Medica
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
Medica
Adult BMI Assessment
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Commercial
Medicare
Advantage
MHCP-MC
2011
H
139369
2011
H
17274
2771
757
1.99%
411
10.00%
453
7
1.55%
NR
NR
4.38%
411
10.00%
453
26
5.74%
Number of Records Excluded Because of Valid
Data Errors
0
0
Number of administrative data records excluded
6535
2356
Number of medical record data records excluded
0
0
Number of employee/dependent medical records
excluded
0
0
0
411
5
303
74.94%
70.63%
79.25%
0
411
23
310
81.02%
77.11%
84.93%
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 3
Effectiveness of Care
Medica
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Commercial
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
27336
18205
45541
27336
18205
45541
27336
18205
45541
1530
5.60%
814
4.47%
2344
5.15%
101
0.37%
100
0.55%
201
0.44%
3
0.01%
0
0.00%
3
0.01%
0
0.00%
0
0.00%
0
0.00%
411
10.00%
411
10.00%
453
411
10.00%
453
16
3.53%
3
0.66%
19
4.19%
453
0
0.00%
1
0.22%
1
0.22%
0
0
0
Number of administrative data records
excluded
59
59
59
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
264
147
411
264
147
411
264
147
411
15
177
72.73%
67.17%
78.29%
3
95
66.67%
58.71%
74.63%
18
272
70.56%
66.03%
75.09%
0
161
60.98%
54.91%
67.06%
1
55
38.10%
29.90%
46.29%
1
216
52.80%
47.85%
57.75%
0
140
53.03%
46.82%
59.24%
0
69
46.94%
38.53%
55.35%
0
209
50.85%
45.90%
55.81%
Page 4
Effectiveness of Care
Medica
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
BMI Percentile
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of Records Excluded Because of
Valid Data Errors
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
10023
31509
21486
10023
31509
21486
10023
31509
947
4.41%
349
3.48%
1296
4.11%
231
1.08%
163
1.63%
394
1.25%
1
0.00%
2
0.02%
3
0.01%
0
0.00%
0
0.00%
0
0.00%
411
10.00%
411
10.00%
453
411
10.00%
453
17
3.75%
8
1.77%
25
5.52%
453
2
0.44%
4
0.88%
6
1.32%
0
121
121
121
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)
Total
21486
0
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Ages 1217
2011
H
0
Number of administrative data records
excluded
Ages 3-11
278
133
411
278
133
411
278
133
411
15
208
80.22%
75.35%
85.08%
7
91
73.68%
65.82%
81.54%
22
299
78.10%
73.98%
82.22%
2
184
66.91%
61.20%
72.62%
4
70
55.64%
46.82%
64.46%
6
254
63.26%
58.48%
68.04%
0
144
51.80%
45.74%
57.85%
0
76
57.14%
48.36%
65.93%
0
220
53.53%
48.58%
58.47%
Page 5
Effectiveness of Care
Medica
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
1
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
HiB
Hepatitis B
VZV
Influenza
2328
75.58%
2582
83.83%
2735
88.80%
2687
87.24%
2194
71.23%
2669
86.66%
2382
77.34%
1027
33.34%
2180
70.78%
2008
65.19%
345
76.16%
383
84.55%
395
87.20%
401
88.52%
314
69.32%
388
85.65%
347
76.60%
152
33.55%
331
73.07%
299
66.00%
310
346
356
363
281
351
310
140
298
268
45
86.37%
82.94%
89.81%
36
92.94%
90.35%
95.54%
15
90.27%
87.28%
93.25%
27
94.89%
92.64%
97.14%
79
87.59%
84.28%
90.90%
15
89.05%
85.91%
92.19%
45
86.37%
82.94%
89.81%
7
35.77%
31.01%
40.52%
31
80.05%
76.06%
84.03%
13
68.37%
63.75%
72.99%
453
0
Numerator Events by administrative Data
MMR
411
10.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
IPV
2011
H
3080
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 6
Effectiveness of Care
Medica
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
1
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
2328
75.58%
1870
60.71%
1793
58.21%
749
24.32%
1588
51.56%
1412
45.84%
681
22.11%
621
20.16%
1275
41.40%
568
18.44%
345
76.16%
272
60.04%
259
57.17%
115
25.39%
234
51.66%
209
46.14%
106
23.40%
101
22.30%
193
42.60%
93
20.53%
310
243
230
104
208
185
96
92
171
85
45
86.37%
82.94%
89.81%
75
77.37%
73.21%
81.54%
78
74.94%
70.63%
79.25%
28
32.12%
27.48%
36.75%
67
66.91%
62.24%
71.58%
55
58.39%
53.51%
63.28%
26
29.68%
25.15%
34.22%
21
27.49%
23.06%
31.93%
46
52.80%
47.85%
57.75%
20
25.55%
21.21%
29.89%
453
0
Numerator Events by administrative Data
Combo 3
411
10.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Combo 2
2011
H
3080
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 7
Effectiveness of Care
Medica
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
1
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
HiB
Hepatitis B
VZV
Influenza
2280
72.59%
2651
84.40%
2727
86.82%
2731
86.95%
2352
74.88%
2720
86.60%
2352
74.88%
973
30.98%
2005
63.83%
1705
54.28%
349
77.04%
399
88.08%
403
88.96%
405
89.40%
350
77.26%
401
88.52%
344
75.94%
132
29.14%
291
64.24%
244
53.86%
323
30
85.89%
82.40%
89.38%
365
25
94.89%
92.64%
97.14%
370
7
91.73%
88.94%
94.51%
369
21
94.89%
92.64%
97.14%
321
60
92.70%
90.06%
95.34%
365
7
90.51%
87.56%
93.47%
318
34
85.64%
82.13%
89.16%
122
10
32.12%
27.48%
36.75%
265
34
72.75%
68.32%
77.18%
220
14
56.93%
52.03%
61.84%
453
0
Numerator Events by administrative Data
MMR
411
0.1
Number of Records Excluded Because of
Valid Data Errors
Denominator
IPV
2011
H
3141
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
Medica
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
1
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
2280
72.59%
1915
60.97%
1827
58.17%
737
23.46%
1473
46.90%
1199
38.17%
643
20.47%
544
17.32%
1039
33.08%
485
15.44%
349
77.04%
293
64.68%
269
59.38%
90
19.87%
210
46.36%
173
38.19%
80
17.66%
74
16.34%
152
33.55%
67
14.79%
323
30
85.89%
82.40%
89.38%
272
55
79.56%
75.54%
83.58%
251
59
75.43%
71.14%
79.71%
83
36
28.95%
24.45%
33.46%
194
54
60.34%
55.49%
65.19%
158
46
49.64%
44.68%
54.59%
73
32
25.55%
21.21%
29.89%
67
28
23.11%
18.92%
27.31%
138
40
43.31%
38.40%
48.22%
60
25
20.68%
16.64%
24.72%
453
0
Numerator Events by administrative Data
Combo 3
411
0.1
Number of Records Excluded Because of
Valid Data Errors
Denominator
Combo 2
2011
H
3141
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
Medica
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Immunizations for Adolescents
Commercial
Data Elements
General
Measure Data
Meningococcal
Tdap
Combo 1
2074
3106
2021
55.96%
83.81%
54.53%
252
55.63%
380
83.89%
245
54.08%
228
12
343
21
221
16
Reported Rate
