South Country Health Alliance
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
South Country Health Alliance
Weight Assessment and Counseling for Nutrition and Physical Activity
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Weight Assessment and Counseling for Nutrition and Physical Activity
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
BMI Percentile
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
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
3764
1672
5436
3764
1672
5436
3764
1672
5436
6
0.16%
3
0.18%
9
0.17%
20
0.53%
10
0.60%
30
0.55%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
411
5.00%
411
5.00%
432
411
5.00%
432
1
0.23%
0
0.00%
1
0.23%
432
3
0.69%
0
0.00%
3
0.69%
Number of Records Excluded Because of
Valid Data Errors
0
0
0
Number of administrative data records
excluded
0
0
0
Number of medical records excluded
0
0
0
Number of employee/dependent records
excluded
0
0
0
Records Added from the Oversample List
0
0
0
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
299
133
432
299
133
432
299
133
432
1
84
28.43%
23.15%
33.71%
0
44
33.08%
24.71%
41.46%
1
128
29.86%
25.43%
34.29%
3
113
38.80%
33.11%
44.49%
0
45
33.83%
25.42%
42.25%
3
158
37.27%
32.59%
41.94%
0
85
28.43%
23.15%
33.71%
0
43
32.33%
24.01%
40.66%
0
128
29.63%
25.21%
34.05%
Page 4
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Jan 6, 2011 10:21 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
539
76.45%
608
86.24%
636
90.21%
644
91.35%
618
87.66%
611
86.67%
541
76.74%
225
31.91%
260
36.88%
295
41.84%
334
77.31%
376
87.04%
390
90.28%
395
91.44%
382
88.43%
377
87.27%
334
77.31%
137
31.71%
150
34.72%
178
41.20%
334
23
82.83%
79.15%
86.51%
376
23
92.58%
89.98%
95.17%
390
2
90.95%
88.13%
93.78%
395
7
93.27%
90.79%
95.75%
382
18
92.81%
90.25%
95.36%
377
5
88.63%
85.52%
91.74%
334
22
82.60%
78.90%
86.29%
137
9
33.87%
29.29%
38.46%
150
15
38.28%
33.58%
42.99%
178
25
47.10%
42.27%
51.93%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
1
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
705
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
431
Page 7
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Status
Data Last Refreshed:
Jan 6, 2011 10:21 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
493
69.93%
467
66.24%
190
26.95%
219
31.06%
235
33.33%
103
14.61%
108
15.32%
114
16.17%
53
7.52%
307
71.06%
290
67.13%
115
26.62%
125
28.94%
143
33.10%
59
13.66%
66
15.28%
64
14.81%
32
7.41%
307
27
77.49%
73.44%
81.55%
290
29
74.01%
69.76%
78.27%
115
17
30.63%
26.16%
35.09%
125
18
33.18%
28.62%
37.74%
143
30
40.14%
35.40%
44.88%
59
10
16.01%
12.43%
19.59%
66
18
19.49%
15.63%
23.35%
64
17
18.79%
14.99%
22.60%
32
11
9.98%
7.03%
12.92%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
1
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
705
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
431
Page 8
Effectiveness of Care
South Country Health Alliance
Breast Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Commercial
NR
NR
NR
Medicare
Advantage
NR
NR
NR
MSHO
SNBC
MHCP-MC
2009
A
70
44
62.86%
50.82%
74.89%
2009
A
220
177
80.45%
74.99%
85.92%
2009
A
434
242
55.76%
50.97%
60.55%
Page 9
Effectiveness of Care
South Country Health Alliance
Cervical Cancer Screening
Data Elements
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Commercial
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
2008
H
2295
Numerator Events by Admin Data on Eligible
Population (before exclusions)
1462
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
63.70%
411
5.00%
432
287
66.44%
0
0
9
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
NR
0
423
287
39
77.07%
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NR
NR
72.94%
81.19%
HEDIS 2010 (Reporting Year 2009)
Page 10
Effectiveness of Care
South Country Health Alliance
Colorectal Cancer Screening
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Data Elements
Commercial
Medicare
Advantage
MSHO
SNBC
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
2009
H
366
2009
H
258
Number of numerator events by administrative data in eligible population
(before exclusions)
118
119
32.24%
362
0.00%
362
119
32.87%
0
0
0
0
0
362
119
50
46.69%
41.41%
51.96%
46.12%
258
0.00%
258
121
46.90%
0
0
1
0
0
257
121
23
56.03%
49.77%
62.29%
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
NR
NR
NR
