UCare Minnesota General Info Disclaimers Code WCC Effectiveness of Care Measures Prevention and Screening Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents HEDIS 2010 (Reporting Year 2009) Data Last Refreshed: 1/6/2011 Page 2 Page 28 Page Adult's Access to Preventive/Ambulatory Health Services 54 CAP Children's and Adolescents' Access to Primary Care Practitioners 59 IET Initiation/Engagement of Alcohol & Other Drug Dependence Treatment 61 Prenatal and Postpartum Care 66 27 AAP 3 Access / Availability of Care Measures 0 Code CIS Childhood Immunization Status 5 29 BCS Breast Cancer Screening 9 30 PPC CCS Cervical Cancer Screening 10 COL Colorectal Cancer Screening 11 0 Code CHL Chlamydia Screening in Women 12 Well Child Visits in the First 15 Months of Life 68 GSO Glaucoma Screening in Older Adults 14 31 W15 32 W34 Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life 70 LSC Lead Screening in Children 15 33 AWC Adolescent Well-Care Visits 71 COA Care for Older Adults 34 AMB Ambulatory Care 72 16 Respiratory Conditions IPU Inpatient Utilization - General Hospital/Acute Care 77 IAD Identification of Alcohol and Other Drug Services 82 Pharmacotherapy Management of COPD Exacerbation 17 36 SPR Use of Spirometry Testing in the Assessment and Diagnosis of COPD 20 37 MPT ASM Use of Appropriate Medications for People with Asthma 21 Cardiovascular 0 Code Cholesterol Management for Patients with Cardiovascular Conditions 23 CBP Controlling High Blood Pressure 26 Persistence of Beta Blocker Treatment After Hearth Attack 27 PBH Diabetes CDC Comprehensive Diabetes Care 28 Musculoskeletal OMW Osteoporosis Management in Women Who had a Fracture 33 Behavioral Health AMM Antidepressant Medication Management 34 ADD Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication 39 FUH Follow-up After Hospitalization for Mental Illness 41 Medication Management Annual Monitoring for Patients on Persistent Medications 44 MRP Medication Reconciliation Post Discharge 49 DDE Potentially Harmful Drug-Disease Interactions in the Elderly 50 DAE Use of High Risk Medications in the Elderly 52 MPM Page 35 PCE CMC Use of Services Measures 38 BCR 39 ENP Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services87 Health Plan Descriptive Information Measures Page Board Certification 92 Enrollment by Product Line (Age & Sex) 94 DISCLAIMERS -1 ( this page left blank intentionally ) 0. Disclaimer Query located below HEDIS 2010 (Reporting Year 2009) Page 2 Effectiveness of Care UCare Minnesota Weight Assessment and Counseling for Nutrition and Physical Activity Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial BMI Percentile Data Elements General Measure Data Ages 3-11 Ages 12-17 Counseling for Nutrition Total General Measure Data Ages 3-11 Ages 12-17 Total Counseling for Physical Activity General Ages 12Measure Ages 3-11 Total 17 Data Measurement Year Data Collection Methodology Eligible Member Population Numerator events by admin data in eligible population Current Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Final Sample Size (FSS) Numerator events by admin data in FSS Admin rate on FSS NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR Number of Records Excluded Because of Valid Data Errors Number of administrative data records excluded Number of medical records excluded Number of employee/dependent records excluded Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) Page 3 Effectiveness of Care UCare Minnesota Weight Assessment and Counseling for Nutrition and Physical Activity Data Last Refreshed: Jan 6, 2011 10:11 AM Minnesota Health Care Programs - Managed Care (MHCP-MC) BMI Percentile Data Elements Measurement Year Data Collection Methodology Eligible Member Population General Measure Data Number of Records Excluded Because of Valid Data Errors Total 2009 H Numerator events by admin data in eligible population Current Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Final Sample Size (FSS) Numerator events by admin data in FSS Admin rate on FSS Ages 3-11 Ages 12-17 Counseling for Nutrition General Measure Data Ages 3-11 Ages 12-17 Total 2009 H Counseling for Physical Activity General Ages 12Measure Ages 3-11 Total 17 Data 2009 H 12603 6843 19446 12603 6843 19446 12603 6843 19446 64 0.51% 61 0.89% 125 0.64% 163 1.29% 124 1.81% 287 1.48% 0 0.00% 6 0.09% 6 0.03% 0 0.00% 0 0.00% 0 0.00% 411 5.00% 411 5.00% 432 411 5.00% 432 0 0.00% 1 0.23% 1 0.23% 432 10 2.31% 0 0.00% 10 2.31% 0 0 0 125 125 125 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 Number of administrative data records excluded Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) 269 142 411 269 142 411 269 142 411 0 30 11.15% 7.20% 15.10% 1 31 22.54% 15.31% 29.76% 1 61 15.09% 11.50% 18.67% 4 126 48.33% 42.17% 54.48% 0 54 38.03% 29.69% 46.37% 4 180 44.77% 39.84% 49.70% 0 105 39.03% 33.02% 45.05% 0 54 38.03% 29.69% 46.37% 0 159 38.69% 33.86% 43.52% Page 4 Effectiveness of Care UCare Minnesota Childhood Immunization Status Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial Data Elements General Measure Data Pneumococcal Hepatitis A Rotavirus Conjugate DTaP IPV MMR HiB Hepatitis B VZV Influenza NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR Measurement Year Data Collection Methodology Eligible Member Population Numerator events by admin data in eligible population Current Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Final Sample Size (FSS) Numerator events by admin data in FSS Admin rate on FSS Number of Records Excluded Because of Valid Data Errors Number of Records Excluded because of Contraindications by Admin Data Number of Records Excluded because of Contraindications by Medical Record Review Number of employee/dependent records excluded Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) Page 5 Effectiveness of Care UCare Minnesota Childhood Immunization Status Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial Data Elements General Measure Data Combo 2 Combo 3 Combo 4 Combo 5 Combo 6 Combo 7 Combo 8 Combo 9 Combo10 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR 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 Records Excluded because of Contraindications by Admin Data Number of Records Excluded because of Contraindications by Medical Record Review Number of employee/dependent records excluded Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) Page 6 Effectiveness of Care UCare Minnesota Childhood Immunization Status Data Last Refreshed: Jan 6, 2011 10:11 AM Minnesota Health Care Programs - Managed Care (MHCP-MC) Data Elements Measurement Year Data Collection Methodology Eligible Member Population General Measure Data HiB Hepatitis B VZV Influenza 1497 74.22% 1678 83.19% 1753 86.91% 1779 88.20% 1526 75.66% 1748 86.66% 1484 73.57% 523 25.93% 970 48.09% 970 48.09% 332 76.85% 366 84.72% 384 88.89% 389 90.05% 333 77.08% 383 88.66% 315 72.92% 112 25.93% 213 49.31% 215 49.77% 319 35 86.13% 82.67% 89.59% 347 37 93.43% 90.91% 95.95% 364 15 92.21% 89.50% 94.93% 369 25 95.86% 93.82% 97.91% 318 64 92.94% 90.35% 95.54% 364 15 92.21% 89.50% 94.93% 302 32 81.27% 77.37% 85.16% 107 17 30.17% 25.61% 34.73% 204 7 51.34% 46.38% 56.29% 205 14 53.28% 48.34% 58.23% 432 0 Number of Records Excluded because of Contraindications by Admin Data 4 Number of Records Excluded because of Contraindications by Medical Record Review 0 Number of employee/dependent records excluded 0 Records Added from the Oversample List 0 HEDIS 2010 (Reporting Year 2009) MMR 411 0.05 Number of Records Excluded Because of Valid Data Errors Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval IPV 2009 H 2017 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 7 Effectiveness of Care UCare Minnesota Childhood Immunization Status Data Last Refreshed: Jan 6, 2011 10:11 AM Minnesota Health Care Programs - Managed Care (MHC Data Elements Measurement Year Data Collection Methodology Eligible Member Population General Measure Data Combo 5 Combo 6 Combo 7 Combo 8 Combo 9 Combo10 1218 60.39% 1142 56.62% 409 20.28% 745 36.94% 698 34.61% 306 15.17% 281 13.93% 490 24.29% 211 10.46% 278 64.35% 260 60.19% 95 21.99% 175 40.51% 164 37.96% 72 16.67% 71 16.44% 120 27.78% 54 12.50% 266 60 79.32% 75.28% 83.36% 249 55 73.97% 69.60% 78.33% 92 21 27.49% 23.06% 31.93% 167 23 46.23% 41.29% 51.17% 158 30 45.74% 40.80% 50.68% 69 13 19.95% 15.97% 23.94% 69 11 19.46% 15.52% 23.41% 115 14 31.39% 26.78% 36.00% 52 6 14.11% 10.62% 17.60% 432 0 Number of Records Excluded because of Contraindications by Admin Data 4 Number of Records Excluded because of Contraindications by Medical Record Review 0 Number