Blue Plus (HMO Minnesota)
General Info
Disclaimers
HEDIS 2012 (Reporting Year 2011)
Page
Data Last Refreshed: 10/22/2012
2
Effectiveness of Care Measures
Code
Effectiveness of Care Measures
Code
Medication Management
Page
Prevention and Screening
ABA
Adult BMI Assessment
3
WCC
Weight Assessment and Counseling for Nutrition and Physical Activity for
Children/Adolescents
4
CIS
Childhood Immunization Status
6
IMA
Immunizations for Adolescents
10
Page
26 MPM
Annual Monitoring for Patients on Persistent Medications
48
27 MRP
Medication Reconciliation Post Discharge
53
Potentially Harmful Drug-Disease Interactions in the Elderly
54
Use of High Risk Medications in the Elderly
56
28
DDE
29 DAE
BCS
Breast Cancer Screening
12
0 Code
CCS
Cervical Cancer Screening
13
30 AAP
Adult's Access to Preventive/Ambulatory Health Services
58
COL
Colorectal Cancer Screening
14
31 CAP
Children's and Adolescents' Access to Primary Care Practitioners
63
CHL
Chlamydia Screening in Women
15
32
IET
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
65
GSO
Glaucoma Screening in Older Adults
17
33 PPC
Prenatal and Postpartum Care
70
LSC
Lead Screening in Children
18
34
COA
Care for Older Adults
19
Respiratory Conditions
PCE
Pharmacotherapy Management of COPD Exacerbation
20
SPR
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
23
ASM
Use of Appropriate Medications for People with Asthma
24
Cardiovascular
Access / Availability of Care Measures
Use of Services Measures
0 Code
Page
Page
34 W15
Well Child Visits in the First 15 Months of Life
72
35 W34
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
74
Adolescent Well-Care Visits
75
36
AWC
Ambulatory Care
76
38
IPU
Inpatient Utilization - General Hospital/Acute Care
81
IAD
37 AMB
CMC
Cholesterol Management for Patients with Cardiovascular Conditions
26
39
Identification of Alcohol and Other Drug Services
86
CBP
Controlling High Blood Pressure
29
40 MPT
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
91
PBH
Persistence of Beta Blocker Treatment After Heart Attack
30
41 PCR
Plan All-Cause Readmissions
96
Diabetes
CDC
Comprehensive Diabetes Care
41
31
Musculoskeletal
ART
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
36
OMW
Osteoporosis Management in Women Who had a Fracture
37
Behavioral Health
AMM
Antidepressant Medication Management
38
ADD
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
43
FUH
Follow-up After Hospitalization for Mental Illness
45
HEDIS 2012 (Reporting Year 2011)
0 Code
Health Plan Descriptive Information Measures
Page
42 BCR
Board Certification
99
43 ENP
Enrollment by Product Line (Age & Sex)
101
43
DISCLAIMERS
-1
( this page left blank intentionally )
0. Disclaimer Query located below
HEDIS 2012 (Reporting Year 2011)
Page 2
Effectiveness of Care
Blue Plus (HMO Minnesota)
Adult BMI Assessment
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Commercial
Medicare
Advantage
2011
A
13240
2011
H
19708
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
MHCP-MC
663
NR
NR
NR
NR
3.36%
380
5.00%
399
19
4.76%
Number of Records Excluded Because of Valid
Data Errors
0
Number of administrative data records excluded
0
Number of medical record data records excluded
0
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
280
2.11%
1.87%
2.36%
NR
NR
NR
0
399
19
284
75.94%
71.62%
80.26%
Page 3
Effectiveness of Care
Blue Plus (HMO Minnesota)
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Commercial
BMI Percentile
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Nutrition
Total
2011
A
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Physical Activity
Total
2011
A
General
Measure
Data
Ages 3-11
Ages 1217
Total
2011
A
2142
1672
3814
2142
1672
3814
2142
1672
3814
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
95
57
152
9
10
19
0
1
1
4.44%
3.54%
5.33%
3.41%
2.51%
4.31%
3.99%
3.35%
4.62%
0.42%
0.12%
0.72%
0.60%
0.20%
1.00%
0.50%
0.26%
0.73%
0.00%
0.00%
0.02%
0.06%
0.00%
0.21%
0.03%
0.00%
0.09%
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Page 4
Effectiveness of Care
Blue Plus (HMO Minnesota)
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
BMI Percentile
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Total
2011
H
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Ages 3-11 Ages 12-17
Counseling for Nutrition
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Physical Activity
Total
2011
H
General
Measure
Data
Total
16752
8835
25587
16752
8835
25587
16752
8835
25587
230
1.37%
93
1.05%
323
1.26%
109
0.65%
112
1.27%
221
0.86%
0
0.00%
1
0.01%
1
0.00%
0
0.00%
0
0.00%
0
0.00%
411
5.00%
411
5.00%
432
411
5.00%
432
3
0.69%
3
0.69%
6
1.39%
432
2
0.46%
6
1.39%
8
1.85%
0
0
0
Number of administrative data records
excluded
0
0
0
Number of medical records excluded
0
0
0
Number of employee/dependent records
excluded
0
0
0
Records Added from the Oversample List
0
0
0
HEDIS 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
270
162
432
270
162
432
270
162
432
3
166
62.59%
56.64%
68.55%
3
102
64.81%
57.15%
72.48%
6
268
63.43%
58.77%
68.08%
2
129
48.52%
42.37%
54.67%
6
52
35.80%
28.11%
43.49%
8
181
43.75%
38.96%
48.54%
0
103
38.15%
32.17%
44.13%
0
62
38.27%
30.48%
46.07%
0
165
38.19%
33.50%
42.89%
Page 5
Effectiveness of Care
Blue Plus (HMO Minnesota)
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
IPV
MMR
HiB
Hepatitis B
VZV
Influenza
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
202
218
218
223
203
216
212
94
199
176
85.59%
80.90%
90.29%
92.37%
88.77%
95.97%
92.37%
88.77%
95.97%
94.49%
91.37%
97.61%
86.02%
81.38%
90.65%
91.53%
87.76%
95.29%
89.83%
85.76%
93.90%
39.83%
33.37%
46.29%
84.32%
79.47%
89.17%
74.58%
68.81%
80.34%
2011
A
236
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical data records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by administrative Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Page 6
Effectiveness of Care
Blue Plus (HMO Minnesota)
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
DTaP
Combo 2
Combo 3
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
202
177
176
78
163
144
73
66
135
63
85.59%
80.90%
90.29%
75.00%
69.26%
80.74%
74.58%
68.81%
80.34%
33.05%
26.84%
39.26%
69.07%
62.96%
75.18%
61.02%
54.58%
67.45%
30.93%
24.82%
37.04%
27.97%
22.03%
33.90%
57.20%
50.68%