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
NR
NR
NR
NR
NR
NR
HEDIS 2010 (Reporting Year 2009)
Page 11
Effectiveness of Care
South Country Health Alliance
Chlamydia Screening in Women
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Chlamydia Screening in Women
Data Last Refreshed:
Jan 6, 2011 10:21 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
406
181
44.58%
39.62%
49.54%
468
228
48.72%
44.08%
53.35%
874
409
46.80%
43.43%
50.16%
Page 13
Effectiveness of Care
South Country Health Alliance
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Medicare
Advantage
NR
NR
NR
MSHO
2009
A
1312
833
63.49%
60.85%
66.13%
Page 14
Effectiveness of Care
South Country Health Alliance
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Lead Screening in Children
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
MHCP-MC
2009
A
705
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
600
Reported Rate
85.11%
Lower 95% Confidence Interval
82.41%
Upper 95% Confidence Interval
87.81%
HEDIS 2010 (Reporting Year 2009)
Page 15
Effectiveness of Care
South Country Health Alliance
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Medicare Advantage
Data Elements
General
Measure Data
Systemic
corticosteroid
Bronchodilator
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
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
South Country Health Alliance
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 6, 2011 10:21 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
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)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
42
63.64%
51.27%
76.00%
57
86.36%
77.33%
95.40%
2009
A
66
19
34
Page 18
Effectiveness of Care
South Country Health Alliance
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 6, 2011 10:21 AM
SNBC
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
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)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
12
NA
NA
NA
16
NA
NA
NA
2009
A
16
4
1
Page 19
Effectiveness of Care
South Country Health Alliance
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Jan 6, 2011 10:21 AM
MSHO
SNBC
2009
A
35
5
14.29%
1.26%
27.31%
2009
A
8
4
NA
NA
NA
Page 20
Effectiveness of Care
South Country Health Alliance
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jan 6, 2011 10:21 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
71
67
94.37%
88.30%
100.00%
125
100
80.00%
72.59%
87.41%
196
167
85.20%
79.98%
90.43%
2009
A
Page 22
Effectiveness of Care
South Country Health Alliance
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 6, 2011 10:21 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 24
Effectiveness of Care
South Country Health Alliance
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 6, 2011 10:21 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
29
0
67.44%
0.00%
30
0
69.77%
0.00%
30
1
0
20
72.09%
57.52%
86.66%
46.51%
30.44%
62.58%
2009
H
43
43
0.00%
43
0
0
0
43
Page 25
Effectiveness of Care
South Country Health Alliance
Controlling High Blood Pressure
Data Elements
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Medicare
Advantage
MSHO
SNBC
MHCP-MC
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2009
H
324
2009
H
109
2009
H
421
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
0
0
0.00%
254
0.00%
254
0.00%
95
0.00%
95
0.00%
382
0.00%
382
0
0.00%
0
0.00%
0
0.00%
Records Excluded because of Valid Data
Errors
0
0
0
Number of records excluded because of
false positive diagnoses
0
0
0
Number of administrative data records
excluded
0
0
0
Number of medical record data records
excluded
0
0
0
Number of employee/dependent medical
records excluded
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
0
254
0
180
70.87%
65.08%
76.65%
0
95
0
61
64.21%
54.04%
74.38%
0
382
0
243
63.61%
58.66%
68.57%
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
NR
NR
NR
NR
NR
Page 26
Effectiveness of Care
South Country Health Alliance
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Commercial
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Medicare
Advantage
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
NR
NR
NR
NR
NR
NR
MSHO
SNBC
MHCP-MC
2009
A
22
2009
A
2
2009
A
11
20
1
4
NA
NA
NA
NA
NA
NA
NA
NA
NA
Page 27
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 6, 2011 10:21 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
