Medica
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
Medica
Adult BMI Assessment
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Commercial
Medicare
Advantage
MHCP-MC
2010
H
151524
2010
H
15714
2464
625
1.63%
411
10.00%
453
11
2.43%
NR
NR
3.98%
411
10.00%
453
18
3.97%
Number of Records Excluded Because of Valid
Data Errors
0
0
Number of administrative data records excluded
7417
2298
Number of medical record data records excluded
0
0
Number of employee/dependent medical records
excluded
0
0
0
411
10
245
62.04%
57.23%
66.86%
0
411
17
259
67.15%
62.49%
71.82%
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
NR
NR
NR
Page 3
Effectiveness of Care
Medica
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 24, 2011 9:04 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
28664
19178
47842
28664
19178
47842
28664
19178
47842
1451
5.06%
783
4.08%
2234
4.67%
283
0.99%
249
1.30%
532
1.11%
3
0.01%
1
0.01%
4
0.01%
0
0.00%
0
0.00%
0
0.00%
411
10.00%
411
10.00%
453
411
10.00%
453
10
2.21%
10
2.21%
20
4.42%
453
0
0.00%
1
0.22%
1
0.22%
0
0
0
Number of administrative data records
excluded
48
48
48
Number of medical records excluded
0
0
0
Number of employee/dependent records
excluded
0
0
0
Records Added from the Oversample List
0
0
0
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
243
168
411
243
168
411
243
168
411
8
135
58.85%
52.45%
65.24%
7
79
51.19%
43.33%
59.05%
15
214
55.72%
50.79%
60.64%
0
128
52.67%
46.19%
59.16%
1
58
35.12%
27.60%
42.63%
1
186
45.50%
40.56%
50.43%
0
101
41.56%
35.16%
47.97%
0
72
42.86%
35.08%
50.64%
0
173
42.09%
37.20%
46.99%
Page 4
Effectiveness of Care
Medica
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
BMI Percentile
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Nutrition
Total
2010
H
General
Measure
Data
Ages 3-11 Ages 12-17
Total
2010
H
Counseling for Physical Activity
General
Ages 12Measure Ages 3-11
Total
17
Data
2010
H
20267
9655
29922
20267
9655
29922
20267
9655
29922
638
3.15%
294
3.05%
932
3.11%
314
1.55%
188
1.95%
502
1.68%
1
0.00%
2
0.02%
3
0.01%
0
0.00%
0
0.00%
0
0.00%
411
10.00%
411
10.00%
453
411
10.00%
453
5
1.10%
3
0.66%
8
1.77%
453
2
0.44%
3
0.66%
5
1.10%
0
0
0
Number of administrative data records
excluded
135
135
135
Number of medical records excluded
0
0
0
Number of employee/dependent records
excluded
0
0
0
Records Added from the Oversample List
0
0
0
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
289
122
411
289
122
411
289
122
411
5
188
66.78%
61.18%
72.39%
3
74
63.11%
54.14%
72.09%
8
262
65.69%
60.98%
70.40%
2
183
64.01%
58.31%
69.72%
2
55
46.72%
37.46%
55.98%
4
238
58.88%
54.00%
63.76%
0
131
45.33%
39.42%
51.24%
0
61
50.00%
40.72%
59.28%
0
192
46.72%
41.77%
51.66%
Page 5
Effectiveness of Care
Medica
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
3
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
2
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
1993
71.90%
2134
76.98%
2431
87.70%
2274
82.03%
1999
72.11%
2376
85.71%
2016
72.73%
847
30.56%
1549
55.88%
1696
61.18%
329
72.63%
346
76.38%
399
88.08%
373
82.34%
326
71.96%
388
85.65%
332
73.29%
141
31.13%
248
54.75%
277
61.15%
301
316
362
338
297
354
306
126
226
251
53
86.13%
82.67%
89.59%
52
89.54%
86.46%
92.62%
9
90.27%
87.28%
93.25%
45
93.19%
90.63%
95.74%
62
87.35%
84.01%
90.68%
8
88.08%
84.82%
91.33%
39
83.94%
80.27%
87.61%
13
33.82%
29.12%
38.52%
37
63.99%
59.23%
68.75%
16
64.96%
60.23%
69.70%
453
0
Numerator Events by administrative Data
MMR
411
10.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
IPV
2009
H
2772
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
411
Page 6
Effectiveness of Care
Medica
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
3
Number of medical data records excluded
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
2
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
1993
71.90%
1670
60.25%
1624
58.59%
596
21.50%
1219
43.98%
1191
42.97%
502
18.11%
461
16.63%
943
34.02%
403
14.54%
329
72.63%
269
59.38%
257
56.73%
99
21.85%
193
42.60%
191
42.16%
87
19.21%
75
16.56%
146
32.23%
67
14.79%
301
245
237
93
178
173
81
69
132
61
53
86.13%
82.67%
89.59%
73
77.37%
73.21%
81.54%
66
73.72%
69.35%
78.10%
30
29.93%
25.38%
34.48%
51
55.72%
50.79%
60.64%
58
56.20%
51.29%
61.12%
24
25.55%
21.21%
29.89%
29
23.84%
19.60%
28.09%
47
43.55%
38.64%
48.47%
24
20.68%
16.64%
24.72%
453
0
Numerator Events by administrative Data
Combo 3
411
10.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Combo 2
2009
H
2772
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
DTaP
411
Page 7
Effectiveness of Care
Medica
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
8
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
2186
76.78%
2474
86.90%
2509
88.13%
2567
90.17%
2468
86.69%
2494
87.60%
2182
76.64%
830
29.15%
1553
54.55%
1513
53.14%
351
77.48%
394
86.98%
393
86.75%
402
88.74%
391
86.31%
388
85.65%
353
77.92%
133
29.36%
250
55.19%
240
52.98%
320
20
82.73%
78.95%
86.50%
358
20
91.97%
89.22%
94.72%
356
11
89.29%
86.18%
92.41%
363
18
92.70%
90.06%
95.34%
358
22
92.46%
89.78%
95.13%
351
12
88.32%
85.09%
91.55%
320
22
83.21%
79.48%
86.95%
121
11
32.12%
27.48%
36.75%
229
15
59.37%
54.50%
64.24%
218
17
57.18%
52.27%
62.08%
453
0
Numerator Events by administrative Data
MMR
411
0.1
Number of Records Excluded Because of
Valid Data Errors
Denominator
IPV
2009
H
2847
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
411
Page 8
Effectiveness of Care
Medica
Childhood Immunization Status
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Number of administrative data records
excluded
8
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
2186
76.78%
1987
69.79%
1894
66.53%
690
24.24%
1290
45.31%
1195
41.97%
521
18.30%
495
17.39%
915
32.14%
395
13.87%
351
77.48%
312
68.87%
298
65.78%
108
23.84%
205
45.25%
183
40.40%
82
18.10%
76
16.78%
144
31.79%
61
13.47%
320
20
82.73%
78.95%
86.50%
284
33
77.13%
72.95%
81.31%
272
34
74.45%
70.11%
78.79%
100
17
28.47%
23.98%
32.95%
191
24
52.31%
47.36%
57.26%
165
32
47.93%
42.98%
52.88%
75
15
21.90%
17.78%
26.02%
69
14
20.19%
16.19%
24.20%
131
22
37.23%
32.43%
42.02%
55
13
16.55%
12.83%
20.26%
453
0
Numerator Events by administrative Data
