Sanford (PDF: 244kb/ 102 pages)

Sanford Health Plan
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
Sanford Health Plan
Adult BMI Assessment
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
4
0.03%
411
10.00%
453
4
0.88%
0
Number of administrative data records excluded
25
Number of medical record data records excluded
0
Number of employee/dependent medical records
excluded
2
HEDIS 2011 (Reporting Year 2010)
MHCP-MC
2010
H
13006
Number of 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
Medicare
Advantage
27
411
4
244
60.34%
55.49%
65.19%
Page 3
Effectiveness of Care
Sanford Health Plan
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
Counseling for Nutrition
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
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
2422
1544
3966
2422
1544
3966
2422
1544
3966
1
0.04%
0
0.00%
1
0.03%
0
0.00%
0
0.00%
0
0.00%
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
1
0.23%
0
0.00%
1
0.23%
432
0
0.00%
0
0.00%
0
0.00%
0
0
0
Number of administrative data records
excluded
1
1
1
Number of medical records excluded
0
0
0
Number of employee/dependent records
excluded
1
1
1
Records Added from the Oversample List
2
2
2
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)
247
164
411
247
164
411
247
164
411
1
96
39.27%
32.98%
45.56%
0
66
40.24%
32.43%
48.05%
1
162
39.66%
34.81%
44.51%
0
83
33.60%
27.51%
39.70%
0
43
26.22%
19.18%
33.26%
0
126
30.66%
26.08%
35.24%
0
64
25.91%
20.24%
31.58%
0
70
42.68%
34.81%
50.56%
0
134
32.60%
27.95%
37.26%
Page 4
Effectiveness of Care
Sanford Health Plan
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
BMI Percentile
Data Elements
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Nutrition
Total
General
Measure
Data
Ages 3-11 Ages 12-17
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 5
Effectiveness of Care
Sanford Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
1
Number of medical data records excluded
1
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
223
72.64%
251
81.76%
254
82.74%
253
82.41%
238
77.52%
254
82.74%
228
74.27%
66
21.50%
189
61.56%
183
59.61%
223
72.64%
251
81.76%
254
82.74%
253
82.41%
238
77.52%
254
82.74%
228
74.27%
66
21.50%
189
61.56%
183
59.61%
223
251
254
253
238
254
228
66
189
183
35
84.59%
80.37%
88.81%
42
96.07%
93.72%
98.41%
26
91.80%
88.56%
95.05%
39
95.74%
93.31%
98.17%
50
94.43%
91.69%
97.16%
26
91.80%
88.56%
95.05%
41
88.20%
84.41%
91.98%
2
22.30%
17.46%
27.13%
19
68.20%
62.81%
73.59%
16
65.25%
59.74%
70.75%
307
0
Numerator Events by administrative Data
MMR
307
0.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
IPV
2010
H
307
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
305
Page 6
Effectiveness of Care
Sanford Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
1
Number of medical data records excluded
1
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
223
72.64%
197
64.17%
183
59.61%
52
16.94%
141
45.93%
143
46.58%
45
14.66%
38
12.38%
114
37.13%
36
11.73%
223
72.64%
197
64.17%
183
59.61%
52
16.94%
141
45.93%
143
46.58%
45
14.66%
38
12.38%
114
37.13%
36
11.73%
223
197
183
52
141
143
45
38
114
36
35
84.59%
80.37%
88.81%
44
79.02%
74.28%
83.75%
43
74.10%
69.02%
79.18%
13
21.31%
16.55%
26.07%
28
55.41%
49.67%
61.15%
27
55.74%
50.00%
61.48%
7
17.05%
12.66%
21.43%
9
15.41%
11.19%
19.63%
22
44.59%
38.85%
50.33%
7
14.10%
10.03%
18.17%
307
0
Numerator Events by administrative Data
Combo 3
307
0.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Combo 2
2010
H
307
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
305
Page 7
Effectiveness of Care
Sanford Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
General
Measure
Data
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
IPV
MMR
HiB
Hepatitis B
VZV
Influenza
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical data records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by administrative Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Page 8
Effectiveness of Care
Sanford Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
General
Measure
Data
DTaP
Combo 2
Combo 3
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical data records excluded
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by administrative Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Page 9
Effectiveness of Care
Sanford Health Plan
Immunizations for Adolescents
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
Data Elements
General
Measure Data
Meningococcal
Tdap
Combo 1
72
110
63
22.57%
34.48%
19.75%
72
22.57%
110
34.48%
63
19.75%
72
3
110
19
63
7
23.66%
40.69%
22.08%
Lower 95% Confidence Interval
18.82%
35.13%
17.36%
Upper 95% Confidence Interval
28.50%
46.26%
26.81%
Measurement Year
2010
Data Collection Methodology
H
Eligible Member Population
319
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
319
0.00%
319
Records Excluded because of Valid Data Errors
0
