South Country Health Alliance
General Info
Disclaimers
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed: 10/24/2011
Page
2
Effectiveness of Care Measures
Code
Code
Effectiveness of Care Measures
Prevention and Screening
Medication Management
Page
ABA
Adult BMI Assessment
3
WCC
Weight Assessment and Counseling for Nutrition and Physical Activity for
Children/Adolescents
4
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
CIS
Childhood Immunization Status
6
IMA
Immunizations for Adolescents
10
BCS
Breast Cancer Screening
12
0 Code
CCS
Cervical Cancer Screening
13
COL
Colorectal Cancer Screening
14
30 AAP
31 CAP
29 DAE
CHL
Chlamydia Screening in Women
15
32
GSO
Glaucoma Screening in Older Adults
17
33 PPC
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
Page
IET
Access / Availability of Care Measures
Page
Adult's Access to Preventive/Ambulatory Health Services
58
Children's and Adolescents' Access to Primary Care Practitioners
63
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
65
Prenatal and Postpartum Care
70
Use of Services Measures
0 Code
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
Ambulatory Care
76
36
AWC
37 AMB
38
IPU
Inpatient Utilization - General Hospital/Acute Care
81
CMC
Cholesterol Management for Patients with Cardiovascular Conditions
26
39
IAD
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
31
41 BCR
Board Certification
96
42 ENP
Enrollment by Product Line (Age & Sex)
98
Cardiovascular
Diabetes
CDC
Comprehensive Diabetes Care
0 Code
Musculoskeletal
ART
OMW
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
36
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
43
Health Plan Descriptive Information Measures
Page
DISCLAIMERS
-1
( this page left blank intentionally )
0. Disclaimer Query located below
HEDIS 2011 (Reporting Year 2010)
Page 2
Effectiveness of Care
South Country Health Alliance
Adult BMI Assessment
Data Elements
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
Medicare
Advantage
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
2010
H
2402
Numerator Events by Admin Data on Eligible
Population (before exclusions)
113
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
NR
NR
NR
NR
4.70%
411
5.00%
432
29
6.71%
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 2011 (Reporting Year 2010)
NR
NR
NR
NR
NR
NR
0
432
29
216
56.71%
51.92%
61.50%
Page 3
Effectiveness of Care
South Country Health Alliance
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
Counseling for Nutrition
BMI Percentile
Data Elements
General
Measure
Data
Ages 3-11 Ages 12-17
Total
General
Measure
Data
Ages 3-11 Ages 12-17
Total
Counseling for Physical Activity
General
Ages 12Measure Ages 3-11
Total
17
Data
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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number of 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 2011 (Reporting Year 2010)
Page 4
Effectiveness of Care
South Country Health Alliance
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
BMI Percentile
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
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Nutrition
Total
2010
H
General
Measure
Data
Ages 3-11 Ages 12-17
Total
2010
H
Counseling for Physical Activity
General
Ages 12Measure Ages 3-11
Total
17
Data
2010
H
3972
1902
5874
3972
1902
5874
3972
1902
5874
7
0.18%
6
0.32%
13
0.22%
17
0.43%
19
1.00%
36
0.61%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
411
5.00%
411
5.00%
432
411
5.00%
432
2
0.46%
0
0.00%
2
0.46%
432
2
0.46%
2
0.46%
4
0.93%
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
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
301
131
432
301
131
432
301
131
432
2
182
61.13%
55.46%
66.80%
0
70
53.44%
44.51%
62.36%
2
252
58.80%
54.04%
63.55%
2
149
50.17%
44.35%
55.98%
2
60
47.33%
38.40%
56.26%
4
209
49.31%
44.48%
54.14%
0
134
44.52%
38.74%
50.30%
0
58
44.27%
35.39%
53.16%
0
192
44.44%
39.64%
49.25%
Page 5
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
Data Elements
General
Measure
Data
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
IPV
MMR
HiB
Hepatitis B
VZV
Influenza
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical data records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by administrative Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Page 6
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
Data Elements
General
Measure
Data
DTaP
Combo 2
Combo 3
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical data records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by administrative Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Page 7
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
HiB
Hepatitis B
VZV
Influenza
633
79.32%
724
90.73%
723
90.60%
678
84.96%
707
88.60%
690
86.47%
639
80.08%
259
32.46%
443
55.51%
402
50.38%
352
81.48%
398
92.13%
395
91.44%
378
87.50%
383
88.66%
378
87.50%
359
83.10%
145
33.56%
248
57.41%
210
48.61%
352
8
83.33%
79.70%
86.96%
398
7
93.75%
91.35%
96.15%
395
3
92.13%
89.47%
94.78%
378
9
89.58%
86.59%
92.58%
383
12
91.44%
88.68%
94.19%
378
1
87.73%
84.52%
90.94%
359
13
86.11%
82.73%
89.49%
145
3
34.26%
29.67%
38.85%
248
8
59.26%
54.51%
64.01%
210
4
49.54%
44.71%
54.37%
432
0
Numerator Events by administrative Data
MMR
411
0.05
Number of Records Excluded Because of
Valid Data Errors
Denominator
IPV
2010
H
798
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
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
633
79.32%
531
66.54%
505
63.28%
214
26.82%
318
39.85%
297
37.22%
164
20.55%
154
19.30%
188
23.56%
116
14.54%
352
81.48%
299
69.21%
285
65.97%
118
27.31%
180
41.67%
160
37.04%
91
21.06%
81
18.75%
98
22.69%
60
13.89%
352
8
83.33%
79.70%
86.96%
299
14
72.45%
68.13%
76.78%
285
17
69.91%
65.47%
74.35%
118
7
28.94%
24.54%
33.33%
180
12
44.44%
39.64%
49.25%
160
7
38.66%
33.95%
43.37%
91
6
22.45%
18.40%
26.50%
81
4
19.68%
15.81%
23.54%
98
5
23.84%
19.71%
27.98%
60
3
14.58%
11.14%
18.03%