Combo 3
411
0.1
Number of Records Excluded Because of
Valid Data Errors
Denominator
Combo 2
2009
H
2847
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
DTaP
411
Page 9
Effectiveness of Care
Medica
Immunizations for Adolescents
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Commercial
Data Elements
General
Measure Data
Meningococcal
Tdap
Combo 1
2112
3286
2056
53.55%
83.32%
52.13%
260
57.40%
376
83.00%
251
55.41%
231
10
337
20
222
14
58.64%
86.86%
57.42%
Lower 95% Confidence Interval
53.75%
83.47%
52.52%
Upper 95% Confidence Interval
63.52%
90.25%
62.32%
Measurement Year
2010
Data Collection Methodology
H
Eligible Member Population
3944
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
411
10.00%
453
Records Excluded because of Valid Data Errors
0
Number of administrative data records excluded
1
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
411
Page 10
Effectiveness of Care
Medica
Immunizations for Adolescents
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Data Elements
Measure Data
2010
Measurement Year
H
Data Collection Methodology
1915
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
0
Number of administrative data records excluded
0
Number of medical data records excluded
0
Number of employee/dependent medical records
excluded
0
HEDIS 2011 (Reporting Year 2010)
Tdap
Combo 1
1071
1549
1022
55.93%
80.89%
53.37%
255
56.29%
368
81.24%
241
53.20%
233
10
59.12%
54.25%
64.00%
336
19
86.37%
82.94%
89.81%
223
15
57.91%
53.01%
62.80%
411
10.00%
453
Records Excluded because of Valid Data Errors
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Meningococcal
0
411
Page 11
Effectiveness of Care
Medica
Breast Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Commercial
2010
A
50234
35405
70.48%
70.08%
70.88%
Medicare
Advantage
NR
NR
NR
MSHO
SNBC
MHCP-MC
2010
A
522
304
58.24%
53.91%
62.56%
2010
A
190
124
65.26%
58.23%
72.30%
2010
A
4092
2443
59.70%
58.19%
61.22%
Page 12
Effectiveness of Care
Medica
Cervical Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Commercial
MHCP-MC
2010
A
59962
2010
A
17652
NR
NR
NR
NR
46423
12960
77.42%
73.42%
77.09%
77.76%
72.76%
74.07%
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Page 13
Effectiveness of Care
Medica
Colorectal Cancer Screening
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Data Elements
Commercial
Medicare
Advantage
MSHO
SNBC
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
2009
H
42803
2010
H
2567
2010
H
181
Number of numerator events by administrative data in eligible population
(before exclusions)
22257
1125
71
43.83%
411
10.00%
453
202
44.59%
0
16
0
0
0
411
182
38
53.53%
48.58%
58.47%
39.23%
180
0.00%
180
71
39.44%
0
1
0
0
0
180
71
36
59.44%
51.99%
66.90%
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)
52.00%
411
0.1
453
248
54.75%
0
54
0
0
1
411
230
38
65.21%
60.48%
69.93%
NR
NR
NR
NR
NR
Page 14
Effectiveness of Care
Medica
Chlamydia Screening in Women
Data Last Refreshed:
Oct 24, 2011 9:04 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
4652
1856
39.90%
38.48%
41.31%
4722
2314
49.00%
47.57%
50.44%
9374
4170
44.48%
43.47%
45.50%
2010
A
Page 15
Effectiveness of Care
Medica
Chlamydia Screening in Women
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
General
Measure Data
Ages 16-20
Ages 21-24
Total
2422
1448
59.79%
57.81%
61.76%
2019
1343
66.52%
64.43%
68.60%
4441
2791
62.85%
61.41%
64.28%
2010
A
Page 16
Effectiveness of Care
Medica
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Medicare
Advantage
NR
NR
NR
MSHO
2010
A
6966
5356
76.89%
75.89%
77.88%
Page 17
Effectiveness of Care
Medica
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Lead Screening in Children
Data Elements
Commercial
MHCP-MC
2010
A
3262
2010
A
2984
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
2242
2680
Reported Rate
68.73%
89.81%
Lower 95% Confidence Interval
67.12%
88.71%
Upper 95% Confidence Interval
70.34%
90.91%
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population (before exclusions)
Records Excluded because of Valid Data
Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
HEDIS 2011 (Reporting Year 2010)
Page 18
Effectiveness of Care
Medica
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Care for Older Adults
MSHO
Medication Review
Functional
Status
Assessment
Pain
Screening
0
60
0
0
0.00%
0.71%
0.00%
0.00%
0
0.00%
2
0.44%
0
0.00%
0
0.00%
0
221
2
359
0
283
0
273
Reported Rate
53.77%
87.83%
68.86%
66.42%
Lower 95% Confidence Interval
48.83%
84.55%
64.26%
61.74%
Upper 95% Confidence Interval
58.71%
91.12%
73.46%
71.11%
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General Measure
Data
2010
H
8484
Numerator Events by Admin Data on
Eligible Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
411
10.00%
453
Records Excluded because of Valid Data
Errors
0
Number of employee/dependent medical
records excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
HEDIS 2011 (Reporting Year 2010)
Advance Care
Planning
0
411
Page 19
Effectiveness of Care
Medica
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 24, 2011 9:04 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
37
58.73%
45.78%
71.68%
57
90.48%
82.43%
98.52%
2010
A
63
Page 21
Effectiveness of Care
Medica
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Oct 24, 2011 9:04 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
9
NA
NA
NA
9
NA
NA
NA
2010
A
10
Page 22
Effectiveness of Care
Medica
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Oct 24, 2011 9:04 AM
MSHO
SNBC
2010
A
234
40
17.09%
12.06%
22.13%
2010
A
3
1
NA
NA
NA
Page 23
Effectiveness of Care
Medica
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 24, 2011 9:04 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
404
391
96.78%
94.94%
98.63%
1680
1541
91.73%
90.38%
93.07%
2084
1932
92.71%
91.57%
93.85%
2010
A
`
Page 24
Effectiveness of Care
Medica
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
General
Measure Data
Ages 5-11
Ages 12-50
Total
450
431
95.78%
93.81%
97.75%
889
755
84.93%
82.52%
87.34%
1339
1186
88.57%
86.83%
90.31%
2010
A
Page 25
Effectiveness of Care
Medica
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 24, 2011 9:04 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
