1
0.45%
216
5%
216
1
0.46%
137
61.16%
216
5%
216
137
63.43%
159
70.98%
216
5%
216
159
73.61%
1
0.45%
216
5%
216
1
0.46%
161
71.88%
216
5%
216
161
74.54%
2
0.89%
216
5%
216
0
0.00%
1
0.45%
216
5%
216
0
0.00%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
216
1
92
43.06%
36.22%
49.89%
0
216
137
5
65.74%
59.18%
72.30%
0
216
159
1
74.07%
68.00%
80.15%
0
216
1
70
32.87%
26.37%
39.37%
0
216
161
3
75.93%
69.99%
81.86%
0
216
0
151
69.91%
63.56%
76.26%
0
216
0
119
55.09%
48.23%
61.96%
30
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
4
0
216
171
12
84.72%
79.69%
89.75%
0
216
66
35
46.76%
39.87%
53.64%
0
182
0
56
30.77%
23.79%
37.75%
Page 35
Effectiveness of Care
Prime West
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
Data Last Refreshed:
Oct 22, 2012 9:50 AM
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)
Medicare
Advantage
NR
NR
NR
Page 36
Effectiveness of Care
Prime West
Osteoporosis Management in Women Who had a Fracture
Data Last Refreshed:
Oct 22, 2012 9:50 AM
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)
Medicare
Advantage
NR
NR
NR
MSHO
2011
A
72
22
30.56%
19.22%
41.89%
Page 37
Effectiveness of Care
Prime West
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:50 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
NR
NR
NR
NR
NR
NR
Page 39
Effectiveness of Care
Prime West
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:50 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
21
18
NA
NA
NA
17
NA
NA
NA
Page 40
Effectiveness of Care
Prime West
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:50 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
1
1
NA
NA
NA
1
NA
NA
NA
Page 41
Effectiveness of Care
Prime West
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:50 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
180
94
52.22%
44.65%
59.80%
60
33.33%
26.17%
40.50%
Page 42
Effectiveness of Care
Prime West
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 22, 2012 9:50 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
91
32
35.16%
24.80%
45.52%
26
6
NA
NA
NA
2011
A
Page 44
Effectiveness of Care
Prime West
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 9:50 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
NR
NR
NR
NR
NR
NR
Page 45
Effectiveness of Care
Prime West
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 9:50 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
1
NA
NA
NA
1
NA
NA
NA
2011
A
6
Page 46
Effectiveness of Care
Prime West
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 9:50 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
18
NA
NA
NA
14
NA
NA
NA
2011
A
18
Page 47
Effectiveness of Care
Prime West
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:50 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 49
Effectiveness of Care
Prime West
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:50 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
723
697
96.40%
94.98%
97.83%
127
119
93.70%
89.08%
98.32%
885
855
96.61%
95.36%
97.86%
98
92
93.88%
88.62%
99.13%
1833
1763
96.18%
95.28%
97.09%
2011
A
Page 50
Effectiveness of Care
Prime West
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:50 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
58
58
100.00%
99.14%
100.00%
2
2
NA
NA
NA
47
42
89.36%
79.48%
99.24%
39
35
89.74%
78.94%
100.00%
146
137
93.84%
89.59%
98.08%
2011
A
Page 51
Effectiveness of Care
Prime West
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:50 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
210
176
83.81%
78.59%
89.03%
5
4
NA
NA
NA
149
124
83.22%
76.89%
89.56%
26
17
NA
NA
NA
390
321
82.31%
78.39%
86.22%
2011
A
Page 52
Access/Availability of Care
Prime West
Medication Reconciliation Post Discharge
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Data Elements
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
Prime West
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:50 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
NR
NR
NR
NR
NR
NR
Chronic Renal
Failure +
Nonaspirin
NSAIDs or Cox-2
Selective NSAIDs
Total
NR
NR
NR
NR
NR
NR
Page 54
Effectiveness of Care
Prime West
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:50 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
18
2
NA
NA
NA
585
132
22.56%
19.09%
26.04%
2011
A
53
11
20.75%
8.89%
32.62%
514
119
23.15%
19.41%
26.90%
Page 55
Effectiveness of Care
Prime West
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:50 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
At least 1
Prescription
At least 2
Prescriptions
NR
NR
NR
NR
NR
NR
Page 56
Effectiveness of Care
Prime West
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:50 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
1772
At least 1
Prescription
At least 2
Prescriptions
409
23.08%
21.09%
25.07%
63
3.56%
2.66%
4.45%
Page 57
Access/Availability of Care
Prime West
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Medicare Advantage
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
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 59
Access/Availability of Care
Prime West
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:50 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
1772
1772
0
0
1747
NA
NA
NA
NA
NA
NA
98.59%
98.01%
99.17%
1747
98.59%
98.01%
99.17%
2011
A
Page 60
Access/Availability of Care
Prime West
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:50 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
69
177
9
255
68
174
9
98.55%
95.01%
100.00%
98.31%
96.12%
100.00%
NA
NA
NA
251
98.43%
96.71%
100.00%
2011
A
Page 61
Access/Availability of Care
Prime West
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:50 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
2582
812
1
3395
2363
745
1
91.52%
90.42%
92.61%
91.75%
89.79%
93.70%
NA
NA
NA
3109
91.58%
90.63%
92.52%
2011
A
Page 62
Access/Availability of Care
Prime West
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 22, 2012 9:50 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.