58.39%
88.56%
57.66%
Lower 95% Confidence Interval
53.51%
85.37%
52.77%
Upper 95% Confidence Interval
63.28%
91.76%
62.56%
Measurement Year
Data Collection Methodology
Eligible Member Population
2011
H
3706
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
411
10.00%
453
Records Excluded because of Valid Data Errors
0
Number of administrative data records excluded
0
Number of medical data records excluded
0
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
HEDIS 2012 (Reporting Year 2011)
0
411
Page 10
Effectiveness of Care
Medica
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Immunizations for Adolescents
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Data Elements
Measure Data
Measurement Year
2011
Data Collection Methodology
H
Eligible Member Population
2284
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
1357
1878
1306
59.41%
82.22%
57.18%
280
61.81%
376
83.00%
272
60.04%
255
6
63.50%
58.73%
68.28%
339
11
85.16%
81.60%
88.72%
249
7
62.29%
57.48%
67.09%
411
10.00%
453
Records Excluded because of Valid Data Errors
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Meningococcal
0
411
Page 11
Effectiveness of Care
Medica
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 9:39 AM
Commercial
2011
A
45845
31761
69.28%
68.86%
69.70%
Medicare
Advantage
NR
NR
NR
MSHO
SNBC
MHCP-MC
2011
A
580
336
57.93%
53.83%
62.03%
2011
A
459
265
57.73%
53.11%
62.36%
2011
A
4697
2747
58.48%
57.06%
59.90%
Page 12
Effectiveness of Care
Medica
Cervical Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Commercial
2011
A
56261
MHCP-MC
2011
A
19213
NR
NR
NR
NR
42905
13713
76.26%
75.91%
76.61%
71.37%
70.73%
72.02%
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)
Page 13
Effectiveness of Care
Medica
Colorectal Cancer Screening
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Data Elements
Commercial
Medicare
Advantage
MSHO
SNBC
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
2011
H
55041
2011
H
2727
2011
H
444
Number of numerator events by administrative data in eligible population
(before exclusions)
31392
1367
206
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
57.03%
411
0.1
453
271
59.82%
0
45
0
0
0
411
248
30
67.64%
63.00%
72.28%
50.13%
411
10.00%
453
209
46.14%
0
17
0
0
0
411
193
26
53.28%
48.34%
58.23%
46.40%
411
8.00%
444
206
46.40%
0
0
0
0
0
411
189
63
61.31%
56.48%
66.14%
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
NR
NR
Page 14
Effectiveness of Care
Medica
Chlamydia Screening in Women
Data Last Refreshed:
Oct 22, 2012 9:39 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
4376
1690
38.62%
37.17%
40.07%
4852
2506
51.65%
50.23%
53.07%
9228
4196
45.47%
44.45%
46.49%
2011
A
Page 15
Effectiveness of Care
Medica
Chlamydia Screening in Women
Data Last Refreshed:
Oct 22, 2012 9:39 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
2389
1385
57.97%
55.97%
59.97%
1944
1287
66.20%
64.08%
68.33%
4333
2672
61.67%
60.21%
63.13%
2011
A
Page 16
Effectiveness of Care
Medica
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 9:39 AM
Medicare
Advantage
NR
NR
NR
MSHO
2011
A
7409
5688
76.77%
75.80%
77.74%
Page 17
Effectiveness of Care
Medica
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Lead Screening in Children
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
2011
A
3080
MHCP-MC
2011
A
3141
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
1985
2823
Reported Rate
64.45%
89.88%
Lower 95% Confidence Interval
62.74%
88.80%
Upper 95% Confidence Interval
66.15%
90.95%
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
HEDIS 2012 (Reporting Year 2011)
Page 18
Effectiveness of Care
Medica
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Care for Older Adults
MSHO
Medication Review
Functional
Status
Assessment
Pain
Screening
0
0
0
0
0.00%
0.00%
0.00%
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
275
0
384
0
382
0
331
Reported Rate
66.91%
93.43%
92.94%
80.54%
Lower 95% Confidence Interval
62.24%
90.91%
90.35%
76.59%
Upper 95% Confidence Interval
71.58%
95.95%
95.54%
84.48%
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General Measure
Data
2011
H
8912
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
411
10.00%
453
Records Excluded because of Valid Data
Errors
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)
Advance Care
Planning
0
411
Page 19
Effectiveness of Care
Medica
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 9:39 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
109
74.15%
66.73%
81.57%
127
86.39%
80.51%
92.28%
2011
A
147
Page 21
Effectiveness of Care
Medica
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 9:39 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
15
NA
NA
NA
19
NA
NA
NA
2011
A
19
Page 22
Effectiveness of Care
Medica
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)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Oct 22, 2012 9:39 AM
MSHO
SNBC
2011
A
232
39
16.81%
11.78%
21.84%
2011
A
18
5
NA
NA
NA
Page 23
Effectiveness of Care
Medica
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 22, 2012 9:39 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
353
340
14
96.32%
94.21%
98.42%
297
279
10
93.94%
91.06%
96.82%
1134
1012
106
89.24%
87.39%
91.09%
651
606
322
93.09%
91.06%
95.11%
2435
2237
452
91.87%
90.76%
92.97%
2011
A
`
Page 24
Effectiveness of Care
Medica
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 22, 2012 9:39 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
496
469
40
94.56%
92.46%
96.65%
367
325
15
88.56%
85.16%
91.95%
543
421
92
77.53%
73.93%
81.13%
110
86
135
78.18%
70.01%
86.35%
1516
1301
282
85.82%
84.03%
87.61%
2011
A
Page 25
Effectiveness of Care
Medica
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 9:39 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
1681
41
85.85%
2.09%
2011
H
1958
411
10.00%
453
381
9
84.11%
1.99%
343
12
7
241
86.37%
82.94%
89.81%
60.34%
55.49%
65.19%
0
0
0
411
Page 26
Effectiveness of Care
Medica
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 9:39 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
172
5
86.00%
2.50%
172
5
86.00%
2.50%
172
7
5
123
89.50%
85.00%
94.00%
64.00%
