Preferred One Community Health Plan
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
Preferred One Community Health Plan
Adult BMI Assessment
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Medicare
Advantage
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Commercial
2011
A
8807
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Number of Records Excluded Because of Valid
Data Errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
152
1.73%
1.45%
2.00%
Page 3
Effectiveness of Care
Preferred One Community Health Plan
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
BMI Percentile
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Nutrition
Total
2011
A
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Physical Activity
Total
2011
A
General
Measure
Data
Ages 3-11
Ages 1217
Total
2011
A
1976
1270
3246
1976
1270
3246
1976
1270
3246
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
110
53
163
9
3
12
0
0
0
5.57%
4.53%
6.60%
4.17%
3.03%
5.31%
5.02%
4.25%
5.79%
0.46%
0.13%
0.78%
0.24%
0.00%
0.54%
0.37%
0.15%
0.59%
0.00%
0.00%
0.03%
0.00%
0.00%
0.04%
0.00%
0.00%
0.02%
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 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
Preferred One Community Health Plan
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 5
Effectiveness of Care
Preferred One Community Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
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
199
80.24%
211
85.08%
219
88.31%
223
89.92%
197
79.44%
218
87.90%
206
83.06%
79
31.85%
186
75.00%
157
63.31%
199
80.24%
211
85.08%
219
88.31%
223
89.92%
197
79.44%
218
87.90%
206
83.06%
79
31.85%
186
75.00%
157
63.31%
199
211
218
223
197
217
206
79
186
157
13
86.18%
81.66%
90.69%
14
91.46%
87.77%
95.16%
1
89.02%
84.91%
93.13%
10
94.72%
91.72%
97.71%
24
89.84%
85.86%
93.82%
1
88.62%
84.45%
92.79%
14
89.43%
85.39%
93.48%
2
32.93%
26.85%
39.00%
13
80.89%
75.78%
86.01%
16
70.33%
64.41%
76.24%
248
2
Numerator Events by administrative Data
MMR
248
0.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
IPV
2011
H
248
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
246
Page 6
Effectiveness of Care
Preferred One Community Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
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
199
80.24%
171
68.95%
165
66.53%
66
26.61%
145
58.47%
123
49.60%
60
24.19%
55
22.18%
112
45.16%
50
20.16%
199
80.24%
171
68.95%
165
66.53%
66
26.61%
145
58.47%
123
49.60%
60
24.19%
55
22.18%
112
45.16%
50
20.16%
199
171
165
66
145
123
60
55
112
50
13
86.18%
81.66%
90.69%
25
79.67%
74.44%
84.91%
27
78.05%
72.67%
83.42%
12
31.71%
25.69%
37.73%
27
69.92%
63.98%
75.85%
30
62.20%
55.93%
68.46%
12
29.27%
23.38%
35.16%
13
27.64%
21.85%
33.43%
29
57.32%
50.93%
63.70%
13
25.61%
19.95%
31.27%
248
2
Numerator Events by administrative Data
Combo 3
248
0.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Combo 2
2011
H
248
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
246
Page 7
Effectiveness of Care
Preferred One Community Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 8
Effectiveness of Care
Preferred One Community Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 9
Effectiveness of Care
Preferred One Community Health Plan
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Immunizations for Adolescents
Commercial
Data Elements
General
Measure Data
Meningococcal
Tdap
Combo 1
145
230
140
48.33%
76.67%
46.67%
145
48.33%
230
76.67%
140
46.67%
145
13
230
27
140
18
Reported Rate
52.84%
85.95%
52.84%
Lower 95% Confidence Interval
47.02%
81.85%
47.02%
Upper 95% Confidence Interval
58.67%
90.06%
58.67%
Measurement Year
Data Collection Methodology
Eligible Member Population
2011
H
300
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
300
0.00%
300
Records Excluded because of Valid Data Errors
1
Number of administrative data records excluded
0
Number of medical data records excluded
0
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
HEDIS 2012 (Reporting Year 2011)
0
299
Page 10
Effectiveness of Care
Preferred One Community Health Plan
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Immunizations for Adolescents
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Data Elements
Measure Data
Measurement Year
Data Collection Methodology
Eligible Member Population
Meningococcal
Tdap
Combo 1
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Page 11
Effectiveness of Care
Preferred One Community Health Plan
Breast Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
2011
A
2781
1892
68.03%
66.28%
69.78%
Medicare
Advantage
MSHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 12
Effectiveness of Care
Preferred One Community Health Plan
Cervical Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
2011
A
3064
MHCP-MC
NR
NR
NR
NR
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
2274
74.22%
72.65%
75.78%
NR
NR
NR
Page 13
Effectiveness of Care