647
626
1959
1766
1087
1000
1259
1160
96.75%
95.31%
98.20%
90.15%
88.80%
91.49%
92.00%
90.34%
93.66%
92.14%
90.61%
93.66%
2011
A
Page 64
Access/Availability of Care
Prime West
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Medicare Advantage
13-17 Year Olds
Data Elements
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
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 66
Access/Availability of Care
Prime West
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:50 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
32
0
32
0
0
23
1
23
1
NA
NA
NA
NA
NA
NA
71.88%
54.73%
89.02%
3.13%
0.00%
10.72%
71.88%
54.73%
89.02%
3.13%
0.00%
10.72%
Page 67
Access/Availability of Care
Prime West
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:50 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
27
27
0
0
18
7
18
7
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Page 68
Access/Availability of Care
Prime West
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:50 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
31
434
403
13
8
172
57
185
65
41.94%
22.95%
60.92%
25.81%
8.79%
42.82%
42.68%
37.73%
47.63%
14.14%
10.62%
17.67%
42.63%
37.86%
47.39%
14.98%
11.50%
18.45%
Page 69
Access/Availability of Care
Prime West
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 22, 2012 9:50 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
756
2011
H
756
Number of numerator events by administrative data in eligible
population (before exclusions)
455
383
60.19%
411
5.00%
432
271
50.66%
411
5.00%
432
227
62.73%
52.55%
0
0
0
0
411
258
93
0
0
411
216
71
85.40%
81.87%
88.94%
69.83%
65.27%
74.39%
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
Prime West
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 22, 2012 9:50 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
10
1.59%
12
1.91%
26
4.14%
32
5.10%
74
11.78%
118
18.79%
356
56.69%
5
1.16%
9
2.08%
21
4.86%
22
5.09%
44
10.19%
73
16.90%
258
59.72%
4
0
0.97%
0.00%
2.04%
6
0
1.46%
0.18%
2.74%
13
1
3.41%
1.53%
5.28%
15
3
4.38%
2.28%
6.48%
27
4
7.54%
4.87%
10.22%
46
12
14.11%
10.62%
17.60%
251
29
68.13%
63.50%
72.75%
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
628
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
Prime West
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Last Refreshed:
Oct 22, 2012 9:50 AM
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
838
NR
53.51%
411
5.00%
432
256
NR
59.26%
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
1566
0
NR
NR
NR
0
411
242
11
61.56%
56.73%
66.38%
Page 74
Use of Services
Prime West
Adolescent Well-Care Visits
Data Last Refreshed:
Oct 22, 2012 9:50 AM
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
584
NR
28.91%
411
5.00%
432
124
NR
28.70%
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
2020
0
NR
NR
NR
0
411
119
26
35.28%
30.54%
40.02%
Page 75
Use of Services
Prime West
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Medicare Advantage
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
NR
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 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 77
Use of Services
Prime West
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:50 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
8
6357
7972
11343
0
25680
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
0
0
2
5755
7142
8773
0
21672
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