57.10%
70.90%
2011
H
200
200
0.00%
200
0
0
0
200
Page 28
Effectiveness of Care
Medica
Controlling High Blood Pressure
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Data Elements
Commercial
Medicare
Advantage
MSHO
SNBC
MHCP-MC
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2011
H
17280
2011
H
2678
2011
H
375
2011
H
3362
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
0
0
0
0.00%
411
15.00%
473
0.00%
348
0.00%
348
0.00%
411
15.00%
473
0
0.00%
0
0.00%
0
0.00%
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
15.00%
473
0
0.00%
NR
NR
Records Excluded because of Valid Data
Errors
1
1
4
1
Number of records excluded because of
false positive diagnoses
0
0
0
0
Number of administrative data records
excluded
388
351
27
113
Number of medical record data records
excluded
0
2
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
Records Added from the OverSample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
1
411
0
287
69.83%
65.27%
74.39%
3
411
0
303
73.72%
69.35%
78.10%
0
344
0
276
80.23%
75.88%
84.59%
1
411
0
297
72.26%
67.81%
76.71%
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
Page 29
Effectiveness of Care
Medica
Persistence of Beta Blocker Treatment After Heart Attack
Data Elements
Commercial
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Medicare
Advantage
MSHO
SNBC
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
2011
A
168
2011
A
43
2011
A
2
2011
A
50
Numerator Events by Admin Data on
Eligible Population
147
39
2
43
90.70%
80.85%
100.00%
NA
NA
NA
86.00%
75.38%
96.62%
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
87.50%
82.20%
92.80%
NR
NR
NR
Page 30
Effectiveness of Care
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
HbA1c
Testing
Poor HbA1c
Control
(>9.0%)
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
2011
H
9351
2011
H
9351
2011
H
9351
8383
89.65%
548
10%
603
504
83.58%
9191
98.29%
548
10%
603
595
98.67%
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
9351
2011
H
9351
2011
H
9351
2011
H
9351
2011
H
9351
2011
H
9351
2011
H
9351
119
1.27%
548
10%
603
3
0.50%
140
1.50%
548
10%
603
8
1.33%
4744
50.73%
548
10%
603
319
52.90%
7831
83.75%
548
10%
603
483
80.10%
182
1.95%
548
10%
603
11
1.82%
7564
80.89%
548
10%
603
499
82.75%
24
0.26%
548
10%
603
1
0.17%
21
0.22%
548
10%
603
1
0.17%
3
3
3
3
3
3
3
3
3
3
Number of administrative data records
excluded
110
110
110
110
110
110
110
110
110
110
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
3
548
7
377
70.07%
66.15%
74.00%
3
548
289
38
59.67%
55.47%
63.87%
3
548
441
42
88.14%
85.34%
90.94%
3
548
10
294
55.47%
51.22%
59.73%
3
548
463
16
87.41%
84.54%
90.28%
3
548
1
424
77.55%
73.97%
81.14%
3
548
1
324
59.31%
55.10%
63.51%
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)
84
16
3
548
459
55
93.80%
91.68%
95.91%
3
548
55
45
18.25%
14.92%
21.57%
2
448
3
210
47.54%
42.81%
52.28%
Page 31
Effectiveness of Care
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:39 AM
MSHO
LDL-C
Screening
LDL-C Level
<100 mg/dL
2011
H
1312
2011
H
1312
2011
H
1312
2011
H
1312
2011
H
1312
2011
H
1312
2011
H
1312
16
1.22%
411
10%
453
3
0.66%
902
68.75%
411
10%
453
317
69.98%
1056
80.49%
411
10%
453
337
74.39%
53
4.04%
411
10%
453
20
4.42%
1165
88.80%
411
10%
453
401
88.52%
27
2.06%
411
10%
453
6
1.32%
22
1.68%
411
10%
453
6
1.32%
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
2
411
329
60
94.65%
92.35%
96.94%
2
411
23
28
12.41%
9.10%
15.72%
2
411
3
314
77.13%
72.95%
81.31%
2
411
286
22
74.94%
70.63%
79.25%
2
411
304
41
83.94%
80.27%
87.61%
2
411
18
226
59.37%
54.50%
64.24%
2
411
365
6
90.27%
87.28%
93.25%
2
411
6
317
78.59%
74.50%
82.68%
2
411
6
273
67.88%
63.25%
72.52%
2011
H
1312
2011
H
1312
1207
92.00%
411
10%
453
361
79.69%
1289
98.25%
411
10%
453
444
98.01%
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
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
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:39 AM
SNBC
2011
H
417
2011
H
417
2011
H
417
2011
H
417
2011
H
417
2011
H
417
11
2.64%
411
1%
416
5
1.20%
298
71.46%
411
1%
416
298
71.63%
250
59.95%
411
1%
416
210
50.48%
24
5.76%
411
1%
416
18
4.33%
230
55.16%
411
1%
416
229
55.05%
17
4.08%
411
1%
416
6
1.44%
14
3.36%
411
1%
416
7
1.68%
13
13
13
13
13
13
13
13
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
5
403
212
165
93.55%
91.03%
96.07%
5
403
34
35
17.12%
13.32%
20.92%
5
403
5
288
72.70%
68.23%
77.18%
5
403
293
28
79.65%
75.60%
83.71%
5
403
207
136
85.11%
81.51%
88.71%
5
403
18
202
54.59%
49.61%
59.58%
5
403
227
91
78.91%
74.80%
83.02%
5
403
6
336
84.86%
81.24%
88.49%
5
403
7
262
66.75%
62.03%
71.47%
313
75.06%
411
1%
416
212
50.96%
401
96.16%
411
1%
416
400
96.15%
Number of Records Excluded Because of
Valid Data Errors
13
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
417
2011
H
417
Numerator events by admin data in eligible
population
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Eye Exam
2011
H
417
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
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:39 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
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2011
H
2546
2011
H
2546
2011
H
2546
2011
H
2546
2011
H
2546
2011
H
2546
2011
H
2546
20
0.79%
411
10%
453
3
0.66%
1349
52.99%
411
10%
453
251
55.41%
1960
76.98%
411
10%
453
330
72.85%
65
2.55%
411
10%
453
10
2.21%
1955
76.79%
411
10%
453
363
80.13%
11
0.43%
411
10%
453
1
0.22%
9
0.35%
411
10%
453
1
0.22%
13
13
13
13
13
13
13
13
69
69
69
69
69
69
69
69
69
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
13
411
337
51
94.40%
92.06%
96.75%
13
411
31
68
24.09%
19.83%
28.34%
13
411
2
257
63.02%
58.23%
67.81%
13
411
229
42
65.94%
61.23%
70.64%
13
411
309
37
84.18%
80.54%
87.83%
13
411
8
172
43.80%
38.88%
48.71%
13
411
338
8
84.18%
80.54%
87.83%
13
411
1
335
81.75%
77.90%
85.61%
13
411
1
246
60.10%
55.24%
64.95%
HbA1c
Testing
Poor HbA1c
Control
2011
H
2546
2011
H
2546
2231
87.63%
411
10%
453
359
79.25%
2516
98.82%
411
10%
453
444
98.01%
13
Good HbA1c
Control
(<7.0%)
2011
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 35
Effectiveness of Care
Medica