63.73%
26.69%
20.84%
32.55%
2011
A
236
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical data records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by administrative Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Page 7
Effectiveness of Care
Blue Plus (HMO Minnesota)
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
0
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
HiB
Hepatitis B
VZV
Influenza
1851
78.00%
2127
89.63%
2093
88.20%
2156
90.86%
1939
81.71%
2070
87.23%
1916
80.74%
679
28.61%
1555
65.53%
1300
54.78%
327
75.69%
377
87.27%
372
86.11%
385
89.12%
342
79.17%
369
85.42%
340
78.70%
122
28.24%
274
63.43%
235
54.40%
327
20
80.32%
76.46%
84.19%
377
14
90.51%
87.63%
93.39%
372
5
87.27%
84.01%
90.53%
385
10
91.44%
88.68%
94.19%
342
43
89.12%
86.07%
92.17%
369
7
87.04%
83.75%
90.32%
340
20
83.33%
79.70%
86.96%
122
9
30.32%
25.87%
34.77%
274
22
68.52%
64.02%
73.01%
235
10
56.71%
51.92%
61.50%
432
0
Numerator Events by administrative Data
MMR
411
0.05
Number of Records Excluded Because of
Valid Data Errors
Denominator
IPV
2011
H
2373
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
432
Page 8
Effectiveness of Care
Blue Plus (HMO Minnesota)
Childhood Immunization Status
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
0
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
1851
78.00%
1583
66.71%
1532
64.56%
548
23.09%
1198
50.48%
1004
42.31%
473
19.93%
384
16.18%
847
35.69%
338
14.24%
327
75.69%
282
65.28%
272
62.96%
99
22.92%
209
48.38%
179
41.44%
83
19.21%
66
15.28%
147
34.03%
55
12.73%
327
20
80.32%
76.46%
84.19%
282
39
74.31%
70.07%
78.54%
272
37
71.53%
67.16%
75.90%
99
21
27.78%
23.44%
32.12%
209
37
56.94%
52.16%
61.73%
179
31
48.61%
43.78%
53.44%
83
21
24.07%
19.93%
28.22%
66
14
18.52%
14.74%
22.30%
147
31
41.20%
36.45%
45.96%
55
15
16.20%
12.61%
19.79%
432
0
Numerator Events by administrative Data
Combo 3
411
0.05
Number of Records Excluded Because of
Valid Data Errors
Denominator
Combo 2
2011
H
2373
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
432
Page 9
Effectiveness of Care
Blue Plus (HMO Minnesota)
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Immunizations for Adolescents
Commercial
Data Elements
General
Measure Data
Meningococcal
Tdap
Combo 1
Current Year's Admin Rate
NR
NR
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
NR
NR
NR
200
298
197
Reported Rate
57.64%
85.88%
56.77%
Lower 95% Confidence Interval
52.29%
82.07%
51.42%
Upper 95% Confidence Interval
62.98%
89.69%
62.13%
Measurement Year
Data Collection Methodology
Eligible Member Population
2011
A
347
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
HEDIS 2012 (Reporting Year 2011)
Page 10
Effectiveness of Care
Blue Plus (HMO Minnesota)
Data Last Refreshed:
Oct 22, 2012 9:18 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
1792
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
801
1421
780
44.70%
79.30%
43.53%
188
43.52%
344
79.63%
184
42.59%
188
7
45.14%
40.33%
49.95%
344
13
82.64%
78.95%
86.33%
184
8
44.44%
39.64%
49.25%
411
5.00%
432
Records Excluded because of Valid Data Errors
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Meningococcal
0
432
Page 11
Effectiveness of Care
Blue Plus (HMO Minnesota)
Breast Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Commercial
2011
A
5586
4006
71.72%
70.52%
72.91%
Medicare
Advantage
NR
NR
NR
MSHO
2011
A
412
224
54.37%
49.44%
59.30%
SNBC
MHCP-MC
NR
NR
NR
2011
A
6040
3640
60.26%
59.02%
61.51%
Page 12
Effectiveness of Care
Blue Plus (HMO Minnesota)
Cervical Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Commercial
2011
A
5973
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
12383
NR
NR
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
MHCP-MC
2010
H
18550
66.75%
328
5.00%
345
245
71.01%
0
0
7
0
4307
72.11%
70.96%
73.25%
0
338
245
21
78.70%
74.19%
83.21%
Page 13
Effectiveness of Care
Blue Plus (HMO Minnesota)
Colorectal Cancer Screening
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Data Elements
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
Commercial
Medicare
Advantage
2011
A
6306
HEDIS 2012 (Reporting Year 2011)
SNBC
2011
H
2062
Number of numerator events by administrative data in eligible population
(before exclusions)
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid data errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical records
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
MSHO
822
NR
NR
NR
NR
3573
56.66%
55.43%
57.89%
NR
NR
NR
39.86%
411
10.00%
453
190
41.94%
2
0
0
0
0
451
190
57
54.77%
50.06%
59.47%
NR
NR
NR
NR
NR
Page 14
Effectiveness of Care
Blue Plus (HMO Minnesota)
Chlamydia Screening in Women
Data Last Refreshed:
Oct 22, 2012 9:18 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
390
131
33.59%
28.77%
38.41%
503
247
49.11%
44.64%
53.57%
893
378
42.33%
39.03%
45.63%
2011
A
Page 15
Effectiveness of Care
Blue Plus (HMO Minnesota)
Chlamydia Screening in Women
Data Last Refreshed:
Oct 22, 2012 9:18 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
2140
940
43.93%
41.80%
46.05%
1930
998
51.71%
49.45%
53.97%
4070
1938
47.62%
46.07%
49.16%
2011
A
Page 16
Effectiveness of Care
Blue Plus (HMO Minnesota)
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Medicare
Advantage
NR
NR
NR
MSHO
2011
A
7012
5047
71.98%
70.92%
73.03%
Page 17
Effectiveness of Care
Blue Plus (HMO Minnesota)
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Lead Screening in Children
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
2011
A
236
MHCP-MC
2011
A
2373
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
184
1966
Reported Rate
77.97%
82.85%
Lower 95% Confidence Interval
72.47%
81.31%
Upper 95% Confidence Interval
83.47%
84.39%
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
Blue Plus (HMO Minnesota)
Data Last Refreshed:
Oct 22, 2012 9:18 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
196
0
317
0
333
0
154
Reported Rate
45.79%
74.07%
77.80%
35.98%
Lower 95% Confidence Interval
40.96%
69.80%
73.75%
31.32%
Upper 95% Confidence Interval
50.63%
78.33%
81.86%
40.65%
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General Measure
Data
2011
H
8587
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
5.00%
432
Records Excluded because of Valid Data