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
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 29
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 6, 2011 10:21 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
147
2009
H
147
126
85.71%
147
0%
147
129
87.76%
144
97.96%
147
0%
147
144
97.96%
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
147
2009
H
147
2009
H
147
2009
H
147
2009
H
147
2009
H
147
2009
H
147
2
1.36%
147
0%
147
2
1.36%
98
66.67%
147
0%
147
103
70.07%
119
80.95%
147
0%
147
122
82.99%
6
4.08%
147
0%
147
5
3.40%
128
87.07%
147
0%
147
132
89.80%
7
4.76%
147
0%
147
0
0.00%
6
4.08%
147
0%
147
0
0.00%
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
147
129
5
91.16%
86.23%
96.09%
0
147
40
4
29.93%
22.19%
37.68%
0
147
2
91
63.27%
55.13%
71.40%
0
147
103
13
78.91%
71.98%
85.85%
0
147
122
2
84.35%
78.14%
90.57%
0
147
5
77
55.78%
47.41%
64.15%
0
147
132
2
91.16%
86.23%
96.09%
0
147
0
107
72.79%
65.25%
80.32%
0
147
0
81
55.10%
46.72%
63.48%
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
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 6, 2011 10:21 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
146
2009
H
146
134
91.78%
146
0%
146
136
93.15%
146
100.00%
146
0%
146
146
100.00%
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
146
2009
H
146
2009
H
146
2009
H
146
2009
H
146
2009
H
146
2009
H
146
0
0.00%
146
0%
146
0
0.00%
113
77.40%
146
0%
146
117
80.14%
123
84.25%
146
0%
146
125
85.62%
0
0.00%
146
0%
146
0
0.00%
119
81.51%
146
0%
146
120
82.19%
0
0.00%
146
0%
146
0
0.00%
0
0.00%
146
0%
146
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
146
136
2
94.52%
90.49%
98.55%
0
146
31
7
26.03%
18.57%
33.49%
0
146
0
100
68.49%
60.62%
76.37%
0
146
117
10
86.99%
81.19%
92.79%
0
146
125
6
89.73%
84.46%
94.99%
0
146
0
83
56.85%
48.47%
65.23%
0
146
120
2
83.56%
77.21%
89.92%
0
146
0
111
76.03%
68.76%
83.29%
0
146
0
92
63.01%
54.84%
71.19%
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
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 6, 2011 10:21 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
394
2009
H
394
2009
H
267
2009
H
394
2009
H
394
2009
H
394
2009
H
394
2009
H
394
2009
H
394
2009
H
394
309
78.43%
372
0%
372
309
83.06%
392
99.49%
372
0%
372
370
99.46%
0
0.00%
372
0%
372
0
0.00%
1
0.25%
372
0%
372
1
0.27%
226
57.36%
372
0%
372
231
62.10%
263
66.75%
372
0%
372
270
72.58%
3
0.76%
372
0%
372
3
0.81%
254
64.47%
372
0%
372
255
68.55%
2
0.51%
372
0%
372
1
0.27%
1
0.25%
372
0%
372
1
0.27%
0
0
129
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
372
1
200
54.03%
48.83%
59.23%
0
372
231
33
70.97%
66.22%
75.71%
0
372
270
15
76.61%
72.18%
81.05%
0
372
3
142
38.98%
33.89%
44.07%
0
372
255
32
77.15%
72.75%
81.55%
0
372
1
268
72.31%
67.63%
76.99%
0
372
1
184
49.73%
44.52%
54.95%
Number of Administrative required exclusions
127
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
2
0
372
309
13
86.56%
82.96%
90.16%
0
372
100
39
37.37%
32.32%
42.42%
0
243
0
86
35.39%
29.17%
41.61%
Page 32
Effectiveness of Care
South Country Health Alliance
Osteoporosis Management in Women Who had a Fracture
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Jan 6, 2011 10:21 AM
MSHO
2009
A
80
6
7.50%
1.10%
13.90%
Page 33
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Jan 6, 2011 10:21 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
NR
NR
NR
Effective
Continuation
Phase
Treatment
NR
NR
NR
Page 35
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Jan 6, 2011 10:21 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
18
12
NA
NA
NA
7
NA
NA
NA
Page 36
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Jan 6, 2011 10:21 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
7
5
NA
NA
NA
5
NA
NA
NA
Page 37
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Jan 6, 2011 10:21 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
198
108
54.55%
47.36%
61.73%
70
35.35%
28.44%
42.27%
Page 38
Effectiveness of Care
South Country Health Alliance
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jan 6, 2011 10:21 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
137
50
36.50%
28.07%
44.92%
43
15
34.88%
19.48%
50.29%
2009
A
Page 40
Effectiveness of Care
South Country Health Alliance
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 6, 2011 10:21 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