Number of administrative data records excluded
1
Number of medical data records excluded
0
Number of employee/dependent medical records
excluded
1
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
HEDIS 2011 (Reporting Year 2010)
0
317
Page 10
Effectiveness of Care
Sanford Health Plan
Immunizations for Adolescents
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Data Elements
Measure Data
Measurement Year
Data Collection Methodology
Eligible Member Population
Meningococcal
Tdap
Combo 1
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Page 11
Effectiveness of Care
Sanford Health Plan
Breast Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
2010
A
4606
3456
75.03%
73.77%
76.29%
Medicare
Advantage
MSHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 12
Effectiveness of Care
Sanford Health Plan
Cervical Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
MHCP-MC
2010
A
5863
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
NR
NR
NR
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
4569
77.93%
NR
76.86%
79.00%
NR
NR
Page 13
Effectiveness of Care
Sanford Health Plan
Colorectal Cancer Screening
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Data Elements
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible 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 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
Medicare
Advantage
MSHO
SNBC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
2010
H
5088
216
4.25%
409
0.05
430
216
50.23%
0
2
0
0
2
409
216
29
59.90%
55.03%
64.77%
Page 14
Effectiveness of Care
Sanford Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Oct 24, 2011 8:56 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
Ages 21-24
Total
406
119
29.31%
24.76%
33.86%
513
146
28.46%
24.46%
32.46%
919
265
28.84%
25.85%
31.82%
2010
A
Page 15
Effectiveness of Care
Sanford Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Oct 24, 2011 8:56 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
NR
NR
NR
Ages 21-24
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 16
Effectiveness of Care
Sanford Health Plan
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Medicare
Advantage
MSHO
NR
NR
NR
NR
NR
NR
Page 17
Effectiveness of Care
Sanford Health Plan
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Lead Screening in Children
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
MHCP-MC
2010
A
306
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
65
Reported Rate
21.24%
NR
Lower 95% Confidence Interval
16.50%
NR
Upper 95% Confidence Interval
25.99%
NR
HEDIS 2011 (Reporting Year 2010)
Page 18
Effectiveness of Care
Sanford Health Plan
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Care for Older Adults
MSHO
Medication Review
Functional
Status
Assessment
Pain
Screening
NR
NR
NR
NR
NR
NR
NR
NR
Reported Rate
NR
NR
NR
NR
Lower 95% Confidence Interval
NR
NR
NR
NR
Upper 95% Confidence Interval
NR
NR
NR
NR
Advance Care
Planning
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Data Elements
General Measure
Data
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population (before exclusions)
Records Excluded because of Valid Data
Errors
Number of employee/dependent medical
records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
HEDIS 2011 (Reporting Year 2010)
Page 19
Effectiveness of Care
Sanford Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 24, 2011 8:56 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
NR
NR
NR
NR
NR
NR
Page 21
Effectiveness of Care
Sanford Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 24, 2011 8:56 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
NR
NR
NR
NR
NR
NR
Page 22
Effectiveness of Care
Sanford Health Plan
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Medicare
Advantage
MSHO
SNBC
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 23
Effectiveness of Care
Sanford Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 24, 2011 8:56 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
Ages 12-50
Total
40
39
97.50%
91.41%
100.00%
201
186
92.54%
88.66%
96.42%
241
225
93.36%
90.01%
96.71%
2010
A
`
Page 24
Effectiveness of Care
Sanford Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 24, 2011 8:56 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
NR
NR
NR
Ages 12-50
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 25
Effectiveness of Care
Sanford Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 24, 2011 8:56 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
160
47
76.19%
22.38%
160
47
76.19%
22.38%
160
24
47
85
90.20%
85.87%
94.52%
64.71%
57.90%
71.51%
2009
H
210
210
0.00%
210
6
0
0
204
Page 26
Effectiveness of Care
Sanford Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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)
Page 28
Effectiveness of Care
Sanford Health Plan
Controlling High Blood Pressure
Data Elements
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2010