Errors
4
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
428
Page 19
Effectiveness of Care
Blue Plus (HMO Minnesota)
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 9:18 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
149
64.22%
57.84%
70.61%
190
81.90%
76.73%
87.07%
2011
A
232
Page 21
Effectiveness of Care
Blue Plus (HMO Minnesota)
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 22, 2012 9:18 AM
SNBC
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
NR
NR
NR
NR
NR
NR
Page 22
Effectiveness of Care
Blue Plus (HMO Minnesota)
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Oct 22, 2012 9:18 AM
MSHO
SNBC
2011
A
258
55
21.32%
16.13%
26.51%
NR
NR
NR
Page 23
Effectiveness of Care
Blue Plus (HMO Minnesota)
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 22, 2012 9:18 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
43
43
1
100.00%
98.84%
100.00%
29
28
1
NA
NA
NA
130
116
20
89.23%
83.52%
94.94%
109
103
35
94.50%
89.76%
99.24%
311
290
57
93.25%
90.30%
96.20%
2011
A
`
Page 24
Effectiveness of Care
Blue Plus (HMO Minnesota)
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 22, 2012 9:18 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
357
334
18
93.56%
90.87%
96.24%
240
207
10
86.25%
81.68%
90.82%
453
372
98
82.12%
78.48%
85.76%
158
133
179
84.18%
78.17%
90.18%
1208
1046
305
86.59%
84.63%
88.55%
2011
A
Page 25
Effectiveness of Care
Blue Plus (HMO Minnesota)
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
163
0
88.59%
83.72%
93.45%
0.00%
0.00%
0.27%
2011
A
184
Page 26
Effectiveness of Care
Blue Plus (HMO Minnesota)
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 22, 2012 9:18 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
232
0
85.93%
0.00%
232
0
85.93%
0.00%
232
5
0
149
87.78%
83.69%
91.87%
55.19%
49.07%
61.30%
2011
H
270
270
5.00%
270
0
0
0
270
Page 28
Effectiveness of Care
Blue Plus (HMO Minnesota)
Controlling High Blood Pressure
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Data Elements
Commercial
Medicare
Advantage
MSHO
SNBC
MHCP-MC
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2011
H
1614
2011
H
1915
2011
H
3584
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
0
0
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
0.00%
411
10.00%
453
0
0.00%
NR
NR
0.00%
411
10.00%
453
0
0.00%
NR
NR
0.00%
411
10.00%
453
0
0.00%
Records Excluded because of Valid Data
Errors
1
3
1
Number of records excluded because of
false positive diagnoses
1
2
1
Number of administrative data records
excluded
0
0
2
Number of medical record data records
excluded
1
0
0
Number of employee/dependent medical
records excluded
0
0
0
Records Added from the OverSample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
0
451
0
302
66.96%
62.51%
71.41%
0
450
0
341
75.78%
71.71%
79.85%
0
450
0
317
70.44%
66.12%
74.77%
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
NR
NR
NR
Page 29
Effectiveness of Care
Blue Plus (HMO Minnesota)
Persistence of Beta Blocker Treatment After Heart Attack
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Medicare
Advantage
MSHO
SNBC
MHCP-MC
2011
A
15
2011
A
76
2011
A
38
Numerator Events by Admin Data on
Eligible Population
10
73
29
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NA
NA
NA
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
96.05%
91.02%
100.00%
NR
NR
NR
76.32%
61.48%
91.15%
Page 30
Effectiveness of Care
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Poor HbA1c
Control
(>9.0%)
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
2011
A
851
2011
2011
NR
NR
NR
NR
HbA1c
Testing
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
2011
A
851
2011
A
851
2011
2011
A
851
2011
2011
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
502
719
58.99%
55.63%
62.35%
84.49%
82.00%
86.98%
NR
NR
NR
NR
NR
NR
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Number of HbA1c < 7 required administrative
data records excluded
Number of HbA1c < 7 required medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
773
90.83%
88.84%
92.83%
NR
NR
NR
NR
NR
NR
NR
NR
NR
697
NR
NR
NR
81.90%
79.26%
84.55%
Page 31
Effectiveness of Care
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:18 AM
MSHO
LDL-C
Screening
LDL-C Level
<100 mg/dL
2011
H
941
2011
H
941
2011
H
941
2011
H
941
2011
H
941
2011
H
941
2011
H
941
8
0.85%
411
10%
453
2
0.44%
621
65.99%
411
10%
453
293
64.68%
752
79.91%
411
10%
453
364
80.35%
12
1.28%
411
10%
453
2
0.44%
827
87.89%
411
10%
453
397
87.64%
21
2.23%
411
10%
453
4
0.88%
21
2.23%
411
10%
453
4
0.88%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
453
407
6
91.17%
88.45%
93.89%
0
453
95
28
27.15%
22.95%
31.36%
0
453
2
302
67.11%
62.67%
71.55%
0
453
293
50
75.72%
71.66%
79.78%
0
453
364
12
83.00%
79.43%
86.57%
0
453
2
252
56.07%
51.39%
60.75%
0
453
397
7
89.18%
86.21%
92.15%
0
453
4
333
74.39%
70.26%
78.52%
0
453
4
303
67.77%
63.36%
72.18%
2011
H
941
2011
H
941
851
90.44%
411
10%
453
407
89.85%
929
98.72%
411
10%
453
450
99.34%
Number of Records Excluded Because of
Valid Data Errors
0
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Blood
Pressure
<140/80
mm Hg
Eye Exam
Poor HbA1c
Control
Measurement Year
Data Collection Methodology
Eligible Member Population
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Adequate
HbA1c
Control
(<8.0%)
HbA1c
Testing
Data Elements
Good HbA1c
Control
(<7.0%)
NR
NR
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
Page 33
Effectiveness of Care
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:18 AM
SNBC
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
Monitoring for
Pressure
Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<140/80
mm Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Page 34
Effectiveness of Care
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 22, 2012 9:18 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
2730
2011
H
2730
2011
H
2730
2011
H
2730
2011
H
2730
2011
H
2730
2011
H
2730
5
0.18%
411
10%
453
2
0.44%
1513
55.42%
411
10%
453
253
55.85%
2118
77.58%
411
10%
453
356
78.59%
4
0.15%
411
10%
453
1
0.22%
2160
79.12%
411
10%
453
357
78.81%
6
0.22%
411
10%
453
1
0.22%
6
0.22%
411
10%
453
1
0.22%
1
1
1
1
1
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
452
408
6
91.59%
88.92%
94.26%
0
452
73
61
29.65%