NR
NR
NR
NR
NR
NR
Page 41
Effectiveness of Care
South Country Health Alliance
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 6, 2011 10:21 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
5
NA
NA
NA
5
NA
NA
NA
2009
A
16
Page 42
Effectiveness of Care
South Country Health Alliance
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 6, 2011 10:21 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
40
85.11%
73.86%
96.35%
31
65.96%
51.35%
80.57%
2009
A
47
Page 43
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 6, 2011 10:21 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 45
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 6, 2011 10:21 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
662
626
94.56%
92.76%
96.36%
99
96
96.97%
93.09%
100.00%
803
761
94.77%
93.17%
96.37%
90
87
96.67%
92.40%
100.00%
1654
1570
94.92%
93.83%
96.01%
2009
A
Page 46
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 6, 2011 10:21 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
129
114
88.37%
82.45%
94.29%
6
5
NA
NA
NA
106
98
92.45%
86.95%
97.95%
126
99
78.57%
71.01%
86.13%
367
316
86.10%
82.43%
89.78%
2009
A
Page 47
Effectiveness of Care
South Country Health Alliance
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 6, 2011 10:21 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
216
177
81.94%
76.58%
87.31%
6
6
NA
NA
NA
181
147
81.22%
75.25%
87.18%
47
30
63.83%
49.03%
78.63%
450
360
80.00%
76.19%
83.81%
2009
A
Page 48
Access/Availability of Care
South Country Health Alliance
Medication Reconciliation Post Discharge
Data Elements
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jan 6, 2011 10:21 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
Page 50
Effectiveness of Care
South Country Health Alliance
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jan 6, 2011 10:21 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
126
25
19.84%
12.48%
27.20%
432
97
22.45%
18.40%
26.50%
17
0
NA
NA
NA
575
122
21.22%
17.79%
24.65%
Page 51
Effectiveness of Care
South Country Health Alliance
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jan 6, 2011 10:21 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
At least 1
Prescription
At least 2
Prescriptions
NR
NR
NR
NR
NR
NR
Page 52
Effectiveness of Care
South Country Health Alliance
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jan 6, 2011 10:21 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
1614
At least 1
Prescription
At least 2
Prescriptions
379
23.48%
21.38%
25.58%
59
3.66%
2.71%
4.60%
Page 53
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 6, 2011 10:21 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 2010 (Reporting Year 2009)
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 55
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 6, 2011 10:21 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
1614
1614
0
0
1586
NA
NA
NA
NA
NA
NA
98.27%
97.60%
98.93%
1586
98.27%
97.60%
98.93%
2009
A
Page 56
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 6, 2011 10:21 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
236
445
14
695
234
438
14
99.15%
97.77%
100.00%
98.43%
97.16%
99.70%
NA
NA
NA
686
98.71%
97.79%
99.62%
2009
A
Page 57
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 6, 2011 10:21 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
3479
982
706
5167
3218
890
642
92.50%
91.61%
93.39%
90.63%
88.76%
92.50%
90.93%
88.75%
93.12%
4750
91.93%
91.18%
92.68%
2009
A
Page 58
Access/Availability of Care
South Country Health Alliance
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jan 6, 2011 10:21 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.
1049
1011
2788
2459
1531
1355
1679
1476
96.38%
95.20%
97.56%
88.20%
86.98%
89.41%
88.50%
86.87%
90.13%
87.91%
86.32%
89.50%
2009
A
Page 60
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 6, 2011 10:21 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 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 62
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 6, 2011 10:21 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
27
0
27
0
0
16
1
16
1
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Page 63
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 6, 2011 10:21 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