H
1734
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
0.00%
371
15.00%
427
0
0.00%
Records Excluded because of Valid Data
Errors
4
Number of records excluded because of
false positive diagnoses
0
Number of administrative data records
excluded
11
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)
15
371
0
252
67.92%
63.04%
72.81%
Medicare
Advantage
MSHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 29
Effectiveness of Care
Sanford Health Plan
Persistence of Beta Blocker Treatment After Heart Attack
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
Medicare
Advantage
MSHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
2010
A
19
Numerator Events by Admin Data on
Eligible Population
17
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NA
NA
NA
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Page 30
Effectiveness of Care
Sanford Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
HbA1c
Testing
Poor HbA1c
Control
(>9.0%)
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
2009
H
926
2009
H
926
2010
H
926
460
49.68%
548
10%
603
460
76.29%
926
100.00%
548
10%
603
603
100.00%
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
2009
H
926
2010
H
972
2010
H
972
2010
H
972
2009
H
926
2010
H
972
2010
H
972
49
5.29%
411
10%
484
49
10.12%
114
12.31%
548
10%
603
114
18.91%
267
27.47%
548
10%
603
267
44.28%
439
45.16%
548
10%
603
439
72.80%
109
11.21%
548
10%
603
109
18.08%
411
44.38%
548
10%
603
411
68.16%
0
0.00%
548
10%
603
0
0.00%
0
0.00%
548
10%
603
0
0.00%
10
10
3
10
2
2
2
10
2
2
Number of administrative data records
excluded
0
0
0
0
2
2
2
0
2
2
Number of medical record data records
excluded
15
15
12
15
23
23
23
15
23
23
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
25
548
114
274
70.80%
66.90%
74.70%
27
548
267
86
64.42%
60.32%
68.52%
27
548
439
19
83.58%
80.38%
86.77%
27
548
109
157
48.54%
44.26%
52.82%
25
548
411
61
86.13%
83.15%
89.12%
27
548
0
415
75.73%
72.05%
79.41%
27
548
0
299
54.56%
50.30%
58.82%
Number of Administrative required exclusions
118
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)
20
25
548
460
50
93.07%
90.85%
95.28%
25
548
16
89
19.16%
15.77%
22.55%
35
411
49
140
45.99%
41.05%
50.93%
Page 31
Effectiveness of Care
Sanford Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:56 AM
MSHO
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 33
Effectiveness of Care
Sanford Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:56 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
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 34
Effectiveness of Care
Sanford Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 35
Effectiveness of Care
Sanford Health Plan
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Medicare
Advantage
NR
NR
NR
Page 36
Effectiveness of Care
Sanford Health Plan
Osteoporosis Management in Women Who had a Fracture
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Medicare
Advantage
MSHO
NR
NR
NR
NR
NR
NR
Page 37
Effectiveness of Care
Sanford Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:56 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
106
59.55%
52.06%
67.04%
73
41.01%
33.50%
48.52%
2010
A
178
Page 38
Effectiveness of Care
Sanford Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:56 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
NR
NR
NR
NR
NR
NR
Page 40
Effectiveness of Care
Sanford Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:56 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
NR
NR
NR
NR
NR
NR
Page 41
Effectiveness of Care
Sanford Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:56 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
NR
NR
NR
NR
NR
NR
Page 42
Effectiveness of Care
Sanford Health Plan
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 24, 2011 8:56 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
36
11
30.56%
14.12%
46.99%
17
5
NA
NA
NA
2010
A
Page 43
Effectiveness of Care
Sanford Health Plan
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 24, 2011 8:56 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
NR
NR
NR
NR
NR
NR
Page 44
Effectiveness of Care
Sanford Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 24, 2011 8:56 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
NR
NR
NR
NR
NR
NR
Page 46
Effectiveness of Care
Sanford Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 24, 2011 8:56 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
NR
NR
NR
NR
NR
NR
Page 47
Effectiveness of Care
Sanford Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:56 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
1836
1467
79.90%
78.04%
81.76%
34
31
91.18%
80.17%
100.00%
1358
1090
80.27%
78.11%
82.42%
65
45
69.23%
57.24%
81.22%
3293
2633
79.96%
78.57%
81.34%
2010
A
Page 48
Effectiveness of Care
Sanford Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:56 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 50
