Preferred One Community 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
Preferred One Community Health Plan
Adult BMI Assessment
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Medicare
Advantage
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Commercial
2010
A
12745
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Number of Records Excluded Because of Valid
Data Errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
187
1.47%
1.25%
1.68%
Page 3
Effectiveness of Care
Preferred One Community Health Plan
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 24, 2011 8:49 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
A
General
Measure
Data
Ages 3-11 Ages 12-17
Total
2010
A
Counseling for Physical Activity
General
Ages 12Measure Ages 3-11
Total
17
Data
2010
A
3087
2012
5099
3087
2012
5099
3087
2012
5099
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
140
65
205
23
23
46
0
0
0
4.54%
3.78%
5.29%
3.23%
2.43%
4.03%
4.02%
3.47%
4.57%
0.75%
0.43%
1.06%
1.14%
0.65%
1.63%
0.90%
0.63%
1.17%
0.00%
0.00%
0.02%
0.00%
0.00%
0.02%
0.00%
0.00%
0.01%
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
Preferred One Community Health Plan
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
0
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
HiB
Hepatitis B
VZV
Influenza
242
75.39%
274
85.36%
271
84.42%
274
85.36%
269
83.80%
275
85.67%
246
76.64%
81
25.23%
232
72.27%
190
59.19%
242
75.39%
274
85.36%
271
84.42%
274
85.36%
269
83.80%
275
85.67%
246
76.64%
81
25.23%
232
72.27%
190
59.19%
242
274
271
274
269
275
246
81
232
190
27
83.80%
79.61%
87.99%
23
92.52%
89.49%
95.56%
4
85.67%
81.68%
89.66%
25
93.15%
90.23%
96.07%
23
90.97%
87.67%
94.26%
4
86.92%
83.07%
90.76%
27
85.05%
80.99%
89.10%
11
28.66%
23.56%
33.76%
21
78.82%
74.19%
83.44%
23
66.36%
61.03%
71.68%
321
0
Numerator Events by administrative Data
MMR
411
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
IPV
2010
H
321
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
321
Page 6
Effectiveness of Care
Preferred One Community Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
0
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Combo 4
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
242
75.39%
220
68.54%
212
66.04%
68
21.18%
185
57.63%
149
46.42%
61
19.00%
51
15.89%
130
40.50%
45
14.02%
242
75.39%
220
68.54%
212
66.04%
68
21.18%
185
57.63%
149
46.42%
61
19.00%
51
15.89%
130
40.50%
45
14.02%
242
220
212
68
185
149
61
51
130
45
27
83.80%
79.61%
87.99%
26
76.64%
71.85%
81.42%
28
74.77%
69.86%
79.67%
14
25.55%
20.62%
30.47%
25
65.42%
60.06%
70.78%
36
57.63%
52.07%
63.19%
13
23.05%
18.29%
27.82%
13
19.94%
15.41%
24.46%
33
50.78%
45.15%
56.40%
11
17.45%
13.14%
21.75%
321
0
Numerator Events by administrative Data
Combo 3
411
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Combo 2
2010
H
321
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
321
Page 7
Effectiveness of Care
Preferred One Community Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Immunizations for Adolescents
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Commercial
Data Elements
General
Measure Data
Meningococcal
Tdap
Combo 1
189
298
181
47.49%
74.87%
45.48%
189
47.49%
298
74.87%
181
45.48%
189
15
298
28
181
19
51.39%
82.12%
50.38%
Lower 95% Confidence Interval
46.34%
78.22%
45.33%
Upper 95% Confidence Interval
56.43%
86.01%
55.42%
Measurement Year
2010
Data Collection Methodology
H
Eligible Member Population
398
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
411
5.00%
398
Records Excluded because of Valid Data Errors
0
Number of administrative data records excluded
0
Number of medical data records excluded
0
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
HEDIS 2011 (Reporting Year 2010)
0
397
Page 10
Effectiveness of Care
Preferred One Community Health Plan
Immunizations for Adolescents
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Breast Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Commercial
2010
A
4157
2953
71.04%
69.65%
72.43%
Medicare
Advantage
MSHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 12
Effectiveness of Care
Preferred One Community Health Plan
Cervical Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Commercial
MHCP-MC
2010
A
4925
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)
3758
76.30%
NR
75.11%
77.50%
NR
NR
Page 13
Effectiveness of Care
Preferred One Community Health Plan
Colorectal Cancer Screening
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Data Elements
Commercial
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
2010
H
5077
Number of numerator events by administrative data in eligible population
(before exclusions)
1986
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)
39.12%
411
0.05
432
173
40.05%
0
0
0
0
0
411
167
68
57.18%
52.27%
62.08%
Medicare
Advantage
MSHO
SNBC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 14
Effectiveness of Care
Preferred One Community Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Oct 24, 2011 8:49 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
498
185
37.15%
32.80%
41.49%
473
234
49.47%
44.86%