Preferred One Community Health Plan
Colorectal Cancer Screening
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Data Elements
Commercial
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
2011
H
3519
Number of numerator events by administrative data in eligible population
(before exclusions)
1574
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
44.73%
411
0.05
432
195
45.14%
0
0
0
0
0
411
185
65
60.83%
55.99%
65.67%
HEDIS 2012 (Reporting Year 2011)
Medicare
Advantage
MSHO
SNBC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 14
Effectiveness of Care
Preferred One Community Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Oct 22, 2012 9:46 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
Ages 21-24
Total
326
121
37.12%
31.72%
42.51%
303
169
55.78%
50.02%
61.53%
629
290
46.10%
42.13%
50.08%
2011
A
Page 15
Effectiveness of Care
Preferred One Community Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
Ages 21-24
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 16
Effectiveness of Care
Preferred One Community Health Plan
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Medicare
Advantage
MSHO
NR
NR
NR
NR
NR
NR
Page 17
Effectiveness of Care
Preferred One Community Health Plan
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Lead Screening in Children
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
2011
A
248
MHCP-MC
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
156
Reported Rate
62.90%
NR
Lower 95% Confidence Interval
56.69%
NR
Upper 95% Confidence Interval
69.12%
NR
HEDIS 2012 (Reporting Year 2011)
Page 18
Effectiveness of Care
Preferred One Community Health Plan
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Care for Older Adults
MSHO
Medication Review
Functional
Status
Assessment
Pain
Screening
NR
NR
NR
NR
NR
NR
NR
NR
Reported Rate
NR
NR
NR
NR
Lower 95% Confidence Interval
NR
NR
NR
NR
Upper 95% Confidence Interval
NR
NR
NR
NR
Advance Care
Planning
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Data Elements
General Measure
Data
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population (before exclusions)
Records Excluded because of Valid Data
Errors
Number of employee/dependent medical
records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
HEDIS 2012 (Reporting Year 2011)
Page 19
Effectiveness of Care
Preferred One Community Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
NR
NR
NR
Page 21
Effectiveness of Care
Preferred One Community Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
NR
NR
NR
Page 22
Effectiveness of Care
Preferred One Community Health Plan
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Medicare
Advantage
MSHO
SNBC
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 23
Effectiveness of Care
Preferred One Community Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 22, 2012 9:46 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
Ages 12-18
Ages 19-50
Ages 51-64
Total
26
25
0
NA
NA
NA
28
27
0
NA
NA
NA
95
85
1
89.47%
82.78%
96.17%
74
70
2
94.59%
88.77%
100.00%
223
207
3
92.83%
89.21%
96.44%
2011
A
`
Page 24
Effectiveness of Care
Preferred One Community Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 22, 2012 9:46 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
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 25
Effectiveness of Care
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 9:46 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
103
0
88.79%
0.00%
2011
H
116
116
0.00%
116
103
0
88.79%
0.00%
103
1
0
76
89.66%
83.68%
95.63%
65.52%
56.44%
74.60%
0
0
0
116
Page 26
Effectiveness of Care
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 28
Effectiveness of Care
Preferred One Community Health Plan
Controlling High Blood Pressure
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Data Elements
Commercial
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2011
H
1139
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
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
0.00%
411
10.00%
453
0
0.00%
Records Excluded because of Valid Data
Errors
0
Number of records excluded because of
false positive diagnoses
6
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
6
411
0
308
74.94%
70.63%
79.25%
HEDIS 2012 (Reporting Year 2011)
Medicare
Advantage
MSHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 29
Effectiveness of Care
Preferred One Community Health Plan
Persistence of Beta Blocker Treatment After Heart Attack
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Commercial
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Medicare
Advantage
MSHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
2011
A
9
8
NA
NA
NA
Page 30
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
HbA1c
Testing
Poor HbA1c
Control
(>9.0%)
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
2011
H
594
2011
H
594
2011
H
493
526
88.55%
548
5%
576
511
88.72%
593
99.83%
548
5%
576
575
99.83%
Number of Records Excluded Because of