Effectiveness of Care
Sanford Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:56 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 51
Effectiveness of Care
Sanford Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:56 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 52
Access/Availability of Care
Sanford Health Plan
Medication Reconciliation Post Discharge
Data Elements
Data Last Refreshed:
Oct 24, 2011 8:56 AM
MSHO
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
population (before exclusions)
Current year's administrative rate (before exclusions)
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
NR
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
NR
NR
NR
Page 53
Effectiveness of Care
Sanford Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 24, 2011 8:56 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
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 55
Effectiveness of Care
Sanford Health Plan
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 24, 2011 8:56 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
At least 1
Prescription
At least 2
Prescriptions
NR
NR
NR
NR
NR
NR
Page 57
Access/Availability of Care
Sanford Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:56 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 2011 (Reporting Year 2010)
General
Measure Data
Ages 20-44
Ages 45-64
Ages 65+
Total
5218
6188
388
11794
4957
5930
378
95.00%
94.40%
95.60%
95.83%
95.32%
96.34%
97.42%
95.72%
99.13%
11265
95.51%
95.14%
95.89%
2010
A
Page 58
Access/Availability of Care
Sanford Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:56 AM
MSHO
Data Elements
General
Measure Data
Ages 20-44
Ages 45-64
Ages 65+
Total
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
NR
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
NR
NR
NR
NR
HEDIS 2011 (Reporting Year 2010)
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 60
Access/Availability of Care
Sanford Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:56 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 2011 (Reporting Year 2010)
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 61
Access/Availability of Care
Sanford Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
General
Measure Data
Ages 20-44
Ages 45-64
Ages 65+
Total
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
NR
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
NR
NR
NR
NR
HEDIS 2011 (Reporting Year 2010)
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 62
Access/Availability of Care
Sanford Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 24, 2011 8:56 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.
345
339
1739
1530
1413
1243
2385
2140
98.26%
96.74%
99.79%
87.98%
86.42%
89.54%
87.97%
86.24%
89.70%
89.73%
88.49%
90.97%
2010
A
Page 63
Access/Availability of Care
Sanford Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 24, 2011 8:56 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.
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 64
Access/Availability of Care
Sanford Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:56 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 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
13
89
102
8
6
30
27
38
33
NA
NA
NA
NA
NA
NA
33.71%
23.33%
44.09%
30.34%
20.22%
40.45%
37.25%
27.38%
47.13%
32.35%
22.78%
41.92%
Page 65
Access/Availability of Care
Sanford Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:56 AM
MSHO
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 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 67
Access/Availability of Care
Sanford Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:56 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 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 68
Access/Availability of Care
Sanford Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 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 69
Access/Availability of Care
Sanford Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
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
438
2010
H
438
30
175
6.85%
229
5%
241
30
39.95%
229
5%
241
175
12.45%
72.61%
0
0
0
0
229
30
192
0
0
229
175
27
96.94%
94.50%
99.39%
88.21%
83.81%
92.60%
Page 70
Access/Availability of Care
Sanford Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Timeliness of
Prenatal Care
Postpartum
Care
Current year's administrative rate (before exclusions)
NR
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
NR
NR
NR
NR
NR
NR
NR
NR
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
population (before exclusions)
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
Page 71
Use of Services
Sanford Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 24, 2011 8:56 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
3
4
6
15
20
63
174
1.05%
0.00%
2.41%
1.40%
0.00%
2.94%
2.11%
0.26%
3.95%