25.33%
33.97%
0
452
2
265
59.07%
54.43%
63.71%
0
452
253
55
68.14%
63.74%
72.55%
0
452
356
14
81.86%
78.20%
85.52%
0
452
1
203
45.13%
40.43%
49.83%
0
452
357
17
82.74%
79.15%
86.34%
0
452
1
340
75.44%
71.36%
79.52%
0
452
1
257
57.08%
52.41%
61.75%
HbA1c
Testing
Poor HbA1c
Control
2011
H
2730
2011
H
2730
2419
88.61%
411
10%
453
408
90.07%
2724
99.78%
411
10%
453
451
99.56%
1
Good HbA1c
Control
(<7.0%)
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
Blue Plus (HMO Minnesota)
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Medicare
Advantage
NR
NR
NR
Page 36
Effectiveness of Care
Blue Plus (HMO Minnesota)
Osteoporosis Management in Women Who had a Fracture
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Oct 22, 2012 9:18 AM
MSHO
2011
A
366
33
9.02%
5.95%
12.09%
Page 37
Effectiveness of Care
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:18 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
239
176
73.64%
67.85%
79.44%
134
56.07%
49.57%
62.57%
Page 38
Effectiveness of Care
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:18 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
102
76
74.51%
65.56%
83.46%
64
62.75%
52.87%
72.62%
Page 40
Effectiveness of Care
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:18 AM
SNBC
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure Data
Effective
Effective Acute
Continuation
Phase
Phase
Treatment
Treatment
NR
NR
NR
NR
NR
NR
Page 41
Effectiveness of Care
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Oct 22, 2012 9:18 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
1295
687
53.05%
50.29%
55.81%
502
38.76%
36.07%
41.46%
Page 42
Effectiveness of Care
Blue Plus (HMO Minnesota)
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 22, 2012 9:18 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
58
22
37.93%
24.58%
51.28%
19
8
NA
NA
NA
2011
A
Page 43
Effectiveness of Care
Blue Plus (HMO Minnesota)
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 22, 2012 9:18 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
536
212
39.55%
35.32%
43.79%
137
56
40.88%
32.28%
49.47%
2011
A
Page 44
Effectiveness of Care
Blue Plus (HMO Minnesota)
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 9:18 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
47.06%
32.38%
61.74%
16
31.37%
17.66%
45.09%
2011
A
51
Page 46
Effectiveness of Care
Blue Plus (HMO Minnesota)
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 22, 2012 9:18 AM
SNBC
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
30 Days
7 Days
NR
NR
NR
NR
NR
NR
Page 47
Effectiveness of Care
Blue Plus (HMO Minnesota)
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:18 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
1582
1253
79.20%
77.17%
81.24%
9
9
NA
NA
NA
1245
986
79.20%
76.90%
81.49%
75
48
64.00%
52.47%
75.53%
2911
2296
78.87%
77.37%
80.37%
2011
A
Page 48
Effectiveness of Care
Blue Plus (HMO Minnesota)
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:18 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
3565
3396
95.26%
94.55%
95.97%
422
412
97.63%
96.06%
99.20%
3961
3796
95.83%
95.20%
96.47%
437
373
85.35%
81.93%
88.78%
8385
7977
95.13%
94.67%
95.60%
2011
A
Page 50
Effectiveness of Care
Blue Plus (HMO Minnesota)
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:18 AM
SNBC
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 51
Effectiveness of Care
Blue Plus (HMO Minnesota)
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 22, 2012 9:18 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
3185
2673
83.92%
82.63%
85.22%
41
36
87.80%
76.57%
99.04%
2434
2032
83.48%
81.99%
84.98%
309
196
63.43%
57.90%
68.96%
5969
4937
82.71%
81.74%
83.68%
2011
A
Page 52
Access/Availability of Care
Blue Plus (HMO Minnesota)
Medication Reconciliation Post Discharge
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
population (before exclusions)
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2012 (Reporting Year 2011)
Data Last Refreshed:
Oct 22, 2012 9:18 AM
MSHO
2011
H
3204
0
0.00%
411
1.50%
473
0
0.00%
160
0
0
433
0
96
22.17%
18.14%
26.20%
Page 53
Effectiveness of Care
Blue Plus (HMO Minnesota)
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:18 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
133
13
9.77%
4.35%
15.20%
3230
685
21.21%
19.78%
22.63%
2011
A
582
94
16.15%
13.08%
19.23%
2515
578
22.98%
21.32%
24.65%
Page 55
Effectiveness of Care
Blue Plus (HMO Minnesota)
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 22, 2012 9:18 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
8607
At least 1
Prescription
At least 2
Prescriptions
1471
17.09%
16.29%
17.89%
177
2.06%
1.75%
2.36%
Page 57
Access/Availability of Care
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:18 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
5159
6811
242
12212
4871
6497
230
94.42%
93.78%
95.05%
95.39%
94.88%
95.90%
95.04%
92.10%
97.98%
11598
94.97%
94.58%
95.36%
2011
A
Page 58
Access/Availability of Care
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:18 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
8607
8607
0
0
8447
NA
NA
NA
NA
NA
NA
98.14%
97.85%
98.43%
8447
98.14%
97.85%
98.43%
2011
A
Page 60
Access/Availability of Care
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:18 AM
SNBC
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
NR
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
NR
NR
NR
NR
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 61
Access/Availability of Care
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 22, 2012 9:18 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
22547
13648
42
36237
20145
12363
40
89.35%
88.94%
89.75%
90.58%
90.09%
91.08%
95.24%
87.61%
100.00%
32548
89.82%
89.51%
90.13%
2011
A
Page 62
Access/Availability of Care
Blue Plus (HMO Minnesota)
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 22, 2012 9:18 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.
253
236
1271
1143
1396
1247
2579
2308
93.28%
90.00%
96.56%
89.93%
88.24%
91.62%
89.33%
87.67%
90.98%
89.49%
88.29%
90.69%
2011
A
Page 63
Access/Availability of Care
Blue Plus (HMO Minnesota)
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 22, 2012 9:18 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.