68
68
0
0
34
7
34
7
NA
NA
NA
NA
NA
NA
50.00%
37.38%
62.62%
10.29%
2.34%
18.25%
50.00%
37.38%
62.62%
10.29%
2.34%
18.25%
Page 64
Access/Availability of Care
South Country Health Alliance
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 6, 2011 10:21 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
49
547
596
29
12
284
111
313
123
59.18%
44.40%
73.97%
24.49%
11.43%
37.55%
51.92%
47.64%
56.20%
20.29%
16.83%
23.75%
52.52%
48.42%
56.61%
20.64%
17.30%
23.97%
Page 65
Access/Availability of Care
South Country Health Alliance
Prenatal and Postpartum Care
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Prenatal and Postpartum Care
Data Last Refreshed:
Jan 6, 2011 10:21 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
2008
H
1314
2008
H
1314
Number of numerator events by administrative data in eligible
population (before exclusions)
826
740
62.86%
411
5%
432
272
56.32%
411
5%
432
249
62.96%
57.64%
3
3
0
0
429
272
116
0
0
429
249
61
90.44%
87.54%
93.34%
72.26%
67.91%
76.61%
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
South Country Health Alliance
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jan 6, 2011 10:21 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
29
3.59%
21
2.60%
25
3.10%
47
5.82%
105
13.01%
166
20.57%
414
51.30%
19
4.62%
13
3.16%
11
2.68%
27
6.57%
47
11.44%
75
18.25%
219
53.28%
8
0
1.95%
0.49%
3.40%
6
1
1.70%
0.33%
3.08%
9
3
2.92%
1.17%
4.67%
16
2
4.38%
2.28%
6.48%
25
6
7.54%
4.87%
10.22%
39
13
12.65%
9.32%
15.99%
230
53
68.86%
64.26%
73.46%
411
0.00%
411
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
1 visit
2009
H
807
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Zero Visits
411
Page 69
Use of Services
South Country Health Alliance
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Commercial
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Jan 6, 2011 10:21 AM
MHCP-MC
2009
A
2198
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
NR
NR
NR
NR
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
1307
NR
NR
NR
59.46%
57.39%
61.54%
Page 70
Use of Services
South Country Health Alliance
Adolescent Well-Care Visits
Data Elements
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Commercial
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
2009
H
2831
Numerator events by admin data in eligible
population
877
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
30.98%
411
0.00%
411
149
NR
36.25%
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
149
30
43.55%
38.64%
48.47%
Page 71
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Jan 6, 2011 10:21 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
Visits
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
NR
HEDIS 2010 (Reporting Year 2009)
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
Ambulatory
Surgery/Procedures
Procedures
NR
Procedures/
1,000 Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Observation Room Stays
Resulting in Discharge
Stays
NR
Stays/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 73
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Jan 6, 2011 10:21 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
3
5745
6867
10013
0
22628
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
5482
6715
7923
0
20124
HEDIS 2010 (Reporting Year 2009)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
1333.33
954.22
977.87
791.27
889.34
Emergency Room Visits
Visits
0
0
0
0
0
449
347
444
0
1240
Visits/ 1,000
Member
Months
NA
NA
NA
NA
0.00
78.15
50.53
44.34
54.80
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
2
376
422
436
0
1236
Procedures/
1,000 Member
Months
NA
NA
NA
NA
666.67
65.45
61.45
43.54
54.62
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
14
16
10
0
40
Stays/ 1,000
Member
Months
NA
NA
NA
NA
0.00
2.44
2.33
1.00
1.77
Page 74
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Jan 6, 2011 10:21 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
3
3234
5924
165
0
0
0
9326
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
1
2548
6019
123
0
0
0
8691
HEDIS 2010 (Reporting Year 2009)
Visits/ 1,000
Member
Months
NA
NA
333.33
787.88
1016.04
745.45
NA
NA
931.91
Emergency Room Visits
Visits
0
0
1
265
447
10
0
0
0
723
Visits/ 1,000
Member
Months
NA
NA
333.33
81.94
75.46
60.61
NA
NA
77.53
Ambulatory
Surgery/Procedures
Procedures
0
0
0
91
368
8
0
0
0
467