1845
40
86.82%
1.88%
390
13
86.09%
2.87%
356
14
12
263
90.02%
87.01%
93.04%
66.91%
62.24%
71.58%
2010
H
2125
411
10.00%
453
0
0
0
411
Page 26
Effectiveness of Care
Medica
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
149
0
81.42%
0.00%
149
0
81.42%
0.00%
149
10
0
110
86.89%
81.72%
92.05%
60.11%
52.74%
67.48%
2010
H
183
183
0.00%
183
0
0
0
183
Page 28
Effectiveness of Care
Medica
Controlling High Blood Pressure
Data Elements
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Commercial
Medicare
Advantage
MSHO
SNBC
MHCP-MC
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2010
H
18963
2010
H
2674
2010
H
247
2010
H
2941
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
0
0
0
0.00%
411
15.00%
473
0.00%
229
0.00%
229
0.00%
411
15.00%
473
0
0.00%
0
0.00%
0
0.00%
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
0.00%
411
15.00%
473
0
0.00%
NR
NR
Records Excluded because of Valid Data
Errors
0
0
0
0
Number of records excluded because of
false positive diagnoses
0
0
0
0
Number of administrative data records
excluded
436
448
18
129
Number of medical record data records
excluded
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
411
0
282
68.61%
64.00%
73.22%
0
411
0
305
74.21%
69.86%
78.56%
0
229
0
180
78.60%
73.07%
84.13%
0
411
0
283
68.86%
64.26%
73.46%
Records Added from the OverSample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
NR
NR
NR
Page 29
Effectiveness of Care
Medica
Persistence of Beta Blocker Treatment After Heart Attack
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Commercial
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Medicare
Advantage
MSHO
SNBC
MHCP-MC
2010
A
160
2010
A
47
2010
A
1
2010
A
36
126
40
1
29
85.11%
73.86%
96.35%
NA
NA
NA
80.56%
66.24%
94.87%
78.75%
72.10%
85.40%
NR
NR
NR
Page 30
Effectiveness of Care
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 9:04 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
10050
2010
H
10050
2010
H
10050
8951
89.06%
548
10%
603
490
81.26%
9853
98.04%
548
10%
603
592
98.18%
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
10050
2009
H
7843
2009
H
7843
2009
H
7843
2009
H
7843
2010
H
10050
2010
H
10050
124
1.23%
447
10%
490
3
0.61%
171
1.70%
548
10%
603
7
1.16%
4034
51.43%
548
10%
603
326
54.06%
6434
82.03%
548
10%
603
514
85.24%
162
2.07%
548
10%
603
17
2.82%
6279
80.06%
548
10%
603
488
80.93%
0
0.00%
548
10%
603
0
0.00%
0
0.00%
548
10%
603
0
0.00%
10
10
10
10
0
0
0
0
10
10
Number of administrative data records
excluded
123
123
123
123
105
105
105
105
123
123
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
10
548
7
363
67.52%
63.51%
71.53%
4
548
2
327
60.04%
55.84%
64.23%
4
548
466
8
86.50%
83.54%
89.45%
4
548
0
260
47.45%
43.17%
51.72%
4
548
3
467
85.77%
82.75%
88.78%
10
548
0
424
77.37%
73.78%
80.97%
10
548
0
342
62.41%
58.26%
66.56%
Number of Administrative required exclusions
27
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)
76
10
548
453
50
91.79%
89.40%
94.18%
10
548
63
67
23.72%
20.07%
27.38%
8
445
3
185
42.25%
37.55%
46.95%
Page 31
Effectiveness of Care
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 9:04 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
HbA1c
Testing
Poor HbA1c
Control
2010
H
1203
2010
H
1203
1100
91.44%
411
10%
453
369
81.46%
1161
96.51%
411
10%
453
439
96.91%
Good HbA1c
Control
(<7.0%)
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2010
H
1203
2010
H
1203
2010
H
1203
2010
H
1203
2010
H
1203
2010
H
1203
2010
H
1203
36
2.99%
411
10%
453
13
2.87%
853
70.91%
411
10%
453
318
70.20%
966
80.30%
411
10%
453
340
75.06%
37
3.08%
411
10%
453
20
4.42%
1062
88.28%
411
10%
453
399
88.08%
5
0.42%
411
10%
453
5
1.10%
5
0.42%
411
10%
453
5
1.10%
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80
mm Hg
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
411
334
52
93.92%
91.48%
96.35%
0
411
44
31
18.25%
14.39%
22.10%
0
411
9
292
73.24%
68.83%
77.64%
0
411
286
16
73.48%
69.09%
77.87%
0
411
309
29
82.24%
78.42%
86.06%
0
411
17
213
55.96%
51.04%
60.88%
0
411
365
10
91.24%
88.39%
94.10%
0
411
5
307
75.91%
71.66%
80.17%
0
411
5
280
69.34%
64.76%
73.92%
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
NR
NR
NR
Page 33
Effectiveness of Care
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 9:04 AM
SNBC
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
HbA1c
Testing
Poor HbA1c
Control
2010
H
257
2010
H
257
231
89.88%
257
0%
257
231
89.88%
251
97.67%
257
0%
257
251
97.67%
Good HbA1c
Control
(<7.0%)
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80
mm Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2010
H
257
2010
H
257
2010
H
257
2010
H
257
2010
H
257
2010
H
257
2010
H
257
10
3.89%
257
0%
257
6
2.33%
180
70.04%
257
0%
257
180
70.04%
203
78.99%
257
0%
257
203
78.99%
12
4.67%
257
0%
257
6
2.33%
201
78.21%
257
0%
257
201
78.21%
5
1.95%
257
0%
257
0
0.00%
4
1.56%
257
0%
257
0
0.00%
7
7
7
7
7
7
7
7
7
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
250
194
43
94.80%
91.85%
97.75%
0
250
18
29
18.80%
13.76%
23.84%
0
250
10
168
71.20%
65.39%
77.01%
0
250
178
9
74.80%
69.22%
80.38%
0
250
197
17
85.60%
81.05%
90.15%
0
250
12
122
53.60%
47.22%
59.98%
0
250
199
15
85.60%
81.05%
90.15%
0
250
5
204
83.60%
78.81%
88.39%
0
250
4
165
67.60%
61.60%
73.60%
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
NR
NR
NR
Page 34
Effectiveness of Care
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2010
H
2237
2010
H
2237
2010
H
2237
2010
H
2237
2010
H
2237
2010
H
2237
2010
H
2237
2010
H
2237
2010
H
2237
2010
H
2237
1954
87.35%
548
10%
603
535
88.72%
2198
98.26%
548
10%
603
588
97.51%
24
1.07%
480
10%
527
5
0.95%
34
1.52%
548
10%
603
12
1.99%
1215
54.31%
548
10%
603
339
56.22%
1713
76.58%
548
10%
603
463
76.78%
54
2.41%
548
10%
603
15
2.49%
1700
75.99%
548
10%
603
474
78.61%
0
0.00%
548
10%
603
0
0.00%
0
0.00%
548
10%
603
0
0.00%
4
4
4
4
4
4
4
4
4
4
82
82
82
82
82
82
82
82
82
82
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
548
13
307
58.39%
54.18%
62.61%
4
548
309
34
62.59%
58.45%
66.73%
4
548
408
27
79.38%
75.90%
82.86%
4
548
11
230
43.98%
39.73%
48.23%
4
548
431
15
81.39%
78.04%
84.74%
4
548
0
428
78.10%
74.55%
81.66%
4
548
0
328
59.85%
55.66%