432
0
Numerator Events by administrative Data
Combo 3
411
0.05
Number of Records Excluded Because of
Valid Data Errors
Denominator
Combo 2
2010
H
798
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
South Country Health Alliance
Immunizations for Adolescents
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
Data Elements
General
Measure Data
Meningococcal
Tdap
Combo 1
Current Year's Admin Rate
NR
NR
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
NR
NR
NR
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
NR
NR
NR
Lower 95% Confidence Interval
NR
NR
NR
Upper 95% Confidence Interval
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical data records excluded
Number of employee/dependent medical records
excluded
HEDIS 2011 (Reporting Year 2010)
Page 10
Effectiveness of Care
South Country Health Alliance
Immunizations for Adolescents
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Data Elements
Measure Data
2010
Measurement Year
H
Data Collection Methodology
440
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
0
Number of administrative data records excluded
0
Number of medical data records excluded
0
Number of employee/dependent medical records
excluded
0
HEDIS 2011 (Reporting Year 2010)
Tdap
Combo 1
178
362
171
40.45%
82.27%
38.86%
179
41.44%
361
83.56%
172
39.81%
179
5
42.59%
37.81%
47.37%
361
6
84.95%
81.47%
88.44%
172
5
40.97%
36.22%
45.73%
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
South Country Health Alliance
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 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
NR
NR
NR
Medicare
Advantage
NR
NR
NR
MSHO
SNBC
MHCP-MC
2010
A
71
50
70.42%
59.10%
81.74%
2010
A
265
208
78.49%
73.35%
83.63%
2010
A
434
248
57.14%
52.37%
61.91%
Page 12
Effectiveness of Care
South Country Health Alliance
Cervical Cancer Screening
Data Elements
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
2010
H
3100
Numerator Events by Admin Data on Eligible
Population (before exclusions)
2064
Current Year's Admin Rate
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
NR
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
66.58%
411
5.00%
432
295
68.29%
0
1
3
0
NR
0
428
295
29
75.70%
NR
NR
71.52%
79.88%
Page 13
Effectiveness of Care
South Country Health Alliance
Colorectal Cancer Screening
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Data Elements
Medicare
Advantage
MSHO
SNBC
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
2010
H
367
2010
H
306
Number of numerator events by administrative data in eligible population
(before exclusions)
131
125
35.69%
362
0.00%
362
150
41.44%
0
0
0
0
0
362
150
28
49.17%
43.88%
54.46%
40.85%
305
0.00%
305
150
49.18%
0
0
1
0
0
304
150
24
57.24%
51.51%
62.96%
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid data errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical records
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
Commercial
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 14
Effectiveness of Care
South Country Health Alliance
Chlamydia Screening in Women
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Ages 16-20
NR
NR
NR
Ages 21-24
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 15
Effectiveness of Care
South Country Health Alliance
Chlamydia Screening in Women
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Ages 16-20
Ages 21-24
Total
468
191
40.81%
36.25%
45.37%
467
216
46.25%
41.62%
50.88%
935
407
43.53%
40.30%
46.76%
2010
A
Page 16
Effectiveness of Care
South Country Health Alliance
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 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Medicare
Advantage
NR
NR
NR
MSHO
2010
A
1311
931
71.01%
68.52%
73.51%
Page 17
Effectiveness of Care
South Country Health Alliance
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Lead Screening in Children
Data Elements
Commercial
Measurement Year
Data Collection Methodology
Eligible Member Population
MHCP-MC
2010
A
798
Numerator Events by Admin Data on
Eligible Population (before exclusions)
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
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
670
Reported Rate
NR
83.96%
Lower 95% Confidence Interval
NR
81.35%
Upper 95% Confidence Interval
NR
86.57%
HEDIS 2011 (Reporting Year 2010)
Page 18
Effectiveness of Care
South Country Health Alliance
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Care for Older Adults
MSHO
Medication Review
Functional
Status
Assessment
Pain
Screening
157
1
0
0
9.99%
0.06%
0.00%
0.00%
68
16.55%
0
0.00%
0
0.00%
0
0.00%
68
174
0
338
0
237
0
268
Reported Rate
58.88%
82.24%
57.66%
65.21%
Lower 95% Confidence Interval
54.00%
78.42%
52.77%
60.48%
Upper 95% Confidence Interval
63.76%
86.06%
62.56%
69.93%
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General Measure
Data
2010
H
1572
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
0.00%
411
Records Excluded because of Valid Data
Errors
0
Number of employee/dependent medical
records excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
HEDIS 2011 (Reporting Year 2010)
Advance Care
Planning
0
411
Page 19
Effectiveness of Care
South Country Health Alliance
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
NR
NR
NR
NR
NR
NR
Page 20
Effectiveness of Care
South Country Health Alliance
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
27
65.85%
50.12%
81.59%
36
87.80%
76.57%
99.04%
2010
A
41
Page 21
Effectiveness of Care
South Country Health Alliance
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
6
NA
NA
NA
10
NA
NA
NA
2010
A
11
Page 22
Effectiveness of Care
South Country Health Alliance
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 2011 (Reporting Year 2010)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Oct 24, 2011 8:53 AM
MSHO
SNBC
2010
A
34
3
8.82%
0.00%
19.83%
2010
A
8
1
NA
NA
NA
Page 23
Effectiveness of Care
South Country Health Alliance
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Ages 5-11