Procedures/
1,000 Member
Months
NA
NA
0.00
28.14
62.12
48.48
NA
NA
50.08
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
2
8
0
0
0
0
10
Stays/ 1,000
Member
Months
NA
NA
0.00
0.62
1.35
0.00
NA
NA
1.07
Page 75
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Jan 6, 2011 10:21 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
19561
107411
70285
97757
23152
4953
3115
3730
0
329964
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
16590
42023
23839
60702
15353
4068
2111
1926
0
166612
HEDIS 2010 (Reporting Year 2009)
Visits/ 1,000
Member
Months
848.12
391.24
339.18
620.95
663.14
821.32
677.69
516.35
504.94
Emergency Room Visits
Visits
1909
5936
3019
8839
1182
261
161
130
0
21437
Visits/ 1,000
Member
Months
97.59
55.26
42.95
90.42
51.05
52.70
51.69
34.85
64.97
Ambulatory
Surgery/Procedures
Procedures
337
1245
698
3274
1035
331
156
160
0
7236
Procedures/
1,000 Member
Months
17.23
11.59
9.93
33.49
44.70
66.83
50.08
42.90
21.93
Observation Room Stays
Resulting in Discharge
Stays
57
53
149
773
35
2
4
18
0
1091
Stays/ 1,000
Member
Months
2.91
0.49
2.12
7.91
1.51
0.40
1.28
4.83
3.31
Page 76
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jan 6, 2011 10:21 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 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 78
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Member Months
0
0
0
0
3
5745
6867
10013
0
22628
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
220
269
348
0
837
NA
NA
NA
NA
0.00
38.29
39.17
34.75
0
0
0
0
0
181
214
292
0
687
NA
NA
NA
NA
0.00
31.51
31.16
29.16
0
0
0
0
0
39
55
56
0
150
NA
NA
NA
NA
0.00
6.79
8.01
5.59
0
0
0
0
0
HEDIS 2010 (Reporting Year 2009)
36.99
30.36
6.63
NA
NA
0.00
0.00
Days
Days / 1,000
Member
Months
0
0
0
0
0
954
1090
1352
0
3396
NA
NA
NA
NA
0.00
166.06
158.73
135.02
0
0
0
0
0
713
746
1067
0
2526
NA
NA
NA
NA
0.00
124.11
108.64
106.56
0
0
0
0
0
241
344
285
0
870
NA
NA
NA
NA
0.00
41.95
50.09
28.46
0
0
0
0
0
150.08
111.63
38.45
NA
NA
0.00
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
4.34
4.05
3.89
NA
4.06
NA
NA
NA
NA
NA
3.94
3.49
3.65
NA
3.68
NA
NA
NA
NA
NA
6.18
6.25
5.09
NA
5.80
NA
NA
NA
NA
NA
Page 79
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Member Months
0
0
3
3234
5924
165
0
0
0
9326
Discharges
Discharges /
1,000 Member
Months
0
0
0
52
187
6
0
0
0
245
NA
NA
0.00
16.08
31.57
36.36
NA
NA
0
0
0
38
135
4
0
0
0
177
NA
NA
0.00
11.75
22.79
24.24
NA
NA
0
0
0
12
52
2
0
0
0
66
NA
NA
0.00
3.71
8.78
12.12
NA
NA
0
2
0
0
2
0.00
0.62
0.00
HEDIS 2010 (Reporting Year 2009)
26.27
18.98
7.08
0.22
Days
0
0
0
203
911
19
0
0
0
1133
Days / 1,000
Member
Months
NA
NA
0.00
62.77
153.78
115.15
NA
NA
121.49
0
0
0
147
582
6
0
0
0
735
NA
NA
0.00
45.45
98.24
36.36
NA
NA
0
0
0
50
329
13
0
0
0
392
NA
NA
0.00
15.46
55.54
78.79
NA
NA
0
6
0
0
6
0.00
1.86
0.00
78.81
42.03
0.65
Average
Length of Stay
NA
NA
NA
3.90
4.87
3.17
NA
NA
NA
4.62
NA
NA
NA
3.87
4.31
1.50
NA
NA
NA
4.15
NA
NA
NA
4.17
6.33
6.50
NA
NA
NA
5.94
NA
3.00
NA
NA
3.00
Page 80
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
<1
19561
1-9
107411
10-19
70285
20-44
97757
45-64
23152
65-74
4953
75-84
3115
85+
3730
Unknown
0
Total
329964
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
147
184
344
1979
311
176
126
102
0
3369
7.51
1.71
4.89
20.24
13.43
35.53
40.45
27.35
120
144
81
303
146
117
96
90
0
1097
6.13
1.34
1.15
3.10
6.31
23.62
30.82
24.13
27
40
47
318
164
59
30
12
0
697
1.38
0.37
0.67
3.25
7.08
11.91
9.63
3.22
216
1358
1
0
1575
3.07
13.89
0.04
HEDIS 2010 (Reporting Year 2009)
10.21
3.32
2.11
8.24
Days
Days / 1,000
Member
Months
751
551
892
4818
969
871
489
359
0
9700
38.39
5.13
12.69
49.29
41.85
175.85
156.98
96.25
564
397
179
796
465
442
366
314
0
3523
28.83
3.70
2.55
8.14
20.08
89.24
117.50
84.18
187
154
166
809
501
429
123
45
0
2414
9.56
1.43
2.36
8.28
21.64
86.61
39.49
12.06
547
3213
3
0
3763
7.78
32.87
0.13
29.40
10.68
7.32
19.68
Average
Length of Stay
5.11
2.99
2.59
2.43
3.12
4.95
3.88
3.52
NA
2.88
4.70
2.76
2.21
2.63
3.18
3.78
3.81
3.49
NA
3.21
6.93
3.85
3.53
2.54
3.05
7.27
4.10
3.75
NA
3.46
2.53
2.37
3.00
NA
2.39
Page 81
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Medicare Advantage
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2010 (Reporting Year 2009)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Inpatient
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