64.05%
Number of Administrative required exclusions
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Blood
Pressure
<130/80
mm Hg
64
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
15
4
548
439
62
91.42%
88.99%
93.86%
4
548
57
104
29.38%
25.47%
33.28%
4
469
6
181
39.87%
35.33%
44.41%
Page 35
Effectiveness of Care
Medica
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Medicare
Advantage
NR
NR
NR
Page 36
Effectiveness of Care
Medica
Osteoporosis Management in Women Who had a Fracture
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Oct 24, 2011 9:04 AM
MSHO
2010
A
307
29
9.45%
6.01%
12.88%
Page 37
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 9:04 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
1767
70.68%
68.88%
72.48%
1370
54.80%
52.83%
56.77%
2010
A
2500
Page 38
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 9:04 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
56
62.92%
52.32%
73.52%
54
60.67%
49.96%
71.38%
2010
A
89
Page 40
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 9:04 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
5
NA
NA
NA
3
NA
NA
NA
2010
A
12
Page 41
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Oct 24, 2011 9:04 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
552
50.23%
47.23%
53.23%
383
34.85%
31.99%
37.71%
2010
A
1099
Page 42
Effectiveness of Care
Medica
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 24, 2011 9:04 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
603
227
37.65%
33.70%
41.60%
193
80
41.45%
34.24%
48.66%
2010
A
Page 43
Effectiveness of Care
Medica
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 24, 2011 9:04 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
555
263
47.39%
43.14%
51.63%
154
68
44.16%
35.99%
52.32%
2010
A
Page 44
Effectiveness of Care
Medica
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 24, 2011 9:04 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
36
62.07%
48.72%
75.42%
23
39.66%
26.20%
53.11%
2010
A
58
Page 46
Effectiveness of Care
Medica
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Oct 24, 2011 9:04 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
120
87.59%
81.71%
93.48%
98
71.53%
63.61%
79.45%
2010
A
137
Page 47
Effectiveness of Care
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 9:04 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
13646
11049
80.97%
80.31%
81.63%
154
118
76.62%
69.61%
83.63%
10586
8630
81.52%
80.78%
82.27%
690
464
67.25%
63.67%
70.82%
25076
20261
80.80%
80.31%
81.29%
2010
A
Page 48
Effectiveness of Care
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 9:04 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
3165
2972
93.90%
93.05%
94.75%
300
282
94.00%
91.15%
96.85%
3207
3037
94.70%
93.91%
95.49%
449
381
84.86%
81.43%
88.28%
7121
6672
93.69%
93.12%
94.27%
2010
A
Page 50
Effectiveness of Care
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 9:04 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
190
182
95.79%
92.67%
98.91%
6
6
NA
NA
NA
162
153
94.44%
90.61%
98.28%
170
147
86.47%
81.03%
91.91%
528
488
92.42%
90.07%
94.78%
2010
A
Page 51
Effectiveness of Care
Medica
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Oct 24, 2011 9:04 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
2122
1791
84.40%
82.83%
85.97%
21
17
NA
NA
NA
1677
1410
84.08%
82.30%
85.86%
221
170
76.92%
71.14%
82.70%
4041
3388
83.84%
82.69%
84.99%
2010
A
Page 52
Access/Availability of Care
Medica
Medication Reconciliation Post Discharge
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
population (before exclusions)
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
Data Last Refreshed:
Oct 24, 2011 9:04 AM
MSHO
2010
H
5490
0
0.00%
411
10%
453
0
0.00%
0
0
0
411
0
297
72.26%
67.81%
76.71%
Page 53
Effectiveness of Care
Medica
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 24, 2011 9:04 AM
MSHO
Drug-Disease Interactions
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
General
Measure
Data
History of Falls +
Tricyclic
Antidepressants,
Antipsychotics or
Sleep Agents
Chronic Renal
Dementia +
Failure +
Tricyclic
Antidepressants Nonaspirin NSAIDs
or Anticholinergic or Cox-2 Selective
NSAIDs
Agents
Total
2010
A
445
90
20.22%
16.38%
24.07%
2037
492
24.15%
22.27%
26.04%
130
13
10.00%
4.46%
15.54%
2612
595
22.78%
21.15%
24.41%
Page 55
Effectiveness of Care
Medica
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 24, 2011 9:04 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
General
Measure
Data
2010
A
7692
At least 1
Prescription
At least 2
Prescriptions
1743
22.66%
21.72%
23.60%
375
4.88%
4.39%
5.36%
Page 57
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 9:04 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
59984
69063
3697
132744
56751
66617
3624
94.61%
94.43%
94.79%
96.46%
96.32%
96.60%
98.03%
97.56%
98.49%
126992
95.67%
95.56%
95.78%
2010
A
Page 58
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 9:04 AM
MSHO
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
General
Measure Data
Ages 20-44
Ages 45-64
Ages 65+
Total
0
0
8520
8520
0
0
8296
NA
NA
NA
NA
NA
NA
97.37%
97.03%
97.72%
8296
97.37%
97.03%
97.72%
2010
A
Page 60
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 9:04 AM
SNBC
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
General
Measure Data
Ages 20-44
Ages 45-64
Ages 65+
Total
521
682
7
1210
507
665
7
97.31%
95.83%
98.80%
97.51%
96.26%
98.75%
NA
NA
NA
1179
97.44%
96.51%
98.37%
2010
A
Page 61
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
General
Measure Data
Ages 20-44
Ages 45-64
Ages 65+
Total
20978
8799
12
29789
18820
7968
9
89.71%
89.30%
90.13%
90.56%
89.94%
91.17%
NA
NA
NA
26797
89.96%
89.61%
90.30%
2010
A
Page 62
Access/Availability of Care
Medica
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 24, 2011 9:04 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.
3624
3561
18339
16791
15754
14318
27369
24865
98.26%
97.82%
98.70%
91.56%
91.15%
91.96%
90.88%
90.43%
91.34%
90.85%
90.51%
91.19%
2010
A
Page 63
Access/Availability of Care
Medica
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 24, 2011 9:04 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.
4592
4512
14378