3376
3327
11287
10381
7099
6528
9600
8949
98.55%
98.13%
98.97%
91.97%
91.47%
92.48%
91.96%
91.32%
92.60%
93.22%
92.71%
93.73%
2011
A
Page 64
Access/Availability of Care
Blue Plus (HMO Minnesota)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:18 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
16
230
246
9
3
87
33
96
36
NA
NA
NA
NA
NA
NA
37.83%
31.34%
44.31%
14.35%
9.60%
19.10%
39.02%
32.73%
45.32%
14.63%
10.01%
19.25%
Page 65
Access/Availability of Care
Blue Plus (HMO Minnesota)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:18 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
136
0
136
0
0
74
9
74
9
NA
NA
NA
NA
NA
NA
54.41%
45.67%
63.15%
6.62%
2.07%
11.16%
54.41%
45.67%
63.15%
6.62%
2.07%
11.16%
Page 67
Access/Availability of Care
Blue Plus (HMO Minnesota)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:18 AM
SNBC
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 68
Access/Availability of Care
Blue Plus (HMO Minnesota)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 22, 2012 9:18 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
210
3210
3000
93
44
1221
439
1314
483
44.29%
37.33%
51.24%
20.95%
15.21%
26.69%
40.70%
38.93%
42.47%
14.63%
13.35%
15.91%
40.93%
39.22%
42.65%
15.05%
13.79%
16.30%
Page 69
Access/Availability of Care
Blue Plus (HMO Minnesota)
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
2011
A
339
2011
A
339
Current year's administrative rate (before exclusions)
NR
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
NR
NR
243
174
71.68%
66.74%
76.63%
51.33%
45.86%
56.80%
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
population (before exclusions)
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2012 (Reporting Year 2011)
Page 70
Access/Availability of Care
Blue Plus (HMO Minnesota)
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 22, 2012 9:18 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
4210
2011
H
4210
Number of numerator events by administrative data in eligible
population (before exclusions)
2516
2267
59.76%
411
10.00%
453
267
53.85%
411
10.00%
453
227
58.94%
50.11%
1
1
0
0
452
267
131
0
0
452
227
75
88.05%
84.95%
91.15%
66.81%
62.36%
71.27%
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
Blue Plus (HMO Minnesota)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 22, 2012 9:18 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
16
1
0
1
9
25
180
6.90%
3.42%
10.37%
0.43%
0.00%
1.49%
0.00%
0.00%
0.22%
0.43%
0.00%
1.49%
3.88%
1.18%
6.58%
10.78%
6.57%
14.98%
77.59%
72.00%
83.17%
2011
A
232
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
Blue Plus (HMO Minnesota)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
0
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Oversample List
0
HEDIS 2012 (Reporting Year 2011)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
29
1.03%
54
1.92%
64
2.28%
121
4.31%
318
11.32%
573
20.41%
1649
58.73%
3
0.70%
6
1.40%
22
5.12%
20
4.65%
43
10.00%
87
20.23%
249
57.91%
1
0
0.23%
0.00%
0.80%
5
0
1.16%
0.03%
2.29%
14
0
3.26%
1.46%
5.05%
16
3
4.42%
2.36%
6.48%
32
3
8.14%
5.44%
10.84%
63
8
16.51%
12.89%
20.14%
251
34
66.28%
61.69%
70.86%
409
5.00%
430
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
1 visit
2011
H
2808
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Zero Visits
430
Page 73
Use of Services
Blue Plus (HMO Minnesota)
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
2011
A
1070
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
HEDIS 2012 (Reporting Year 2011)
MHCP-MC
2011
H
9255
5987
NR
64.69%
371
5.00%
390
244
NR
62.56%
0
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Data Last Refreshed:
Oct 22, 2012 9:18 AM
0
745
69.63%
66.82%
72.43%
0
390
244
12
65.64%
60.80%
70.48%
Page 74
Use of Services
Blue Plus (HMO Minnesota)
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Commercial
2011
A
3576
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
4954
NR
32.11%
411
5.00%
432
151
NR
34.95%
0
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2012 (Reporting Year 2011)
MHCP-MC
2011
H
15430
0
1178
32.94%
31.39%
34.50%
0
432
151
23
40.28%
35.54%
45.02%
Page 75
Use of Services
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
3667
34954
48801
112474
124903
3467
219
22
0
328507
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
3104
10780
10777
27676
42431
1596
173
8
0
96545
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
846.47
308.41
220.84
246.07
339.71
460.34
789.95
363.64
293.89
Emergency Room Visits
Visits
138
616
674
1436
1469
45
4
0
0
4382
Visits/ 1,000
Member
Months
37.63
17.62
13.81
12.77
11.76
12.98
18.26
0.00
13.34
Page 76
Use of Services
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:18 AM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
0
0
3
31949
38653
49939
0
120544
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
4
28561
34561
38455
0
101581
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
1333.33
893.96
894.13
770.04
842.69
Emergency Room Visits
Visits
0
0
0
0
0
1692
1839
2155
0
5686
Visits/ 1,000
Member
Months
NA
NA
NA
NA
0.00
52.96
47.58
43.15
47.17
Page 78
Use of Services
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:18 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
NR
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Emergency Room Visits
Visits
NR
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 79
Use of Services
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Oct 22, 2012 9:18 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
67174
407413
323399
525653
249647
357
56
22
0
1573721
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
55120
141083
92695
230615
128397
266
38
10
0
648224
HEDIS 2012 (Reporting Year 2011)
Visits/ 1,000
Member
Months
820.56
346.29
286.63