of employee/dependent records excluded 0 Records Added from the Oversample List 0 HEDIS 2010 (Reporting Year 2009) Combo 4 411 0.05 Number of Records Excluded Because of Valid Data Errors Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval Combo 3 2009 H 2017 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 Combo 2 411 Page 8 Effectiveness of Care UCare Minnesota Breast Cancer Screening Data Elements Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial NR NR NR Medicare Advantage MSHO SNBC MHCP-MC 2009 A 4643 3739 80.53% 79.38% 81.68% 2009 A 461 236 51.19% 46.52% 55.86% 2009 A 3 1 NA NA NA 2009 A 2620 1494 57.02% 55.11% 58.94% Page 9 Effectiveness of Care UCare Minnesota Cervical Cancer Screening Data Elements Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial MHCP-MC Measurement Year Data Collection Methodology Eligible Member Population 2009 H 10623 Numerator Events by Admin Data on Eligible Population (before exclusions) 7128 Current Year's Admin Rate Minimum Required Sample Size Oversampling Rate NR 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 NR Number of medical record data records excluded Number of employee/dependent medical records excluded 67.10% 411 5.00% 432 297 68.75% 0 75 2 0 Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate NR 2 411 283 16 72.75% Lower 95% Confidence Interval Upper 95% Confidence Interval NR NR 68.32% 77.18% HEDIS 2010 (Reporting Year 2009) Page 10 Effectiveness of Care UCare Minnesota Colorectal Cancer Screening Data Last Refreshed: Jan 6, 2011 10:11 AM Data Elements Commercial Measurement Year Data collection methodology (administrative or hybrid) Eligible population Number of numerator events by administrative data in eligible population (before exclusions) Current year's administrative rate (before exclusions) Minimum required sample size (MRSS) or other sample size Oversampling rate Final sample size (FSS) Number of numerator events by administrative data in FSS Administrative rate on FSS Number of original sample records excluded because of valid data errors Number of administrative data records excluded Number of medical record data records excluded Number of employee/dependent medical records excluded Records added from the oversample list Denominator Numerator events by administrative data Numerator events by medical records NR Reported rate Lower 95% confidence interval Upper 95% confidence interval NR NR NR HEDIS 2010 (Reporting Year 2009) NR Medicare Advantage 2009 H 19112 MSHO SNBC 2009 H 2139 2009 H 3 7372 637 0 38.57% 411 0.05 432 168 38.89% 0 55 0 0 0 411 160 78 57.91% 53.01% 62.80% 29.78% 411 5.00% 432 130 30.09% 0 8 1 0 1 411 122 41 39.66% 34.81% 44.51% 0.00% 3 0.00% 3 0 0.00% 0 0 0 0 0 3 0 0 NA NA NA Page 11 Effectiveness of Care UCare Minnesota Chlamydia Screening in Women Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data Ages 1620 NR NR NR Ages 2124 NR NR NR Total NR NR NR NR NR Page 12 Effectiveness of Care UCare Minnesota Chlamydia Screening in Women Data Last Refreshed: Jan 6, 2011 10:11 AM Minnesota Health Care Programs - Managed Care (MHCP-MC) General Data Elements Measure Data Measurement Year 2009 Data Collection Methodology A Eligible Member Population Numerator Events by Admin Data Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) Ages 1620 Ages 2124 Total 1539 817 53.09% 50.56% 55.61% 1380 799 57.90% 55.26% 60.54% 2919 1616 55.36% 53.54% 57.18% Page 13 Effectiveness of Care UCare Minnesota Glaucoma Screening in Older Adults Data Elements Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage MSHO 2009 A 36104 28257 78.27% 77.84% 78.69% 2009 A 5820 4236 72.78% 71.63% 73.94% Page 14 Effectiveness of Care UCare Minnesota Data Last Refreshed: Jan 6, 2011 10:11 AM Lead Screening in Children Data Elements Measurement Year Data Collection Methodology Eligible Member Population MHCP-MC 2009 A 2017 Numerator Events by Admin Data on Eligible Population (before exclusions) Current Year's Admin Rate NR Minimum Required Sample Size Oversampling Rate Final Sample Size (FSS) Numerator events by admin data in FSS Admin Rate on FSS NR Records Excluded because of Valid Data Errors Number of administrative data records excluded Number of medical record data records excluded Number of employee/dependent medical records excluded Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record 1730 Reported Rate 85.77% Lower 95% Confidence Interval 84.22% Upper 95% Confidence Interval 87.32% HEDIS 2010 (Reporting Year 2009) Page 15 Effectiveness of Care UCare Minnesota Data Last Refreshed: Jan 6, 2011 10:11 AM Care for Older Adults MSHO Medication Review Functional Status Assessment Pain Screening NR NR NR NR NR NR NR NR Reported Rate NR NR NR NR Lower 95% Confidence Interval NR NR NR NR Upper 95% Confidence Interval NR NR NR NR Data Elements General Measure Data Advance Care Planning 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 Records Excluded because of Valid Data Errors Number of employee/dependent medical records excluded Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record HEDIS 2010 (Reporting Year 2009) Page 16 Effectiveness of Care UCare Minnesota Pharmacotherapy Management of COPD Exacerbation Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage Data Elements Measurement Year Data Collection Methodology Eligible Member Population General Measure Data Systemic corticosteroid Bronchodilator 171 74.03% 68.15% 79.90% 197 85.28% 80.50% 90.07% 2009 A 231 Exclusions based on direct transfers to another facility Exclusions based on readmissions Numerator Events by Admin Data Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) Page 17 Effectiveness of Care UCare Minnesota Pharmacotherapy Management of COPD Exacerbation Data Last Refreshed: Jan 6, 2011 10:11 AM MSHO Data Elements Measurement Year Data Collection Methodology Eligible Member Population General Measure Data Systemic corticosteroid Bronchodilator 82 63.08% 54.40% 71.76% 118 90.77% 85.41% 96.13% 2009 A 130 Exclusions based on direct transfers to another facility Exclusions based on readmissions Numerator Events by Admin Data Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) Page 18 Effectiveness of Care UCare Minnesota Pharmacotherapy Management of COPD Exacerbation Data Last Refreshed: Jan 6, 2011 10:11 AM SNBC Data Elements Measurement Year Data Collection Methodology Eligible Member Population General Measure Data Systemic corticosteroid Bronchodilator 0 NA NA NA 1 NA NA NA 2009 A 1 Exclusions based on direct transfers to another facility Exclusions based on readmissions Numerator Events by Admin Data Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) Page 19 Effectiveness of Care UCare Minnesota Use of Spirometry Testing in the Assessment and Diagnosis of COPD Data Elements Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage MSHO SNBC 2009 A 916 299 32.64% 29.55% 35.73% 2009 A 240 41 17.08% 12.11% 22.05% 2009 A 0 0 NA NA NA Page 20 Effectiveness of Care UCare Minnesota Use of Appropriate Medications for People with Asthma Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data Ages 5-11 NR NR NR Ages 12-50 Total NR NR NR NR NR NR NR NR ` Page 21 Effectiveness of Care UCare Minnesota Use of Appropriate Medications for People with Asthma Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data Ages 5-11 Ages 12-50 Total 244 229 93.85% 90.63% 97.07% 510 437 85.69% 82.55% 88.82% 754 666 88.33% 85.97% 90.69% 2009 A Page 22 Effectiveness of Care UCare Minnesota Cholesterol Management for Patients with Cardiovascular Conditions Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data LDL-C screening LDL-C Level of <100 mg/dL NR NR NR NR NR NR NR NR NR NR Page 23 Effectiveness of Care UCare Minnesota Cholesterol Management for Patients with Cardiovascular Conditions Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data LDL-C screening LDL-C Level of <100 mg/dL 1377 6 88.33% 0.38% 387 1 89.58% 0.23% 367 11 1 254 91.97% 89.22% 94.72% 62.04% 57.23% 66.86% 2009 H 1559 411 5.00% 432 0 1 1 411 Page 24 Effectiveness of Care UCare Minnesota Cholesterol Management for Patients with Cardiovascular Conditions Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data LDL-C screening LDL-C Level of <100 mg/dL 87 0 77.68% 0.00% 86 0 77.48% 0.00% 86 3 0 53 80.91% 73.11% 88.71% 48.18% 38.39% 57.97% 2009 H 112 111 0.00% 111 1 0 0 110 Page 25 Effectiveness of Care UCare Minnesota Controlling High Blood Pressure Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage MSHO SNBC MHCP-MC Measurement Year Data Collection Methodology (Hybrid) Eligible Member Population 2009 H 16931 