NR
NR
NR
Ages 12-50
Total
NR
NR
NR
NR
NR
NR
NR
NR
`
Page 24
Effectiveness of Care
South Country Health Alliance
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Ages 5-11
Ages 12-50
Total
82
73
89.02%
81.65%
96.40%
130
107
82.31%
75.36%
89.25%
212
180
84.91%
79.85%
89.96%
2010
A
Page 25
Effectiveness of Care
South Country Health Alliance
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 26
Effectiveness of Care
South Country Health Alliance
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
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
South Country Health Alliance
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
29
0
67.44%
0.00%
30
0
69.77%
0.00%
30
1
0
20
72.09%
57.52%
86.66%
46.51%
30.44%
62.58%
2009
H
43
43
0.00%
43
0
0
0
43
Page 28
Effectiveness of Care
South Country Health Alliance
Controlling High Blood Pressure
Data Elements
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Medicare
Advantage
MSHO
SNBC
MHCP-MC
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2010
H
333
2010
H
133
2010
H
330
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
0
0
0.00%
257
0.00%
257
0.00%
116
0.00%
116
0.00%
325
0.00%
325
0
0.00%
0
0.00%
0
0.00%
Records Excluded because of Valid Data
Errors
0
0
2
Number of records excluded because of
false positive diagnoses
0
0
2
Number of administrative data records
excluded
1
0
0
Number of medical record data records
excluded
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
256
0
193
75.39%
69.92%
80.86%
0
116
0
92
79.31%
71.51%
87.11%
0
323
0
210
65.02%
59.66%
70.37%
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Added from the OverSample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Commercial
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 29
Effectiveness of Care
South Country Health Alliance
Persistence of Beta Blocker Treatment After Heart Attack
Data Elements
Commercial
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Medicare
Advantage
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
NR
NR
NR
NR
NR
NR
MSHO
SNBC
MHCP-MC
2010
A
20
2010
A
2
2010
A
6
15
2
3
NA
NA
NA
NA
NA
NA
NA
NA
NA
Page 30
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
Data Elements
HbA1c
Testing
Poor HbA1c
Control
(>9.0%)
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80
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 2011 (Reporting Year 2010)
Page 31
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Medicare Advantage
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80
mm Hg
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 2011 (Reporting Year 2010)
Page 32
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:53 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
HbA1c
Testing
Poor HbA1c
Control
2010
H
157
2010
H
157
148
94.27%
157
0%
157
148
94.27%
157
100.00%
157
0%
157
157
100.00%
Good HbA1c
Control
(<7.0%)
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2010
H
157
2010
H
157
2010
H
157
2010
H
157
2010
H
157
2010
H
157
2010
H
157
0
0.00%
157
0%
157
0
0.00%
105
66.88%
157
0%
157
109
69.43%
137
87.26%
157
0%
157
139
88.54%
0
0.00%
157
0%
157
0
0.00%
141
89.81%
157
0%
157
141
89.81%
0
0.00%
157
0%
157
0
0.00%
0
0.00%
157
0%
157
0
0.00%
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80
mm Hg
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
157
148
2
95.54%
91.99%
99.09%
0
157
26
4
19.11%
12.64%
25.58%
0
157
0
116
73.89%
66.70%
81.07%
0
157
109
10
75.80%
68.78%
82.81%
0
157
139
1
89.17%
83.99%
94.35%
0
157
0
98
62.42%
54.53%
70.31%
0
157
141
2
91.08%
86.31%
95.86%
0
157
0
128
81.53%
75.14%
87.92%
0
157
0
120
76.43%
69.48%
83.39%
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 2011 (Reporting Year 2010)
NR
NR
NR
Page 33
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:53 AM
SNBC
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
HbA1c
Testing
Poor HbA1c
Control
2010
H
167
2010
H
167
150
89.82%
166
0%
166
150
90.36%
167
100.00%
166
0%
166
166
100.00%
Good HbA1c
Control
(<7.0%)
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80
mm Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2010
H
167
2010
H
167
2010
H
167
2010
H
167
2010
H
167
2010
H
167
2010
H
167
0
0.00%
166
0%
166
0
0.00%
119
71.26%
166
0%
166
119
71.69%
133
79.64%
166
0%
166
137
82.53%
0
0.00%
166
0%
166
0
0.00%
127
76.05%
166
0%
166
129
77.71%
1
0.60%
166
0%
166
0
0.00%
1
0.60%
166
0%
166
0
0.00%
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
166
150
4
92.77%
88.53%
97.01%
0
166
28
12
24.10%
17.29%
30.90%
0
166
0
113
68.07%
60.68%
75.47%
0
166
119
14
80.12%
73.75%
86.49%
0
166
137
1
83.13%
77.13%
89.13%
0
166
0
89
53.61%
45.73%
61.50%
0
166
129
7
81.93%
75.77%
88.08%
0
166
0
133
80.12%
73.75%
86.49%
0
166
0
120
72.29%
65.18%
79.40%
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 2011 (Reporting Year 2010)
NR
NR
NR
Page 34
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:53 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
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2010
H
337
2010
H
337
2010
H
307
2010
H
337
2010
H
337
2010
H
337
2010
H
337
2010
H
337
2010
H
337
2010
H
337
272
80.71%
311
0%
311
263
84.57%
337
100.00%
311
0%
311
311
100.00%
0
0.00%
311
0%
311
0
0.00%
0
0.00%
311
0%
311
0
0.00%
188
55.79%
311
0%
311
174
55.95%
210
62.31%
311
0%
311
215
69.13%
1
0.30%
311
0%
311
1
0.32%
217
64.39%
311
0%
311
217
69.77%
1
0.30%
311
0%
311
1
0.32%
0
0.00%
311
0%
311
0
0.00%
0
0
34
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
311
0
160
51.45%
45.73%
57.16%
0
311
174
21
62.70%
57.17%
68.24%
0
311
215
6
71.06%
65.86%
76.26%
0
311
1
89
28.94%
23.74%
34.14%
0
311
217
12
73.63%
68.58%
78.69%
0
311
1
254
81.99%
77.56%
86.42%
0
311
0
204
65.59%
60.15%
71.04%
Number of Administrative required exclusions
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Blood
Pressure
<130/80
mm Hg
33
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
1
0
311
263
8
87.14%
83.26%
91.02%
0
311
61
58
38.26%