438.72
514.31
745.10
678.57
454.55
411.91
Emergency Room Visits
Visits
6260
18939
11018
32227
8727
9
2
4
0
77186
Visits/ 1,000
Member
Months
93.19
46.49
34.07
61.31
34.96
25.21
35.71
181.82
49.05
Page 80
Use of Services
Blue Plus (HMO Minnesota)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:18 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
3667
34954
48801
112474
124903
3467
219
22
0
328507
Discharges
Discharges /
1,000 Member
Months
33
39
52
623
681
36
9
1
0
1474
9.00
1.12
1.07
5.54
5.45
10.38
41.10
45.45
28
24
30
114
278
16
6
1
0
497
7.64
0.69
0.61
1.01
2.23
4.61
27.40
45.45
5
15
20
103
402
20
3
0
0
568
1.36
0.43
0.41
0.92
3.22
5.77
13.70
0.00
2
406
0
0
408
0.04
3.61
0.00
HEDIS 2012 (Reporting Year 2011)
4.49
1.51
1.73
1.43
Days
Days / 1,000
Member
Months
160
82
185
1713
2239
119
27
4
0
4529
43.63
2.35
3.79
15.23
17.93
34.32
123.29
181.82
98
45
88
406
956
62
20
4
0
1679
26.72
1.29
1.80
3.61
7.65
17.88
91.32
181.82
62
37
87
262
1282
57
7
0
0
1794
16.91
1.06
1.78
2.33
10.26
16.44
31.96
0.00
10
1045
0
0
1055
0.20
9.29
0.00
13.79
5.11
5.46
3.69
Average
Length of Stay
4.85
2.10
3.56
2.75
3.29
3.31
3.00
4.00
NA
3.07
3.50
1.88
2.93
3.56
3.44
3.88
3.33
4.00
NA
3.38
12.40
2.47
4.35
2.54
3.19
2.85
2.33
NA
NA
3.16
5.00
2.57
NA
NA
2.59
Page 81
Use of Services
Blue Plus (HMO Minnesota)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:18 AM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Member Months
0
0
0
0
3
31949
38653
49939
0
120544
Discharges
0
0
0
0
0
1294
1703
2070
0
5067
Discharges /
1,000 Member
Months
NA
NA
NA
NA
0.00
40.50
44.06
41.45
42.03
0
0
0
0
0
1004
1396
1759
0
4159
NA
NA
NA
NA
0.00
31.43
36.12
35.22
0
0
0
0
0
287
302
305
0
894
NA
NA
NA
NA
0.00
8.98
7.81
6.11
0
0
0
0
0
HEDIS 2012 (Reporting Year 2011)
34.50
7.42
NA
NA
0.00
0.00
Days
0
0
0
0
0
6017
8169
8664
0
22850
0
0
0
0
0
4279
6089
6874
0
17242
0
0
0
0
0
1732
2059
1772
0
5563
0
0
0
0
0
Days / 1,000
Member
Months
NA
NA
NA
NA
0.00
188.33
211.34
173.49
189.56
NA
NA
NA
NA
0.00
133.93
157.53
137.65
143.03
NA
NA
NA
NA
0.00
54.21
53.27
35.48
46.15
NA
NA
0.00
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
4.65
4.80
4.19
NA
4.51
NA
NA
NA
NA
NA
4.26
4.36
3.91
NA
4.15
NA
NA
NA
NA
NA
6.03
6.82
5.81
NA
6.22
NA
NA
NA
NA
NA
Page 83
Use of Services
Blue Plus (HMO Minnesota)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:18 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Member Months
NR
Discharges
Discharges /
1,000 Member
Months
Days
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2012 (Reporting Year 2011)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Days / 1,000
Member
Months
NR
NR
NR
NR
NR
NR
Average
Length of Stay
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 84
Use of Services
Blue Plus (HMO Minnesota)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 22, 2012 9:18 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
67174
407413
323399
525653
249647
357
56
22
0
1573721
Discharges
Discharges /
1,000 Member
Months
649
717
1020
6951
2162
1
1
1
0
11502
9.66
1.76
3.15
13.22
8.66
2.80
17.86
45.45
558
573
339
1325
1220
0
1
1
0
4017
8.31
1.41
1.05
2.52
4.89
0.00
17.86
45.45
90
143
189
972
930
1
0
0
0
2325
1.34
0.35
0.58
1.85
3.73
2.80
0.00
0.00
489
4644
8
0
5141
HEDIS 2012 (Reporting Year 2011)
7.31
2.55
1.48
1.51
8.83
0.03
4.68
Days
Days / 1,000
Member
Months
2962
1943
2593
18099
7891
2
2
3
0
33495
44.09
4.77
8.02
34.43
31.61
5.60
35.71
136.36
2319
1397
849
3658
4051
0
2
3
0
12279
34.52
3.43
2.63
6.96
16.23
0.00
35.71
136.36
638
545
563
2658
3813
2
0
0
0
8219
9.50
1.34
1.74
5.06
15.27
5.60
0.00
0.00
1175
11735
20
0
12930
3.63
22.32
0.08
21.28
7.80
5.22
11.77
Average
Length of Stay
4.56
2.71
2.54
2.60
3.65
2.00
2.00
3.00
NA
2.91
4.16
2.44
2.50
2.76
3.32
NA
2.00
3.00
NA
3.06
7.09
3.81
2.98
2.73
4.10
2.00
NA
NA
NA
3.54
2.40
2.53
2.50
NA
2.52
Page 85
Use of Services
Blue Plus (HMO Minnesota)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:18 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
27138
12725
16635
16685
74546
1946
0
149675
25021
11973
17921
22648
97336
1762
0
176661
52159
24698
34556
39333
171882
3708
0
326336
27138
12725
16635
16685
74546
1946
0
149675
25021
11973
17921
22648
97336
1762
0
176661
52159
24698
34556
39333
171882
3708
0
326336
27138
12725
16635
16685
74546
1946
0
149675
25021
11973
17921
22648
97336
1762
0
176661
52159
24698
34556
39333
171882
3708
0
326336
27138
12725
16635
16685
74546
1946
0
149675
25021
11973
17921
22648
97336
1762
0
176661
52159
24698
34556
39333
171882
3708
0
326336
Any Services
Age
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Inpatient
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
22
11
33
57
29
86
32
16
48
117
63
180
2
2
4
0
0
0
230
121
351
0.00%
0.00%
0.00%
2.07%
1.10%
1.60%
4.11%
1.94%
2.99%
2.30%
0.85%
1.46%
1.88%
0.78%
1.26%
1.23%
1.36%
1.29%
NA
NA
NA
1.84%
0.82%
1.29%
0
0
0
12
5
17
21
7
28
4
3
7
33
16
49
1
0
1
0
0
0
71
31
102
0.00%
0.00%
0.00%
1.13%
0.50%
0.83%
1.51%
0.47%
0.97%
0.29%
0.16%
0.21%
0.53%
0.20%
0.34%
0.62%
0.00%
0.32%
NA
NA
NA
0.57%
0.21%
0.38%
0
0
0
1
0
1
1
0
1
1
0
1
1
1
2
0
0
0
0
0
0
4
1
5
0.00%
0.00%
0.00%
0.09%
0.00%
0.05%
0.07%
0.00%
0.03%
0.07%
0.00%
0.03%
0.02%
0.01%
0.01%
0.00%
0.00%
0.00%
NA
NA
NA
0.03%
0.01%
0.02%
0
0
0
20
8
28
50
26
76
32
16
48
110
56
166
2
2
4
0
0
0
214
108
322
0.00%
0.00%
0.00%
1.89%
0.80%
1.36%
3.61%
1.74%
2.64%
2.30%
0.85%
1.46%
1.77%
0.69%
1.16%
1.23%
1.36%
1.29%
NA
NA
NA
1.72%
0.73%
1.18%
HEDIS 2012 (Reporting Year 2011)
Page 86
Use of Services
Blue Plus (HMO Minnesota)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:18 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
13-17
18-24
25-34
35-64
65+
Unknown
Total
Member Months
(Outpatient/ED)
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