2009 H 1917 2009 H 13 2009 H 1815 Numerator Events by Admin Data on Eligible Population (before exclusions) 0 0 0 0 0.00% 411 10.00% 453 0.00% 411 10.00% 453 0.00% 12 0.00% 12 0.00% 411 15.00% 473 0 0.00% 0 0.00% 0 0.00% 0 0.00% Records Excluded because of Valid Data Errors 11 10 0 28 Number of records excluded because of false positive diagnoses 0 0 0 0 Number of administrative data records excluded 947 216 2 68 Number of medical record data records excluded 1 2 0 1 Number of employee/dependent medical records excluded 0 0 0 0 Records Added from the OverSample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval 12 411 0 267 64.96% 60.23% 69.70% 12 411 0 256 62.29% 57.48% 67.09% 0 12 0 11 NA NA NA 29 411 0 235 57.18% 52.27% 62.08% Data Elements 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 HEDIS 2010 (Reporting Year 2009) Commercial NR NR NR NR NR Page 26 Effectiveness of Care UCare Minnesota Persistence of Beta Blocker Treatment After Hearth Attack Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage MSHO SNBC MHCP-MC Measurement Year Data Collection Methodology Eligible Member Population 2009 A 213 2009 A 37 2009 A 0 2009 A 33 Numerator Events by Admin Data on Eligible Population 172 34 0 21 80.75% 75.22% 86.28% 91.89% 81.75% 100.00% NR NR NR 63.64% 45.71% 81.56% Data Elements Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) Commercial NR NR NR Page 27 Effectiveness of Care UCare Minnesota Comprehensive Diabetes Care Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial Data Elements HbA1c Testing Poor HbA1c Good HbA1c Control Control (>9.0%) (<7.0%) Adequate HbA1c Control (<8.0%) Eye Exam LDL-C Screening LDL-C Level <100 mg/dL Blood Blood Monitoring Pressure Pressure for Diabetic <140/90 mm <130/80 Nephropathy Hg 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 NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR Number of administrative data records excluded Number of medical 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 2010 (Reporting Year 2009) Page 28 Effectiveness of Care UCare Minnesota Comprehensive Diabetes Care Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage 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 2009 H 5737 2009 H 5737 5371 93.62% 411 5% 432 403 93.29% 5686 99.11% 411 5% 432 429 99.31% Good HbA1c Control (<7.0%) NR NR Adequate HbA1c Control (<8.0%) Eye Exam LDL-C Screening LDL-C Level <100 mg/dL 2009 H 5737 2009 H 5737 2009 H 5737 2009 H 5737 2009 H 5737 2009 H 5737 2009 H 5737 36 0.63% 411 5% 432 2 0.46% 4004 69.79% 411 5% 432 302 69.91% 5139 89.58% 411 5% 432 389 90.05% 46 0.80% 411 5% 432 2 0.46% 5028 87.64% 411 5% 432 381 88.19% 47 0.82% 411 5% 432 3 0.69% 39 0.68% 411 5% 432 3 0.69% Blood Blood Monitoring Pressure Pressure for Diabetic <140/90 mm <130/80 Nephropathy Hg mm Hg 0 0 0 0 0 0 0 0 0 Number of administrative data records excluded 1 1 1 1 1 1 1 1 1 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 0 411 383 11 95.86% 93.82% 97.91% 0 411 107 0 26.03% 21.67% 30.40% 0 411 2 289 70.80% 66.29% 75.32% 0 411 124 180 73.97% 69.60% 78.33% 0 411 369 7 91.48% 88.66% 94.30% 0 411 2 212 52.07% 47.12% 57.02% 0 411 62 320 92.94% 90.35% 95.54% 0 411 3 297 72.99% 68.58% 77.41% 0 411 3 220 54.26% 49.32% 59.20% 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 2010 (Reporting Year 2009) NR NR NR Page 29 Effectiveness of Care UCare Minnesota Comprehensive Diabetes Care Data Last Refreshed: Jan 6, 2011 10:11 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 2009 H 938 2009 H 938 837 89.23% 411 5% 432 393 90.97% 920 98.08% 411 5% 432 420 97.22% Good HbA1c Control (<7.0%) NR NR Adequate HbA1c Control (<8.0%) Eye Exam LDL-C Screening LDL-C Level <100 mg/dL 2009 H 938 2009 H 938 2009 H 938 2009 H 938 2009 H 938 2009 H 938 2009 H 938 12 1.28% 411 5% 432 7 1.62% 617 65.78% 411 5% 432 283 65.51% 767 81.77% 411 5% 432 346 80.09% 29 3.09% 411 5% 432 17 3.94% 831 88.59% 411 5% 432 385 89.12% 37 3.94% 411 5% 432 20 4.63% 30 3.20% 411 5% 432 15 3.47% Blood Blood Monitoring Pressure Pressure for Diabetic <140/90 mm <130/80 Nephropathy Hg 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 0 411 376 13 94.65% 92.35% 96.94% 0 411 129 0 31.39% 26.78% 36.00% 0 411 7 245 61.31% 56.48% 66.14% 0 411 132 157 70.32% 65.78% 74.85% 0 411 328 12 82.73% 78.95% 86.50% 0 411 17 180 47.93% 42.98% 52.88% 0 411 60 313 90.75% 87.83% 93.68% 0 411 20 269 70.32% 65.78% 74.85% 0 411 15 187 49.15% 44.19% 54.10% 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 2010 (Reporting Year 2009) NR NR NR Page 30 Effectiveness of Care UCare Minnesota Comprehensive Diabetes Care Data Last Refreshed: Jan 6, 2011 10:11 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 2009 H 21 2009 H 21 14 66.67% 21 0% 21 14 66.67% 20 95.24% 21 0% 21 20 95.24% Good HbA1c Control (<7.0%) NR NR Adequate HbA1c Control (<8.0%) Blood Blood Monitoring Pressure Pressure for Diabetic <140/90 mm <130/80 Nephropathy Hg mm Hg Eye Exam LDL-C Screening LDL-C Level <100 mg/dL 2009 H 21 2009 H 21 2009 H 21 2009 H 21 2009 H 21 2009 H 21 2009 H 21 0 0.00% 21 0% 21 0 0.00% 13 61.90% 21 0% 21 13 61.90% 18 85.71% 21 0% 21 18 85.71% 0 0.00% 21 0% 21 0 0.00% 16 76.19% 21 0% 21 16 76.19% 0 0.00% 21 0% 21 0 0.00% 0 0.00% 21 0% 21 0 0.00% 0 0 0 0 0 0 0 0 0 Number of administrative data records excluded 0 0 0 0 0 0 0 0 0 Number of medical record data records excluded 0 0 0 0 0 0 0 0 0 Number of employee/dependent medical records excluded 0 0 0 0 0 0 0 0 0 0 21 14 2 NA NA NA 0 21 10 0 NA NA NA 0 21 0 10 NA NA NA 0 21 6 9 NA NA NA 0 21 18 0 NA NA NA 0 21 0 10 NA NA NA 0 21 2 16 NA NA NA 0 21 0 19 NA NA NA 0 21 0 13 NA NA NA 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 2010 (Reporting Year 2009) NR NR NR Page 31 Effectiveness of Care UCare Minnesota Comprehensive Diabetes Care Data Last Refreshed: Jan 6, 2011 10:11 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 2009 H 1586 2009 H 1586 2009 H 1586 2009 H 1586 2009 H 1586 2009 H 1586 2009 H 1586 2009 H 1586 2009 H 1586 2009 H 1586 1339 84.43% 548 5% 576 494 85.76% 1537 96.91% 548 5% 576 570 98.96% 8 0.50% 548 5% 576 3 0.52% 8 0.50% 548 5% 576 3 0.52% 815 51.39% 548 5% 576 295 51.22% 1236 77.93% 548 5% 576 454 78.82% 7 0.44% 548 5% 576 4 0.69% 1232 77.68% 548 5% 576 459 79.69% 4 0.25% 548 5% 576 2 0.35% 2 0.13% 548 5% 576 1 0.17% 0 0 0 0 0 0 0 0 0 0 38 38 37 38 38 38 38 38 38 38 14 14 14 14 14 14 14 14 14 14 0 0 0 0 0 0 0 0 0 0 14 548 3 290 53.47% 49.20% 57.73% 14 548 144 180 59.12% 54.92% 63.33% 14 548 433 21 82.85% 79.60% 86.09% 14 548 4 214 39.78% 35.59% 43.97% 14 548 73 390 84.49% 81.37% 87.61% 14 548 2 402 73.72% 69.95% 77.50% 14 548 1 272 49.82% 45.54% 54.10% Number of Administrative required exclusions 183 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 2010 (Reporting Year 2009) Blood Blood Monitoring Pressure Pressure for Diabetic <140/90 mm <130/80 Nephropathy Hg mm Hg 43 14 548 470 30 91.24% 88.78% 93.70% 14 548 195 0 35.58% 31.48% 39.68% 14 462 3 175 38.53% 33.98% 43.07% Page 32 Effectiveness of Care UCare Minnesota Osteoporosis Management in Women Who had a Fracture Data Elements Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage MSHO 2009 A 770 139 18.05% 15.27% 20.83% 2009 A 257 38 14.79% 10.25% 19.32% Page 33 Effectiveness of Care UCare Minnesota Antidepressant Medication Management Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Effective Acute Measure Phase Data Treatment NR NR NR Effective Continuation Phase Treatment NR NR NR Page 34 Effectiveness of Care UCare Minnesota Antidepressant Medication Management Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Effective Acute Measure Phase Data Treatment Effective Continuation Phase Treatment 2009 A 465 350 75.27% 71.24% 79.30% 288 61.94% 57.41% 66.46% Page 35 Effectiveness of Care UCare Minnesota Antidepressant Medication Management Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Effective Acute Measure Phase Data Treatment Effective Continuation Phase Treatment 2009 A 99 66 66.67% 56.88% 76.46% 56 56.57% 46.30% 66.83% Page 36 Effectiveness of Care UCare Minnesota Antidepressant Medication Management Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Effective Acute Measure Phase Data Treatment Effective Continuation Phase Treatment 2009 A 0 0 NA NA NA 0 NA NA NA Page 37 Effectiveness of Care UCare Minnesota Antidepressant Medication Management Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Effective Acute Measure Phase Data Treatment Effective Continuation Phase Treatment 2009 A 647 319 49.30% 45.37% 53.23% 221 34.16% 30.43% 37.89% Page 38 Effectiveness of Care UCare