Valid Data Errors
2
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
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 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)
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2011
H
594
2011
H
594
2011
H
594
2011
H
594
2011
H
594
2011
H
594
2011
H
594
1
0.20%
493
0%
493
1
0.20%
1
0.17%
548
5%
576
1
0.17%
315
53.03%
548
5%
576
307
53.30%
502
84.51%
548
5%
576
486
84.38%
1
0.17%
548
5%
576
1
0.17%
502
84.51%
548
5%
576
487
84.55%
0
0.00%
548
5%
576
0
0.00%
0
0.00%
548
5%
576
0
0.00%
2
2
2
2
2
2
2
2
2
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
2
548
1
371
67.88%
63.88%
71.88%
2
548
289
78
66.97%
62.94%
71.00%
2
548
465
7
86.13%
83.15%
89.12%
2
548
1
300
54.93%
50.67%
59.18%
2
548
462
17
87.41%
84.54%
90.28%
2
548
0
453
82.66%
79.40%
85.93%
2
548
0
358
65.33%
61.25%
69.40%
101
20
2
548
486
16
91.61%
89.19%
94.02%
2
548
96
35
23.91%
20.24%
27.57%
2
421
1
191
45.61%
40.73%
50.48%
Page 31
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:46 AM
MSHO
Data Elements
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
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
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 33
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:46 AM
SNBC
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Page 34
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
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
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 35
Effectiveness of Care
Preferred One Community Health Plan
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Medicare
Advantage
NR
NR
NR
Page 36
Effectiveness of Care
Preferred One Community Health Plan
Osteoporosis Management in Women Who had a Fracture
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Medicare
Advantage
MSHO
NR
NR
NR
NR
NR
NR
Page 37
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:46 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
2011
A
210
149
70.95%
64.57%
77.33%
111
52.86%
45.87%
59.85%
Page 38
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
NR
NR
NR
Page 40
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
NR
NR
NR
Page 41
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
NR
NR
NR
Page 42
Effectiveness of Care
Preferred One Community Health Plan
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 22, 2012 9:46 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
67
26
38.81%
26.39%
51.22%
24
10
NA
NA
NA
2011
A
Page 43
Effectiveness of Care
Preferred One Community Health Plan
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
NR
NR
NR
Page 44
Effectiveness of Care
Preferred One Community Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
NR
NR
NR
Page 46
Effectiveness of Care
Preferred One Community Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
NR
NR
NR
Page 47
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:46 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
1040
847
81.44%
79.03%
83.85%
9
5
NA
NA
NA
795
640
80.50%
77.69%
83.32%
54
31
57.41%
43.29%
71.52%
1898
1523
80.24%
78.42%
82.06%
2011
A
Page 48
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 50
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 51
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 52
Access/Availability of Care
Preferred One Community Health Plan
Medication Reconciliation Post Discharge
Data Elements
Data Last Refreshed:
Oct 22, 2012 9:46 AM
MSHO
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
population (before exclusions)
Current year's administrative rate (before exclusions)
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
NR
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
Page 53
Effectiveness of Care
Preferred One Community Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
NR
NR
NR
NR
NR
Chronic Renal
Failure +
Nonaspirin
NSAIDs or Cox-2
Selective NSAIDs
Total
NR
NR
NR
NR
NR
NR
Page 55
Effectiveness of Care
Preferred One Community Health Plan
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:46 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
At least 1
Prescription
At least 2
Prescriptions
NR
NR
NR
NR
NR
NR
Page 57
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2012 (Reporting Year 2011)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
3751
3744
178
7673
3473
3574
175
92.59%
91.74%
93.44%
95.46%
94.78%
96.14%
98.31%
96.14%
100.00%
7222
94.12%
93.59%
94.66%
2011
A
Page 58
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:46 AM
MSHO
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 60
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:46 AM
SNBC
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 61
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 62
Access/Availability of Care
Preferred One Community Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 22, 2012 9:46 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.