0
0
0
0
1
31014
0
31015
0
0
0
0
2
89527
0
89529
0
0
0
0
3
120541
0
120544
0
0
0
0
1
31014
0
31015
0
0
0
0
2
89527
0
89529
0
0
0
0
3
120541
0
120544
0
0
0
0
1
31014
0
31015
0
0
0
0
2
89527
0
89529
0
0
0
0
3
120541
0
120544
0
0
0
0
1
31014
0
31015
0
0
0
0
2
89527
0
89529
0
0
0
0
3
120541
0
120544
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
102
122
224
0
0
0
102
122
224
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.95%
1.64%
2.23%
NA
NA
NA
3.95%
1.64%
2.23%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
40
56
96
0
0
0
40
56
96
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
1.55%
0.75%
0.96%
NA
NA
NA
1.55%
0.75%
0.96%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
81
81
162
0
0
0
81
81
162
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.13%
1.09%
1.61%
NA
NA
NA
3.13%
1.09%
1.61%
HEDIS 2012 (Reporting Year 2011)
Page 88
Use of Services
Blue Plus (HMO Minnesota)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:18 AM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2012 (Reporting Year 2011)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Inpatient
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 89
Use of Services
Blue Plus (HMO Minnesota)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 22, 2012 9:18 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
296647
80069
66638
84372
176266
251
0
704243
285953
79010
112642
154703
236986
184
0
869478
582600
159079
179280
239075
413252
435
0
1573721
296647
80069
66638
84372
176266
251
0
704243
285953
79010
112642
154703
236986
184
0
869478
582600
159079
179280
239075
413252
435
0
1573721
296647
80069
66638
84372
176266
251
0
704243
285953
79010
112642
154703
236986
184
0
869478
582600
159079
179280
239075
413252
435
0
1573721
296647
80069
66638
84372
176266
251
0
704243
285953
79010
112642
154703
236986
184
0
869478
582600
159079
179280
239075
413252
435
0
1573721
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
13
6
19
355
231
586
798
685
1483
1415
1249
2664
2115
1516
3631
1
1
2
0
0
0
4697
3688
8385
0.05%
0.03%
0.04%
5.32%
3.51%
4.42%
14.37%
7.30%
9.93%
20.13%
9.69%
13.37%
14.40%
7.68%
10.54%
4.78%
6.52%
5.52%
NA
NA
NA
8.00%
5.09%
6.39%
2
1
3
121
88
209
251
230
481
366
349
715
642
401
1043
0
0
0
0
0
0
1382
1069
2451
0.01%
0.00%
0.01%
1.81%
1.34%
1.58%
4.52%
2.45%
3.22%
5.21%
2.71%
3.59%
4.37%
2.03%
3.03%
0.00%
0.00%
0.00%
NA
NA
NA
2.35%
1.48%
1.87%
0
0
0
12
11
23
20
15
35
28
26
54
37
27
64
0
0
0
0
0
0
97
79
176
0.00%
0.00%
0.00%
0.18%
0.17%
0.17%
0.36%
0.16%
0.23%
0.40%
0.20%
0.27%
0.25%
0.14%
0.19%
0.00%
0.00%
0.00%
NA
NA
NA
0.17%
0.11%
0.13%
12
5
17
343
214
557
753
619
1372
1357
1196
2553
1988
1443
3431
1
1
2
0
0
0
4454
3478
7932
0.05%
0.02%
0.04%
5.14%
3.25%
4.20%
13.56%
6.59%
9.18%
19.30%
9.28%
12.81%
13.53%
7.31%
9.96%
4.78%
6.52%
5.52%
NA
NA
NA
7.59%
4.80%
6.05%
HEDIS 2012 (Reporting Year 2011)
Page 90
Use of Services
Blue Plus (HMO Minnesota)
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Male
Female
Total
Male
Female
Total
27138
12725
107866
1946
0
149675
25021
11973
137905
1762
0
176661
52159
24698
245771
3708
0
326336
27138
12725
107866
1946
0
149675
25021
11973
137905
1762
0
176661
52159
24698
245771
3708
0
326336
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
27138
12725
107866
1946
0
149675
25021
11973
137905
1762
0
176661
52159
24698
245771
3708
0
326336
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
Member Months
(Outpatient/ED)
Male
Female
Total
27138
12725
107866
1946
0
149675
25021
11973
137905
1762
0
176661
52159
24698
245771
3708
0
326336
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
173
96
269
133
119
252
555
1176
1731
10
5
15
0
0
0
871
1396
2267
7.65%
4.60%
6.19%
12.54%
11.93%
12.24%
6.17%
10.23%
8.45%
6.17%
3.41%
4.85%
NA
NA
NA
6.98%
9.48%
8.34%
0
0
0
6
14
20
29
23
52
0
0
0
0
0
0
35
37
72
0.00%
0.00%
0.00%
0.57%
1.40%
0.97%
0.32%
0.20%
0.25%
0.00%
0.00%
0.00%
NA
NA
NA
0.28%
0.25%
0.26%
3
0
3
3
6
9
6
18
24
1
0
1
0
0
0
13
24
37
0.13%
0.00%
0.07%
0.28%
0.60%
0.44%
0.07%
0.16%
0.12%
0.62%
0.00%
0.32%
NA
NA
NA
0.10%
0.16%
0.14%
173
96
269
133
119
252
552
1173
1725
10
5
15
0
0
0
868
1393
2261
7.65%
4.60%
6.19%
12.54%
11.93%
12.24%
6.14%
10.21%
8.42%
6.17%
3.41%
4.85%
NA
NA
NA
6.96%
9.46%
8.31%
HEDIS 2012 (Reporting Year 2011)
Page 91
Use of Services
Blue Plus (HMO Minnesota)
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:18 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Male
Female
Total
Male
Female
Total
0
0
1
31014
0
31015
0
0
2
89527
0
89529
0
0
3
120541
0
120544
0
0
1
31014
0
31015
0
0
2
89527
0
89529
0
0
3
120541
0
120544
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
Male
Female
Total
0
0
1
31014
0
31015
0
0
1
31014
0
31015
0
0
2
89527
0
89529
0
0
3
120541
0
120544
0
0
2
89527
0
89529
0
0
3
120541
0
120544
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
0
0
0
349
980
1329
0
0
0
349
980
1329
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
13.50%
13.14%
13.23%
NA
NA
NA
13.50%
13.14%
13.23%
0
0
0
0
0
0
0
0
0
94
262
356
0
0
0
94
262
356
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.64%
3.51%
3.54%
NA
NA
NA
3.64%
3.51%
3.54%
0
0
0
0
0
0
0
0
0
0
7
7
0
0
0
0
7
7
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.09%
0.07%
NA
NA
NA
0.00%
0.09%
0.07%
0
0
0
0
0
0
0
0
0
280
792
1072
0
0
0
280
792
1072
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
10.83%
10.62%
10.67%
NA
NA
NA
10.83%
10.62%
10.67%
HEDIS 2012 (Reporting Year 2011)
Page 93
Use of Services
Blue Plus (HMO Minnesota)
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:18 AM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
Member Months
(Inpatient)
Female
Total
NR
NR
NR
NR
NR
NR
NR
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2012 (Reporting Year 2011)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