Minnesota Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication Data Last Refreshed: Jan 6, 2011 10:11 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 Interva HEDIS 2010 (Reporting Year 2009) General Measure Data Initiation Phase Continuation and Maintenance Phase NR NR NR NR NR NR Page 39 Effectiveness of Care UCare Minnesota Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication Data Last Refreshed: Jan 6, 2011 10:11 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 Interva HEDIS 2010 (Reporting Year 2009) General Measure Data Initiation Phase Continuation and Maintenance Phase 370 135 36.49% 31.45% 41.53% 100 43 43.00% 32.80% 53.20% 2009 A Page 40 Effectiveness of Care UCare Minnesota Follow-up After Hospitalization for Mental Illness Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data 30 Days 7 Days 85 75.22% 66.82% 83.62% 75 66.37% 57.22% 75.53% 2009 A 113 Page 41 Effectiveness of Care UCare Minnesota Follow-up After Hospitalization for Mental Illness Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data 30 Days 7 Days 19 59.38% 40.80% 77.95% 14 43.75% 25.00% 62.50% 2009 A 32 Page 42 Effectiveness of Care UCare Minnesota Follow-up After Hospitalization for Mental Illness Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data 30 Days 7 Days 8 NA NA NA 6 NA NA NA 2009 A 10 Page 43 Effectiveness of Care UCare Minnesota Annual Monitoring for Patients on Persistent Medications Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) 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 44 Effectiveness of Care UCare Minnesota Annual Monitoring for Patients on Persistent Medications Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data Annual Monitoring for Members on ACE Inhibitors or ARBs Digoxin Diuretics Anticonvulsants Total 16712 14879 89.03% 88.56% 89.51% 1063 969 91.16% 89.40% 92.91% 16970 15203 89.59% 89.13% 90.05% 524 385 73.47% 69.60% 77.35% 35269 31436 89.13% 88.81% 89.46% 2009 A Page 45 Effectiveness of Care UCare Minnesota Annual Monitoring for Patients on Persistent Medications Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data Annual Monitoring for Members on ACE Inhibitors or ARBs Digoxin Diuretics Anticonvulsants Total 2736 2511 91.78% 90.73% 92.82% 303 292 96.37% 94.10% 98.64% 2879 2694 93.57% 92.66% 94.49% 355 298 83.94% 79.98% 87.90% 6273 5795 92.38% 91.72% 93.04% 2009 A Page 46 Effectiveness of Care UCare Minnesota Annual Monitoring for Patients on Persistent Medications Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data Annual Monitoring for Members on ACE Inhibitors or ARBs Digoxin Diuretics Anticonvulsants Total 10 10 NA NA NA 0 0 NA NA NA 10 9 NA NA NA 5 4 NA NA NA 25 23 NA NA NA 2009 A Page 47 Effectiveness of Care UCare Minnesota Annual Monitoring for Patients on Persistent Medications Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data Annual Monitoring for Members on ACE Inhibitors or ARBs Digoxin Diuretics Anticonvulsants Total 1361 1134 83.32% 81.30% 85.34% 18 15 NA NA NA 1086 924 85.08% 82.92% 87.25% 168 121 72.02% 64.94% 79.11% 2633 2194 83.33% 81.88% 84.77% 2009 A Page 48 Access/Availability of Care UCare Minnesota Medication Reconciliation Post Discharge Data Elements Data Last Refreshed: Jan 6, 2011 10:11 AM MSHO Measurement Year Data collection methodology (Administrative or Hybrid) Eligible member population Number of numerator events by administrative data in eligible population (before exclusions) Current year's administrative rate (before exclusions) NR Minimum required sample size (MRSS) or other sample size Oversampling rate Final sample size (FSS) Number of numerator events by administrative data in FSS Administrative rate on FSS NR Number of original sample records excluded because of valid data errors Number of employee/dependent medical records excluded Records added from the oversample list Denominator Numerator events by administrative data Numerator events by medical record Reported rate Lower 95% confidence interval Upper 95% confidence interval HEDIS 2010 (Reporting Year 2009) NR NR NR Page 49 Effectiveness of Care UCare Minnesota Potentially Harmful Drug-Disease Interactions in the Elderly Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data History of Falls + Dementia + Chronic Renal Tricyclic Tricyclic Failure + Antidepressants, Antidepressants or Nonaspirin NSAIDs Antipsychotics or Anticholinergic or Cox-2 Selective Sleep Agents Agents NSAIDs Total 2009 A 1654 198 11.97% 10.38% 13.57% 2638 511 19.37% 17.84% 20.90% 252 14 5.56% 2.53% 8.58% 4544 723 15.91% 14.84% 16.99% Page 50 Effectiveness of Care UCare Minnesota Potentially Harmful Drug-Disease Interactions in the Elderly Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data History of Falls + Dementia + Chronic Renal Tricyclic Tricyclic Failure + Antidepressants, Antidepressants or Nonaspirin NSAIDs Antipsychotics or Anticholinergic or Cox-2 Selective Sleep Agents Agents NSAIDs Total 2009 A 488 91 18.65% 15.09% 22.21% 1768 445 25.17% 23.12% 27.22% 106 14 13.21% 6.29% 20.12% 2362 550 23.29% 21.56% 25.01% Page 51 Effectiveness of Care UCare Minnesota Use of High Risk Medications in the Elderly Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data 2009 A 51127 At least 1 Prescription At least 2 Prescriptions 8078 15.80% 15.48% 16.12% 1307 2.56% 2.42% 2.69% Page 52 Effectiveness of Care UCare Minnesota Use of High Risk Medications in the Elderly Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data 2009 A 7298 At least 1 Prescription At least 2 Prescriptions 1720 23.57% 22.59% 24.55% 330 4.52% 4.04% 5.01% Page 53 Access/Availability of Care UCare Minnesota Adult's Access to Preventive/Ambulatory Health Services Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial Data Elements General Measure Data Ages 20-44 Ages 45-64 Ages 65+ Total Measurement Year Data collection methodology (Administrative only) Eligible member population (i.e. members who meet all denominator criteria) NR Numerator events by administrative data Reported rate Lower 95% confidence interval Upper 95% confidence interval NR NR NR NR HEDIS 2010 (Reporting Year 2009) NR NR NR NR NR NR NR NR NR Page 54 Access/Availability of Care UCare Minnesota Adult's Access to Preventive/Ambulatory Health Services Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage 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 2010 (Reporting Year 2009) General Measure Data Ages 20-44 Ages 45-64 Ages 65+ Total 63 1438 54225 55726 60 1393 52198 95.24% 89.19% 100.00% 96.87% 95.94% 97.81% 96.26% 96.10% 96.42% 53651 96.28% 96.12% 96.43% 2009 A Page 55 Access/Availability of Care UCare Minnesota Adult's Access to Preventive/Ambulatory Health Services Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data Ages 20-44 Ages 45-64 Ages 65+ Total 0 0 7298 7298 0 0 7153 NA NA NA NA NA NA 98.01% 97.69% 98.34% 7153 98.01% 97.69% 98.34% 2009 A Page 56 Access/Availability of Care UCare Minnesota Adult's Access to Preventive/Ambulatory Health Services Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data Ages 20-44 Ages 45-64 Ages 65+ Total 32 45 1 78 31 45 1 96.88% 89.28% 100.00% 100.00% 98.89% 100.00% NA NA NA 77 98.72% 95.58% 100.00% 2009 A Page 57 Access/Availability of Care UCare Minnesota Adult's Access to Preventive/Ambulatory Health Services Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data Ages 20-44 Ages 45-64 Ages 65+ Total 12858 6211 17 19086 11386 5610 16 88.55% 88.00% 89.11% 90.32% 89.58% 91.07% NA NA NA 17012 89.13% 88.69% 89.58% 2009 A Page 58 Access/Availability of Care UCare Minnesota Children's and Adolescents' Access to Primary Care Practitioners Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data 12-24 months 25 months 6 yrs. 7-11 yrs. 12-19 yrs. NR NR NR NR NR NR NR NR NR NR NR NR Page 59 Access/Availability of Care UCare Minnesota Children's and Adolescents' Access to Primary Care Practitioners Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) General Measure Data 12-24 months 25 months 6 yrs. 7-11 yrs. 12-19 yrs. 3267 3164 8891 7905 4974 4408 7565 6777 96.85% 96.23% 97.46% 88.91% 88.25% 89.57% 88.62% 87.73% 89.51% 89.58% 88.89% 90.28% 2009 A Page 60 Access/Availability of Care UCare Minnesota Initiation/Engagement of Alcohol & Other Drug Dependence Treatment Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial 13-17 Year Olds Data Elements General Measure Data Initiation of AOD Treatment Engagement of AOD Treatment 18+ Year Olds Initiation of AOD Treatment Engagement of AOD Treatment Total Initiation of AOD Treatment Engagement of AOD Treatment Measurement Year Data collection methodology (Administrative