239
233
1189
1097
1066
962
1790
1613
97.49%
95.30%
99.68%
92.26%
90.70%
93.82%
90.24%
88.42%
92.07%
90.11%
88.70%
91.52%
2011
A
Page 63
Access/Availability of Care
Preferred One Community Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
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
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)
Page 64
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 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
268
15
283
10
3
74
27
84
30
NA
NA
NA
NA
NA
NA
27.61%
22.07%
33.15%
10.07%
6.28%
13.86%
29.68%
24.18%
35.18%
10.60%
6.84%
14.36%
Page 65
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:46 AM
MSHO
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 67
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:46 AM
SNBC
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
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 68
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 69
Access/Availability of Care
Preferred One Community Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
2011
H
360
2011
H
360
Number of numerator events by administrative data in eligible
population (before exclusions)
224
189
62.22%
360
0.00%
360
224
52.50%
360
0.00%
360
189
62.22%
52.50%
6
6
0
0
354
223
109
0
0
354
189
90
93.79%
91.13%
96.44%
78.81%
74.42%
83.21%
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 70
Access/Availability of Care
Preferred One Community Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 71
Use of Services
Preferred One Community Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
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
0
4
2
5
9
24
177
0.00%
0.00%
0.23%
1.81%
0.00%
3.79%
0.90%
0.00%
2.38%
2.26%
0.08%
4.45%
4.07%
1.24%
6.90%
10.86%
6.53%
15.19%
80.09%
74.60%
85.58%
2011
A
221
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
Preferred One Community Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 73
Use of Services
Preferred One Community Health Plan
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
2011
A
981
MHCP-MC
NR
NR
NR
NR
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
680
69.32%
66.38%
72.25%
NR
NR
NR
Page 74
Use of Services
Preferred One Community Health Plan
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
2011
A
2890
MHCP-MC
NR
NR
NR
NR
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
917
31.73%
30.02%
33.44%
NR
NR
NR
Page 75
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
3830
39497
49150
132204
108321
3178
204
12
0
336396
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
3329
11857
11225
29414
32555
1606
115
3
0
90104
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
869.19
300.20
228.38
222.49
300.54
505.35
563.73
250.00
267.85
Emergency Room Visits
Visits
113
622
562
1480
958
57
2
2
0
3796
Visits/ 1,000
Member
Months
29.50
15.75
11.43
11.19
8.84
17.94
9.80
166.67
11.28
Page 76
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:46 AM
MSHO
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 78
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:46 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
NR
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 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 79
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:46 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
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 80
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:46 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
3830
39497
49150
132204
108321
3178
204
12
0
336396
Discharges
Discharges /
1,000 Member
Months
33
40
63
650
550
49
3
2
0
1390
8.62
1.01
1.28
4.92
5.08
15.42
14.71
166.67
27
27
36
127
253
23
0
1
0
494
7.05
0.68
0.73
0.96
2.34
7.24
0.00
83.33
6
13
24
135
295
26
3
1
0
503
1.57
0.33
0.49
1.02
2.72
8.18
14.71
83.33
3
388
2
0
393
0.06
2.93
0.02
HEDIS 2012 (Reporting Year 2011)
4.13
1.47
1.50
1.36
Days
Days / 1,000
Member
Months
159
109
264
1940
2231
153
8
10
0
4874
41.51
2.76
5.37
14.67
20.60
48.14
39.22
833.33
139
68
156
448
1017
68
0
4
0
1900
36.29
1.72
3.17
3.39
9.39
21.40
0.00
333.33
20
41
101
456
1210
85
8
6
0
1927
5.22
1.04
2.05
3.45
11.17
26.75
39.22
500.00
7
1036
4
0
1047
0.14
7.84
0.04
14.49
5.65
5.73
3.61
Average
Length of Stay
4.82
2.73
4.19
2.98
4.06
3.12