250.00
905.30
895.89
773.43
843.93
Emergency Room Visits
Visits
0
0
0
0
0
305
374
459
0
1138
Visits/ 1,000
Member
Months
NA
NA
NA
NA
0.00
47.98
46.91
40.47
44.31
Page 78
Use of Services
Prime West
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:50 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
0
998
2232
92
0
0
0
3322
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
1008
2351
86
0
0
0
3445
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
NA
NA
NA
1010.02
1053.32
934.78
NA
NA
1037.03
Emergency Room Visits
Visits
0
0
0
100
142
11
0
0
0
253
Visits/ 1,000
Member
Months
NA
NA
NA
100.20
63.62
119.57
NA
NA
76.16
Page 79
Use of Services
Prime West
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:50 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
13391
74243
47936
73104
19884
20
2
2
0
228582
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
11259
26522
14682
36201
11060
9
0
0
0
99733
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
840.79
357.23
306.28
495.20
556.23
450.00
0.00
0.00
436.31
Emergency Room Visits
Visits
1293
3796
1883
5692
900
0
0
0
0
13564
Visits/ 1,000
Member
Months
96.56
51.13
39.28
77.86
45.26
0.00
0.00
0.00
59.34
Page 80
Use of Services
Prime West
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:50 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
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 82
Use of Services
Prime West
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:50 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
8
6357
7972
11343
0
25680
Discharges
0
0
0
0
0
256
384
512
0
1152
0
0
0
0
0
193
308
431
0
932
0
0
0
0
0
55
66
72
0
193
0
0
0
0
0
HEDIS 2012 (Reporting Year 2011)
Discharges /
1,000 Member
Months
NA
NA
NA
NA
0.00
40.27
48.17
45.14
44.86
NA
NA
NA
NA
0.00
30.36
38.64
38.00
36.29
NA
NA
NA
NA
0.00
8.65
8.28
6.35
7.52
NA
NA
0.00
0.00
Days
0
0
0
0
0
1144
1789
2322
0
5255
0
0
0
0
0
789
1360
1848
0
3997
0
0
0
0
0
307
347
430
0
1084
0
0
0
0
0
Days / 1,000
Member
Months
NA
NA
NA
NA
0.00
179.96
224.41
204.71
204.63
NA
NA
NA
NA
0.00
124.12
170.60
162.92
155.65
NA
NA
NA
NA
0.00
48.29
43.53
37.91
42.21
NA
NA
0.00
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
4.47
4.66
4.54
NA
4.56
NA
NA
NA
NA
NA
4.09
4.42
4.29
NA
4.29
NA
NA
NA
NA
NA
5.58
5.26
5.97
NA
5.62
NA
NA
NA
NA
NA
Page 83
Use of Services
Prime West
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:50 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
0
998
2232
92
0
0
0
3322
Discharges
0
0
0
15
78
5
0
0
0
98
0
0
0
7
51
5
0
0
0
63
Discharges /
1,000 Member
Months
NA
NA
NA
15.03
34.95
54.35
NA
NA
29.50
NA
NA
NA
7.01
22.85
54.35
NA
NA
18.96
0
0
0
6
23
0
0
0
0
29
NA
NA
NA
6.01
10.30
0.00
NA
NA
0
1
0
0
1
NA
1.00
0.00
HEDIS 2012 (Reporting Year 2011)
8.73
0.31
Days
0
0
0
36
341
22
0
0
0
399
Days / 1,000
Member
Months
NA
NA
NA
36.07
152.78
239.13
NA
NA
120.11
0
0
0
18
188
22
0
0
0
228
NA
NA
NA
18.04
84.23
239.13
NA
NA
0
0
0
13
120
0
0
0
0
133
NA
NA
NA
13.03
53.76
0.00
NA
NA
0
3
0
0
3
NA
3.01
0.00
68.63
40.04
0.93
Average
Length of Stay
NA
NA
NA
2.40
4.37
4.40
NA
NA
NA
4.07
NA
NA
NA
2.57
3.69
4.40
NA
NA
NA
3.62
NA
NA
NA
2.17
5.22
NA
NA
NA
NA
4.59
NA
3.00
NA
NA
3.00
Page 84
Use of Services
Prime West
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:50 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
13391
74243
47936
73104
19884
20
2
2
0
228582
Discharges
Discharges /
1,000 Member
Months
133