only) Eligible member population Numerator events by administrative data Reported rate Lower 95% confidence interval Upper 95% confidence interval HEDIS 2010 (Reporting Year 2009) NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR Page 61 Access/Availability of Care UCare Minnesota Initiation/Engagement of Alcohol & Other Drug Dependence Treatment Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage 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 2010 (Reporting Year 2009) 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 2009 A 0 433 433 0 0 195 24 195 24 NA NA NA NA NA NA 45.03% 40.23% 49.84% 5.54% 3.27% 7.81% 45.03% 40.23% 49.84% 5.54% 3.27% 7.81% Page 62 Access/Availability of Care UCare Minnesota Initiation/Engagement of Alcohol & Other Drug Dependence Treatment Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) 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 2009 A 110 0 110 0 0 38 6 38 6 NA NA NA NA NA NA 34.55% 25.20% 43.89% 5.45% 0.76% 10.15% 34.55% 25.20% 43.89% 5.45% 0.76% 10.15% Page 63 Access/Availability of Care UCare Minnesota Initiation/Engagement of Alcohol & Other Drug Dependence Treatment Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) 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 2009 A 0 12 12 0 0 4 0 4 0 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Page 64 Access/Availability of Care UCare Minnesota Initiation/Engagement of Alcohol & Other Drug Dependence Treatment Data Last Refreshed: Jan 6, 2011 10:11 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 2010 (Reporting Year 2009) 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 2009 A 186 2015 2201 71 44 726 336 797 380 38.17% 30.92% 45.42% 23.66% 17.28% 30.03% 36.03% 33.91% 38.15% 16.67% 15.02% 18.33% 36.21% 34.18% 38.24% 17.26% 15.66% 18.87% Page 65 Access/Availability of Care UCare Minnesota Prenatal and Postpartum Care Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial Timeliness of Prenatal Care Postpartum Care Current year's administrative rate (before exclusions) NR NR Minimum required sample size (MRSS) or other sample size Oversampling rate Final sample size (FSS) Number of numerator events by administrative data in FSS Administrative rate on FSS NR NR NR NR NR NR NR NR Data Elements Measurement Year Data collection methodology (Administrative or Hybrid) Eligible member population Number of numerator events by administrative data in eligible population (before exclusions) Number of original sample records excluded because of valid data errors Number of employee/dependent medical records excluded Records added from the oversample list Denominator Numerator events by administrative data Numerator events by medical record Reported rate Lower 95% confidence interval Upper 95% confidence interval HEDIS 2010 (Reporting Year 2009) Page 66 Access/Availability of Care UCare Minnesota Prenatal and Postpartum Care Data Last Refreshed: Jan 6, 2011 10:11 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 2009 H 3854 2009 H 3854 Number of numerator events by administrative data in eligible population (before exclusions) 2011 2055 52.18% 411 5% 432 226 53.32% 411 5% 432 227 52.31% 52.55% 0 0 0 0 411 149 182 0 0 411 151 108 80.54% 76.59% 84.48% 63.02% 58.23% 67.81% 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 2010 (Reporting Year 2009) Page 67 Use of Services UCare Minnesota Well Child Visits in the First 15 Months of Life Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial Data Elements General Measure Data Zero Visits 1 visit 2 visits 3 visits 4 visits 5 visits 6 or more visits NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR Measurement Year Data Collection Methodology Eligible Member Population Numerator events by admin data in eligible population Currect Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Final sample size (FSS) Numerator events by admin data in FSS Administrative rate on FSS Number of Records Excluded Because of Valid Data Errors Number of employee/dependent medical records excluded Additional Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) Page 68 Use of Services UCare Minnesota Well Child Visits in the First 15 Months of Life Data Last Refreshed: Jan 6, 2011 10:11 AM Minnesota Health Care Programs - Managed Care (MHCP-MC) Data Elements Measurement Year Data Collection Methodology Eligible Member Population General Measure Data 0 Number of employee/dependent medical records excluded 0 Additional Records Added from the Oversample List 0 HEDIS 2010 (Reporting Year 2009) 2 visits 3 visits 4 visits 5 visits 6 or more visits 63 2.27% 70 2.52% 106 3.82% 210 7.56% 355 12.78% 567 20.41% 1407 50.65% 10 2.31% 11 2.55% 15 3.47% 35 8.10% 49 11.34% 96 22.22% 216 50.00% 6 0 1.46% 0.18% 2.74% 4 1 1.22% 0.04% 2.40% 4 3 1.70% 0.33% 3.08% 16 7 5.60% 3.25% 7.94% 21 10 7.54% 4.87% 10.22% 60 21 19.71% 15.74% 23.68% 207 51 62.77% 57.98% 67.57% 411 5.00% 432 Number of Records Excluded Because of Valid Data Errors Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval 1 visit 2009 H 2778 Numerator events by admin data in eligible population Currect Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Final sample size (FSS) Numerator events by admin data in FSS Administrative rate on FSS Zero Visits 411 Page 69 Use of Services UCare Minnesota Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life Data Elements Commercial Data Last Refreshed: Jan 6, 2011 10:11 AM MHCP-MC Measurement Year Data Collection Methodology Eligible Member Population 2009 H 7003 Numerator events by admin data in eligible population 4397 Current Year's Admin Rate Minimum Required Sample Size Oversampling Rate Final sample size (FSS) Numerator events by admin data in FSS Administrative rate on FSS Records Excluded because of Valid Data Errors NR 62.79% 411 5.00% 432 262 NR 60.65% 0 Number of employee/dependent medical records excluded Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) 0 NR NR NR 0 411 250 11 63.50% 58.73% 68.28% Page 70 Use of Services UCare Minnesota Adolescent Well-Care Visits Data Elements Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial MHCP-MC Measurement Year Data Collection Methodology Eligible Member Population 2009 H 12193 Numerator events by admin data in eligible population 4380 Current Year's Admin Rate Minimum Required Sample Size Oversampling Rate Final sample size (FSS) Numerator events by admin data in FSS Administrative rate on FSS Records Excluded because of Valid Data Errors NR 35.92% 411 5.00% 432 170 NR 39.35% 0 Number of employee/dependent medical records excluded Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2010 (Reporting Year 2009) 0 NR NR NR 0 411 159 32 46.47% 41.53% 51.42% Page 71 Use of Services UCare Minnesota Ambulatory Care Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial Age <1 1-9 10-19 20-44 45-64 65-74 75-84 85+ Unknown Total Member Months NR Outpatient Visits (Excludes MH/CD) Age Visits <1 1-9 10-19 20-44 45-64 65-74 75-84 85+ Unknown Total Visits/ 1,000 Member Months NR NR Emergency Room Visits Visits NR NR NR NR NR NR NR HEDIS 2010 (Reporting Year 2009) NR Visits/ 1,000 Member Months NR NR Ambulatory Surgery/Procedures Procedures NR NR NR NR NR NR NR NR Procedures/ 1,000 Member Months NR NR Observation Room Stays Resulting in Discharge Stays NR NR NR NR NR NR NR NR Stays/ 1,000 Member Months NR NR NR NR NR NR NR NR NR NR Page 72 Use of Services UCare Minnesota Ambulatory Care Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage Age <1 1-9 10-19 20-44 45-64 65-74 75-84 85+ Unknown Total Member Months 0 0 0 1394 21916 392344 218791 89731 0 724176 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 0 908 18006 213995 154184 64047 0 451140 HEDIS 2010 (Reporting Year 2009) Visits/ 1,000 Member Months NA NA NA 651.36 821.59 545.43 704.71 713.77 622.97 Emergency Room Visits Visits 0 0 0 120 785 6104 4822 2790 0 14621 Visits/ 1,000 Member Months NA NA NA 86.08 35.82 15.56 22.04 31.09 20.19 Ambulatory Surgery/Procedures Procedures 0 0 0 68 1100 14451 8551 2090 0 26260 Procedures/ 1,000 Member Months NA NA NA 48.78 50.19 36.83 39.08 23.29 36.26 Observation Room Stays Resulting in Discharge Stays 0 0 0 6 51 446 472 284 0 1259 Stays/ 1,000 Member Months NA NA NA 4.30 2.33 1.14 2.16 3.17 1.74 Page 73 Use of Services UCare Minnesota Ambulatory Care Data Last Refreshed: Jan 6, 2011 10:11 AM MSHO Age <1 1-9 10-19 20-44 45-64 65-74 75-84 85+ Unknown Total Member Months 0 0 0 0 0 34043 34143 31532 0 99718 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 6 26794 25665 19340 0 71805 HEDIS 2010 (Reporting Year 2009) Visits/ 1,000 