32.70%
43.83%
0
277
0
96
34.66%
28.87%
40.44%
Page 35
Effectiveness of Care
South Country Health Alliance
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 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Medicare
Advantage
NR
NR
NR
Page 36
Effectiveness of Care
South Country Health Alliance
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 2011 (Reporting Year 2010)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Oct 24, 2011 8:53 AM
MSHO
2010
A
77
10
12.99%
4.83%
21.14%
Page 37
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Effective
Acute Phase
Treatment
Effective
Continuation
Phase
Treatment
NR
NR
NR
NR
NR
NR
Page 38
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Effective
Acute Phase
Treatment
Effective
Continuation
Phase
Treatment
NR
NR
NR
NR
NR
NR
Page 39
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Effective
Acute Phase
Treatment
Effective
Continuation
Phase
Treatment
12
NA
NA
NA
11
NA
NA
NA
2010
A
17
Page 40
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Effective
Acute Phase
Treatment
Effective
Continuation
Phase
Treatment
1
NA
NA
NA
0
NA
NA
NA
2010
A
3
Page 41
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Effective
Acute Phase
Treatment
Effective
Continuation
Phase
Treatment
121
52.16%
45.51%
58.80%
81
34.91%
28.56%
41.26%
2010
A
232
Page 42
Effectiveness of Care
South Country Health Alliance
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
NR
NR
NR
NR
NR
NR
Page 43
Effectiveness of Care
South Country Health Alliance
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
163
80
49.08%
41.10%
57.06%
61
31
50.82%
37.45%
64.19%
2010
A
Page 44
Effectiveness of Care
South Country Health Alliance
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
30 Days
7 Days
NR
NR
NR
NR
NR
NR
Page 45
Effectiveness of Care
South Country Health Alliance
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
30 Days
7 Days
5
NA
NA
NA
3
NA
NA
NA
2010
A
11
Page 46
Effectiveness of Care
South Country Health Alliance
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
30 Days
7 Days
29
76.32%
61.48%
91.15%
25
65.79%
49.39%
82.19%
2010
A
38
Page 47
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 48
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
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
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
649
599
92.30%
90.17%
94.42%
95
93
97.89%
94.48%
100.00%
763
727
95.28%
93.71%
96.85%
94
84
89.36%
82.60%
96.13%
1601
1503
93.88%
92.67%
95.08%
2010
A
Page 50
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
134
121
90.30%
84.91%
95.68%
7
6
NA
NA
NA
121
109
90.08%
84.34%
95.82%
121
99
81.82%
74.53%
89.10%
383
335
87.47%
84.02%
90.91%
2010
A
Page 51
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
273
230
84.25%
79.74%
88.75%
2
2
NA
NA
NA
206
168
81.55%
76.01%
87.09%
42
28
66.67%
51.22%
82.11%
523
428
81.84%
78.44%
85.24%
2010
A
Page 52
Access/Availability of Care
South Country Health Alliance
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 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:53 AM
MSHO
2010
H
1025
0
0.00%
432
5%
432
0
0.00%
19
0
0
413
0
39
9.44%
6.50%
12.38%
Page 53
Effectiveness of Care
South Country Health Alliance
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
History of Falls +
Tricyclic
Antidepressants,
Antipsychotics or
Sleep Agents
NR
NR
NR
Chronic Renal
Dementia +
Failure +
Tricyclic
Antidepressants Nonaspirin NSAIDs
or Anticholinergic or Cox-2 Selective
NSAIDs
Agents
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
Page 54
Effectiveness of Care
South Country Health Alliance
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
History of Falls +
Tricyclic
Antidepressants,
Antipsychotics or
Sleep Agents
Chronic Renal
Dementia +
Failure +
Tricyclic
Antidepressants Nonaspirin NSAIDs
or Anticholinergic or Cox-2 Selective
NSAIDs
Agents
Total
2010
A
120
25
20.83%
13.15%
28.52%
453
109
24.06%
20.02%
28.11%
20
1
NA
NA
NA
593
135
22.77%
19.31%
26.22%
Page 55
Effectiveness of Care
South Country Health Alliance
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
At least 1
Prescription
At least 2
Prescriptions
NR
NR
NR
NR
NR
NR
Page 56
Effectiveness of Care
South Country Health Alliance
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure
Data
2010
A
1574
At least 1
Prescription
At least 2
Prescriptions
337
21.41%
19.35%
23.47%
47
2.99%
2.11%
3.86%
Page 57
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
Data Elements
General
Measure Data
Ages 20-44
Ages 45-64
Ages 65+
Total
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
NR
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
NR
NR
NR
NR
HEDIS 2011 (Reporting Year 2010)
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 58
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 59
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Ages 20-44
Ages 45-64
Ages 65+
Total
0
0
1574
1574
0
0
1540
NA
NA
NA
NA
NA
NA
97.84%
97.09%
98.59%
1540
97.84%
97.09%
98.59%
2010
A
Page 60
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:53 AM
SNBC
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
General
Measure Data
Ages 20-44
Ages 45-64
Ages 65+
Total
235
472
21
728
231
466
20
98.30%
96.43%
100.00%
98.73%
97.61%
99.85%
NA
NA
NA
717
98.49%
97.53%
99.44%
2010
A
Page 61
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General
Measure Data
Ages 20-44
Ages 45-64
Ages 65+
Total
4052
1066
1
5119
3640
938
1
89.83%
88.89%
90.78%
87.99%
85.99%
89.99%
NA
NA
NA
4579
89.45%
88.60%
90.30%
2010
A
Page 62
Access/Availability of Care
South Country Health Alliance
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General Measure
Data
12-24 months
25 months 6 yrs.
7-11 yrs.
12-19 yrs.
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 63
Access/Availability of Care
South Country Health Alliance
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
General Measure
Data
12-24 months
25 months 6 yrs.
7-11 yrs.
12-19 yrs.