2.67
5.00
NA
3.51
5.15
2.52
4.33
3.53
4.02
2.96
NA
4.00
NA
3.85
3.33
3.15
4.21
3.38
4.10
3.27
2.67
6.00
NA
3.83
2.33
2.67
2.00
NA
2.66
Page 81
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:46 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
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 83
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:46 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
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 84
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:46 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
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 85
Use of Services
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
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
29252
12493
19659
28787
85228
2041
0
177460
28281
11978
16930
24238
76156
1353
0
158936
57533
24471
36589
53025
161384
3394
0
336396
29252
12493
19659
28787
85228
2041
0
177460
28281
11978
16930
24238
76156
1353
0
158936
57533
24471
36589
53025
161384
3394
0
336396
29252
12493
19659
28787
85228
2041
0
177460
28281
11978
16930
24238
76156
1353
0
158936
57533
24471
36589
53025
161384
3394
0
336396
29252
12493
19659
28787
85228
2041
0
177460
28281
11978
16930
24238
76156
1353
0
158936
57533
24471
36589
53025
161384
3394
0
336396
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
0
1
1
21
5
26
71
35
106
78
24
102
176
82
258
3
1
4
0
0
0
349
148
497
0.00%
0.04%
0.02%
2.02%
0.50%
1.27%
4.33%
2.48%
3.48%
3.25%
1.19%
2.31%
2.48%
1.29%
1.92%
1.76%
0.89%
1.41%
NA
NA
NA
2.36%
1.12%
1.77%
0
0
0
3
4
7
11
11
22
13
9
22
41
29
70
2
0
2
0
0
0
70
53
123
0.00%
0.00%
0.00%
0.29%
0.40%
0.34%
0.67%
0.78%
0.72%
0.54%
0.45%
0.50%
0.58%
0.46%
0.52%
1.18%
0.00%
0.71%
NA
NA
NA
0.47%
0.40%
0.44%
0
0
0
1
1
2
6
5
11
4
3
7
6
12
18
0
0
0
0
0
0
17
21
38
0.00%
0.00%
0.00%
0.10%
0.10%
0.10%
0.37%
0.35%
0.36%
0.17%
0.15%
0.16%
0.08%
0.19%
0.13%
0.00%
0.00%
0.00%
NA
NA
NA
0.11%
0.16%
0.14%
0
1
1
20
5
25
71
35
106
78
24
102
176
81
257
3
1
4
0
0
0
348
147
495
0.00%
0.04%
0.02%
1.92%
0.50%
1.23%
4.33%
2.48%
3.48%
3.25%
1.19%
2.31%
2.48%
1.28%
1.91%
1.76%
0.89%
1.41%
NA
NA
NA
2.35%
1.11%
1.77%
HEDIS 2012 (Reporting Year 2011)
Page 86
Use of Services
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:46 AM
MSHO
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
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)
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 88
Use of Services
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:46 AM
SNBC
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
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)
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 89
Use of Services
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 90
Use of Services
Preferred One Community Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Male
Female
Total
Male
Female
Total
29252
12493
133674
2041
0
177460
28281
11978
117324
1353
0
158936
57533
24471
250998
3394
0
336396
29252
12493
133674
2041
0
177460
28281
11978
117324
1353
0
158936
57533
24471
250998
3394
0
336396
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
29252
12493
133674
2041
0
177460
28281
11978
117324
1353
0
158936
57533
24471
250998
3394
0
336396
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
Member Months
(Outpatient/ED)
Male
Female
Total
29252
12493
133674
2041
0
177460
28281
11978
117324
1353
0
158936
57533
24471
250998
3394
0
336396
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
168
115
283
105
130
235
619
1000
1619
5
7
12
0
0
0
897
1252
2149
6.89%
4.88%
5.90%
10.09%
13.02%
11.52%
5.56%
10.23%
7.74%
2.94%
6.21%
4.24%
NA
NA
NA
6.07%
9.45%
7.67%
4
2
6
7
7
14
29
45
74
1
1
2
0
0
0
41
55
96
0.16%
0.08%
0.13%
0.67%
0.70%
0.69%
0.26%
0.46%
0.35%
0.59%
0.89%
0.71%
NA
NA
NA
0.28%
0.42%
0.34%
10
8
18
6
16
22
18
49
67
0
1
1
0
0
0
34
74
108
0.41%
0.34%
0.38%
0.58%
1.60%
1.08%
0.16%
0.50%
0.32%
0.00%
0.89%
0.35%
NA
NA
NA
0.23%
0.56%
0.39%
167
115
282
103
130
233
608
992
1600
4
7
11
0
0
0
882
1244
2126
6.85%
4.88%
5.88%
9.89%
13.02%
11.43%
5.46%
10.15%
7.65%
2.35%
6.21%
3.89%
NA
NA
NA
5.96%
9.39%
7.58%
HEDIS 2012 (Reporting Year 2011)
Page 91
Use of Services
Preferred One Community Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:46 AM
MSHO