Member Months NA NA NA NA NA 787.06 751.69 613.35 720.08 Emergency Room Visits Visits 0 0 0 0 0 1418 1372 1114 0 3904 Visits/ 1,000 Member Months NA NA NA NA NA 41.65 40.18 35.33 39.15 Ambulatory Surgery/Procedures Procedures 0 0 0 0 0 1159 999 476 0 2634 Procedures/ 1,000 Member Months NA NA NA NA NA 34.05 29.26 15.10 26.41 Observation Room Stays Resulting in Discharge Stays 0 0 0 0 0 81 104 60 0 245 Stays/ 1,000 Member Months NA NA NA NA NA 2.38 3.05 1.90 2.46 Page 74 Use of Services UCare Minnesota Ambulatory Care Data Last Refreshed: Jan 6, 2011 10:11 AM SNBC Age <1 1-9 10-19 20-44 45-64 65-74 75-84 85+ Unknown Total Member Months 0 0 14 778 1045 13 0 0 0 1850 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 12 467 981 20 0 0 0 1480 HEDIS 2010 (Reporting Year 2009) Visits/ 1,000 Member Months NA NA 857.14 600.26 938.76 1538.46 NA NA 800.00 Emergency Room Visits Visits 0 0 3 147 97 2 0 0 0 249 Visits/ 1,000 Member Months NA NA 214.29 188.95 92.82 153.85 NA NA 134.59 Ambulatory Surgery/Procedures Procedures 0 0 0 14 42 1 0 0 0 57 Procedures/ 1,000 Member Months NA NA 0.00 17.99 40.19 76.92 NA NA 30.81 Observation Room Stays Resulting in Discharge Stays 0 0 0 4 2 0 0 0 0 6 Stays/ 1,000 Member Months NA NA 0.00 5.14 1.91 0.00 NA NA 3.24 Page 75 Use of Services UCare Minnesota Ambulatory Care Data Last Refreshed: Jan 6, 2011 10:11 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 65095 327845 261148 328504 122404 312 29 0 0 1105337 Outpatient Visits (Excludes MH/CD) Age <1 1-9 10-19 20-44 45-64 65-74 75-84 85+ Unknown Total Visits 46308 97627 61281 146445 67816 163 23 0 0 419663 HEDIS 2010 (Reporting Year 2009) Visits/ 1,000 Member Months 711.39 297.78 234.66 445.79 554.03 522.44 793.10 NA 379.67 Emergency Room Visits Visits 6736 17690 8749 26175 6453 11 2 0 0 65816 Visits/ 1,000 Member Months 103.48 53.96 33.50 79.68 52.72 35.26 68.97 NA 59.54 Ambulatory Surgery/Procedures Procedures 456 1729 1056 5348 3535 11 1 0 0 12136 Procedures/ 1,000 Member Months 7.01 5.27 4.04 16.28 28.88 35.26 34.48 NA 10.98 Observation Room Stays Resulting in Discharge Stays 129 270 180 761 235 0 0 0 0 1575 Stays/ 1,000 Member Months 1.98 0.82 0.69 2.32 1.92 0.00 0.00 NA 1.42 Page 76 Use of Services UCare Minnesota 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: Jan 6, 2011 10:11 AM Member Months NR Discharges Discharges / 1,000 Member Months Days NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR HEDIS 2010 (Reporting Year 2009) NR NR NR NR NR NR NR NR NR 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 77 Use of Services UCare Minnesota Inpatient Utilization - General Hospital/Acute Care Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage Age Member Months <1 0 1-9 0 10-19 0 20-44 1394 45-64 21916 65-74 392344 75-84 218791 85+ 89731 Unknown 0 Total 724176 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 0 0 0 28 668 5806 5480 3345 0 15327 Discharges / 1,000 Member Months NA NA NA 20.09 30.48 14.80 25.05 37.28 21.16 0 0 0 21 394 2972 3374 2548 0 9309 NA NA NA 15.06 17.98 7.57 15.42 28.40 0 0 0 7 274 2834 2106 797 0 6018 NA NA NA 5.02 12.50 7.22 9.63 8.88 0 0 0 0 0 NA 0.00 0.00 HEDIS 2010 (Reporting Year 2009) 12.85 8.31 0.00 Days Days / 1,000 Member Months 0 0 0 128 2949 23426 22708 13922 0 63133 NA NA NA 91.82 134.56 59.71 103.79 155.15 0 0 0 77 1508 10376 12412 9350 0 33723 NA NA NA 55.24 68.81 26.45 56.73 104.20 0 0 0 51 1441 13050 10296 4572 0 29410 NA NA NA 36.59 65.75 33.26 47.06 50.95 0 0 0 0 0 NA 0.00 0.00 87.18 46.57 40.61 0.00 Average Length of Stay NA NA NA 4.57 4.41 4.03 4.14 4.16 NA 4.12 NA NA NA 3.67 3.83 3.49 3.68 3.67 NA 3.62 NA NA NA 7.29 5.26 4.60 4.89 5.74 NA 4.89 NA NA NA NA NA Page 78 Use of Services UCare Minnesota 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: Jan 6, 2011 10:11 AM Member Months 0 0 0 0 0 34043 34143 31532 0 99718 Discharges Discharges / 1,000 Member Months 0 0 0 0 0 1273 1363 1136 0 3772 NA NA NA NA NA 37.39 39.92 36.03 0 0 0 0 0 918 1059 972 0 2949 NA NA NA NA NA 26.97 31.02 30.83 0 0 0 0 0 355 304 164 0 823 NA NA NA NA NA 10.43 8.90 5.20 0 0 0 0 0 NA NA NA HEDIS 2010 (Reporting Year 2009) 37.83 29.57 8.25 NA Days 0 0 0 0 0 5784 6805 4875 0 17464 0 0 0 0 0 3658 4648 3742 0 12048 Days / 1,000 Member Months NA NA NA NA NA 169.90 199.31 154.60 175.13 NA NA NA NA NA 107.45 136.13 118.67 120.82 0 0 0 0 0 2126 2157 1133 0 5416 NA NA NA NA NA 62.45 63.18 35.93 0 0 0 0 0 NA NA NA 54.31 NA Average Length of Stay NA NA NA NA NA 4.54 4.99 4.29 NA 4.63 NA NA NA NA NA 3.98 4.39 3.85 NA 4.09 NA NA NA NA NA 5.99 7.10 6.91 NA 6.58 NA NA NA NA NA Page 79 Use of Services UCare Minnesota 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: Jan 6, 2011 10:11 AM Member Months 0 0 14 778 1045 13 0 0 0 1850 Discharges Discharges / 1,000 Member Months 0 0 0 11 28 0 0 0 0 39 NA NA 0.00 14.14 26.79 0.00 NA NA 0 0 0 8 17 0 0 0 0 25 NA NA 0.00 10.28 16.27 0.00 NA NA 0 0 0 3 11 0 0 0 0 14 NA NA 0.00 3.86 10.53 0.00 NA NA 0 0 0 0 0 0.00 0.00 0.00 HEDIS 2010 (Reporting Year 2009) 21.08 13.51 7.57 0.00 Days Days / 1,000 Member Months 0 0 0 43 110 0 0 0 0 153 NA NA 0.00 55.27 105.26 0.00 NA NA 0 0 0 26 57 0 0 0 0 83 NA NA 0.00 33.42 54.55 0.00 NA NA 0 0 0 17 53 0 0 0 0 70 NA NA 0.00 21.85 50.72 0.00 NA NA 0 0 0 0 0 0.00 0.00 0.00 82.70 44.86 37.84 0.00 Average Length of Stay NA NA NA 3.91 3.93 NA NA NA NA 3.92 NA NA NA 3.25 3.35 NA NA NA NA 3.32 NA NA NA 5.67 4.82 NA NA NA NA 5.00 NA NA NA NA NA Page 80 Use of Services UCare Minnesota Inpatient Utilization - General Hospital/Acute Care Data Last Refreshed: Jan 6, 2011 10:11 AM Minnesota Health Care Programs - Managed Care (MHCP-MC) Age Member Months <1 65095 1-9 327845 10-19 261148 20-44 328504 45-64 122404 65-74 312 75-84 29 85+ 0 Unknown 0 Total 1105337 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 805 723 1053 6024 1582 6 2 0 0 10195 12.37 2.21 4.03 18.34 12.92 19.23 68.97 NA 698 578 247 1114 941 3 2 0 0 3583 10.72 1.76 0.95 3.39 7.69 9.62 68.97 NA 107 145 184 752 629 3 0 0 0 1820 1.64 0.44 0.70 2.29 5.14 9.62 0.00 NA 622 4158 12 0 4792 HEDIS 2010 (Reporting Year 2009) 9.22 3.24 1.65 2.38 12.66 0.10 6.73 Days Days / 1,000 Member Months 4517 1979 2958 16262 5997 20 4 0 0 31737 69.39 6.04 11.33 49.50 48.99 64.10 137.93 NA 3174 1359 755 3454 3046 8 4 0 0 11800 48.76 4.15 2.89 10.51 24.88 25.64 137.93 NA 1343 620 706 2479 2924 12 0 0 0 8084 20.63 1.89 2.70 7.55 23.89 38.46 0.00 NA 1497 10329 27 0 11853 5.73 31.44 0.22 28.71 10.68 7.31 16.65 Average Length of Stay 5.61 2.74 2.81 2.70 3.79 3.33 2.00 NA NA 3.11 4.55 2.35 3.06 3.10 3.24 2.67 2.00 NA NA 3.29 12.55 4.28 3.84 3.30 4.65 4.00 NA NA NA 4.44 2.41 2.48 2.25 NA 2.47 Page 81 Use of Services UCare Minnesota Identification of Alcohol and Other Drug Services Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial Member Months (Any) Age 0-12 13-17 18-24 25-34 35-64 65+ Unknown Total Male NR Female NR Total NR NR NR NR NR NR NR NR 13-17 18-24 25-34 35-64 65+ Unknown Total Sex M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total Number NR NR NR NR NR NR NR NR NR NR HEDIS 2010 (Reporting Year 2009) Male NR Female Total 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 Number NR NR NR NR NR NR NR NR NR NR Male NR Female Total NR NR NR NR NR NR NR NR NR Intensive Outpatient/Partial Hospitalization Inpatient Any Services Age 0-12 Member Months (Intensive Outpatient/Partial Hospitalization) Member Months (Inpatient) Percent NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR Number NR NR NR NR NR NR NR NR NR NR Percent NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR Member Months (Outpatient/ED) Male NR Female Total NR NR NR NR NR NR NR NR NR Outpatient/ED Number NR NR NR NR NR NR NR NR NR NR Percent NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR Page 82 Use of Services UCare Minnesota Identification of Alcohol and Other Drug Services Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage Member Months (Any) Age 0-12 13-17 18-24 25-34 35-64 65+ Unknown Total Male 0 0 41 143 10266 290027 0 300477 Female 0 0 19 149 12692 410839 0 423699 Total 0 0 60 292 22958 700866 0 724176 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 1 2 3 75 60 135 290 245 535 0 0 0 366 307 673 HEDIS 2010 (Reporting Year 2009) Member Months (Intensive Outpatient/Partial Hospitalization) Member Months (Inpatient) Male 0 0 41 143 10266 290027 0 300477 Female 0 0 19 149 12692 410839 0 423699 Total 0 0 60 292 22958 700866 0 724176 Inpatient Percent NA NA NA NA NA NA 0.00% 0.00% 0.00% 8.39% 16.11% 12.33% 8.77% 5.67% 7.06% 1.20% 0.72% 0.92% NA NA NA 1.46% 0.87% 1.12% Number 0 0 0 0 0 0 0 0 0 1 0 1 24 