54.08%
971
419
43.15%
39.98%
46.32%
2010
A
Page 15
Effectiveness of Care
Preferred One Community Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Medicare
Advantage
MSHO
NR
NR
NR
NR
NR
NR
Page 17
Effectiveness of Care
Preferred One Community Health Plan
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Lead Screening in Children
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
MHCP-MC
2010
A
321
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
216
Reported Rate
67.29%
NR
Lower 95% Confidence Interval
62.00%
NR
Upper 95% Confidence Interval
72.58%
NR
HEDIS 2011 (Reporting Year 2010)
Page 18
Effectiveness of Care
Preferred One Community Health Plan
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Medicare
Advantage
MSHO
SNBC
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 23
Effectiveness of Care
Preferred One Community Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 24, 2011 8:49 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
48
45
93.75%
85.86%
100.00%
209
180
86.12%
81.20%
91.05%
257
225
87.55%
83.32%
91.78%
2010
A
`
Page 24
Effectiveness of Care
Preferred One Community Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 24, 2011 8:49 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
152
0
93.83%
0.00%
152
0
93.83%
0.00%
152
2
0
105
95.06%
91.42%
98.71%
64.81%
57.15%
72.48%
2010
H
162
411
5.00%
162
0
0
0
162
Page 26
Effectiveness of Care
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Controlling High Blood Pressure
Data Elements
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Commercial
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2010
H
1684
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
0.00%
411
15.00%
473
0
0.00%
Records Excluded because of Valid Data
Errors
2
Number of records excluded because of
false positive diagnoses
5
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)
2
411
0
262
63.75%
58.98%
68.52%
Medicare
Advantage
MSHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 29
Effectiveness of Care
Preferred One Community Health Plan
Persistence of Beta Blocker Treatment After Heart Attack
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
Medicare
Advantage
MSHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
2010
A
18
Numerator Events by Admin Data on
Eligible Population
15
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NA
NA
NA
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Page 30
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:49 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%)
2010
H
939
2010
H
939
2010
H
784
857
91.27%
548
5%
576
523
90.80%
935
99.57%
548
5%
576
573
99.48%
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
939
2010
H
939
2010
H
939
2010
H
939
2010
H
939
2010
H
939
2010
H
939
1
0.13%
548
5%
474
1
0.21%
1
0.11%
548
5%
576
1
0.17%
479
51.01%
548
5%
576
293
50.87%
824
87.75%
548
5%
576
504
87.50%
3
0.32%
548
5%
576
2
0.35%
801
85.30%
548
5%
576
492
85.42%
2
0.21%
548
5%
576
1
0.17%
2
0.21%
548
5%
576
1
0.17%
2
2
0
2
2
2
2
2
2
2
Number of administrative data records
excluded
0
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
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
2
548
1
321
58.76%
54.55%
62.97%
2
548
277
85
66.06%
62.00%
70.11%
2
548
480
4
88.32%
85.54%
91.10%
2
548
2
280
51.46%
47.18%
55.74%
2
548
466
11
87.04%
84.14%
89.95%
2
548
1
387
70.80%
66.90%
74.70%
2
548
1
302
55.29%
51.04%
59.55%
Number of Administrative required exclusions
450
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)
450
2
548
500
9
92.88%
90.64%
95.13%
2
548
123
40
29.74%
25.83%
33.66%
2
450
1
185
41.33%
36.67%
45.99%
Page 31
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Medicare
Advantage
NR
NR
NR
Page 36
Effectiveness of Care
Preferred One Community Health Plan
Osteoporosis Management in Women Who had a Fracture
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Medicare
Advantage
MSHO
NR
NR
NR
NR
NR
NR
Page 37
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:49 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
179
71.60%
65.81%
77.39%
124
49.60%
43.20%
56.00%
2010
A
250
Page 38
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 24, 2011 8:49 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
81
38
46.91%
35.43%
58.40%
23
11
NA
NA
NA
2010
A
Page 43
Effectiveness of Care
Preferred One Community Health Plan
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:49 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
1578
1297
82.19%
80.27%
84.11%
14
12
NA
NA
NA
1244
1015
81.59%
79.40%
83.79%
70
48
68.57%
56.98%
80.16%
2906
2372
81.62%
80.20%
83.05%
2010
A
Page 48
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Medication Reconciliation Post Discharge
Data Elements
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:49 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
5543
5823
233
11599
5166
5559
230
93.20%
92.53%
93.87%
95.47%
94.92%
96.01%
98.71%
97.05%
100.00%
10955
94.45%
94.03%
94.87%
2010
A
Page 58
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 24, 2011 8:49 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.