140
156
1229
216
0
0
0
0
1874
9.93
1.89
3.25
16.81
10.86
0.00
0.00
0.00
116
119
40
161
101
0
0
0
0
537
8.66
1.60
0.83
2.20
5.08
0.00
0.00
0.00
17
19
24
163
106
0
0
0
0
329
89
893
0
0
982
HEDIS 2012 (Reporting Year 2011)
8.20
2.35
1.27
0.26
0.50
2.23
5.33
0.00
0.00
0.00
1.44
1.86
12.22
0.00
6.97
Days
Days / 1,000
Member
Months
564
424
396
3162
867
0
0
0
0
5413
42.12
5.71
8.26
43.25
43.60
0.00
0.00
0.00
408
302
90
380
334
0
0
0
0
1514
30.47
4.07
1.88
5.20
16.80
0.00
0.00
0.00
156
60
70
483
459
0
0
0
0
1228
11.65
0.81
1.46
6.61
23.08
0.00
0.00
0.00
211
2230
0
0
2441
4.40
30.50
0.00
23.68
6.62
5.37
17.32
Average
Length of Stay
4.24
3.03
2.54
2.57
4.01
NA
NA
NA
NA
2.89
3.52
2.54
2.25
2.36
3.31
NA
NA
NA
NA
2.82
9.18
3.16
2.92
2.96
4.33
NA
NA
NA
NA
3.73
2.37
2.50
NA
NA
2.49
Page 85
Use of Services
Prime West
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Medicare Advantage
Member Months
(Any)
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
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)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Inpatient
Any Services
Age
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(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 87
Use of Services
Prime West
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:50 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
6995
0
6996
0
0
0
0
7
18677
0
18684
0
0
0
0
8
25672
0
25680
0
0
0
0
1
6995
0
6996
0
0
0
0
7
18677
0
18684
0
0
0
0
8
25672
0
25680
0
0
0
0
1
6995
0
6996
0
0
0
0
7
18677
0
18684
0
0
0
0
8
25672
0
25680
0
0
0
0
1
6995
0
6996
0
0
0
0
7
18677
0
18684
0
0
0
0
8
25672
0
25680
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
27
17
44
0
0
0
27
17
44
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
4.63%
1.09%
2.06%
NA
NA
NA
4.63%
1.09%
2.06%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
11
23
0
0
0
12
11
23
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
2.06%
0.71%
1.08%
NA
NA
NA
2.06%
0.71%
1.07%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
22
7
29
0
0
0
22
7
29
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.77%
0.45%
1.36%
NA
NA
NA
3.77%
0.45%
1.36%
HEDIS 2012 (Reporting Year 2011)
Page 88
Use of Services
Prime West
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:50 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
116
131
1044
63
0
1354
0
0
3
239
1697
29
0
1968
0
0
119
370
2741
92
0
3322
0
0
116
131
1044
63
0
1354
0
0
3
239
1697
29
0
1968
0
0
119
370
2741
92
0
3322
0
0
116
131
1044
63
0
1354
0
0
3
239
1697
29
0
1968
0
0
119
370
2741
92
0
3322
0
0
116
131
1044
63
0
1354
0
0
3
239
1697
29
0
1968
0
0
119
370
2741
92
0
3322
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
0
1
1
5
6
16
22
38
0
0
0
0
0
0
18
27
45
NA
NA
NA
NA
NA
NA
10.34%
0.00%
10.08%
9.16%
25.10%
19.46%
18.39%
15.56%
16.64%
0.00%
0.00%
0.00%
NA
NA
NA
15.95%
16.46%
16.26%
0
0
0
0
0
0
0
0
0
0
4
4
6
11
17
0
0
0
0
0
0
6
15
21
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
20.08%
12.97%
6.90%
7.78%
7.44%
0.00%
0.00%
0.00%
NA
NA
NA
5.32%
9.15%
7.59%
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
1
1
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.71%
0.44%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.61%
0.36%
0
0
0
0
0
0
1
0
1
1
5
6
15
18
33
0
0
0
0
0
0
17
23
40
NA
NA
NA
NA
NA
NA
10.34%
0.00%
10.08%
9.16%
25.10%
19.46%
17.24%
12.73%
14.45%
0.00%
0.00%
0.00%
NA
NA
NA
15.07%
14.02%
14.45%
HEDIS 2012 (Reporting Year 2011)