Outpatient/ED
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 94
Use of Services
Blue Plus (HMO Minnesota)
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 22, 2012 9:18 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
296647
80069
327276
251
0
704243
285953
79010
504331
184
0
869478
582600
159079
831607
435
0
1573721
296647
80069
327276
251
0
704243
285953
79010
504331
184
0
869478
582600
159079
831607
435
0
1573721
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
296647
80069
327276
251
0
704243
285953
79010
504331
184
0
869478
582600
159079
831607
435
0
1573721
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
296647
80069
327276
251
0
704243
285953
79010
504331
184
0
869478
582600
159079
831607
435
0
1573721
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
3298
2292
5590
1511
1718
3229
5498
10606
16104
2
1
3
0
0
0
10309
14617
24926
13.34%
9.62%
11.51%
22.65%
26.09%
24.36%
20.16%
25.24%
23.24%
9.56%
6.52%
8.28%
NA
NA
NA
17.57%
20.17%
19.01%
74
35
109
97
151
248
380
578
958
0
0
0
0
0
0
551
764
1315
0.30%
0.15%
0.22%
1.45%
2.29%
1.87%
1.39%
1.38%
1.38%
0.00%
0.00%
0.00%
NA
NA
NA
0.94%
1.05%
1.00%
57
27
84
43
77
120
132
326
458
0
0
0
0
0
0
232
430
662
0.23%
0.11%
0.17%
0.64%
1.17%
0.91%
0.48%
0.78%
0.66%
0.00%
0.00%
0.00%
NA
NA
NA
0.40%
0.59%
0.50%
3293
2292
5585
1500
1712
3212
5421
10524
15945
2
1
3
0
0
0
10216
14529
24745
13.32%
9.62%
11.50%
22.48%
26.00%
24.23%
19.88%
25.04%
23.01%
9.56%
6.52%
8.28%
NA
NA
NA
17.41%
20.05%
18.87%
HEDIS 2012 (Reporting Year 2011)
Page 95
Use of Services
Blue Plus (HMO Minnesota)
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 9:18 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)
216
525
741
324
659
983
234
900
1134
774
2084
2858
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)
45
90
135
59
111
170
32
117
149
136
318
454
Observed
Readmission
(Num/Den)
20.83%
17.14%
18.22%
18.21%
16.84%
17.29%
13.68%
13.00%
13.14%
17.57%
15.26%
15.89%
NA
NA
NA
NA
NA
NA
Average Adjusted
Probability
Total Variance
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
Average Adjusted
Probability
Total Variance
17.05%
15.59%
16.02%
17.92%
16.41%
16.91%
16.27%
14.66%
15.00%
17.18%
15.45%
15.92%
2900.47%
6572.53%
9473.00%
4611.94%
8597.75%
13209.69%
3112.76%
10976.81%
14089.57%
10625.17%
26147.09%
36772.26%
Page 97
Use of Services
Blue Plus (HMO Minnesota)
Plan All-Cause Readmissions
Data Last Refreshed:
Oct 22, 2012 9:18 AM
SNBC
Age
18-44
45-54
55-64
Total
Age
65-74
75-84
85+
Count of Index Stays
(Denominator)
Count of 30-Day
Readmissions
(Numerator)
Observed
Readmission
(Num/Den)
Average Adjusted
Probability
Total Variance
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Count of Index Stays
(Denominator)
Count of 30-Day
Readmissions
(Numerator)
Observed
Readmission
(Num/Den)
Average Adjusted
Probability
Total Variance
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
Total
HEDIS 2012 (Reporting Year 2011)
Page 98
Health Plan Descriptive Information
Blue Plus (HMO Minnesota)
Data Last Refreshed:
Oct 22, 2012 9:18 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
3345
3050
134
6708
2941
2702
133
6051
87.92%
88.59%
99.25%
90.21%
Page 99
Health Plan Descriptive Information
Blue Plus (HMO Minnesota)
Data Last Refreshed:
Oct 22, 2012 9:18 AM
Board Certification
SNBC
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2012 (Reporting Year 2011)
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
NR
NR
NR
NR
Page 100
Health Plan Descriptive Information
Blue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:18 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
1926
7330
10849
12091
7860
5248
Member Months
Female
1741
6863
9912
11094
7479
5029
Total
3667
14193
20761
23185
15339
10277
45304
30.05%
11446
7785
8965
9434
12312
42118
23.69%
12964
11155
11592
11574
15247
87422
26.61%
49942
33.13%
13498
14210
14138
11712
62532
35.18%
17542
18125
19319
16359
112474
34.24%
53558
35.53%
1398
389
101
48
1
9
71345
40.14%
1386
294
40
30
2
10
124903
38.02%
1946
1.29%
0
1762
0.99%
0
3708
1.13%
150750
177757
HEDIS 2012 (Reporting Year 2011)
24410
18940
20557
21008
27559
31040
32335
33457
28071
2784
683
141
78
3
19
0
328507
Page 101
Health Plan Descriptive Information
Blue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:18 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
Blue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:18 AM
MSHO
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0.00%
0
0
0
1
0
0.00%
0
0
0
2
0
0.00%
1
0.00%
5238
6010
5834
5652
4391
3889
2
0.00%
9240
11461
11814
15353
18149
23510
3
0.00%
31014
100.00%
0
89527
100.00%
0
120541
100.00%
31015
89529
HEDIS 2012 (Reporting Year 2011)
0
0
0
0
0
0
0
0
3
14478
17471
17648
21005
22540
27399
0
120544
Page 103
Health Plan Descriptive Information
Blue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:18 AM
SNBC
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2012 (Reporting Year 2011)
Page 104
Health Plan Descriptive Information
Blue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 22, 2012 9:18 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
34466
102812
104653
87552
47233
25104
Member Months
Female
32708
97528
102420
86357
45950
31203
Total
67174
200340
207073
173909
93183
56307
401820
57.06%
41534
43247
41125
32267
33154
396166
45.56%
81439
85600
69103
51487
46697
797986
50.71%
191327
27.17%
36849
33667
24408
15921
334326
38.45%
46070
41142
29297
22293
525653
33.40%
110845
15.74%
135
62
32
12
10
0
138802
15.96%
138
22
12
0
12
0
249647
15.86%
251
0.04%
0
184
0.02%
0
435
0.03%
704243
869478
HEDIS 2012 (Reporting Year 2011)
122973
128847
110228
83754
79851
82919
74809
53705
38214
273
84
44
12
22
0
0
1573721
Page 105