359
351
1996
1800
1524
1357
2620
2342
97.77%
96.11%
99.44%
90.18%
88.85%
91.51%
89.04%
87.44%
90.64%
89.39%
88.19%
90.59%
2010
A
Page 63
Access/Availability of Care
Preferred One Community Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:49 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
24
384
408
10
4
154
37
164
41
NA
NA
NA
NA
NA
NA
40.10%
35.07%
45.14%
9.64%
6.55%
12.72%
40.20%
35.32%
45.08%
10.05%
7.01%
13.09%
Page 65
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 24, 2011 8:49 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
454
2010
H
454
318
241
70.04%
411
5%
432
304
53.08%
411
5%
432
232
70.37%
53.70%
0
0
0
0
411
290
78
0
0
411
220
104
89.54%
86.46%
92.62%
78.83%
74.76%
82.90%
Page 70
Access/Availability of Care
Preferred One Community Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 24, 2011 8:49 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
8
3
4
7
12
36
202
2.94%
0.75%
5.13%
1.10%
0.00%
2.53%
1.47%
0.00%
3.08%
2.57%
0.51%
4.64%
4.41%
1.79%
7.04%
13.24%
9.02%
17.45%
74.26%
68.89%
79.64%
2010
A
272
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
Preferred One Community Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
Data Last Refreshed:
Oct 24, 2011 8:49 AM
MHCP-MC
2010
A
1670
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)
1147
68.68%
66.43%
70.94%
NR
NR
NR
Page 74
Use of Services
Preferred One Community Health Plan
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Commercial
MHCP-MC
2010
A
4641
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)
1466
31.59%
30.24%
32.94%
NR
NR
NR
Page 75
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
5619
58197
70628
185567
151464
3849
234
32
0
475590
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
Visits
3757
9850
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
9250
25764
30336
1311
85
28
0
80381
HEDIS 2011 (Reporting Year 2010)
Visits/ 1,000
Member
Months
668.62
169.25
130.97
138.84
200.29
340.61
363.25
875.00
169.01
Emergency Room Visits
Visits
90
401
492
1421
1055
51
1
1
0
3512
Visits/ 1,000
Member
Months
16.02
6.89
6.97
7.66
6.97
13.25
4.27
31.25
7.38
Page 76
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community 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 8:49 AM
Member Months
5619
58197
70628
185567
151464
3849
234
32
0
475590
Discharges
Discharges /
1,000 Member
Months
49
83
94
877
776
45
1
0
0
1925
8.72
1.43
1.33
4.73
5.12
11.69
4.27
0.00
34
54
41
156
304
26
1
0
0
616
6.05
0.93
0.58
0.84
2.01
6.76
4.27
0.00
15
29
37
214
468
19
0
0
0
782
2.67
0.50
0.52
1.15
3.09
4.94
0.00
0.00
16
507
4
0
527
0.23
2.73
0.03
HEDIS 2011 (Reporting Year 2010)
4.05
1.30
1.64
1.29
Days
248
275
259
2412
2679
159
2
0
0
6034
Days / 1,000
Member
Months
44.14
4.73
3.67
13.00
17.69
41.31
8.55
0.00
12.69
140
131
90
430
854
94
2
0
0
1741
24.92
2.25
1.27
2.32
5.64
24.42
8.55
0.00
108
144
128
701
1818
65
0
0
0
2964
19.22
2.47
1.81
3.78
12.00
16.89
0.00
0.00
41
1281
7
0
1329
0.58
6.90
0.05
3.66
6.23
3.26
Average
Length of Stay
5.06
3.31
2.76
2.75
3.45
3.53
2.00
NA
NA
3.13
4.12
2.43
2.20
2.76
2.81
3.62
2.00
NA
NA
2.83
7.20
4.97
3.46
3.28
3.88
3.42
NA
NA
NA
3.79
2.56
2.53
1.75
NA
2.52
Page 81
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community 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 8:49 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
Preferred One Community 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 8:49 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
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
43016
18137
27170
39269
120169
2493
0
250254
Female
40972
17257
23236
33906
108343
1622
0
225336
Total
83988
35394
50406
73175
228512
4115
0
475590
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
1
0
1
20
12
32
48
31
79
58
27
85
139
86
225
5
0
5
0
0
0
271
156
427