1018
986
3091
2715
1698
1487
1880
1687
96.86%
95.74%
97.98%
87.84%
86.67%
89.00%
87.57%
85.98%
89.17%
89.73%
88.34%
91.13%
2010
A
Page 64
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 65
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Medicare Advantage
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 2011 (Reporting Year 2010)
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
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
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
2010
A
0
31
31
0
0
11
2
11
2
NA
NA
NA
NA
NA
NA
35.48%
17.03%
53.94%
6.45%
0.00%
16.71%
35.48%
17.03%
53.94%
6.45%
0.00%
16.71%
Page 67
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:53 AM
SNBC
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
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
2010
A
0
66
66
0
0
27
5
27
5
NA
NA
NA
NA
NA
NA
40.91%
28.29%
53.53%
7.58%
0.43%
14.72%
40.91%
28.29%
53.53%
7.58%
0.43%
14.72%
Page 68
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
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
2010
A
41
472
513
23
12
199
88
222
100
56.10%
39.69%
72.51%
29.27%
14.12%
44.42%
42.16%
37.60%
46.72%
18.64%
15.02%
22.26%
43.27%
38.89%
47.66%
19.49%
15.97%
23.02%
Page 69
Access/Availability of Care
South Country Health Alliance
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
Current year's administrative rate (before exclusions)
NR
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
NR
NR
NR
NR
NR
NR
NR
NR
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
population (before exclusions)
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
Page 70
Access/Availability of Care
South Country Health Alliance
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 2011 (Reporting Year 2010)
Timeliness of
Prenatal Care
Postpartum
Care
2010
H
1298
2010
H
1298
787
741
60.63%
411
5%
432
263
57.09%
411
5%
432
249
60.88%
57.64%
2
2
0
0
430
263
97
0
0
430
249
64
83.72%
80.12%
87.33%
72.79%
68.47%
77.11%
Page 71
Use of Services
South Country Health Alliance
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
Data Elements
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of employee/dependent medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Page 72
Use of Services
South Country Health Alliance
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 24, 2011 8:53 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 2011 (Reporting Year 2010)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
29
3.59%
21
2.60%
25
3.10%
47
5.82%
105
13.01%
166
20.57%
414
51.30%
19
4.62%
13
3.16%
11
2.68%
27
6.57%
47
11.44%
75
18.25%
219
53.28%
8
0
1.95%
0.49%
3.40%
6
1
1.70%
0.33%
3.08%
9
3
2.92%
1.17%
4.67%
16
2
4.38%
2.28%
6.48%
25
6
7.54%
4.87%
10.22%
39
13
12.65%
9.32%
15.99%
230
53
68.86%
64.26%
73.46%
411
0.00%
411
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
2009
H
807
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Zero Visits
411
Page 73
Use of Services
South Country Health Alliance
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Commercial
Measurement Year
Data Collection Methodology
Data Last Refreshed:
Oct 24, 2011 8:53 AM
MHCP-MC
2010
A
2452
Eligible Member Population
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
NR
NR
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 2011 (Reporting Year 2010)
1470
NR
NR
NR
59.95%
57.99%
61.91%
Page 74
Use of Services
South Country Health Alliance
Adolescent Well-Care Visits
Data Elements
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
2010
H
3241
Numerator events by admin data in eligible
population
952
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
NR
29.37%
411
0.00%
411
130
NR
31.63%
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 2011 (Reporting Year 2010)
0
NR
NR
NR
0
411
130
46
42.82%
37.92%
47.73%
Page 75
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
NR
Outpatient Visits (Excludes
MH/CD)
Age
Visits
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits/ 1,000
Member
Months
NR
NR
Emergency Room Visits
Visits
NR
NR
NR
NR
NR
NR
NR
HEDIS 2011 (Reporting Year 2010)
NR
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 76
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Medicare Advantage
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Member Months
NR
Total
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 2011 (Reporting Year 2010)
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
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:53 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
0
5781
6647
10003
0
22431
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
0
5727
6403
7817
0
19947
HEDIS 2011 (Reporting Year 2010)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
990.66
963.29
781.47
889.26
Emergency Room Visits
Visits
0
0
0
0
0
465
355
427
0
1247
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
80.44
53.41
42.69
55.59
Page 78
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:53 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
17
3135
6110
196
0
0
0
9458
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
3
2655
5840
126
0
0
0
8624
HEDIS 2011 (Reporting Year 2010)
Visits/ 1,000
Member
Months
NA
NA
176.47
846.89
955.81
642.86
NA
NA
911.82
Emergency Room Visits
Visits
0
0
0
239
428
7
0
0
0
674
Visits/ 1,000
Member
Months
NA
NA
0.00
76.24
70.05
35.71
NA
NA
71.26
Page 79
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:53 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
19850
116571
77920
104611
21969
9
0
0
0
340930
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