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 9:39 AM
Medicare
Advantage
NR
NR
NR
Page 36
Effectiveness of Care
Medica
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)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Oct 22, 2012 9:39 AM
MSHO
2011
A
280
35
12.50%
8.45%
16.55%
Page 37
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:39 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
2033
1539
75.70%
73.81%
77.59%
1171
57.60%
55.43%
59.77%
Page 38
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:39 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
77
55
71.43%
60.69%
82.17%
53
68.83%
57.84%
79.83%
Page 40
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:39 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
11
6
NA
NA
NA
4
NA
NA
NA
Page 41
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:39 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
1189
627
52.73%
49.85%
55.61%
426
35.83%
33.06%
38.60%
Page 42
Effectiveness of Care
Medica
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 22, 2012 9:39 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
535
179
33.46%
29.37%
37.55%
145
57
39.31%
31.02%
47.61%
2011
A
Page 43
Effectiveness of Care
Medica
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 22, 2012 9:39 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
672
305
45.39%
41.55%
49.23%
196
108
55.10%
47.88%
62.32%
2011
A
Page 44
Effectiveness of Care
Medica
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 9:39 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
24
51.06%
35.71%
66.42%
9
19.15%
6.84%
31.46%
2011
A
47
Page 46
Effectiveness of Care
Medica
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 9:39 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
118
82.52%
75.94%
89.09%
101
70.63%
62.81%
78.44%
2011
A
143
Page 47
Effectiveness of Care
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:39 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
13921
11351
81.54%
80.89%
82.19%
142
121
85.21%
79.02%
91.40%
10677
8629
80.82%
80.07%
81.57%
639
440
68.86%
65.19%
72.53%
25379
20541
80.94%
80.45%
81.42%
2011
A
Page 48
Effectiveness of Care
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:39 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
3639
3396
93.32%
92.50%
94.15%
307
288
93.81%
90.95%
96.67%
3564
3373
94.64%
93.89%
95.39%
487
396
81.31%
77.75%
84.88%
7997
7453
93.20%
92.64%
93.76%
2011
A
Page 50
Effectiveness of Care
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:39 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
143
137
95.80%
92.17%
99.44%
3
3
NA
NA
NA
148
137
92.57%
88.00%
97.13%
74
58
78.38%
68.32%
88.43%
368
335
91.03%
87.98%
94.09%
2011
A
Page 51
Effectiveness of Care
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:39 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
2481
2136
86.09%
84.71%
87.48%
33
26
78.79%
63.32%
94.25%
1940
1659
85.52%
83.92%
87.11%
236
163
69.07%
62.96%
75.18%
4690
3984
84.95%
83.91%
85.98%
2011
A
Page 52
Access/Availability of Care
Medica
Medication Reconciliation Post Discharge
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
population (before exclusions)
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 9:39 AM
MSHO
2011
H
3406
0
0.00%
411
20.00%
494
0
0.00%
48
0
48
411
0
270
65.69%
60.98%
70.40%
Page 53
Effectiveness of Care
Medica
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:39 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
132
15
11.36%
5.57%
17.16%
2770
629
22.71%
21.13%
24.29%
2011
A
513
105
20.47%
16.88%
24.06%
2125
509
23.95%
22.11%
25.79%
Page 55
Effectiveness of Care
Medica
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:39 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
8591
At least 1
Prescription
At least 2
Prescriptions
1825
21.24%
20.37%
22.11%
329
3.83%
3.42%
4.24%
Page 57
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:39 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
58085
65553
3750
127388
54889
63157
3668
94.50%
94.31%
94.68%
96.34%
96.20%
96.49%
97.81%
97.33%
98.29%
121714
95.55%
95.43%
95.66%
2011
A
Page 58
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:39 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
8948
8948
0
0
8720
NA
NA
NA
NA
NA
NA
97.45%
97.12%
97.78%
8720
97.45%
97.12%
97.78%
2011
A
Page 60
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:39 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
718
1104
28
1850
697
1081
28
97.08%
95.77%
98.38%
97.92%
97.03%
98.80%
NA
NA
NA
1806
97.62%
96.90%
98.34%
2011
A
Page 61
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:39 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
22479
10389
32
32900
20048
9410
29
89.19%
88.78%
89.59%
90.58%
90.01%
91.14%
90.63%
78.96%
100.00%
29487
89.63%
89.30%
89.96%
2011
A
Page 62
Access/Availability of Care
Medica
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 22, 2012 9:39 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.
3259
3223
17098
15804
14487
13264
25336
23011
98.90%
98.52%
99.27%
92.43%
92.03%
92.83%
91.56%
91.10%
92.01%
90.82%
90.47%
91.18%
2011
A
Page 63
Access/Availability of Care
Medica
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 22, 2012 9:39 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.
4283
4213
14597
13395
8901
8183
10702
9800
98.37%
97.97%
98.76%
91.77%
91.32%
92.21%
91.93%
91.36%
92.50%
91.57%
91.04%
92.10%
2011
A
Page 64
Access/Availability of Care
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:39 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
3108
190
3298
76
42
1066
519
1142
561
40.00%
32.77%
47.23%
22.11%
15.94%
28.27%
34.30%
32.61%
35.98%
16.70%
15.37%
18.03%
34.63%
32.99%
36.27%
17.01%
15.71%
18.31%
Page 65
Access/Availability of Care
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:39 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
184
0
184
0
0
77
6
77
6
NA
NA
NA
NA
NA
NA
41.85%
34.45%
49.25%
3.26%
0.42%
6.10%
41.85%
34.45%
49.25%
3.26%
0.42%
6.10%
Page 67
Access/Availability of Care
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:39 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