13128
7910
7343
9975
9211
98.26%
97.87%
98.65%
91.31%
90.84%
91.77%
92.83%
92.26%
93.41%
92.34%
91.81%
92.87%
2010
A
Page 64
Access/Availability of Care
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 9:04 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
213
3405
3618
75
33
1238
598
1313
631
35.21%
28.56%
41.86%
15.49%
10.40%
20.59%
36.36%
34.73%
37.99%
17.56%
16.27%
18.86%
36.29%
34.71%
37.87%
17.44%
16.19%
18.69%
Page 65
Access/Availability of Care
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 9:04 AM
MSHO
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
2010
A
0
153
153
0
0
69
5
69
5
NA
NA
NA
NA
NA
NA
45.10%
36.89%
53.31%
3.27%
0.12%
6.41%
45.10%
36.89%
53.31%
3.27%
0.12%
6.41%
Page 67
Access/Availability of Care
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 9:04 AM
SNBC
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
2010
A
0
188
188
0
0
61
18
61
18
NA
NA
NA
NA
NA
NA
32.45%
25.49%
39.41%
9.57%
5.10%
14.05%
32.45%
25.49%
39.41%
9.57%
5.10%
14.05%
Page 68
Access/Availability of Care
Medica
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
2010
A
317
3120
3437
117
72
1062
499
1179
571
36.91%
31.44%
42.38%
22.71%
17.94%
27.48%
34.04%
32.36%
35.72%
15.99%
14.69%
17.30%
34.30%
32.70%
35.90%
16.61%
15.35%
17.87%
Page 69
Access/Availability of Care
Medica
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
2010
H
4151
2010
H
4151
Number of numerator events by administrative data in eligible
population (before exclusions)
3106
2310
74.83%
411
10%
453
334
55.65%
411
10%
453
278
73.73%
61.37%
0
0
0
0
411
306
81
0
0
411
255
79
94.16%
91.77%
96.55%
81.27%
77.37%
85.16%
Data Elements
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
Page 70
Access/Availability of Care
Medica
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Timeliness of
Prenatal Care
Postpartum
Care
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
2010
H
5131
2010
H
5131
Number of numerator events by administrative data in eligible
population (before exclusions)
3129
2712
60.98%
411
10%
453
275
52.86%
411
10%
453
246
60.71%
54.30%
0
0
0
0
411
252
119
0
0
411
229
47
90.27%
87.28%
93.25%
67.15%
62.49%
71.82%
Data Elements
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2011 (Reporting Year 2010)
Page 71
Use of Services
Medica
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 24, 2011 9:04 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
34
26
35
58
137
453
2274
1.13%
0.73%
1.52%
0.86%
0.52%
1.21%
1.16%
0.76%
1.56%
1.92%
1.42%
2.43%
4.54%
3.78%
5.30%
15.01%
13.72%
16.31%
75.37%
73.82%
76.93%
2010
A
3017
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
Medica
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
63
68
108
205
387
861
2296
1.58%
1.18%
1.98%
1.71%
1.29%
2.12%
2.71%
2.19%
3.22%
5.14%
4.44%
5.84%
9.70%
8.77%
10.64%
21.59%
20.30%
22.88%
57.57%
56.03%
59.12%
2010
A
3988
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
Medica
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Commercial
MHCP-MC
2010
A
15191
2010
A
11713
NR
NR
NR
NR
10638
8119
70.03%
69.30%
70.76%
69.32%
68.48%
70.16%
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Page 74
Use of Services
Medica
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Commercial
MHCP-MC
2010
A
41170
2010
A
16585
NR
NR
NR
NR
14080
6277
34.20%
33.74%
34.66%
37.85%
37.11%
38.59%
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2011 (Reporting Year 2010)
Page 75
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
49797
493384
591342
1608310
1356138
53528
5316
1161
0
4158976
Outpatient Visits (Excludes
MH/CD)
Age
Visits
41746
141415
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
130324
389085
455098
28054
3905
1011
0
1190638
<1
1-9
HEDIS 2011 (Reporting Year 2010)
Visits/ 1,000
Member
Months
838.32
286.62
220.39
241.92
335.58
524.10
734.57
870.80
286.28
Emergency Room Visits
Visits
1474
7278
7079
19344
13758
672
119
43
0
49767
Visits/ 1,000
Member
Months
29.60
14.75
11.97
12.03
10.14
12.55
22.39
37.04
11.97
Page 76
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 9:04 AM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
0
0
5
37367
36913
36637
0
110922
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
0
0
4
32425
30783
27762
0
90974
HEDIS 2011 (Reporting Year 2010)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
800.00
867.74
833.93
757.76
820.16
Emergency Room Visits
Visits
0
0
0
0
0
1732
1361
1160
0
4253
Visits/ 1,000
Member
Months
NA
NA
NA
NA
0.00
46.35
36.87
31.66
38.34
Page 78
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 9:04 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
102
7557
9361
125
0
0
0
17145
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
41
5879
9597
110
0
0
0
15627
HEDIS 2011 (Reporting Year 2010)
Visits/ 1,000
Member
Months
NA
NA
401.96
777.95
1025.21
880.00
NA
NA
911.46
Emergency Room Visits
Visits
0
0
9
854
799
9
0
0
0
1671
Visits/ 1,000
Member
Months
NA
NA
88.24
113.01
85.35
72.00
NA
NA
97.46
Page 79
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Oct 24, 2011 9:04 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
84452
519528
368259
507837
172987
332
25
0
0
1653420
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
66343
167282
95595
241044
98587
180
33
0
0
669064
HEDIS 2011 (Reporting Year 2010)
Visits/ 1,000
Member
Months
785.57
321.99
259.59
474.65
569.91
542.17
1320.00
NA
404.65
Emergency Room Visits
Visits
8357
25552
13999
38915
7081
4
0
0
0
93908
Visits/ 1,000
Member
Months
98.96
49.18
38.01
76.63
40.93
12.05
0.00
NA
56.80
Page 80
Use of Services
Medica
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 9:04 AM
Member Months
49797
493384
591342
1608310
1356138
53528
5316
1161
0
4158976
Discharges
Discharges /
1,000 Member
Months
321
579
793
7772
7503
666
100
42
0
17776
6.45
1.17
1.34
4.83
5.53
12.44
18.81
36.18
258
387
344
1302
2896
285
56
28
0
5556
5.18
0.78
0.58
0.81
2.14
5.32
10.53
24.12
62
192
343
1932
4577
380
44
14
0
7544
1.25
0.39
0.58
1.20
3.38
7.10
8.28
12.06
106
4537
29
0
4672
0.18
2.82
0.02
HEDIS 2011 (Reporting Year 2010)
4.27
1.34
1.81
1.31
Days
Days / 1,000
Member
Months
1310
1570
2554
22071
29208
3270
420
164
0
60567
26.31
3.18
4.32