5.26%
2.50%
8.03%
7.02%
3.88%
10.16%
22.11%
17.11%
27.10%
61.05%
55.22%
66.89%
2010
A
285
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
Sanford Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of employee/dependent medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Page 73
Use of Services
Sanford Health Plan
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
Data Last Refreshed:
Oct 24, 2011 8:56 AM
MHCP-MC
2010
A
1433
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)
736
51.36%
48.74%
53.98%
NR
NR
NR
Page 74
Use of Services
Sanford Health Plan
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
MHCP-MC
2010
A
3394
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)
982
28.93%
27.39%
30.47%
NR
NR
NR
Page 75
Use of Services
Sanford Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
4528
43824
49397
130224
113932
5216
341
4
0
347466
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
Visits
4174
11985
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
10371
30346
36600
2318
149
4
0
95947
HEDIS 2011 (Reporting Year 2010)
Visits/ 1,000
Member
Months
921.82
273.48
209.95
233.03
321.24
444.40
436.95
1000.00
276.13
Emergency Room Visits
Visits
88
506
535
1385
978
55
3
0
0
3550
Visits/ 1,000
Member
Months
19.43
11.55
10.83
10.64
8.58
10.54
8.80
0.00
10.22
Page 76
Use of Services
Sanford Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:56 AM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
NR
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 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 78
Use of Services
Sanford Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:56 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 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 79
Use of Services
Sanford Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
NR
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 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 80
Use of Services
Sanford Health Plan
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 8:56 AM
Member Months
4528
43824
49397
130224
113932
5216
341
4
0
347466
Discharges
Discharges /
1,000 Member
Months
46
75
69
714
669
64
0
1
0
1638
10.16
1.71
1.40
5.48
5.87
12.27
0.00
250.00
40
54
25
101
264
24
0
1
0
509
8.83
1.23
0.51
0.78
2.32
4.60
0.00
250.00
6
21
25
139
405
40
0
0
0
636
1.33
0.48
0.51
1.07
3.55
7.67
0.00
0.00
19
474
0
0
493
0.38
3.64
0.00
HEDIS 2011 (Reporting Year 2010)
4.71
1.46
1.83
1.68
Days
Days / 1,000
Member
Months
183
235
204
2179
2329
211
0
3
0
5344
40.42
5.36
4.13
16.73
20.44
40.45
0.00
750.00
167
154
86
325
828
64
0
3
0
1627
36.88
3.51
1.74
2.50
7.27
12.27
0.00
750.00
16
81
72
603
1501
147
0
0
0
2420
3.53
1.85
1.46
4.63
13.17
28.18
0.00
0.00
46
1251
0
0
1297
0.93
9.61
0.00
15.38
4.68
6.96
4.42
Average
Length of Stay
3.98
3.13
2.96
3.05
3.48
3.30
NA
3.00
NA
3.26
4.18
2.85
3.44
3.22
3.14
2.67
NA
3.00
NA
3.20
2.67
3.86
2.88
4.34
3.71
3.68
NA
NA
NA
3.81
2.42
2.64
NA
NA
2.63
Page 81
Use of Services
Sanford Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
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 8:56 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 83
Use of Services
Sanford Health Plan
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 8:56 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 84
Use of Services
Sanford Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 85
Use of Services
Sanford Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
32305
12781
15386
24338
74362
2651
0
161823
Female
30645
12051
19244
29898
90895
2910
0
185643
Total
62950
24832
34630
54236
165257
5561
0
347466
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
13
13
26
20
20
40
34
17
51
70
49
119
0
0
0
0
0
0
137
99
236
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
32305
12781
15386
24338
74362
2651
0
161823
Female
30645
12051
19244
29898
90895
2910
0
185643
Total
62950
24832
34630
54236
165257
5561
0
347466
Inpatient
Percent
0.00%
0.00%
0.00%
1.22%
1.29%
1.26%
1.56%
1.25%
1.39%
1.68%
0.68%
1.13%
1.13%
0.65%
0.86%
0.00%
0.00%
0.00%
NA
NA
NA
1.02%
0.64%
0.82%
Number
0
0
0
7
5
12
5
3
8
6
2
8
29
20
49
0
0
0
0
0
0
47
30
77
Percent
0.00%
0.00%
0.00%
0.66%
0.50%
0.58%
0.39%
0.19%
0.28%
0.30%
0.08%
0.18%
0.47%
0.26%
0.36%
0.00%
0.00%
0.00%
NA
NA
NA
0.35%
0.19%
0.27%
Male
32305
12781
15386
24338
74362
2651
0
161823
Female
30645
12051
19244
29898
90895
2910
0
185643
Total
62950
24832
34630
54236
165257
5561
0
347466
Member Months
(Outpatient/ED)
Male
32305
12781
15386
24338
74362
2651
0
161823
Female
30645
12051
19244
29898
90895
2910
0
185643
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
4
5
9
8
4
12
9
4
13
19
9
28
0
0
0
0
0
0
40
22
62
Number
0
0
0
9
10
19
17
17
34
30
14
44
45
36
81
0
0
0
0
0
0
101
77
178
Percent
0.00%
0.00%
0.00%
0.38%
0.50%
0.43%
0.62%
0.25%
0.42%
0.44%
0.16%
0.29%
0.31%
0.12%
0.20%
0.00%
0.00%
0.00%
NA
NA
NA
0.30%
0.14%
0.21%