18267
45297
25532
61981
13080
4
0
0
0
164161
HEDIS 2011 (Reporting Year 2010)
Visits/ 1,000
Member
Months
920.25
388.58
327.67
592.49
595.38
444.44
NA
NA
481.51
Emergency Room Visits
Visits
1958
5725
3035
8406
926
0
0
0
0
20050
Visits/ 1,000
Member
Months
98.64
49.11
38.95
80.35
42.15
0.00
NA
NA
58.81
Page 80
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
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
Data Last Refreshed:
Oct 24, 2011 8:53 AM
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 2011 (Reporting Year 2010)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Days / 1,000
Member
Months
NR
NR
NR
NR
NR
NR
Average
Length of Stay
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 81
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Medicare Advantage
Age
Member Months
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
NR
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
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 2011 (Reporting Year 2010)
NR
NR
NR
NR
NR
NR
NR
NR
NR
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
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
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
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Member Months
0
0
0
0
0
5781
6647
10003
0
22431
Discharges
0
0
0
0
0
240
268
364
0
872
0
0
0
0
0
184
208
312
0
704
0
0
0
0
0
56
60
52
0
168
0
0
0
0
0
HEDIS 2011 (Reporting Year 2010)
Discharges /
1,000 Member
Months
NA
NA
NA
NA
NA
41.52
40.32
36.39
38.87
NA
NA
NA
NA
NA
31.83
31.29
31.19
31.39
NA
NA
NA
NA
NA
9.69
9.03
5.20
7.49
NA
NA
NA
NA
Days
0
0
0
0
0
1007
1099
1504
0
3610
Days / 1,000
Member
Months
NA
NA
NA
NA
NA
174.19
165.34
150.35
160.94
0
0
0
0
0
661
739
1199
0
2599
NA
NA
NA
NA
NA
114.34
111.18
119.86
0
0
0
0
0
346
360
305
0
1011
NA
NA
NA
NA
NA
59.85
54.16
30.49
0
0
0
0
0
115.87
45.07
NA
NA
NA
NA
Average
Length of Stay
NA
NA
NA
NA
NA
4.20
4.10
4.13
NA
4.14
NA
NA
NA
NA
NA
3.59
3.55
3.84
NA
3.69
NA
NA
NA
NA
NA
6.18
6.00
5.87
NA
6.02
NA
NA
NA
NA
NA
Page 83
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
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
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Member Months
0
0
17
3135
6110
196
0
0
0
9458
Discharges
0
0
0
34
170
4
0
0
0
208
0
0
0
23
113
3
0
0
0
139
Discharges /
1,000 Member
Months
NA
NA
0.00
10.85
27.82
20.41
NA
NA
21.99
NA
NA
0.00
7.34
18.49
15.31
NA
NA
14.70
0
0
0
8
57
1
0
0
0
66
NA
NA
0.00
2.55
9.33
5.10
NA
NA
0
3
0
0
3
0.00
0.96
0.00
HEDIS 2011 (Reporting Year 2010)
6.98
0.32
Days
Days / 1,000
Member
Months
0
0
0
120
758
19
0
0
0
897
NA
NA
0.00
38.28
124.06
96.94
NA
NA
0
0
0
92
400
6
0
0
0
498
NA
NA
0.00
29.35
65.47
30.61
NA
NA
94.84
52.65
0
0
0
22
358
13
0
0
0
393
NA
NA
0.00
7.02
58.59
66.33
NA
NA
0
6
0
0
6
0.00
1.91
0.00
41.55
0.65
Average
Length of Stay
NA
NA
NA
3.53
4.46
4.75
NA
NA
NA
4.31
NA
NA
NA
4.00
3.54
2.00
NA
NA
NA
3.58
NA
NA
NA
2.75
6.28
13.00
NA
NA
NA
5.95
NA
2.00
NA
NA
2.00
Page 84
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
<1
19850
1-9
116571
10-19
77920
20-44
104611
45-64
21969
65-74
9
75-84
0
85+
0
Unknown
0
Total
340930
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
Discharges
Discharges /
1,000 Member
Months
165
232
321
2020
264
0
0
0
0
3002
8.31
1.99
4.12
19.31
12.02
0.00
NA
NA
134
172
64
261
117
0
0
0
0
748
6.75
1.48
0.82
2.49
5.33
0.00
NA
NA
31
60
56
366
146
0
0
0
0
659
1.56
0.51
0.72
3.50
6.65
0.00
NA
NA
201
1393
1
0
1595
2.58
13.32
0.05
HEDIS 2011 (Reporting Year 2010)
8.81
2.19
1.93
7.80
Days
Days / 1,000
Member
Months
696
557
817
4994
887
0
0
0
0
7951
35.06
4.78
10.49
47.74
40.38
0.00
NA
NA
499
367
147
713
331
0
0
0
0
2057
25.14
3.15
1.89
6.82
15.07
0.00
NA
NA
197
190
159
941
554
0
0
0
0
2041
9.92
1.63
2.04
9.00
25.22
0.00
NA
NA
511
3340
2
0
3853
6.56
31.93
0.09
23.32
6.03
5.99
18.84
Average
Length of Stay
4.22
2.40
2.55
2.47
3.36
NA
NA
NA
NA
2.65
3.72
2.13
2.30
2.73
2.83
NA
NA
NA
NA
2.75
6.35
3.17
2.84
2.57
3.79
NA
NA
NA
NA
3.10
2.54
2.40
2.00
NA
2.42
Page 85
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
Female
NR
NR
Total
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 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
Female
NR
NR
Total
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
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
Female
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
Total
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 86
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Medicare Advantage
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
Female
NR
NR
Total
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 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
Female
NR
NR
Total
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
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
Female
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
Total
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
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:53 AM
MSHO
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
0
0
5926
0
5926
Female
0
0
0
0
0
16505
0
16505
Total
0
0
0
0
0
22431
0
22431
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24
23
47
0
0
0
24
23
47
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
0
0
0
0
0
5926
0
5926
Female
0
0
0
0
0
16505
0
16505
Total
0
0
0
0
0
22431
0
22431
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
11
14
25
0
0
0
11
14
25
Female
0
0
0
0
0
16505
0
16505
Total
0
0
0
0
0
22431
0
22431
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
4.86%
1.67%
2.51%
NA
NA
NA
4.86%
1.67%