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
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2012 (Reporting Year 2011)
Male
NR
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
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
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 93
Use of Services
Preferred One Community Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:46 AM
SNBC
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
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2012 (Reporting Year 2011)
Male
NR
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
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
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 94
Use of Services
Preferred One Community Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:46 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
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2012 (Reporting Year 2011)
Male
NR
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
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
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 95
Use of Services
Preferred One Community Health Plan
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 9:46 AM
MSHO
Age
18-44
45-54
55-64
Total
Age
65-74
75-84
85+
Total
Count of Index Stays
(Denominator)
Count of 30-Day
Readmissions
(Numerator)
Observed
Readmission
(Num/Den)
Average Adjusted
Probability
Total Variance
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Count of Index Stays
(Denominator)
Count of 30-Day
Readmissions
(Numerator)
Observed
Readmission
(Num/Den)
Average Adjusted
Probability
Total Variance
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2012 (Reporting Year 2011)
Page 97
Use of Services
Preferred One Community Health Plan
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 9:46 AM
SNBC
Age
18-44
45-54
55-64
Total
Age
65-74
75-84
85+
Count of Index Stays
(Denominator)
Count of 30-Day
Readmissions
(Numerator)
Observed
Readmission
(Num/Den)
Average Adjusted
Probability
Total Variance
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Count of Index Stays
(Denominator)
Count of 30-Day
Readmissions
(Numerator)
Observed
Readmission
(Num/Den)
Average Adjusted
Probability
Total Variance
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
Total
HEDIS 2012 (Reporting Year 2011)
Page 98
Health Plan Descriptive Information
Preferred One Community Health Plan
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Board Certification
MSHO
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2012 (Reporting Year 2011)
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
NR
NR
NR
NR
Page 99
Health Plan Descriptive Information
Preferred One Community Health Plan
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Board Certification
SNBC
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2012 (Reporting Year 2011)
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
NR
NR
NR
NR
Page 100
Health Plan Descriptive Information
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Commercial
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
1882
8661
11460
12223
7519
5574
Member Months
Female
1948
8084
11292
11227
7708
4899
Total
3830
16745
22752
23450
15227
10473
47319
26.66%
14085
14002
14785
12835
15417
45158
28.41%
12031
11755
12483
11296
13515
92477
27.49%
71124
40.08%
16619
17401
14334
8622
61080
38.43%
15856
15328
12027
8134
132204
39.30%
56976
32.11%
1647
253
99
42
0
0
51345
32.31%
1143
135
49
14
12
0
108321
32.20%
2041
1.15%
0
1353
0.85%
0
3394
1.01%
177460
158936
HEDIS 2012 (Reporting Year 2011)
26116
25757
27268
24131
28932
32475
32729
26361
16756
2790
388
148
56
12
0
0
336396
Page 101
Health Plan Descriptive Information
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:46 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
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:46 AM
MSHO
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 103
Health Plan Descriptive Information
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:46 AM
SNBC
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Member Months
Female
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 104
Health Plan Descriptive Information
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 105