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
43016
18137
27170
39269
120169
2493
0
250254
Female
40972
17257
23236
33906
108343
1622
0
225336
Total
83988
35394
50406
73175
228512
4115
0
475590
Inpatient
Percent
0.03%
0.00%
0.01%
1.32%
0.83%
1.08%
2.12%
1.60%
1.88%
1.77%
0.96%
1.39%
1.39%
0.95%
1.18%
2.41%
0.00%
1.46%
NA
NA
NA
1.30%
0.83%
1.08%
Number
1
0
1
3
3
6
12
12
24
11
6
17
39
35
74
3
0
3
0
0
0
69
56
125
Percent
0.03%
0.00%
0.01%
0.20%
0.21%
0.20%
0.53%
0.62%
0.57%
0.34%
0.21%
0.28%
0.39%
0.39%
0.39%
1.44%
0.00%
0.87%
NA
NA
NA
0.33%
0.30%
0.32%
Male
43016
18137
27170
39269
120169
2493
0
250254
Female
40972
17257
23236
33906
108343
1622
0
225336
Total
83988
35394
50406
73175
228512
4115
0
475590
Member Months
(Outpatient/ED)
Male
43016
18137
27170
39269
120169
2493
0
250254
Female
40972
17257
23236
33906
108343
1622
0
225336
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
3
0
3
5
4
9
5
1
6
8
5
13
0
0
0
0
0
0
21
10
31
Number
0
0
0
17
10
27
44
26
70
53
23
76
118
73
191
3
0
3
0
0
0
235
132
367
Percent
0.00%
0.00%
0.00%
0.20%
0.00%
0.10%
0.22%
0.21%
0.21%
0.15%
0.04%
0.10%
0.08%
0.06%
0.07%
0.00%
0.00%
0.00%
NA
NA
NA
0.10%
0.05%
0.08%
Total
83988
35394
50406
73175
228512
4115
0
475590
Percent
0.00%
0.00%
0.00%
1.12%
0.70%
0.92%
1.94%
1.34%
1.67%
1.62%
0.81%
1.25%
1.18%
0.81%
1.00%
1.44%
0.00%
0.87%
NA
NA
NA
1.13%
0.70%
0.93%
Page 86
Use of Services
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:49 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
43016
18137
186608
2493
0
250254
Female
40972
17257
165485
1622
0
225336
Total
83988
35394
352093
4115
0
475590
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
146
109
255
120
132
252
499
987
1486
5
7
12
0
0
0
770
1235
2005
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
43016
18137
186608
2493
0
250254
Female
40972
17257
165485
1622
0
225336
Total
83988
35394
352093
4115
0
475590
Number
0
4
4
6
12
18
25
58
83
0
0
0
0
0
0
31
74
105
Female
40972
17257
165485
1622
0
225336
Total
83988
35394
352093
4115
0
475590
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
4.07%
3.19%
3.64%
7.94%
9.18%
8.54%
3.21%
7.16%
5.06%
2.41%
5.18%
3.50%
NA
NA
NA
3.69%
6.58%
5.06%
Male
43016
18137
186608
2493
0
250254
Percent
0.00%
0.12%
0.06%
0.40%
0.83%
0.61%
0.16%
0.42%
0.28%
0.00%
0.00%
0.00%
NA
NA
NA
0.15%
0.39%
0.26%
Number
12
9
21
8
10
18
20
50
70
0
1
1
0
0
0
40
70
110
Percent
0.33%
0.26%
0.30%
0.53%
0.70%
0.61%
0.13%
0.36%
0.24%
0.00%
0.74%
0.29%
NA
NA
NA
0.19%
0.37%
0.28%
Member Months
(Outpatient/ED)
Male
43016
18137
186608
2493
0
250254
Female
40972
17257
165485
1622
0
225336
Total
83988
35394
352093
4115
0
475590
Outpatient/ED
Number
143
105
248
117
126
243
488
967
1455
5
7
12
0
0
0
753
1205
1958
Percent
3.99%
3.08%
3.54%
7.74%
8.76%
8.24%
3.14%
7.01%
4.96%
2.41%
5.18%
3.50%
NA
NA
NA
3.61%
6.42%
4.94%
Page 91
Use of Services
Preferred One Community Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:49 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
2921
12518
17219
17665
10830
7875
Member Months
Female
2698
11910
16550
16269
10802
7187
Total
5619
24428
33769
33934
21632
15062
69028
27.58%
19295
19772
19497
19308
21434
65416
29.03%
16049
16567
17339
17135
19171
134444
28.27%
99306
39.68%
24316
23533
19940
11638
86261
38.28%
22320
21532
16931
11254
185567
39.02%
79427
31.74%
1969
340
124
43
12
5
72037
31.97%
1307
233
53
14
15
0
151464
31.85%
2493
1.00%
0
1622
0.72%
0
4115
0.87%
250254
225336
HEDIS 2011 (Reporting Year 2010)
35344
36339
36836
36443
40605
46636
45065
36871
22892
3276
573
177
57
27
5
0
475590
Page 98
Health Plan Descriptive Information
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:49 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
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 8:49 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