215
215
0
0
69
26
69
26
NA
NA
NA
NA
NA
NA
32.09%
25.62%
38.57%
12.09%
7.50%
16.68%
32.09%
25.62%
38.57%
12.09%
7.50%
16.68%
Page 68
Access/Availability of Care
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:39 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
311
3780
3469
131
83
1128
554
1259
637
42.12%
36.47%
47.77%
26.69%
21.61%
31.76%
32.52%
30.94%
34.09%
15.97%
14.74%
17.20%
33.31%
31.79%
34.82%
16.85%
15.65%
18.06%
Page 69
Access/Availability of Care
Medica
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
2011
H
3949
2011
H
3949
Number of numerator events by administrative data in eligible
population (before exclusions)
2940
2175
74.45%
411
10.00%
453
324
55.08%
411
10.00%
453
241
71.52%
53.20%
0
0
0
0
411
298
89
0
0
411
228
107
94.16%
91.77%
96.55%
81.51%
77.63%
85.38%
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
Medica
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 22, 2012 9:39 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
5035
2011
H
5035
Number of numerator events by administrative data in eligible
population (before exclusions)
3121
2534
61.99%
411
10.00%
453
284
50.33%
411
10.00%
453
224
62.69%
49.45%
0
0
0
0
411
256
117
0
0
411
200
77
90.75%
87.83%
93.68%
67.40%
62.74%
72.05%
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
Medica
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 22, 2012 9:39 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
15
19
22
62
143
408
2085
0.54%
0.25%
0.84%
0.69%
0.36%
1.02%
0.80%
0.45%
1.15%
2.25%
1.68%
2.82%
5.19%
4.35%
6.04%
14.81%
13.47%
16.16%
75.71%
74.09%
77.33%
2011
A
2754
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
Medica
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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
65
55
99
213
433
779
2359
1.62%
1.22%
2.03%
1.37%
1.00%
1.75%
2.47%
1.98%
2.97%
5.32%
4.61%
6.03%
10.82%
9.84%
11.79%
19.46%
18.22%
20.70%
58.93%
57.39%
60.47%
2011
A
4003
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
Medica
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 9:39 AM
Commercial
2011
A
14101
MHCP-MC
2011
A
11994
NR
NR
NR
NR
9982
8341
70.79%
70.04%
71.54%
69.54%
68.72%
70.37%
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)
Page 74
Use of Services
Medica
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Commercial
2011
A
39210
MHCP-MC
2011
A
17304
NR
NR
NR
NR
13282
6456
33.87%
33.40%
34.34%
37.31%
36.59%
38.03%
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)
Page 75
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
45387
457049
548514
1516892
1268700
50627
4464
1102
0
3892735
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
38814
138948
125503
358518
417837
25650
3070
954
0
1109294
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
855.18
304.01
228.81
236.35
329.34
506.65
687.72
865.70
284.97
Emergency Room Visits
Visits
1267
7115
6755
19482
13553
736
109
55
0
49072
Visits/ 1,000
Member
Months
27.92
15.57
12.32
12.84
10.68
14.54
24.42
49.91
12.61
Page 76
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:39 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
41137
40597
37848
0
119590
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
8
36111
35639
28249
0
100007
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
1000.00
877.82
877.87
746.38
836.25
Emergency Room Visits
Visits
0
0
0
0
0
2109
1985
1515
0
5609
Visits/ 1,000
Member
Months
NA
NA
NA
NA
0.00
51.27
48.90
40.03
46.90
Page 78
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:39 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
134
10015
14767
185
0
0
0
25101
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
79
7458
13970
186
0
0
0
21693
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
NA
NA
589.55
744.68
946.03
1005.41
NA
NA
864.23
Emergency Room Visits
Visits
0
0
11
1176
1432
16
0
0
0
2635
Visits/ 1,000
Member
Months
NA
NA
82.09
117.42
96.97
86.49
NA
NA
104.98
Page 79
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:39 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
81223
537047
390876
559765
212875
356
12
0
0
1782154
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
63817
173956
102005
253007
118531
198
6
12
2
711534
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
785.70
323.91
260.97
451.99
556.81
556.18
500.00
NA
399.26
Emergency Room Visits
Visits
8641
28756
15024
45007
9964
5
0
3
0
107400
Visits/ 1,000
Member
Months
106.39
53.54
38.44
80.40
46.81
14.04
0.00
NA
60.26
Page 80
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:39 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
45387
457049
548514
1516892
1268700
50627
4464
1102
0
3892735
Discharges
Discharges /
1,000 Member
Months
358
590
869
7258
6815
593
87
28
0
16598
7.89
1.29
1.58
4.78
5.37
11.71
19.49
25.41
286
452
456
1396
3159
321
56
18
0
6144
6.30
0.99
0.83
0.92
2.49
6.34
12.54
16.33
68
138
289
1432
3650
272
31
10
0
5890
1.50
0.30
0.53
0.94
2.88
5.37
6.94
9.07
124
4430
5
0
4559
HEDIS 2012 (Reporting Year 2011)
4.26
1.58
1.51
0.23
2.92
0.00
1.37
Days
Days / 1,000
Member
Months
1996
1652
2729
20315
25456
2816
376
131
0
55471
43.98
3.61
4.98
13.39
20.06
55.62
84.23
118.87
1527
1220
1359
4484
12251
1573
227
81
0
22722
33.64
2.67
2.48
2.96
9.66
31.07
50.85
73.50
463
432
1056
4334
13191
1243
149
50
0
20918
10.20
0.95
1.93
2.86
10.40
24.55
33.38
45.37
314
11497
13
0
11824
0.57
7.58
0.01
14.25
5.84
5.37
3.55
Average
Length of Stay
5.58
2.80
3.14
2.80
3.74
4.75
4.32
4.68
NA
3.34
5.34
2.70
2.98
3.21
3.88
4.90
4.05
4.50
NA
3.70
6.81
3.13
3.65
3.03
3.61
4.57
4.81
5.00
NA
3.55
2.53
2.60
2.60
NA
2.59
Page 81
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:39 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
41137
40597
37848
0
119590
Discharges
0
0
0
0
0
1467
1630
1365
0
4462
0
0
0
0
0
1104
1334
1175
0
3613
0
0
0
0
0
363
296
190
0
849
0
0
0
0
0
HEDIS 2012 (Reporting Year 2011)
Discharges /
1,000 Member
Months
NA
NA
NA
NA
0.00
35.66
40.15
36.07
37.31
NA
NA
NA
NA
0.00
26.84
32.86
31.05
30.21
NA
NA
NA
NA
0.00
8.82
7.29
5.02
7.10
NA
NA
0.00
0.00
Days
0
0
0
0
0
6943
7447
5719
0
20109
0
0
0
0
0
4834
5565