27 51 149 139 288 0 0 0 174 166 340 Percent NA NA NA NA NA NA 0.00% 0.00% 0.00% 8.39% 0.00% 4.11% 2.81% 2.55% 2.67% 0.62% 0.41% 0.49% NA NA NA 0.69% 0.47% 0.56% Male 0 0 41 143 10266 290027 0 300477 Female 0 0 19 149 12692 410839 0 423699 Total 0 0 60 292 22958 700866 0 724176 Member Months (Outpatient/ED) Male 0 0 41 143 10266 290027 0 300477 Female 0 0 19 149 12692 410839 0 423699 Intensive Outpatient/Partial Hospitalization Outpatient/ED Number 0 0 0 0 0 0 0 0 0 0 0 0 2 1 3 1 3 4 0 0 0 3 4 7 Number 0 0 0 0 0 0 0 0 0 0 2 2 58 47 105 182 126 308 0 0 0 240 175 415 Percent NA NA NA NA NA NA 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.23% 0.09% 0.16% 0.00% 0.01% 0.01% NA NA NA 0.01% 0.01% 0.01% Total 0 0 60 292 22958 700866 0 724176 Percent NA NA NA NA NA NA 0.00% 0.00% 0.00% 0.00% 16.11% 8.22% 6.78% 4.44% 5.49% 0.75% 0.37% 0.53% NA NA NA 0.96% 0.50% 0.69% Page 83 Use of Services UCare Minnesota Identification of Alcohol and Other Drug Services Data Last Refreshed: Jan 6, 2011 10:11 AM MSHO Member Months (Any) Age 0-12 13-17 18-24 25-34 35-64 65+ Unknown Total Male 0 0 0 0 0 27646 0 27646 Female 0 0 0 0 0 72072 0 72072 Total 0 0 0 0 0 99718 0 99718 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 90 90 180 0 0 0 90 90 180 HEDIS 2010 (Reporting Year 2009) Member Months (Intensive Outpatient/Partial Hospitalization) Member Months (Inpatient) Male 0 0 0 0 0 27646 0 27646 Female 0 0 0 0 0 72072 0 72072 Total 0 0 0 0 0 99718 0 99718 Inpatient Percent NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.91% 1.50% 2.17% NA NA NA 3.91% 1.50% 2.17% Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 38 79 0 0 0 41 38 79 Percent NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.78% 0.63% 0.95% NA NA NA 1.78% 0.63% 0.95% Male 0 0 0 0 0 27646 0 27646 Female 0 0 0 0 0 72072 0 72072 Total 0 0 0 0 0 99718 0 99718 Member Months (Outpatient/ED) Male 0 0 0 0 0 27646 0 27646 Female 0 0 0 0 0 72072 0 72072 Intensive Outpatient/Partial Hospitalization Outpatient/ED Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 1 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 62 132 0 0 0 70 62 132 Percent NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.04% 0.00% 0.01% NA NA NA 0.04% 0.00% 0.01% Total 0 0 0 0 0 99718 0 99718 Percent NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.04% 1.03% 1.59% NA NA NA 3.04% 1.03% 1.59% Page 84 Use of Services UCare Minnesota Identification of Alcohol and Other Drug Services Data Last Refreshed: Jan 6, 2011 10:11 AM SNBC Age 0-12 13-17 18-24 25-34 35-64 65+ Unknown Total Male 0 0 45 138 516 5 0 704 Female 0 0 64 116 958 8 0 1146 Total 0 0 109 254 1474 13 0 1850 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 2 4 6 13 11 24 0 0 0 0 0 0 15 15 30 HEDIS 2010 (Reporting Year 2009) Member Months (Intensive Outpatient/Partial Hospitalization) Member Months (Inpatient) Member Months (Any) Male 0 0 45 138 516 5 0 704 Female 0 0 64 116 958 8 0 1146 Total 0 0 109 254 1474 13 0 1850 Inpatient Percent NA NA NA NA NA NA 0.00% 0.00% 0.00% 17.39% 41.38% 28.35% 30.23% 13.78% 19.54% 0.00% 0.00% 0.00% NA NA NA 25.57% 15.71% 19.46% Number 0 0 0 0 0 0 0 0 0 2 1 3 2 3 5 0 0 0 0 0 0 4 4 8 Percent NA NA NA NA NA NA 0.00% 0.00% 0.00% 17.39% 10.34% 14.17% 4.65% 3.76% 4.07% 0.00% 0.00% 0.00% NA NA NA 6.82% 4.19% 5.19% Male 0 0 45 138 516 5 0 704 Female 0 0 64 116 958 8 0 1146 Total 0 0 109 254 1474 13 0 1850 Member Months (Outpatient/ED) Male 0 0 45 138 516 5 0 704 Female 0 0 64 116 958 8 0 1146 Intensive Outpatient/Partial Hospitalization Outpatient/ED Number 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 1 Number 0 0 0 0 0 0 0 0 0 1 3 4 11 10 21 0 0 0 0 0 0 12 13 25 Percent NA NA NA NA NA NA 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 2.33% 0.00% 0.81% 0.00% 0.00% 0.00% NA NA NA 1.70% 0.00% 0.65% Total 0 0 109 254 1474 13 0 1850 Percent NA NA NA NA NA NA 0.00% 0.00% 0.00% 8.70% 31.03% 18.90% 25.58% 12.53% 17.10% 0.00% 0.00% 0.00% NA NA NA 20.45% 13.61% 16.22% Page 85 Use of Services UCare Minnesota Identification of Alcohol and Other Drug Services Data Last Refreshed: Jan 6, 2011 10:11 AM Minnesota Health Care Programs - Managed Care (MHCP-MC) Member Months Member Months (Any) (Inpatient) Age Male Female Male Female Total Total 0-12 239854 234620 474474 239854 234620 474474 13-17 66176 66053 132229 66176 66053 132229 18-24 48577 88293 136870 48577 88293 136870 25-34 45121 95358 140479 45121 95358 140479 35-64 98453 122491 220944 98453 122491 220944 65+ 134 207 341 134 207 341 Unknown 0 0 0 0 0 0 Total 498315 607022 1105337 498315 607022 1105337 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 13 1 14 229 123 352 491 465 956 765 723 1488 1703 1127 2830 0 1 1 0 0 0 3201 2440 5641 HEDIS 2010 (Reporting Year 2009) Inpatient Percent 0.07% 0.01% 0.04% 4.15% 2.23% 3.19% 12.13% 6.32% 8.38% 20.35% 9.10% 12.71% 20.76% 11.04% 15.37% 0.00% 5.80% 3.52% NA NA NA 7.71% 4.82% 6.12% Number 5 0 5 21 17 38 76 86 162 142 144 286 387 246 633 0 0 0 0 0 0 631 493 1124 Percent 0.03% 0.00% 0.01% 0.38% 0.31% 0.34% 1.88% 1.17% 1.42% 3.78% 1.81% 2.44% 4.72% 2.41% 3.44% 0.00% 0.00% 0.00% NA NA NA 1.52% 0.97% 1.22% Member Months (Intensive Outpatient/Partial Male Female Total 239854 234620 474474 66176 66053 132229 48577 88293 136870 45121 95358 140479 98453 122491 220944 134 207 341 0 0 0 498315 607022 1105337 Male 239854 66176 48577 45121 98453 134 0 498315 Member Months (Outpatient/ED) Female Total 234620 474474 66053 132229 88293 136870 95358 140479 122491 220944 207 341 0 0 607022 1105337 Intensive Outpatient/Partial Hospitalization Outpatient/ED Number 1 0 1 2 0 2 10 7 17 30 20 50 46 35 81 0 0 0 0 0 0 89 62 151 Number 9 1 10 221 115 336 457 418 875 720 660 1380 1572 1046 2618 0 1 1 0 0 0 2979 2241 5220 Percent 0.01% 0.00% 0.00% 0.04% 0.00% 0.02% 0.25% 0.10% 0.15% 0.80% 0.25% 0.43% 0.56% 0.34% 0.44% 0.00% 0.00% 0.00% NA NA NA 0.21% 0.12% 0.16% Percent 0.05% 0.01% 0.03% 4.01% 2.09% 3.05% 11.29% 5.68% 7.67% 19.15% 8.31% 11.79% 19.16% 10.25% 14.22% 0.00% 5.80% 3.52% NA NA NA 7.17% 4.43% 5.67% Page 86 Use of Services UCare Minnesota Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial Member Months (Any) Age Male Female 0-12 13-17 18-64 65+ Unknown Total NR NR Total NR NR NR NR NR NR Any Services Sex M F Total M 13-17 F Total M 18-64 F Total M 65+ F Total Unknown M F Total Total M F Total Age Number 0-12 NR NR NR NR NR NR NR NR HEDIS 2010 (Reporting Year 2009) 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 87 Use of Services UCare Minnesota Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage Member Months (Any) Age 0-12 13-17 18-64 65+ Unknown Total Male 0 0 10450 290027 0 300477 Female 0 0 12860 410839 0 423699 Total 0 0 23310 700866 0 724176 Sex M F Total M 13-17 F Total M 18-64 F Total M 65+ F Total Unknown M F Total Total M F Total Age Number 0 0 0 0 0 0 181 352 533 568 1229 1797 0 0 0 749 1581 2330 HEDIS 2010 (Reporting Year 2009) Male 0 0 10450 290027 0 300477 Female 0 0 12860 410839 0 423699 Total 0 0 23310 700866 0 724176 Percent NA NA NA NA NA NA 20.78% 32.85% 27.44% 2.35% 3.59% 3.08% NA NA NA 2.99% 4.48% 3.86% Number 0 0 0 0 0 0 17 28 45 70 139 209 0 0 0 87 167 254 Male 0 0 10450 290027 0 300477 Female 0 0 12860 410839 0 423699 Total 0 0 23310 700866 0 724176 Intensive Outpatient/Partial Hospitalization Inpatient Any Services 0-12 Member Months (Intensive Outpatient/Partial Hospitalization) Member Months (Inpatient) Percent NA NA NA NA NA NA 1.95% 2.61% 2.32% 0.29% 0.41% 0.36% NA NA NA 0.35% 0.47% 0.42% Number 0 0 0 0 0 0 22 40 62 22 51 73 0 0 0 44 91 135 Percent NA NA NA NA NA NA 2.53% 3.73% 3.19% 0.09% 0.15% 0.12% NA NA NA 0.18% 0.26% 0.22% Member Months (Outpatient/ED) Male 0 0 10450 290027 0 300477 Female 0 0 12860 410839 0 423699 Total 0 0 23310 700866 0 724176 Outpatient/ED Number 0 0 0 0 0 0 170 337 507 518 1113 1631 0 0 0 688 1450 2138 Percent NA NA NA NA NA NA 19.52% 31.45% 26.10% 2.14% 3.25% 2.79% NA NA NA 2.75% 4.11% 3.54% Page 88 Use of Services UCare Minnesota Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services Data Last Refreshed: Jan 6, 2011 10:11 AM MSHO Member Months (Any) Age 0-12 13-17 18-64 65+ Unknown Total Male 0 0 0 27646 0 27646 Female 0 0 0 72072 0 72072 Total 0 0 0 99718 0 99718 Any Services Sex M F Total M 13-17 F Total M 18-64 F Total M 65+ F Total Unknown M F Total Total M F Total Age 0-12 Number 0 0 0 0 0 0 0 0 0 221 596 817 0 0 0 221 596 817 HEDIS 2010 (Reporting Year 2009) Member Months (Intensive Outpatient/Partial Hospitalization) Member Months (Inpatient) Male 0 0 0 27646 0 27646 Female 0 0 0 72072 0 72072 Total 0 0 0 99718 0 99718 Number 0 0 0 