2.51%
Male
0
0
0
0
0
5926
0
5926
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
2.23%
1.02%
1.34%
NA
NA
NA
2.23%
1.02%
1.34%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Member Months
(Outpatient/ED)
Male
0
0
0
0
0
5926
0
5926
Female
0
0
0
0
0
16505
0
16505
Total
0
0
0
0
0
22431
0
22431
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18
10
28
0
0
0
18
10
28
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
3.64%
0.73%
1.50%
NA
NA
NA
3.64%
0.73%
1.50%
Page 88
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:53 AM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
146
480
3366
67
0
4059
Female
0
0
133
622
4515
129
0
5399
Total
0
0
279
1102
7881
196
0
9458
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
0
0
0
0
0
0
2
2
4
2
4
6
41
52
93
0
1
1
0
0
0
45
59
104
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
146
480
3366
67
0
4059
Female
0
0
133
622
4515
129
0
5399
Total
0
0
279
1102
7881
196
0
9458
Inpatient
Percent
NA
NA
NA
NA
NA
NA
16.44%
18.05%
17.20%
5.00%
7.72%
6.53%
14.62%
13.82%
14.16%
0.00%
9.30%
6.12%
NA
NA
NA
13.30%
13.11%
13.20%
Number
0
0
0
0
0
0
1
0
1
0
1
1
17
26
43
0
0
0
0
0
0
18
27
45
Percent
NA
NA
NA
NA
NA
NA
8.22%
0.00%
4.30%
0.00%
1.93%
1.09%
6.06%
6.91%
6.55%
0.00%
0.00%
0.00%
NA
NA
NA
5.32%
6.00%
5.71%
Male
0
0
146
480
3366
67
0
4059
Female
0
0
133
622
4515
129
0
5399
Total
0
0
279
1102
7881
196
0
9458
Member Months
(Outpatient/ED)
Male
0
0
146
480
3366
67
0
4059
Female
0
0
133
622
4515
129
0
5399
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
0
0
0
0
0
0
2
2
4
2
4
6
31
46
77
0
1
1
0
0
0
35
53
88
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Total
0
0
279
1102
7881
196
0
9458
Percent
NA
NA
NA
NA
NA
NA
16.44%
18.05%
17.20%
5.00%
7.72%
6.53%
11.05%
12.23%
11.72%
0.00%
9.30%
6.12%
NA
NA
NA
10.35%
11.78%
11.17%
Page 89
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
84834
19034
11656
14358
20136
3
0
150021
Female
79162
18983
27273
35756
29729
6
0
190909
Total
163996
38017
38929
50114
49865
9
0
340930
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
3
3
6
77
59
136
150
192
342
221
335
556
259
237
496
0
0
0
0
0
0
710
826
1536
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
84834
19034
11656
14358
20136
3
0
150021
Female
79162
18983
27273
35756
29729
6
0
190909
Total
163996
38017
38929
50114
49865
9
0
340930
Inpatient
Percent
0.04%
0.05%
0.04%
4.85%
3.73%
4.29%
15.44%
8.45%
10.54%
18.47%
11.24%
13.31%
15.44%
9.57%
11.94%
0.00%
0.00%
0.00%
NA
NA
NA
5.68%
5.19%
5.41%
Number
2
2
4
7
7
14
12
50
62
32
76
108
48
56
104
0
0
0
0
0
0
101
191
292
Percent
0.03%
0.03%
0.03%
0.44%
0.44%
0.44%
1.24%
2.20%
1.91%
2.67%
2.55%
2.59%
2.86%
2.26%
2.50%
0.00%
0.00%
0.00%
NA
NA
NA
0.81%
1.20%
1.03%
Male
84834
19034
11656
14358
20136
3
0
150021
Female
79162
18983
27273
35756
29729
6
0
190909
Total
163996
38017
38929
50114
49865
9
0
340930
Member Months
(Outpatient/ED)
Male
84834
19034
11656
14358
20136
3
0
150021
Female
79162
18983
27273
35756
29729
6
0
190909
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
0
1
1
0
1
1
0
0
0
0
0
0
0
0
0
0
2
2
Number
2
1
3
72
54
126
145
172
317
212
308
520
246
214
460
0
0
0
0
0
0
677
749
1426
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.04%
0.03%
0.00%
0.03%
0.02%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.01%
0.01%
Total
163996
38017
38929
50114
49865
9
0
340930
Percent
0.03%
0.02%
0.02%
4.54%
3.41%
3.98%
14.93%
7.57%
9.77%
17.72%
10.34%
12.45%
14.66%
8.64%
11.07%
0.00%
0.00%
0.00%
NA
NA
NA
5.42%
4.71%
5.02%
Page 90
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
NR
NR
Total
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 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Male
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
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Outpatient/ED
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 91
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Medicare Advantage
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
NR
NR
Total
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 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Male
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
Female
NR
NR
Total
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
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:53 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
0
5926
0
5926
Female
0
0
0
16505
0
16505
Total
0
0
0
22431
0
22431
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
0
0
0
0
0
0
0
0
0
66
175
241
0
0
0
66
175
241
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
0
5926
0
5926
Female
0
0
0
16505
0
16505
Total
0
0
0
22431
0
22431
Number
0
0
0
0
0
0
0
0
0
25
67
92
0
0
0
25
67
92
Female
0
0
0
16505
0
16505
Total
0
0
0
22431
0
22431
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
13.36%
12.72%
12.89%
NA
NA
NA
13.36%
12.72%
12.89%
Male
0
0
0
5926
0
5926
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
5.06%
4.87%
4.92%
NA
NA
NA
5.06%
4.87%
4.92%
Number
0
0
0
0
0
0
0
0
0
2
2
4
0
0
0
2
2
4
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.40%
0.15%
0.21%
NA
NA
NA
0.40%
0.15%
0.21%
Member Months
(Outpatient/ED)
Male
0
0
0
5926
0
5926
Female
0
0
0
16505
0
16505
Total
0
0
0
22431
0
22431
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
44
122
166
0
0
0
44
122
166
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
8.91%
8.87%
8.88%
NA
NA
NA
8.91%
8.87%
8.88%
Page 93
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:53 AM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
3992
67
0
4059
Female
0
0
5270
129
0
5399
Total
0
0
9262
196