Page 89
Use of Services
Prime West
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:50 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
53103
11264
8384
10838
16647
6
0
100242
52235
11834
17410
23900
22943
18
0
128340
105338
23098
25794
34738
39590
24
0
228582
53103
11264
8384
10838
16647
6
0
100242
52235
11834
17410
23900
22943
18
0
128340
105338
23098
25794
34738
39590
24
0
228582
53103
11264
8384
10838
16647
6
0
100242
52235
11834
17410
23900
22943
18
0
128340
105338
23098
25794
34738
39590
24
0
228582
53103
11264
8384
10838
16647
6
0
100242
52235
11834
17410
23900
22943
18
0
128340
105338
23098
25794
34738
39590
24
0
228582
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
1
4
5
47
41
88
116
142
258
185
232
417
272
215
487
0
0
0
0
0
0
621
634
1255
0.02%
0.09%
0.06%
5.01%
4.16%
4.57%
16.60%
9.79%
12.00%
20.48%
11.65%
14.40%
19.61%
11.25%
14.76%
0.00%
0.00%
0.00%
NA
NA
NA
7.43%
5.93%
6.59%
0
2
2
18
15
33
31
62
93
35
64
99
78
53
131
0
0
0
0
0
0
162
196
358
0.00%
0.05%
0.02%
1.92%
1.52%
1.71%
4.44%
4.27%
4.33%
3.88%
3.21%
3.42%
5.62%
2.77%
3.97%
0.00%
0.00%
0.00%
NA
NA
NA
1.94%
1.83%
1.88%
0
0
0
0
0
0
1
1
2
0
2
2
1
1
2
0
0
0
0
0
0
2
4
6
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.14%
0.07%
0.09%
0.00%
0.10%
0.07%
0.07%
0.05%
0.06%
0.00%
0.00%
0.00%
NA
NA
NA
0.02%
0.04%
0.03%
1
2
3
43
38
81
110
121
231
180
214
394
257
199
456
0
0
0
0
0
0
591
574
1165
0.02%
0.05%
0.03%
4.58%
3.85%
4.21%
15.74%
8.34%
10.75%
19.93%
10.74%
13.61%
18.53%
10.41%
13.82%
0.00%
0.00%
0.00%
NA
NA
NA
7.07%
5.37%
6.12%
HEDIS 2012 (Reporting Year 2011)
Page 90
Use of Services
Prime West
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Medicare Advantage
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 92
Use of Services
Prime West
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:50 AM
MSHO
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
1
6995
0
6996
0
0
7
18677
0
18684
0
0
8
25672
0
25680
0
0
1
6995
0
6996
0
0
7
18677
0
18684
0
0
8
25672
0
25680
0
0
1
6995
0
6996
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
7
18677
0
18684
0
0
8
25672
0
25680
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
0
0
1
6995
0
6996
0
0
7
18677
0
18684
0
0
8
25672
0
25680
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
0
0
0
70
189
259
0
0
0
70
189
259
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
12.01%
12.14%
12.11%
NA
NA
NA
12.01%
12.14%
12.10%
0
0
0
0
0
0
0
0
0
19
66
85
0
0
0
19
66
85
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.26%
4.24%
3.97%
NA
NA
NA
3.26%
4.24%
3.97%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
0
0
0
0
0
0
0
0
0
54
129
183
0
0
0
54
129
183
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
9.26%
8.29%
8.55%
NA
NA
NA
9.26%
8.29%
8.55%
HEDIS 2012 (Reporting Year 2011)
Page 93
Use of Services
Prime West
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:50 AM
SNBC
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
1291
63
0
1354
0
0
1939
29
0
1968
0
0
3230
92
0
3322
0
0
1291
63
0
1354
0
0
1939
29
0
1968
0
0
3230
92
0
3322
0
0
1291
63
0
1354
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
1939
29
0
1968
0
0
3230
92
0
3322
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
0
0
1291
63
0
1354
0
0
1939
29
0
1968
0
0
3230
92
0
3322
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
70
113
183
2
0
2
0
0
0
72
113
185
NA
NA
NA
NA
NA
NA
65.07%
69.93%
67.99%
38.10%