0 0 0 0 0 0 47 91 138 0 0 0 47 91 138 Female 0 0 0 72072 0 72072 Total 0 0 0 99718 0 99718 Intensive Outpatient/Partial Hospitalization Inpatient Percent NA NA NA NA NA NA NA NA NA 9.59% 9.92% 9.83% NA NA NA 9.59% 9.92% 9.83% Male 0 0 0 27646 0 27646 Percent NA NA NA NA NA NA NA NA NA 2.04% 1.52% 1.66% NA NA NA 2.04% 1.52% 1.66% Number 0 0 0 0 0 0 0 0 0 15 36 51 0 0 0 15 36 51 Percent NA NA NA NA NA NA NA NA NA 0.65% 0.60% 0.61% NA NA NA 0.65% 0.60% 0.61% Member Months (Outpatient/ED) Male 0 0 0 27646 0 27646 Female 0 0 0 72072 0 72072 Total 0 0 0 99718 0 99718 Outpatient/ED Number 0 0 0 0 0 0 0 0 0 183 520 703 0 0 0 183 520 703 Percent NA NA NA NA NA NA NA NA NA 7.94% 8.66% 8.46% NA NA NA 7.94% 8.66% 8.46% Page 89 Use of Services UCare Minnesota Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services Data Last Refreshed: Jan 6, 2011 10:11 AM SNBC Member Months (Any) Age 0-12 13-17 18-64 65+ Unknown Total Male 0 0 699 5 0 704 Female 0 0 1138 8 0 1146 Total 0 0 1837 13 0 1850 Any Services Sex M F Total M 13-17 F Total M 18-64 F Total M 65+ F Total Unknown M F Total Total M F Total Age 0-12 Number 0 0 0 0 0 0 50 68 118 0 0 0 0 0 0 50 68 118 HEDIS 2010 (Reporting Year 2009) Member Months (Intensive Outpatient/Partial Hospitalization) Member Months (Inpatient) Male 0 0 699 5 0 704 Female 0 0 1138 8 0 1146 Total 0 0 1837 13 0 1850 Number 0 0 0 0 0 0 3 5 8 0 1 1 0 0 0 3 6 9 Female 0 0 1138 8 0 1146 Total 0 0 1837 13 0 1850 Intensive Outpatient/Partial Hospitalization Inpatient Percent NA NA NA NA NA NA 85.84% 71.70% 77.08% 0.00% 0.00% 0.00% NA NA NA 85.23% 71.20% 76.54% Male 0 0 699 5 0 704 Percent NA NA NA NA NA NA 5.15% 5.27% 5.23% 0.00% 150.00% 92.31% NA NA NA 5.11% 6.28% 5.84% Number 0 0 0 0 0 0 9 16 25 0 0 0 0 0 0 9 16 25 Percent NA NA NA NA NA NA 15.45% 16.87% 16.33% 0.00% 0.00% 0.00% NA NA NA 15.34% 16.75% 16.22% Member Months (Outpatient/ED) Male 0 0 699 5 0 704 Female 0 0 1138 8 0 1146 Total 0 0 1837 13 0 1850 Outpatient/ED Number 0 0 0 0 0 0 47 63 110 0 0 0 0 0 0 47 63 110 Percent NA NA NA NA NA NA 80.69% 66.43% 71.86% 0.00% 0.00% 0.00% NA NA NA 80.11% 65.97% 71.35% Page 90 Use of Services UCare Minnesota Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services Data Last Refreshed: Jan 6, 2011 10:11 AM Minnesota Health Care Programs - Managed Care(MHCP-MC Member Months (Any) Age 0-12 13-17 18-64 65+ Unknown Total Male 239854 66176 192151 134 0 498315 Female 234620 66053 306142 207 0 607022 Total 474474 132229 498293 341 0 1105337 Any Services Sex M F Total M 13-17 F Total M 18-64 F Total M 65+ F Total Unknown M F Total Total M F Total Age 0-12 Number 1633 1157 2790 806 888 1694 3795 6434 10229 0 1 1 0 0 0 6234 8480 14714 HEDIS 2010 (Reporting Year 2009) Member Months (Intensive Outpatient/Partial Hospitalization) Member Months (Inpatient) Male 239854 66176 192151 134 0 498315 Female 234620 66053 306142 207 0 607022 Total 474474 132229 498293 341 0 1105337 Number 30 23 53 30 70 100 339 352 691 0 0 0 0 0 0 399 445 844 Female 234620 66053 306142 207 0 607022 Total 474474 132229 498293 341 0 1105337 Intensive Outpatient/Partial Hospitalization Inpatient Percent 8.17% 5.92% 7.06% 14.62% 16.13% 15.37% 23.70% 25.22% 24.63% 0.00% 5.80% 3.52% NA NA NA 15.01% 16.76% 15.97% Male 239854 66176 192151 134 0 498315 Percent 0.15% 0.12% 0.13% 0.54% 1.27% 0.91% 2.12% 1.38% 1.66% 0.00% 0.00% 0.00% NA NA NA 0.96% 0.88% 0.92% Number 188 130 318 107 116 223 513 751 1264 0 0 0 0 0 0 808 997 1805 Percent 0.94% 0.66% 0.80% 1.94% 2.11% 2.02% 3.20% 2.94% 3.04% 0.00% 0.00% 0.00% NA NA NA 1.95% 1.97% 1.96% Member Months (Outpatient/ED) Male 239854 66176 192151 134 0 498315 Female 234620 66053 306142 207 0 607022 Total 474474 132229 498293 341 0 1105337 Outpatient/ED Number 1590 1124 2714 783 845 1628 3582 6196 9778 0 1 1 0 0 0 5955 8166 14121 Percent 7.95% 5.75% 6.86% 14.20% 15.35% 14.77% 22.37% 24.29% 23.55% 0.00% 5.80% 3.52% NA NA NA 14.34% 16.14% 15.33% Page 91 Health Plan Descriptive Information UCare Minnesota Data Last Refreshed: Jan 6, 2011 10:11 AM Board Certification MSHO Type of Physician Family Medicine Internal Medicine Geriatricians Other practitioner Specialists HEDIS 2010 (Reporting Year 2009) Number of Physicians in Active Board Certification Each Practice Area Percent Number 3353 3146 148 6588 2921 2803 146 5877 87.12% 89.10% 98.65% 89.21% Page 92 Health Plan Descriptive Information UCare Minnesota Data Last Refreshed: Jan 6, 2011 10:11 AM Board Certification SNBC Type of Physician Family Medicine Internal Medicine Geriatricians Other practitioner Specialists HEDIS 2010 (Reporting Year 2009) Number of Physicians in Active Board Certification Each Practice Area Percent Number 3353 3146 148 6588 2921 2803 146 5877 87.12% 89.10% 98.65% 89.21% Page 93 Health Plan Descriptive Information UCare Minnesota Enrollment by Product Line (Age & Sex) Data Last Refreshed: Jan 6, 2011 10:11 AM Commercial Male <1 1-4 5-9 10-14 15-17 18-19 0-19 Subtotal 0-19 Subtotal: % 20-24 25-29 30-34 35-39 40-44 20-44 Subtotal 20-44 Subtotal: % 45-49 50-54 55-59 60-64 45-64 Subtotal 45-64 Subtotal: % 65-69 70-74 75-79 80-84 85-89 >=90 >=65 Subtotal >=65 Subtotal: % Age Unknown Total Member Months Female Total NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR HEDIS 2010 (Reporting Year 2009) NR NR NR NR NR NR NR Page 94 Health Plan Descriptive Information UCare Minnesota Enrollment by Product Line (Age & Sex) Data Last Refreshed: Jan 6, 2011 10:11 AM Medicare Advantage <1 1-4 5-9 10-14 15-17 18-19 0-19 Subtotal 0-19 Subtotal: % 20-24 25-29 30-34 35-39 40-44 20-44 Subtotal 20-44 Subtotal: % 45-49 50-54 55-59 60-64 45-64 Subtotal 45-64 Subtotal: % 65-69 70-74 75-79 80-84 85-89 >=90 >=65 Subtotal >=65 Subtotal: % Age Unknown Total Male 0 0 0 0 0 0 Member Months Female 0 0 0 0 0 0 Total 0 0 0 0 0 0 0 0.00% 41 47 96 187 302 0 0.00% 19 68 81 179 374 0 0.00% 673 0.22% 749 1532 2633 4863 721 0.17% 820 1759 3502 6058 1394 0.19% 9777 3.25% 94528 77611 53457 37189 19355 7887 12139 2.87% 126358 93847 70710 57435 37454 25035 21916 3.03% 290027 96.52% 0 410839 96.96% 0 300477 423699 HEDIS 2010 (Reporting Year 2009) 60 115 177 366 676 1569 3291 6135 10921 220886 171458 124167 94624 56809 32922 700866 96.78% 0 724176 Page 95 Health Plan Descriptive Information UCare Minnesota Enrollment by Product Line (Age & Sex) Data Last Refreshed: Jan 6, 2011 10:11 AM MSHO <1 1-4 5-9 10-14 15-17 18-19 0-19 Subtotal 0-19 Subtotal: % 20-24 25-29 30-34 35-39 40-44 20-44 Subtotal 20-44 Subtotal: % 45-49 50-54 55-59 60-64 45-64 Subtotal 45-64 Subtotal: % 65-69 70-74 75-79 80-84 85-89 >=90 >=65 Subtotal >=65 Subtotal: % Age Unknown Total Male 0 0 0 0 0 0 Member Months Female 0 0 0 0 0 0 Total 0 0 0 0 0 0 0 0.00% 0 0 0 0 0 0 0.00% 0 0 0 0 0 0 0.00% 0 0.00% 0 0 0 0 0 0.00% 0 0 0 0 0 0.00% 0 0.00% 5759 6408 5497 4280 3258 2444 0 0.00% 10502 11374 12241 12125 11931 13899 0 0.00% 27646 100.00% 0 72072 100.00% 0 99718 100.00% 27646 72072 HEDIS 2010 (Reporting Year 2009) 0 0 0 0 0 0 0 0 0 16261 17782 17738 16405 15189 16343 0 99718 Page 96 Health Plan Descriptive Information UCare Minnesota Enrollment by Product Line (Age & Sex) Data Last Refreshed: Jan 6, 2011 10:11 AM SNBC <1 1-4 5-9 10-14 15-17 18-19 0-19 Subtotal 0-19 Subtotal: % 20-24 25-29 30-34 35-39 40-44 20-44 Subtotal 20-44 Subtotal: % 45-49 50-54 55-59 60-64 45-64 Subtotal 45-64 Subtotal: % 65-69 70-74 75-79 80-84 85-89 >=90 >=65 Subtotal >=65 Subtotal: % Age Unknown Total Male 0 0 0 0 0 5 Member Months Female 0 0 0 0 0 9 Total 0 0 0 0 0 14 5 0.71% 40 46 92 74 108 9 0.79% 55 64 52 136 111 14 0.76% 360 51.14% 95 87 106 46 418 36.47% 152 183 257 119 778 42.05% 334 47.44% 5 0 0 0 0 0 711 62.04% 8 0 0 0 0 0 1045 56.49% 5 0.71% 0 8 0.70% 0 13 0.70% 704 1146 HEDIS 2010 (Reporting Year 2009) 95 110 144 210 219 247 270 363 165 13 0 0 0 0 0 0 1850 Page 97 Health Plan Descriptive Information UCare Minnesota Enrollment by Product Line (Age & Sex) Data Last Refreshed: Jan 6, 2011 10:11 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 32838 86168 80657 66503 39864 21343 Member Months Female 32257 82897 78123 67333 40063 26042 Total 65095 169065 158780 133836 79927 47385 327373 65.70% 27234 24394 20727 19762 20676 326715 53.82% 62251 56491 38867 31527 26575 654088 59.18% 112793 22.63% 21568 17408 11671 7368 215711 35.54% 24140 17495 12812 9942 328504 29.72% 58015 11.64% 101 33 0 0 0 0 64389 10.61% 143 35 24 5 0 0 122404 11.07% 134 0.03% 0 207 0.03% 0 341 0.03% 498315 607022 HEDIS 2010 (Reporting Year 2009) 89485 80885 59594 51289 47251 45708 34903 24483 17310 244 68 24 5 0 0 0 1105337 Page 98
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