Female
NR
NR
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 83
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 6, 2011 10:21 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
0
1
5921
0
5922
Female
0
0
0
0
2
16704
0
16706
Total
0
0
0
0
3
22625
0
22628
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
19
22
41
0
0
0
19
22
41
HEDIS 2010 (Reporting Year 2009)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
0
0
1
5921
0
5922
Female
0
0
0
0
2
16704
0
16706
Total
0
0
0
0
3
22625
0
22628
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.85%
1.58%
2.17%
NA
NA
NA
3.85%
1.58%
2.17%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
8
20
0
0
0
12
8
20
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
2.43%
0.57%
1.06%
NA
NA
NA
2.43%
0.57%
1.06%
Male
0
0
0
0
1
5921
0
5922
Female
0
0
0
0
2
16704
0
16706
Total
0
0
0
0
3
22625
0
22628
Member Months
(Outpatient/ED)
Male
0
0
0
0
1
5921
0
5922
Female
0
0
0
0
2
16704
0
16706
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
14
23
0
0
0
9
14
23
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Total
0
0
0
0
3
22625
0
22628
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
1.82%
1.01%
1.22%
NA
NA
NA
1.82%
1.01%
1.22%
Page 84
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 6, 2011 10:21 AM
SNBC
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
134
468
3448
52
0
4102
Female
0
0
136
665
4310
113
0
5224
Total
0
0
270
1133
7758
165
0
9326
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
0
0
0
2
3
5
3
7
10
40
58
98
0
0
0
0
0
0
45
68
113
HEDIS 2010 (Reporting Year 2009)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
0
0
134
468
3448
52
0
4102
Female
0
0
136
665
4310
113
0
5224
Total
0
0
270
1133
7758
165
0
9326
Inpatient
Percent
NA
NA
NA
NA
NA
NA
17.91%
26.47%
22.22%
7.69%
12.63%
10.59%
13.92%
16.15%
15.16%
0.00%
0.00%
0.00%
NA
NA
NA
13.16%
15.62%
14.54%
Number
0
0
0
0
0
0
2
1
3
0
4
4
17
24
41
0
0
0
0
0
0
19
29
48
Percent
NA
NA
NA
NA
NA
NA
17.91%
8.82%
13.33%
0.00%
7.22%
4.24%
5.92%
6.68%
6.34%
0.00%
0.00%
0.00%
NA
NA
NA
5.56%
6.66%
6.18%
Male
0
0
134
468
3448
52
0
4102
Female
0
0
136
665
4310
113
0
5224
Total
0
0
270
1133
7758
165
0
9326
Member Months
(Outpatient/ED)
Male
0
0
134
468
3448
52
0
4102
Female
0
0
136
665
4310
113
0
5224
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
0
0
0
0
0
0
0
3
3
3
4
7
37
47
84
0
0
0
0
0
0
40
54
94
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Total
0
0
270
1133
7758
165
0
9326
Percent
NA
NA
NA
NA
NA
NA
0.00%
26.47%
13.33%
7.69%
7.22%
7.41%
12.88%
13.09%
12.99%
0.00%
0.00%
0.00%
NA
NA
NA
11.70%
12.40%
12.10%
Page 85
Use of Services
South Country Health Alliance
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Member Months
Member Months
(Any)
(Inpatient)
Age
Male
Female
Male
Female
Total
0-12
77997
74025
152022
77997
74025
13-17
16974
17208
34182
16974
17208
18-24
11167
26318
37485
11167
26318
25-34
12652
32157
44809
12652
32157
35-64
21309
28359
49668
21309
28359
65+
3851
7947
11798
3851
7947
Unknown
0
0
0
0
0
Total
143950
186014
329964
143950
186014
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
4
2
6
77
57
134
228
190
418
269
298
567
394
272
666
21
17
38
0
0
0
993
836
1829
HEDIS 2010 (Reporting Year 2009)
Total
152022
34182
37485
44809
49668
11798
0
329964
Inpatient
Percent
0.06%
0.03%
0.05%
5.44%
3.97%
4.70%
24.50%
8.66%
13.38%
25.51%
11.12%
15.18%
22.19%
11.51%
16.09%
6.54%
2.57%
3.87%
NA
NA
NA
8.28%
5.39%
6.65%
Number
0
0
0
13
16
29
41
45
86
41
78
119
110
60
170
7
8
15
0
0
0
212
207
419
Percent
0.00%
0.00%
0.00%
0.92%
1.12%
1.02%
4.41%
2.05%
2.75%
3.89%
2.91%
3.19%
6.19%
2.54%
4.11%
2.18%
1.21%
1.53%
NA
NA
NA
1.77%
1.34%
1.52%
Member Months
(Intensive Outpatient/Partial
Male
Female
Total
77997
74025
152022
16974
17208
34182
11167
26318
37485
12652
32157
44809
21309
28359
49668
3851
7947
11798
0
0
0
143950
186014
329964
Male
77997
16974
11167
12652
21309
3851
0
143950
Member Months
(Outpatient/ED)
Female
74025
17208
26318
32157
28359
7947
0
186014
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
0
1
1
0
0
0
2
1
3
0
0
0
0
0
0
2
2
4
Number
4
2
6
75
49
124
214
174
388
258
266
524
363
254
617
17
11
28
0
0
0
931
756
1687
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.05%
0.03%
0.00%
0.00%
0.00%
0.11%
0.04%
0.07%
0.00%
0.00%
0.00%
NA
NA
NA
0.02%
0.01%
0.01%
Total
152022
34182
37485
44809