Total
62950
24832
34630
54236
165257
5561
0
347466
Percent
0.00%
0.00%
0.00%
0.85%
1.00%
0.92%
1.33%
1.06%
1.18%
1.48%
0.56%
0.97%
0.73%
0.48%
0.59%
0.00%
0.00%
0.00%
NA
NA
NA
0.75%
0.50%
0.61%
Page 86
Use of Services
Sanford Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:56 AM
MSHO
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
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Female
NR
NR
Total
NR
NR
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
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
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
Member Months
(Outpatient/ED)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Outpatient/ED
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
Page 88
Use of Services
Sanford Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:56 AM
SNBC
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 89
Use of Services
Sanford Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 90
Use of Services
Sanford Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
32305
12781
114086
2651
0
161823
Female
30645
12051
140037
2910
0
185643
Total
62950
24832
254123
5561
0
347466
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
107
58
165
105
90
195
376
794
1170
6
8
14
0
0
0
594
950
1544
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
32305
12781
114086
2651
0
161823
Female
30645
12051
140037
2910
0
185643
Total
62950
24832
254123
5561
0
347466
Number
4
1
5
10
8
18
28
33
61
0
2
2
0
0
0
42
44
86
Female
30645
12051
140037
2910
0
185643
Total
62950
24832
254123
5561
0
347466
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
3.97%
2.27%
3.15%
9.86%
8.96%
9.42%
3.95%
6.80%
5.52%
2.72%
3.30%
3.02%
NA
NA
NA
4.40%
6.14%
5.33%
Male
32305
12781
114086
2651
0
161823
Percent
0.15%
0.04%
0.10%
0.94%
0.80%
0.87%
0.29%
0.28%
0.29%
0.00%
0.82%
0.43%
NA
NA
NA
0.31%
0.28%
0.30%
Number
0
0
0
2
1
3
2
12
14
0
0
0
0
0
0
4
13
17
Percent
0.00%
0.00%
0.00%
0.19%
0.10%
0.14%
0.02%
0.10%
0.07%
0.00%
0.00%
0.00%
NA
NA
NA
0.03%
0.08%
0.06%
Member Months
(Outpatient/ED)
Male
32305
12781
114086
2651
0
161823
Female
30645
12051
140037
2910
0
185643
Total
62950
24832
254123
5561
0
347466
Outpatient/ED
Number
105
57
162
100
84
184
368
760
1128
6
7
13
0
0
0
579
908
1487
Percent
3.90%
2.23%
3.09%
9.39%
8.36%
8.89%
3.87%
6.51%
5.33%
2.72%
2.89%
2.81%
NA
NA
NA
4.29%
5.87%
5.14%
Page 91
Use of Services
Sanford Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:56 AM
MSHO
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 93
Use of Services
Sanford Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:56 AM
SNBC
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 94
Use of Services
Sanford Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care(MHCP-MC)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
NR
NR
Total
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 2011 (Reporting Year 2010)
Male
Female
NR
NR
Total
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
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
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
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 95
Health Plan Descriptive Information
Sanford Health Plan
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:56 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
2192
10011
12314
12336
8233
4787
Member Months
Female
2336
10262
11237
11398
7463
5180
Total
4528
20273
23551
23734
15696
9967
49873
30.82%
10599
12190
12148
11653
11789
47876
25.79%
14064
15278
14620
13812
14071
97749
28.13%
58379
36.08%
14713
14087
12661
9459
71845
38.70%
17963
17736
15751
11562
130224
37.48%
50920
31.47%
2056
444
127
20
4
0
63012
33.94%
2365
351
173
21
0
0
113932
32.79%
2651
1.64%
0
2910
1.57%
0
5561
1.60%
161823
185643
HEDIS 2011 (Reporting Year 2010)
24663
27468
26768
25465
25860
32676
31823
28412
21021
4421
795
300
41
4
0
0
347466
Page 98
Health Plan Descriptive Information
Sanford Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:56 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
Sanford Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:56 AM
MSHO
Male
Member Months
Female
<1
1-4
5-9
10-14
15-17
18-19
Total
NR
NR
NR
NR
NR
NR
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
NR
NR
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
NR
NR
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
NR
NR
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
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
HEDIS 2011 (Reporting Year 2010)
Page 100
Health Plan Descriptive Information
Sanford Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:56 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: %
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 101
Health Plan Descriptive Information
Sanford Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
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 102