4651
0
15050
0
0
0
0
0
2109
1882
1068
0
5059
0
0
0
0
0
Days / 1,000
Member
Months
NA
NA
NA
NA
0.00
168.78
183.44
151.10
168.15
NA
NA
NA
NA
0.00
117.51
137.08
122.89
125.85
NA
NA
NA
NA
0.00
51.27
46.36
28.22
42.30
NA
NA
0.00
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
4.73
4.57
4.19
NA
4.51
NA
NA
NA
NA
NA
4.38
4.17
3.96
NA
4.17
NA
NA
NA
NA
NA
5.81
6.36
5.62
NA
5.96
NA
NA
NA
NA
NA
Page 83
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:39 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
134
10015
14767
185
0
0
0
25101
Discharges
0
0
1
187
424
6
0
0
0
618
0
0
1
131
301
4
0
0
0
437
Discharges /
1,000 Member
Months
NA
NA
7.46
18.67
28.71
32.43
NA
NA
24.62
NA
NA
7.46
13.08
20.38
21.62
NA
NA
17.41
0
0
0
49
123
2
0
0
0
174
NA
NA
0.00
4.89
8.33
10.81
NA
NA
0
7
0
0
7
0.00
0.70
0.00
HEDIS 2012 (Reporting Year 2011)
6.93
0.28
Days
0
0
6
734
1804
28
0
0
0
2572
0
0
6
480
1158
18
0
0
0
1662
0
0
0
215
646
10
0
0
0
871
0
39
0
0
39
Days / 1,000
Member
Months
NA
NA
44.78
73.29
122.16
151.35
NA
NA
102.47
NA
NA
44.78
47.93
78.42
97.30
NA
NA
66.21
NA
NA
0.00
21.47
43.75
54.05
NA
NA
34.70
0.00
3.89
0.00
1.57
Average
Length of Stay
NA
NA
6.00
3.93
4.25
4.67
NA
NA
NA
4.16
NA
NA
6.00
3.66
3.85
4.50
NA
NA
NA
3.80
NA
NA
NA
4.39
5.25
5.00
NA
NA
NA
5.01
NA
5.57
NA
NA
5.57
Page 84
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:39 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
81223
537047
390876
559765
212875
356
12
0
0
1782154
Discharges
Discharges /
1,000 Member
Months
901
1030
1198
8532
2239
3
0
0
0
13903
11.09
1.92
3.06
15.24
10.52
8.43
0.00
NA
800
850
377
1767
1303
1
0
0
0
5098
9.85
1.58
0.96
3.16
6.12
2.81
0.00
NA
99
180
211
1308
926
2
0
0
0
2726
610
5457
10
0
6077
HEDIS 2012 (Reporting Year 2011)
7.80
2.86
1.22
0.34
0.54
2.34
4.35
5.62
0.00
NA
1.53
1.56
9.75
0.05
5.22
Days
Days / 1,000
Member
Months
5304
2925
3423
22429
7933
13
0
0
0
42027
65.30
5.45
8.76
40.07
37.27
36.52
0.00
NA
4324
2177
1044
5093
4435
4
0
0
0
17077
53.24
4.05
2.67
9.10
20.83
11.24
0.00
NA
978
748
804
3748
3472
9
0
0
0
9759
12.04
1.39
2.06
6.70
16.31
25.28
0.00
NA
1575
13588
26
0
15189
4.03
24.27
0.12
23.58
9.58
5.48
13.05
Average
Length of Stay
5.89
2.84
2.86
2.63
3.54
4.33
NA
NA
NA
3.02
5.41
2.56
2.77
2.88
3.40
4.00
NA
NA
NA
3.35
9.88
4.16
3.81
2.87
3.75
4.50
NA
NA
NA
3.58
2.58
2.49
2.60
NA
2.50
Page 85
Use of Services
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:39 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
336598
141212
198633
306464
952606
31514
0
1967027
326211
134944
191523
297615
950353
24679
0
1925325
662809
276156
390156
604079
1902959
56193
0
3892352
336598
141212
198633
306464
952606
31514
0
1967027
326211
134944
191523
297615
950353
24679
0
1925325
662809
276156
390156
604079
1902959
56193
0
3892352
336598
141212
198633
306464
952606
31514
0
1967027
326211
134944
191523
297615
950353
24679
0
1925325
662809
276156
390156
604079
1902959
56193
0
3892352
336598
141212
198633
306464
952606
31514
0
1967027
326211
134944
191523
297615
950353
24679
0
1925325
662809
276156
390156
604079
1902959
56193
0
3892352
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
4
2
6
202
114
316
633
296
929
632
336
968
1606
1063
2669
33
12
45
0
0
0
3110
1823
4933
0.01%
0.01%
0.01%
1.72%
1.01%
1.37%
3.82%
1.85%
2.86%
2.47%
1.35%
1.92%
2.02%
1.34%
1.68%
1.26%
0.58%
0.96%
NA
NA
NA
1.90%
1.14%
1.52%
2
0
2
54
31
85
123
61
184
117
55
172
378
244
622
16
6
22
0
0
0
690
397
1087
0.01%
0.00%
0.00%
0.46%
0.28%
0.37%
0.74%
0.38%
0.57%
0.46%
0.22%
0.34%
0.48%
0.31%
0.39%
0.61%
0.29%
0.47%
NA
NA
NA
0.42%
0.25%
0.34%
0
0
0
22
17
39
46
25
71
54
17
71
83
59
142
0
0
0
0
0
0
205
118
323
0.00%
0.00%
0.00%
0.19%
0.15%
0.17%
0.28%
0.16%
0.22%
0.21%
0.07%
0.14%
0.10%
0.07%
0.09%
0.00%
0.00%
0.00%
NA
NA
NA
0.13%
0.07%
0.10%
3
2
5
191
108
299
604
269
873
580
320
900
1491
984
2475
25
10
35
0
0
0
2894
1693
4587
0.01%
0.01%
0.01%
1.62%
0.96%
1.30%
3.65%
1.69%
2.69%
2.27%
1.29%
1.79%
1.88%
1.24%
1.56%
0.95%
0.49%
0.75%
NA
NA
NA
1.77%
1.06%
1.41%
HEDIS 2012 (Reporting Year 2011)
Page 86
Use of Services
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:39 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
2
33170
0
33172
0
0
0
0
6
85444
0
85450
0
0
0
0
8
118614
0
118622
0
0
0
0
2
33170
0
33172
0
0
0
0
6
85444
0
85450
0
0
0
0
8
118614
0
118622
0
0
0
0
2
33170
0
33172
0
0
0
0
6
85444
0
85450
0
0
0
0
8
118614
0
118622
0
0
0
0
2
33170
0
33172
0
0
0
0
6
85444
0
85450
0
0
0
0
8
118614
0
118622
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
164
122
286
0
0
0
164
122
286
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
5.93%
1.71%
2.89%
NA
NA
NA
5.93%
1.71%
2.89%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
83
52
135
0
0
0
83
52
135
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.00%
0.73%
1.37%
NA
NA
NA
3.00%
0.73%
1.37%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
3
0
0
0
1
2
3
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.04%
0.03%
0.03%
NA
NA
NA
0.04%
0.03%
0.03%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
122
92
214
0
0
0
122
92
214
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
4.41%
1.29%
2.17%
NA
NA
NA
4.41%
1.29%
2.16%
HEDIS 2012 (Reporting Year 2011)
Page 88
Use of Services
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:39 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
813
2057
7264
56
0
10190
0
0
812
1988
11982
129
0
14911
0
0
1625
4045
19246
185
0
25101
0
0
813
2057
7264
56
0
10190
0
0
812
1988
11982
129
0
14911
0
0
1625
4045
19246
185
0
25101
0
0
813
2057
7264
56
0
10190
0
0
812
1988
11982
129
0
14911
0
0
1625
4045
19246
185
0
25101
0
0
813
2057
7264
56
0
10190
0
0
812
1988
11982
129
0
14911
0
0
1625
4045
19246
185
0
25101
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
11
8
19
34
34
68
142
196
338
0
1
1
0
0
0
187
239
426
NA
NA
NA
NA
NA
NA
16.24%
11.82%
14.03%
19.83%
20.52%
20.17%
23.46%
19.63%
21.07%
0.00%
9.30%
6.49%
NA
NA
NA
22.02%
19.23%
20.37%
0
0
0
0
0
0
5
4
9
12
9
21
41
50
91
0
1
1
0
0
0
58
64
122
NA
NA
NA
NA
NA
NA
7.38%
5.91%
6.65%
7.00%
5.43%
6.23%
6.77%
5.01%
5.67%
0.00%
9.30%
6.49%
NA
NA
NA
6.83%
5.15%
5.83%
0
0
0
0
0