13.72
21.54
61.09
79.01
141.26
822
875
948
3380
9393
1171
208
92
0
16889
16.51
1.77
1.60
2.10
6.93
21.88
39.13
79.24
486
695
1337
6709
19730
2096
212
72
0
31337
9.76
1.41
2.26
4.17
14.55
39.16
39.88
62.02
269
11978
65
0
12312
0.45
7.45
0.05
14.56
4.06
7.53
3.46
Average
Length of Stay
4.08
2.71
3.22
2.84
3.89
4.91
4.20
3.90
NA
3.41
3.19
2.26
2.76
2.60
3.24
4.11
3.71
3.29
NA
3.04
7.84
3.62
3.90
3.47
4.31
5.52
4.82
5.14
NA
4.15
2.54
2.64
2.24
NA
2.64
Page 81
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
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 9:04 AM
Member Months
0
0
0
0
5
37367
36913
36637
0
110922
Discharges
0
0
0
0
0
1231
1470
1261
0
3962
Discharges /
1,000 Member
Months
NA
NA
NA
NA
0.00
32.94
39.82
34.42
35.72
0
0
0
0
0
841
1087
1050
0
2978
NA
NA
NA
NA
0.00
22.51
29.45
28.66
0
0
0
0
0
389
382
210
0
981
NA
NA
NA
NA
0.00
10.41
10.35
5.73
0
0
0
0
0
NA
NA
0.00
HEDIS 2011 (Reporting Year 2010)
26.85
8.84
0.00
Days
0
0
0
0
0
6191
6876
5380
0
18447
0
0
0
0
0
3521
4387
4107
0
12015
Days / 1,000
Member
Months
NA
NA
NA
NA
0.00
165.68
186.28
146.85
166.31
NA
NA
NA
NA
0.00
94.23
118.85
112.10
108.32
0
0
0
0
0
2667
2488
1271
0
6426
NA
NA
NA
NA
0.00
71.37
67.40
34.69
0
0
0
0
0
NA
NA
0.00
57.93
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
5.03
4.68
4.27
NA
4.66
NA
NA
NA
NA
NA
4.19
4.04
3.91
NA
4.03
NA
NA
NA
NA
NA
6.86
6.51
6.05
NA
6.55
NA
NA
NA
NA
NA
Page 83
Use of Services
Medica
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 9:04 AM
Member Months
0
0
102
7557
9361
125
0
0
0
17145
Discharges
0
0
3
151
313
4
0
0
0
471
0
0
1
89
202
2
0
0
0
294
Discharges /
1,000 Member
Months
NA
NA
29.41
19.98
33.44
32.00
NA
NA
27.47
NA
NA
9.80
11.78
21.58
16.00
NA
NA
17.15
0
0
2
51
111
2
0
0
0
166
NA
NA
19.61
6.75
11.86
16.00
NA
NA
0
11
0
0
11
0.00
1.46
0.00
HEDIS 2011 (Reporting Year 2010)
9.68
0.65
Days
0
0
20
675
1345
56
0
0
0
2096
0
0
2
353
715
4
0
0
0
1074
Days / 1,000
Member
Months
NA
NA
196.08
89.32
143.68
448.00
NA
NA
122.25
NA
NA
19.61
46.71
76.38
32.00
NA
NA
62.64
0
0
18
299
630
52
0
0
0
999
NA
NA
176.47
39.57
67.30
416.00
NA
NA
0
23
0
0
23
0.00
3.04
0.00
58.27
1.35
Average
Length of Stay
NA
NA
6.67
4.47
4.30
14.00
NA
NA
NA
4.45
NA
NA
2.00
3.97
3.54
2.00
NA
NA
NA
3.65
NA
NA
9.00
5.86
5.68
26.00
NA
NA
NA
6.02
NA
2.09
NA
NA
2.09
Page 84
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
<1
84452
1-9
519528
10-19
368259
20-44
507837
45-64
172987
65-74
332
75-84
25
85+
0
Unknown
0
Total
1653420
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
826
1028
1322
8634
1897
5
3
0
0
13715
9.78
1.98
3.59
17.00
10.97
15.06
120.00
NA
695
783
332
1412
881
5
2
0
0
4110
8.23
1.51
0.90
2.78
5.09
15.06
80.00
NA
129
245
230
1472
998
0
1
0
0
3075
1.53
0.47
0.62
2.90
5.77
0.00
40.00
NA
759
5750
18
0
6527
2.06
11.32
0.10
HEDIS 2011 (Reporting Year 2010)
8.29
2.49
1.86
6.22
Days
Days / 1,000
Member
Months
3782
3106
3793
23152
6913
12
19
0
0
40777
44.78
5.98
10.30
45.59
39.96
36.14
760.00
NA
2194
1890
830
3712
2577
12
10
0
0
11225
25.98
3.64
2.25
7.31
14.90
36.14
400.00
NA
1585
1216
946
4639
4292
0
9
0
0
12687
18.77
2.34
2.57
9.13
24.81
0.00
360.00
NA
2007
14801
44
0
16852
5.45
29.15
0.25
24.66
6.79
7.67
16.06
Average
Length of Stay
4.58
3.02
2.87
2.68
3.64
2.40
6.33
NA
NA
2.97
3.16
2.41
2.50
2.63
2.93
2.40
5.00
NA
NA
2.73
12.29
4.96
4.11
3.15
4.30
NA
9.00
NA
NA
4.13
2.64
2.57
2.44
NA
2.58
Page 85
Use of Services
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
364419
152741
200889
318982
1015979
33451
0
2086461
Female
352432
145498
196333
315100
1036223
26554
0
2072140
Total
716851
298239
397222
634082
2052202
60005
0
4158601
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
8
5
13
221
164
385
639
318
957
679
331
1010
1811
1077
2888
43
20
63
0
0
0
3401
1915
5316
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
364419
152741
200889
318982
1015979
33451
0
2086461
Female
352432
145498
196333
315100
1036223
26554
0
2072140
Total
716851
298239
397222
634082
2052202
60005
0
4158601
Inpatient
Percent
0.03%
0.02%
0.02%
1.74%
1.35%
1.55%
3.82%
1.94%
2.89%
2.55%
1.26%
1.91%
2.14%
1.25%
1.69%
1.54%
0.90%
1.26%
NA
NA
NA
1.96%
1.11%
1.53%
Number
2
2
4
33
50
83
120
59
179
109
55
164
439
275
714
18
11
29
0
0
0
721
452
1173
Percent
0.01%
0.01%
0.01%
0.26%
0.41%
0.33%
0.72%
0.36%
0.54%
0.41%
0.21%
0.31%
0.52%
0.32%
0.42%
0.65%
0.50%
0.58%
NA
NA
NA
0.41%
0.26%
0.34%
Male
364419
152741
200889
318982
1015979
33451
0
2086461
Female
352432
145498
196333
315100
1036223
26554
0
2072140
Total
716851
298239
397222
634082
2052202
60005
0
4158601
Member Months
(Outpatient/ED)
Male
364419
152741
200889
318982
1015979
33451
0
2086461
Female
352432
145498
196333
315100
1036223
26554
0
2072140
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
25
26
51
44
22
66
61
22
83
116
66
182
1
3
4
0
0
0
247
139
386
Number
6
4
10
217
155
372
615
312
927
656
322
978
1726
1026
2752
38
17
55
0
0
0
3258
1836
5094
Percent
0.00%
0.00%
0.00%
0.20%
0.21%
0.21%
0.26%
0.13%
0.20%
0.23%
0.08%
0.16%
0.14%
0.08%
0.11%
0.04%
0.14%
0.08%
NA
NA
NA
0.14%
0.08%
0.11%
Total
716851
298239
397222
634082
2052202
60005
0
4158601
Percent
0.02%
0.01%
0.02%
1.70%
1.28%
1.50%
3.67%
1.91%
2.80%
2.47%
1.23%
1.85%
2.04%
1.19%
1.61%
1.36%
0.77%
1.10%
NA
NA
NA
1.87%
1.06%
1.47%
Page 86
Use of Services
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 9:04 AM
MSHO
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
0
0
27587
0
27587
Female
0
0
0
0
4
73162
0
73166
Total
0
0
0
0
4
100749
0
100753
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
153
120
273
0
0
0
153
120
273
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
0
0
0
0
0
27587
0
27587
Female
0
0
0
0
4
73162
0
73166
Total
0
0
0
0
4
100749
0
100753
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
67
66
133
0
0
0
67
66
133
Female
0
0
0
0
4
73162
0
73166
Total
0
0
0
0
4
100749
0
100753
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
6.66%
1.97%
3.25%
NA
NA
NA
6.66%
1.97%
3.25%
Male
0
0
0
0
0
27587
0
27587
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
2.91%
1.08%
1.58%
NA
NA
NA
2.91%
1.08%
1.58%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
5
7
0
0
0
2
5
7
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.09%