0
9458
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
0
0
0
0
0
0
176
270
446
1
5
6
0
0
0
177
275
452
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
3992
67
0
4059
Female
0
0
5270
129
0
5399
Total
0
0
9262
196
0
9458
Number
0
0
0
0
0
0
13
31
44
1
1
2
0
0
0
14
32
46
Female
0
0
5270
129
0
5399
Total
0
0
9262
196
0
9458
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
52.91%
61.48%
57.78%
17.91%
46.51%
36.73%
NA
NA
NA
52.33%
61.12%
57.35%
Male
0
0
3992
67
0
4059
Percent
NA
NA
NA
NA
NA
NA
3.91%
7.06%
5.70%
17.91%
9.30%
12.24%
NA
NA
NA
4.14%
7.11%
5.84%
Number
0
0
0
0
0
0
3
1
4
0
0
0
0
0
0
3
1
4
Percent
NA
NA
NA
NA
NA
NA
0.90%
0.23%
0.52%
0.00%
0.00%
0.00%
NA
NA
NA
0.89%
0.22%
0.51%
Member Months
(Outpatient/ED)
Male
0
0
3992
67
0
4059
Female
0
0
5270
129
0
5399
Total
0
0
9262
196
0
9458
Outpatient/ED
Number
0
0
0
0
0
0
175
270
445
1
5
6
0
0
0
176
275
451
Percent
NA
NA
NA
NA
NA
NA
52.61%
61.48%
57.65%
17.91%
46.51%
36.73%
NA
NA
NA
52.03%
61.12%
57.22%
Page 94
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Minnesota Health Care Programs - Managed Care(MHCP-MC)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
84834
19034
46150
3
0
150021
Female
79162
18983
92758
6
0
190909
Total
163996
38017
138908
9
0
340930
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
1001
658
1659
397
466
863
721
2111
2832
0
0
0
0
0
0
2119
3235
5354
HEDIS 2011 (Reporting Year 2010)
Male
84834
19034
46150
3
0
150021
Female
79162
18983
92758
6
0
190909
Total
163996
38017
138908
9
0
340930
Percent
14.16%
9.97%
12.14%
25.03%
29.46%
27.24%
18.75%
27.31%
24.47%
0.00%
0.00%
0.00%
NA
NA
NA
16.95%
20.33%
18.84%
Number
12
7
19
18
33
51
39
101
140
0
0
0
0
0
0
69
141
210
Male
84834
19034
46150
3
0
150021
Female
79162
18983
92758
6
0
190909
Total
163996
38017
138908
9
0
340930
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
Age
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Percent
0.17%
0.11%
0.14%
1.13%
2.09%
1.61%
1.01%
1.31%
1.21%
0.00%
0.00%
0.00%
NA
NA
NA
0.55%
0.89%
0.74%
Number
1
2
3
1
1
2
2
6
8
0
0
0
0
0
0
4
9
13
Percent
0.01%
0.03%
0.02%
0.06%
0.06%
0.06%
0.05%
0.08%
0.07%
0.00%
0.00%
0.00%
NA
NA
NA
0.03%
0.06%
0.05%
Member Months
(Outpatient/ED)
Male
84834
19034
46150
3
0
150021
Female
79162
18983
92758
6
0
190909
Total
163996
38017
138908
9
0
340930
Outpatient/ED
Number
999
657
1656
395
462
857
709
2096
2805
0
0
0
0
0
0
2103
3215
5318
Percent
14.13%
9.96%
12.12%
24.90%
29.21%
27.05%
18.44%
27.12%
24.23%
0.00%
0.00%
0.00%
NA
NA
NA
16.82%
20.21%
18.72%
Page 95
Health Plan Descriptive Information
South Country Health Alliance
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Board Certification
MSHO
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2011 (Reporting Year 2010)
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
1164
548
37
1579
751
402
15
1148
64.52%
73.36%
40.54%
72.70%
Page 96
Health Plan Descriptive Information
South Country Health Alliance
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Board Certification
SNBC
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2011 (Reporting Year 2010)
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
1164
548
37
1579
751
402
15
1148
64.52%
73.36%
40.54%
72.70%
Page 97
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:53 AM
Commercial
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2011 (Reporting Year 2010)
NR
NR
NR
NR
NR
NR
NR
Page 98
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:53 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: %
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
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
NR
NR
NR
NR
NR
NR
Age Unknown
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2011 (Reporting Year 2010)
Page 99
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:53 AM
MSHO
Member Months
Female
0
0
0
0
0
0
<1
1-4
5-9
10-14
15-17
18-19
Male
0
0
0
0
0
0
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
0
0.00%
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
0
0.00%
0
0
0
0
0
0.00%
0
0
0
0
0
0.00%
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
0
0.00%
858
1326
1012
938
816
976
0
0.00%
1560
2037
1817
2880
3455
4756
0
0.00%
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
5926
100.00%
0
16505
100.00%
0
22431
100.00%
5926
16505
HEDIS 2011 (Reporting Year 2010)
Total
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2418
3363
2829
3818
4271
5732
0
22431
Page 100
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:53 AM
SNBC
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
14
Member Months
Female
0
0
0
0
0
3
Total
0
0
0
0
0
17
14
0.34%
132
197
283
333
475
3
0.06%
130
349
273
460
503
17
0.18%
1420
34.98%
724
680
616
538
1715
31.77%
948
904
838
862
3135
33.15%
2558
63.02%
67
0
0
0
0
0
3552
65.79%
129
0
0
0
0
0
6110
64.60%
67
1.65%
0
129
2.39%
0
196
2.07%
4059
5399
HEDIS 2011 (Reporting Year 2010)
262
546
556
793
978
1672
1584
1454
1400
196
0
0
0
0
0
0
9458
Page 101
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:53 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
10596
30995
29220
22188
10869
5084
Member Months
Female
9254
29133
27223
21834
10701
7244
Total
19850
60128
56443
44022
21570
12328
108952
72.62%
6572
7654
6704
5463
4224
105389
55.20%
20029
21045
14711
10682
7527
214341
62.87%
30617
20.41%
4431
3002
1910
1106
73994
38.76%
5379
3221
1702
1218
104611
30.68%
10449
6.97%
3
0
0
0
0
0
11520
6.03%
6
0
0
0
0
0
21969
6.44%
3
0.00%
0
6
0.00%
0
9
0.00%
150021
190909
HEDIS 2011 (Reporting Year 2010)
26601
28699
21415
16145
11751
9810
6223
3612
2324
9
0
0
0
0
0
0
340930
Page 102