0
1
1
2
2
3
5
5
17
22
0
0
0
0
0
0
8
21
29
NA
NA
NA
NA
NA
NA
1.48%
1.48%
1.48%
1.17%
1.81%
1.48%
0.83%
1.70%
1.37%
0.00%
0.00%
0.00%
NA
NA
NA
0.94%
1.69%
1.39%
0
0
0
0
0
0
9
7
16
33
33
66
131
191
322
0
0
0
0
0
0
173
231
404
NA
NA
NA
NA
NA
NA
13.28%
10.34%
11.82%
19.25%
19.92%
19.58%
21.64%
19.13%
20.08%
0.00%
0.00%
0.00%
NA
NA
NA
20.37%
18.59%
19.31%
HEDIS 2012 (Reporting Year 2011)
Page 89
Use of Services
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:39 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
379394
93489
66500
72819
144907
101
0
757210
375336
97532
116095
167640
208126
109
0
964838
754730
191021
182595
240459
353033
210
0
1722048
379394
93489
66500
72819
144907
101
0
757210
375336
97532
116095
167640
208126
109
0
964838
754730
191021
182595
240459
353033
210
0
1722048
379394
93489
66500
72819
144907
101
0
757210
375336
97532
116095
167640
208126
109
0
964838
754730
191021
182595
240459
353033
210
0
1722048
379394
93489
66500
72819
144907
101
0
757210
375336
97532
116095
167640
208126
109
0
964838
754730
191021
182595
240459
353033
210
0
1722048
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
18
18
36
451
299
750
819
888
1707
1431
1832
3263
2547
2183
4730
0
0
0
0
0
0
5266
5220
10486
0.06%
0.06%
0.06%
5.79%
3.68%
4.71%
14.78%
9.18%
11.22%
23.58%
13.11%
16.28%
21.09%
12.59%
16.08%
0.00%
0.00%
0.00%
NA
NA
NA
8.35%
6.49%
7.31%
3
4
7
64
81
145
131
202
333
203
344
547
466
404
870
0
0
0
0
0
0
867
1035
1902
0.01%
0.01%
0.01%
0.82%
1.00%
0.91%
2.36%
2.09%
2.19%
3.35%
2.46%
2.73%
3.86%
2.33%
2.96%
0.00%
0.00%
0.00%
NA
NA
NA
1.37%
1.29%
1.33%
0
1
1
86
56
142
81
71
152
137
148
285
183
146
329
0
0
0
0
0
0
487
422
909
0.00%
0.00%
0.00%
1.10%
0.69%
0.89%
1.46%
0.73%
1.00%
2.26%
1.06%
1.42%
1.52%
0.84%
1.12%
0.00%
0.00%
0.00%
NA
NA
NA
0.77%
0.52%
0.63%
16
16
32
420
271
691
754
803
1557
1352
1720
3072
2411
2085
4496
0
0
0
0
0
0
4953
4895
9848
0.05%
0.05%
0.05%
5.39%
3.33%
4.34%
13.61%
8.30%
10.23%
22.28%
12.31%
15.33%
19.97%
12.02%
15.28%
0.00%
0.00%
0.00%
NA
NA
NA
7.85%
6.09%
6.86%
HEDIS 2012 (Reporting Year 2011)
Page 90
Use of Services
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:39 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Male
Female
Total
Male
Female
Total
336598
141212
1457703
31514
0
1967027
326211
134944
1439491
24679
0
1925325
662809
276156
2897194
56193
0
3892352
336598
141212
1457703
31514
0
1967027
326211
134944
1439491
24679
0
1925325
662809
276156
2897194
56193
0
3892352
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
336598
141212
1457703
31514
0
1967027
326211
134944
1439491
24679
0
1925325
662809
276156
2897194
56193
0
3892352
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
Member Months
(Outpatient/ED)
Male
Female
Total
336598
141212
1457703
31514
0
1967027
326211
134944
1439491
24679
0
1925325
662809
276156
2897194
56193
0
3892352
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
2035
1299
3334
1453
1620
3073
7726
13208
20934
115
106
221
0
0
0
11329
16233
27562
7.25%
4.78%
6.04%
12.35%
14.41%
13.35%
6.36%
11.01%
8.67%
4.38%
5.15%
4.72%
NA
NA
NA
6.91%
10.12%
8.50%
19
20
39
84
121
205
273
330
603
4
5
9
0
0
0
380
476
856
0.07%
0.07%
0.07%
0.71%
1.08%
0.89%
0.22%
0.28%
0.25%
0.15%
0.24%
0.19%
NA
NA
NA
0.23%
0.30%
0.26%
119
90
209
129
185
314
283
534
817
1
0
1
0
0
0
532
809
1341
0.42%
0.33%
0.38%
1.10%
1.65%
1.36%
0.23%
0.45%
0.34%
0.04%
0.00%
0.02%
NA
NA
NA
0.32%
0.50%
0.41%
2032
1297
3329
1448
1611
3059
7688
13175
20863
115
105
220
0
0
0
11283
16188
27471
7.24%
4.77%
6.03%
12.30%
14.33%
13.29%
6.33%
10.98%
8.64%
4.38%
5.11%
4.70%
NA
NA
NA
6.88%
10.09%
8.47%
HEDIS 2012 (Reporting Year 2011)
Page 91
Use of Services
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:39 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Male
Female
Total
Male
Female
Total
0
0
2
33170
0
33172
0
0
6
85444
0
85450
0
0
8
118614
0
118622
0
0
2
33170
0
33172
0
0
6
85444
0
85450
0
0
8
118614
0
118622
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
Male
Female
Total
0
0
2
33170
0
33172
0
0
2
33170
0
33172
0
0
6
85444
0
85450
0
0
8
118614
0
118622
0
0
6
85444
0
85450
0
0
8
118614
0
118622
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
1
2
3
374
1016
1390
0
0
0
375
1018
1393
NA
NA
NA
NA
NA
NA
600.00%
400.00%
450.00%
13.53%
14.27%
14.06%
NA
NA
NA
13.57%
14.30%
14.09%
0
0
0
0
0
0
0
0
0
67
181
248
0
0
0
67
181
248
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
2.42%
2.54%
2.51%
NA
NA
NA
2.42%
2.54%
2.51%
0
0
0
0
0
0
0
1
1
36
80
116
0
0
0
36
81
117
NA
NA
NA
NA
NA
NA
0.00%
200.00%
150.00%
1.30%
1.12%
1.17%
NA
NA
NA
1.30%
1.14%
1.18%
0
0
0
0
0
0
1
2
3
336
905
1241
0
0
0
337
907
1244
NA
NA
NA
NA
NA
NA
600.00%
400.00%
450.00%
12.16%
12.71%
12.56%
NA
NA
NA
12.19%
12.74%
12.58%
HEDIS 2012 (Reporting Year 2011)
Page 93
Use of Services
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:39 AM
SNBC
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
10134
56
0
10190
0
0
14782
129
0
14911
0
0
24916
185
0
25101
0
0
10134
56
0
10190
0
0
14782
129
0
14911
0
0
24916
185
0
25101
0
0
10134
56
0
10190
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
14782
129
0
14911
0
0
24916
185
0
25101
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
0
0
10134
56
0
10190
0
0
14782
129
0
14911
0
0
24916
185
0
25101
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
592
938
1530
2
4
6
0
0
0
594
942
1536
NA
NA
NA
NA
NA
NA
70.10%
76.15%
73.69%
42.86%
37.21%
38.92%
NA
NA
NA
69.95%
75.81%
73.43%
0
0
0
0
0
0
52
90
142
0
0
0
0
0
0
52
90
142
NA
NA
NA
NA
NA
NA
6.16%
7.31%
6.84%
0.00%
0.00%
0.00%
NA
NA
NA
6.12%
7.24%
6.79%
0
0
0
0
0
0
57
114
171
0
0
0
0
0
0
57
114
171
NA
NA
NA
NA
NA
NA
6.75%
9.25%
8.24%
0.00%
0.00%
0.00%
NA
NA
NA
6.71%
9.17%
8.17%
0
0
0
0
0
0
589
933
1522
2
4
6
0
0
0
591
937
1528
NA
NA
NA
NA
NA
NA
69.75%
75.74%
73.30%
42.86%
37.21%
38.92%
NA
NA
NA
69.60%
75.41%
73.05%
HEDIS 2012 (Reporting Year 2011)
Page 94
Use of Services
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:39 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
379394
93489
284226
101
0
757210
375336
97532
491861
109
0
964838
754730
191021
776087
210
0
1722048