0.08%
0.08%
NA
NA
NA
0.09%
0.08%
0.08%
Member Months
(Outpatient/ED)
Male
0
0
0
0
0
27587
0
27587
Female
0
0
0
0
4
73162
0
73166
Total
0
0
0
0
4
100749
0
100753
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
132
104
236
0
0
0
132
104
236
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
5.74%
1.71%
2.81%
NA
NA
NA
5.74%
1.71%
2.81%
Page 88
Use of Services
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 9:04 AM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
1
709
1401
4847
34
0
6992
Female
0
0
705
1548
7809
91
0
10153
Total
0
1
1414
2949
12656
125
0
17145
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
0
0
0
11
14
25
36
32
68
133
148
281
1
0
1
0
0
0
181
194
375
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
1
709
1401
4847
34
0
6992
Female
0
0
705
1548
7809
91
0
10153
Total
0
1
1414
2949
12656
125
0
17145
Inpatient
Percent
NA
NA
NA
0.00%
NA
0.00%
18.62%
23.83%
21.22%
30.84%
24.81%
27.67%
32.93%
22.74%
26.64%
35.29%
0.00%
9.60%
NA
NA
NA
31.06%
22.93%
26.25%
Number
0
0
0
0
0
0
5
5
10
13
12
25
39
50
89
0
0
0
0
0
0
57
67
124
Percent
NA
NA
NA
0.00%
NA
0.00%
8.46%
8.51%
8.49%
11.13%
9.30%
10.17%
9.66%
7.68%
8.44%
0.00%
0.00%
0.00%
NA
NA
NA
9.78%
7.92%
8.68%
Male
0
1
709
1401
4847
34
0
6992
Female
0
0
705
1548
7809
91
0
10153
Total
0
1
1414
2949
12656
125
0
17145
Member Months
(Outpatient/ED)
Male
0
1
709
1401
4847
34
0
6992
Female
0
0
705
1548
7809
91
0
10153
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
1
1
2
3
6
9
9
17
26
0
0
0
0
0
0
13
24
37
Number
0
0
0
0
0
0
11
13
24
36
31
67
128
141
269
1
0
1
0
0
0
176
185
361
Percent
NA
NA
NA
0.00%
NA
0.00%
1.69%
1.70%
1.70%
2.57%
4.65%
3.66%
2.23%
2.61%
2.47%
0.00%
0.00%
0.00%
NA
NA
NA
2.23%
2.84%
2.59%
Total
0
1
1414
2949
12656
125
0
17145
Percent
NA
NA
NA
0.00%
NA
0.00%
18.62%
22.13%
20.37%
30.84%
24.03%
27.26%
31.69%
21.67%
25.51%
35.29%
0.00%
9.60%
NA
NA
NA
30.21%
21.87%
25.27%
Page 89
Use of Services
Medica
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
367645
88730
63544
66701
131056
173
0
717849
Female
362681
92103
117451
162326
200826
184
0
935571
Total
730326
180833
180995
229027
331882
357
0
1653420
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
21
13
34
442
284
726
832
842
1674
1304
1756
3060
2345
1983
4328
0
0
0
0
0
0
4944
4878
9822
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
367645
88730
63544
66701
131056
173
0
717849
Female
362681
92103
117451
162326
200826
184
0
935571
Total
730326
180833
180995
229027
331882
357
0
1653420
Inpatient
Percent
0.07%
0.04%
0.06%
5.98%
3.70%
4.82%
15.71%
8.60%
11.10%
23.46%
12.98%
16.03%
21.47%
11.85%
15.65%
0.00%
0.00%
0.00%
NA
NA
NA
8.26%
6.26%
7.13%
Number
4
5
9
69
85
154
140
170
310
181
376
557
429
399
828
0
0
0
0
0
0
823
1035
1858
Percent
0.01%
0.02%
0.01%
0.93%
1.11%
1.02%
2.64%
1.74%
2.06%
3.26%
2.78%
2.92%
3.93%
2.38%
2.99%
0.00%
0.00%
0.00%
NA
NA
NA
1.38%
1.33%
1.35%
Male
367645
88730
63544
66701
131056
173
0
717849
Female
362681
92103
117451
162326
200826
184
0
935571
Total
730326
180833
180995
229027
331882
357
0
1653420
Member Months
(Outpatient/ED)
Male
367645
88730
63544
66701
131056
173
0
717849
Female
362681
92103
117451
162326
200826
184
0
935571
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
2
3
5
86
48
134
101
94
195
161
178
339
211
207
418
0
0
0
0
0
0
561
530
1091
Number
18
11
29
420
267
687
793
786
1579
1240
1668
2908
2240
1892
4132
0
0
0
0
0
0
4711
4624
9335
Percent
0.01%
0.01%
0.01%
1.16%
0.63%
0.89%
1.91%
0.96%
1.29%
2.90%
1.32%
1.78%
1.93%
1.24%
1.51%
0.00%
0.00%
0.00%
NA
NA
NA
0.94%
0.68%
0.79%
Total
730326
180833
180995
229027
331882
357
0
1653420
Percent
0.06%
0.04%
0.05%
5.68%
3.48%
4.56%
14.98%
8.03%
10.47%
22.31%
12.33%
15.24%
20.51%
11.31%
14.94%
0.00%
0.00%
0.00%
NA
NA
NA
7.88%
5.93%
6.78%
Page 90
Use of Services
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
364419
152741
1535850
33451
0
2086461
Female
352432
145498
1547656
26554
0
2072140
Total
716851
298239
3083506
60005
0
4158601
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
2231
1332
3563
1637
1746
3383
8818
15162
23980
125
130
255
0
0
0
12811
18370
31181
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
364419
152741
1535850
33451
0
2086461
Female
352432
145498
1547656
26554
0
2072140
Total
716851
298239
3083506
60005
0
4158601
Number
35
16
51
78
158
236
297
366
663
7
5
12
0
0
0
417
545
962
Female
352432
145498
1547656
26554
0
2072140
Total
716851
298239
3083506
60005
0
4158601
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
7.35%
4.54%
5.96%
12.86%
14.40%
13.61%
6.89%
11.76%
9.33%
4.48%
5.87%
5.10%
NA
NA
NA
7.37%
10.64%
9.00%
Male
364419
152741
1535850
33451
0
2086461
Percent
0.12%
0.05%
0.09%
0.61%
1.30%
0.95%
0.23%
0.28%
0.26%
0.25%
0.23%
0.24%
NA
NA
NA
0.24%
0.32%
0.28%
Number
115
72
187
138
183
321
312
637
949
2
1
3
0
0
0
567
893
1460
Percent
0.38%
0.25%
0.31%
1.08%
1.51%
1.29%
0.24%
0.49%
0.37%
0.07%
0.05%
0.06%
NA
NA
NA
0.33%
0.52%
0.42%
Member Months
(Outpatient/ED)
Male
364419
152741
1535850
33451
0
2086461
Female
352432
145498
1547656
26554
0
2072140
Total
716851
298239
3083506
60005
0
4158601
Outpatient/ED
Number
2226
1331
3557
1631
1743
3374
8797
15145
23942
122
130
252
0
0
0
12776
18349
31125
Percent
7.33%
4.53%
5.95%
12.81%
14.38%
13.58%
6.87%
11.74%
9.32%
4.38%
5.87%
5.04%
NA
NA
NA
7.35%
10.63%
8.98%
Page 91
Use of Services
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 9:04 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
0
27587
0
27587
Female
0
0
4
73162
0
73166
Total
0
0
4
100749
0
100753
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
0
0
0
0
1
1
418
1107
1525
0
0
0
418
1108
1526
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
0
27587
0
27587
Female
0
0
4
73162
0
73166
Total
0
0
4
100749
0
100753
Number
0
0
0
0
0
0
0
0
0
105
297
402
0
0
0
105
297
402
Female
0
0
4
73162
0
73166
Total
0
0
4
100749
0
100753
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
300.00%
300.00%
18.18%
18.16%
18.16%
NA
NA
NA
18.18%
18.17%
18.18%
Male
0
0
0
27587
0
27587
Percent
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
4.57%
4.87%
4.79%
NA
NA
NA
4.57%
4.87%
4.79%
Number
0
0
0
0
0
0
0
1
1
31
74
105
0
0
0
31
75
106
Percent