0.00%
26.09%
NA
NA
NA
63.81%
68.90%
66.83%
0
0
0
0
0
0
5
14
19
1
0
1
0
0
0
6
14
20
NA
NA
NA
NA
NA
NA
4.65%
8.66%
7.06%
19.05%
0.00%
13.04%
NA
NA
NA
5.32%
8.54%
7.22%
0
0
0
0
0
0
2
4
6
0
0
0
0
0
0
2
4
6
NA
NA
NA
NA
NA
NA
1.86%
2.48%
2.23%
0.00%
0.00%
0.00%
NA
NA
NA
1.77%
2.44%
2.17%
0
0
0
0
0
0
70
111
181
1
0
1
0
0
0
71
111
182
NA
NA
NA
NA
NA
NA
65.07%
68.70%
67.24%
19.05%
0.00%
13.04%
NA
NA
NA
62.92%
67.68%
65.74%
HEDIS 2012 (Reporting Year 2011)
Page 94
Use of Services
Prime West
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:50 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
53103
11264
35869
6
0
100242
52235
11834
64253
18
0
128340
105338
23098
100122
24
0
228582
53103
11264
35869
6
0
100242
52235
11834
64253
18
0
128340
105338
23098
100122
24
0
228582
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
53103
11264
35869
6
0
100242
52235
11834
64253
18
0
128340
105338
23098
100122
24
0
228582
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
53103
11264
35869
6
0
100242
52235
11834
64253
18
0
128340
105338
23098
100122
24
0
228582
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
629
481
1110
246
293
539
717
1501
2218
0
0
0
0
0
0
1592
2275
3867
14.21%
11.05%
12.65%
26.21%
29.71%
28.00%
23.99%
28.03%
26.58%
0.00%
0.00%
0.00%
NA
NA
NA
19.06%
21.27%
20.30%
9
6
15
16
17
33
46
81
127
0
0
0
0
0
0
71
104
175
0.20%
0.14%
0.17%
1.70%
1.72%
1.71%
1.54%
1.51%
1.52%
0.00%
0.00%
0.00%
NA
NA
NA
0.85%
0.97%
0.92%
1
3
4
2
5
7
9
18
27
0
0
0
0
0
0
12
26
38
0.02%
0.07%
0.05%
0.21%
0.51%
0.36%
0.30%
0.34%
0.32%
0.00%
0.00%
0.00%
NA
NA
NA
0.14%
0.24%
0.20%
627
481
1108
245
291
536
706
1484
2190
0
0
0
0
0
0
1578
2256
3834
14.17%
11.05%
12.62%
26.10%
29.51%
27.85%
23.62%
27.72%
26.25%
0.00%
0.00%
0.00%
NA
NA
NA
18.89%
21.09%
20.13%
HEDIS 2012 (Reporting Year 2011)
Page 95
Use of Services
Prime West
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Medicare Advantage
Age
18-44
45-54
55-64
Total
Age
65-74
75-84
85+
Total
Count of Index Stays
(Denominator)
Count of 30-Day
Readmissions
(Numerator)
Observed
Readmission
(Num/Den)
Average Adjusted
Probability
Total Variance
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Count of Index Stays
(Denominator)
Count of 30-Day
Readmissions
(Numerator)
Observed
Readmission
(Num/Den)
Average Adjusted
Probability
Total Variance
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2012 (Reporting Year 2011)
Page 96
Use of Services
Prime West
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 9:50 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
1
1
0
1
1
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)
40
84
124
60
139
199
55
208
263
155
431
586
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)
7
12
19
11
27
38
5
35
40
23
74
97
Observed
Readmission
(Num/Den)
17.50%
14.29%
15.32%
18.33%
19.42%
19.10%
9.09%
16.83%
15.21%
14.84%
17.17%
16.55%
NA
NA
0.00%
0.00%
NA
0.00%
0.00%
Average Adjusted
Probability
Total Variance
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
20.09%
20.09%
0.00%
20.09%
20.09%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
16.06%
16.06%
0.00%
16.06%
16.06%
Average Adjusted
Probability
Total Variance
15.73%
15.53%
15.60%
16.87%
16.94%
16.92%
17.70%
14.68%
15.31%
16.87%
15.57%
15.92%
506.88%
1052.31%
1559.19%
807.81%
1869.31%
2677.12%
780.36%
2533.37%
3313.73%
2095.05%
5454.99%
7550.04%
Page 97
Use of Services
Prime West