379394
93489
284226
101
0
757210
375336
97532
491861
109
0
964838
754730
191021
776087
210
0
1722048
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
379394
93489
284226
101
0
757210
375336
97532
491861
109
0
964838
754730
191021
776087
210
0
1722048
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
379394
93489
284226
101
0
757210
375336
97532
491861
109
0
964838
754730
191021
776087
210
0
1722048
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
4174
2853
7027
1745
2015
3760
5912
12710
18622
1
0
1
0
0
0
11832
17578
29410
13.20%
9.12%
11.17%
22.40%
24.79%
23.62%
24.96%
31.01%
28.79%
11.88%
0.00%
5.71%
NA
NA
NA
18.75%
21.86%
20.49%
81
49
130
112
190
302
361
556
917
0
0
0
0
0
0
554
795
1349
0.26%
0.16%
0.21%
1.44%
2.34%
1.90%
1.52%
1.36%
1.42%
0.00%
0.00%
0.00%
NA
NA
NA
0.88%
0.99%
0.94%
610
424
1034
282
337
619
776
1549
2325
0
0
0
0
0
0
1668
2310
3978
1.93%
1.36%
1.64%
3.62%
4.15%
3.89%
3.28%
3.78%
3.59%
0.00%
0.00%
0.00%
NA
NA
NA
2.64%
2.87%
2.77%
4158
2842
7000
1736
2000
3736
5863
12660
18523
1
0
1
0
0
0
11758
17502
29260
13.15%
9.09%
11.13%
22.28%
24.61%
23.47%
24.75%
30.89%
28.64%
11.88%
0.00%
5.71%
NA
NA
NA
18.63%
21.77%
20.39%
HEDIS 2012 (Reporting Year 2011)
Page 95
Use of Services
Medica
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 9:39 AM
MSHO
Count of Index Stays
(Denominator)
Age
18-44
45-54
55-64
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
0
0
0
0
0
0
0
0
0
0
0
0
Count of Index Stays
(Denominator)
Age
65-74
75-84
85+
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2012 (Reporting Year 2011)
318
536
854
275
590
865
145
575
720
738
1701
2439
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)
67
99
166
59
105
164
24
102
126
150
306
456
Observed
Readmission
(Num/Den)
21.07%
18.47%
19.44%
21.45%
17.80%
18.96%
16.55%
17.74%
17.50%
20.33%
17.99%
18.70%
NA
NA
NA
NA
NA
NA
Average Adjusted
Probability
Total Variance
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
Average Adjusted
Probability
Total Variance
18.53%
15.86%
16.85%
18.95%
16.65%
17.38%
17.62%
16.07%
16.38%
18.51%
16.20%
16.90%
15.09%
13.34%
28.44%
15.36%
13.88%
29.24%
14.52%
13.49%
28.00%
44.97%
40.71%
85.68%
Page 97
Use of Services
Medica
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 9:39 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
50
85
135
39
97
136
37
51
88
126
233
359
Count of Index Stays
(Denominator)
Age
65-74
75-84
85+
Sex
M
F
Total
M
F
Total
M
F
Total
M
Total
HEDIS 2012 (Reporting Year 2011)
1
3
4
0
0
0
0
0
0
1
3
4
Count of 30-Day
Readmissions
(Numerator)
7
9
16
6
10
16
4
6
10
17
25
42
Observed
Readmission
(Num/Den)
14.00%
10.59%
11.85%
15.38%
10.31%
11.76%
10.81%
11.76%
11.36%
13.49%
10.73%
11.70%
Average Adjusted
Probability
Total Variance
18.56%
16.09%
17.00%
17.37%
15.76%
16.22%
19.82%
16.55%
17.92%
18.57%
16.05%
16.93%
15.12%
13.50%
28.62%
14.35%
13.28%
27.63%
15.89%
13.81%
29.70%
45.37%
40.58%
85.95%
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
33.38%
20.10%
23.42%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
33.38%
20.10%
23.42%
22.24%
16.06%
38.30%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
22.24%
16.06%
38.30%
NA
NA
0.00%
0.00%
0.00%
Page 98
Health Plan Descriptive Information
Medica
Data Last Refreshed:
Oct 22, 2012 9:39 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
3096
1814
147
5713
2813
1688
146
5256
90.86%
93.05%
99.32%
92.00%
Page 99
Health Plan Descriptive Information
Medica
Data Last Refreshed:
Oct 22, 2012 9:39 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
3437
1914
164
6248
3107
1770
162
5723
90.40%
92.48%
98.78%
91.60%
Page 100
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:39 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
22931
101141
131167
136783
85816
56874
Member Months
Female
22456
96860
127881
131767
82214
55060
Total
45387
198001
259048
268550
168030
111934
534712
27.18%
141759
145788
160691
151065
170203
516238
26.81%
136464
142797
154824
146079
167222
1050950
27.00%
769506
39.12%
187110
185651
152227
106549
747386
38.82%
185744
189449
152678
109292
1516892
38.97%
631537
32.10%
21786
6633
1966
624
308
197
637163
33.09%
18284
3924
1370
504
404
193
1268700
32.59%
31514
1.60%
0
24679
1.28%
0
56193
1.44%
1967269
1925466
HEDIS 2012 (Reporting Year 2011)
278223
288585
315515
297144
337425
372854
375100
304905
215841
40070
10557
3336
1128
712
390
0
3892735
Page 101
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:39 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
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:39 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
2
0
0.00%
0
0
0
6
0
0.00%
2
0.01%
6992
7947
6517
5723
3781
2454
6
0.01%
12049
14149
13877
14480
15010
16603
8
0.01%
33414
99.99%
0
86168
99.99%
0
119582
99.99%
33416
86174
HEDIS 2012 (Reporting Year 2011)
0
0
0
0
0
0
0
0
8
19041
22096
20394
20203
18791
19057
0
119590
Page 103
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:39 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
77
Member Months
Female
0
0
0
0
0
57
Total
0
0
0
0
0
134
77
0.76%
736
1086
971
658
1106
57
0.38%
755
890
1098
1118
1597
134
0.53%
4557
44.72%
1464
1735
1427
874
5458
36.60%
2308
2642
2544
1773
10015
39.90%
5500
53.97%
56
0
0
0
0
0
9267
62.15%
129
0
0
0
0
0
14767
58.83%
56
0.55%
0
129
0.87%
0
185
0.74%
10190
14911
HEDIS 2012 (Reporting Year 2011)
1491
1976
2069
1776
2703
3772
4377
3971
2647
185
0
0
0
0
0
0
25101
Page 104
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:39 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
41325
131099
139651
106286
54522
28884
Member Months
Female
39898
129288
137009
110553
56120
34511
Total
81223
260387
276660
216839
110642
63395
501767
64.10%
40163
39269
39338
34219
33853
507379
50.77%
85733
94749
79520
62562
50359
1009146
56.63%
186842
23.87%
32644
28700
19771
12850
372923
37.31%
42260
34408
23742
18500
559765
31.41%
93965
12.00%
121
43
0
0
0
0
118910
11.90%
180
12
9
3
0
0
212875
11.94%
164
0.02%
0
204
0.02%
0
368
0.02%
782738
999416
HEDIS 2012 (Reporting Year 2011)
125896
134018
118858
96781
84212
74904
63108
43513
31350
301
55
9
3
0
0
0
1782154
Page 105