NA
NA
NA
NA
NA
NA
NA
300.00%
300.00%
1.35%
1.21%
1.25%
NA
NA
NA
1.35%
1.23%
1.26%
Member Months
(Outpatient/ED)
Male
0
0
0
27587
0
27587
Female
0
0
4
73162
0
73166
Total
0
0
4
100749
0
100753
Outpatient/ED
Number
0
0
0
0
0
0
0
1
1
349
909
1258
0
0
0
349
910
1259
Percent
NA
NA
NA
NA
NA
NA
NA
300.00%
300.00%
15.18%
14.91%
14.98%
NA
NA
NA
15.18%
14.92%
15.00%
Page 93
Use of Services
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 9:04 AM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
1
6957
34
0
6992
Female
0
0
10062
91
0
10153
Total
0
1
17019
125
0
17145
Any Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
1
0
1
502
754
1256
1
8
9
0
0
0
504
762
1266
HEDIS 2011 (Reporting Year 2010)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
1
6957
34
0
6992
Female
0
0
10062
91
0
10153
Total
0
1
17019
125
0
17145
Number
0
0
0
0
0
0
61
87
148
0
0
0
0
0
0
61
87
148
Female
0
0
10062
91
0
10153
Total
0
1
17019
125
0
17145
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
1200.00%
NA
1200.00%
86.59%
89.92%
88.56%
35.29%
105.49%
86.40%
NA
NA
NA
86.50%
90.06%
88.61%
Male
0
1
6957
34
0
6992
Percent
NA
NA
NA
0.00%
NA
0.00%
10.52%
10.38%
10.44%
0.00%
0.00%
0.00%
NA
NA
NA
10.47%
10.28%
10.36%
Number
0
0
0
0
0
0
43
117
160
0
0
0
0
0
0
43
117
160
Percent
NA
NA
NA
0.00%
NA
0.00%
7.42%
13.95%
11.28%
0.00%
0.00%
0.00%
NA
NA
NA
7.38%
13.83%
11.20%
Member Months
(Outpatient/ED)
Male
0
1
6957
34
0
6992
Female
0
0
10062
91
0
10153
Total
0
1
17019
125
0
17145
Outpatient/ED
Number
0
0
0
1
0
1
499
751
1250
1
8
9
0
0
0
501
759
1260
Percent
NA
NA
NA
1200.00%
NA
1200.00%
86.07%
89.56%
88.14%
35.29%
105.49%
86.40%
NA
NA
NA
85.98%
89.71%
88.19%
Page 94
Use of Services
Medica
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care(MHCP-MC)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
367645
88730
261301
173
0
717849
Female
362681
92103
480603
184
0
935571
Total
730326
180833
741904
357
0
1653420
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
3936
2625
6561
1721
1857
3578
5651
12584
18235
0
0
0
0
0
0
11308
17066
28374
HEDIS 2011 (Reporting Year 2010)
Male
367645
88730
261301
173
0
717849
Female
362681
92103
480603
184
0
935571
Total
730326
180833
741904
357
0
1653420
Percent
12.85%
8.69%
10.78%
23.28%
24.19%
23.74%
25.95%
31.42%
29.49%
0.00%
0.00%
0.00%
NA
NA
NA
18.90%
21.89%
20.59%
Number
63
39
102
112
192
304
364
557
921
0
0
0
0
0
0
539
788
1327
Male
367645
88730
261301
173
0
717849
Female
362681
92103
480603
184
0
935571
Total
730326
180833
741904
357
0
1653420
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
Age
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Percent
0.21%
0.13%
0.17%
1.51%
2.50%
2.02%
1.67%
1.39%
1.49%
0.00%
0.00%
0.00%
NA
NA
NA
0.90%
1.01%
0.96%
Number
621
370
991
327
314
641
780
1698
2478
0
0
0
0
0
0
1728
2382
4110
Percent
2.03%
1.22%
1.63%
4.42%
4.09%
4.25%
3.58%
4.24%
4.01%
0.00%
0.00%
0.00%
NA
NA
NA
2.89%
3.06%
2.98%
Member Months
(Outpatient/ED)
Male
367645
88730
261301
173
0
717849
Female
362681
92103
480603
184
0
935571
Total
730326
180833
741904
357
0
1653420
Outpatient/ED
Number
3922
2622
6544
1711
1853
3564
5629
12557
18186
0
0
0
0
0
0
11262
17032
28294
Percent
12.80%
8.68%
10.75%
23.14%
24.14%
23.65%
25.85%
31.35%
29.42%
0.00%
0.00%
0.00%
NA
NA
NA
18.83%
21.85%
20.53%
Page 95
Health Plan Descriptive Information
Medica
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 9:04 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
25206
109248
140942
149175
92636
61128
Member Months
Female
24591
105651
137543
141779
88394
58230
Total
49797
214899
278485
290954
181030
119358
578335
27.72%
139764
151226
167778
165938
182186
556188
26.84%
138112
153470
161653
164667
183516
1134523
27.28%
806892
38.67%
204406
194808
158847
109967
801418
38.67%
207304
198191
165795
116820
1608310
38.67%
668028
32.01%
23245
6571
2316
793
369
157
688110
33.21%
19525
4187
1593
614
474
161
1356138
32.61%
33451
1.60%
0
26554
1.28%
0
60005
1.44%
2086706
2072270
HEDIS 2011 (Reporting Year 2010)
277876
304696
329431
330605
365702
411710
392999
324642
226787
42770
10758
3909
1407
843
318
0
4158976
Page 98
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 9:04 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
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 9:04 AM
MSHO
Member Months
Female
0
0
0
0
0
0
<1
1-4
5-9
10-14
15-17
18-19
Male
0
0
0
0
0
0
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
0
0.00%
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
0
0.00%
0
0
0
0
0
0.00%
0
0
0
5
0
0.00%
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
0
0.00%
6407
7161
5969
4675
3542
2418
5
0.01%
11078
12721
12693
13576
14128
16549
5
0.00%
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
30172
100.00%
0
80745
99.99%
0
110917
100.00%
30172
80750
HEDIS 2011 (Reporting Year 2010)
Total
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
17485
19882
18662
18251
17670
18967
0
110922
Page 100
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 9:04 AM
SNBC
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
1
0
59
Member Months
Female
0
0
0
0
0
42
Total
0
0
0
1
0
101
60
0.86%
650
800
601
562
703
42
0.41%
663
698
850
835
1195
102
0.59%
3316
47.43%
1105
1095
912
470
4241
41.77%
1535
1711
1564
969
7557
44.08%
3582
51.23%
34
0
0
0
0
0
5779
56.92%
91
0
0
0
0
0
9361
54.60%
34
0.49%
0
91
0.90%
0
125
0.73%
6992
10153
HEDIS 2011 (Reporting Year 2010)
1313
1498
1451
1397
1898
2640
2806
2476
1439
125
0
0
0
0
0
0
17145
Page 101
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 24, 2011 9:04 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
42472
132986
130109
99047
51761
28045
Member Months
Female
41980
127713
128720
102112
54259
33035
Total
84452
260699
258829
201159
106020
61080
484420
67.48%
35499
33729
32972
29516
27987
487819
52.14%
84416
89954
72372
57799
43593
972239
58.80%
159703
22.25%
27121
22464
14633
9335
348134
37.21%
37311
28679
19023
14421
507837
30.71%
73553
10.25%
126
34
4
9
0
0
99434
10.63%
146
26
12
0
0
0
172987
10.46%
173
0.02%
0
184
0.02%
0
357
0.02%
717849
935571
HEDIS 2011 (Reporting Year 2010)
119915
123683
105344
87315
71580
64432
51143
33656
23756
272
60
16
9
0
0
0
1653420
Page 102