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 9:50 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
1
11
12
13
20
33
2
27
29
16
58
74
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)
4
1
5
0
0
0
0
0
0
4
1
5
Count of 30-Day
Readmissions
(Numerator)
0
0
0
1
5
6
0
7
7
1
12
13
Observed
Readmission
(Num/Den)
0.00%
0.00%
0.00%
7.69%
25.00%
18.18%
0.00%
25.93%
24.14%
6.25%
20.69%
17.57%
Average Adjusted
Probability
Total Variance
10.43%
15.81%
15.36%
19.67%
18.10%
18.72%
18.17%
17.49%
17.53%
18.90%
17.38%
17.71%
9.34%
140.29%
149.63%
175.10%
255.78%
430.88%
27.30%
368.79%
396.09%
211.74%
764.86%
976.60%
Count of 30-Day
Readmissions
(Numerator)
0
0
0
0
0
0
0
0
0
0
0
0
Observed
Readmission
(Num/Den)
0.00%
0.00%
0.00%
Average Adjusted
Probability
Total Variance
15.73%
10.98%
14.78%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
15.73%
10.98%
14.78%
52.40%
9.78%
62.18%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
52.40%
9.78%
62.18%
NA
NA
0.00%
0.00%
0.00%
Page 98
Health Plan Descriptive Information
Prime West
Board Certification
Data Last Refreshed:
Oct 22, 2012 9:50 AM
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
639
586
35
1836
549
523
26
1545
85.92%
89.25%
74.29%
84.15%
Page 99
Health Plan Descriptive Information
Prime West
Board Certification
Data Last Refreshed:
Oct 22, 2012 9:50 AM
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
639
586
35
1832
549
523
26
1544
85.92%
89.25%
74.29%
84.28%
Page 100
Health Plan Descriptive Information
Prime West
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:50 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
Prime West
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:50 AM
Medicare Advantage
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Member Months
Female
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 102
Health Plan Descriptive Information
Prime West
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:50 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
7
0
0.00%
1
0.01%
1069
1158
1155
1260
1176
1177
7
0.04%
2012
2118
2464
3093
3777
5213
8
0.03%
6995
99.99%
0
18677
99.96%
0
25672
99.97%
6996
18684
HEDIS 2012 (Reporting Year 2011)
0
0
0
0
0
0
0
0
8
3081
3276
3619
4353
4953
6390
0
25680
Page 103
Health Plan Descriptive Information
Prime West
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:50 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
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
116
71
60
93
100
0
0.00%
3
84
155
83
233
0
0.00%
440
32.50%
217
286
204
144
558
28.35%
286
349
386
360
998
30.04%
851
62.85%
63
0
0
0
0
0
1381
70.17%
29
0
0
0
0
0
2232
67.19%
63
4.65%
0
29
1.47%
0
92
2.77%
1354
1968
HEDIS 2012 (Reporting Year 2011)
119
155
215
176
333
503
635
590
504
92
0
0
0
0
0
0
3322
Page 104
Health Plan Descriptive Information
Prime West
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:50 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
6847
19346
18343
13429
6402
3189
Member Months
Female
6544
18546
18008
14351
6620
3945
Total
13391
37892
36351
27780
13022
7134
67556
67.39%
5195
5614
5224
3833
3564
68014
53.00%
13465
13453
10447
6783
5526
135570
59.31%
23430
23.37%
3396
2744
2085
1025
49674
38.71%
4393
3194
1824
1223
73104
31.98%
9250
9.23%
5
0
1
0
0
0
10634
8.29%
13
2
1
0
1
1
19884
8.70%
6
0.01%
0
18
0.01%
0
24
0.01%
100242
128340
HEDIS 2012 (Reporting Year 2011)
18660
19067
15671
10616
9090
7789
5938
3909
2248
18
2
2
0
1
1
0
228582
Page 105