49668
11798
0
329964
Percent
0.06%
0.03%
0.05%
5.30%
3.42%
4.35%
23.00%
7.93%
12.42%
24.47%
9.93%
14.03%
20.44%
10.75%
14.91%
5.30%
1.66%
2.85%
NA
NA
NA
7.76%
4.88%
6.14%
Page 86
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Medicare Advantage
Member Months
(Any)
Age
Male
Female
0-12
13-17
18-64
65+
Unknown
Total
NR
NR
Total
NR
NR
NR
NR
NR
NR
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
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2010 (Reporting Year 2009)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Outpatient/ED
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 88
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 6, 2011 10:21 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
1
5921
0
5922
Female
0
0
2
16704
0
16706
Total
0
0
3
22625
0
22628
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
66
168
234
0
0
0
66
168
234
HEDIS 2010 (Reporting Year 2009)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
1
5921
0
5922
Female
0
0
2
16704
0
16706
Total
0
0
3
22625
0
22628
Number
0
0
0
0
0
0
0
0
0
22
56
78
0
0
0
22
56
78
Female
0
0
2
16704
0
16706
Total
0
0
3
22625
0
22628
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
13.38%
12.07%
12.41%
NA
NA
NA
13.37%
12.07%
12.41%
Male
0
0
1
5921
0
5922
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
4.46%
4.02%
4.14%
NA
NA
NA
4.46%
4.02%
4.14%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Member Months
(Outpatient/ED)
Male
0
0
1
5921
0
5922
Female
0
0
2
16704
0
16706
Total
0
0
3
22625
0
22628
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
51
120
171
0
0
0
51
120
171
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
10.34%
8.62%
9.07%
NA
NA
NA
10.33%
8.62%
9.07%
Page 89
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 6, 2011 10:21 AM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
4050
52
0
4102
Female
0
0
5111
113
0
5224
Total
0
0
9161
165
0
9326
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
175
267
442
0
3
3
0
0
0
175
270
445
HEDIS 2010 (Reporting Year 2009)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
4050
52
0
4102
Female
0
0
5111
113
0
5224
Total
0
0
9161
165
0
9326
Number
0
0
0
0
0
0
14
37
51
0
0
0
0
0
0
14
37
51
Female
0
0
5111
113
0
5224
Total
0
0
9161
165
0
9326
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
51.85%
62.69%
57.90%
0.00%
31.86%
21.82%
NA
NA
NA
51.19%
62.02%
57.26%
Male
0
0
4050
52
0
4102
Percent
NA
NA
NA
NA
NA
NA
4.15%
8.69%
6.68%
0.00%
0.00%
0.00%
NA
NA
NA
4.10%
8.50%
6.56%
Number
0
0
0
0
0
0
5
4
9
0
0
0
0
0
0
5
4
9
Percent
NA
NA
NA
NA
NA
NA
1.48%
0.94%
1.18%
0.00%
0.00%
0.00%
NA
NA
NA
1.46%
0.92%
1.16%
Member Months
(Outpatient/ED)
Male
0
0
4050
52
0
4102
Female
0
0
5111
113
0
5224
Total
0
0
9161
165
0
9326
Outpatient/ED
Number
0
0
0
0
0
0
174
267
441
0
3
3
0
0
0
174
270
444
Percent
NA
NA
NA
NA
NA
NA
51.56%
62.69%
57.77%
0.00%
31.86%
21.82%
NA
NA
NA
50.90%
62.02%
57.13%
Page 90
Use of Services
South Country Health Alliance
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 6, 2011 10:21 AM
Minnesota Health Care Programs - Managed Care(MHCP-MC
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
77997
16974
45128
3851
0
143950
Female
74025
17208
86834
7947
0
186014
Total
152022
34182
131962
11798
0
329964
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
931
570
1501
341
420
761
987
2052
3039
35
91
126
0
0
0
2294
3133
5427
HEDIS 2010 (Reporting Year 2009)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
77997
16974
45128
3851
0
143950
Female
74025
17208
86834
7947
0
186014
Total
152022
34182
131962
11798
0
329964
Number
11
11
22
18
33
51
81
108
189
8
18
26
0
0
0
118
170
288
Female
74025
17208
86834
7947
0
186014
Total
152022
34182
131962
11798
0
329964
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
14.32%
9.24%
11.85%
24.11%
29.29%
26.72%
26.25%
28.36%
27.64%
10.91%
13.74%
12.82%
NA
NA
NA
19.12%
20.21%
19.74%
Male
77997
16974
45128
3851
0
143950
Percent
0.17%
0.18%
0.17%
1.27%
2.30%
1.79%
2.15%
1.49%
1.72%
2.49%
2.72%
2.64%
NA
NA
NA
0.98%
1.10%
1.05%
Number
2
0
2
0
0
0
9
15
24
0
0
0
0
0
0
11
15
26
Percent
0.03%
0.00%
0.02%
0.00%
0.00%
0.00%
0.24%
0.21%
0.22%
0.00%
0.00%
0.00%
NA
NA
NA
0.09%
0.10%
0.09%
Member Months
(Outpatient/ED)
Male
77997
16974
45128
3851
0
143950
Female
74025
17208
86834
7947
0
186014
Total
152022
34182
131962
11798
0
329964
Outpatient/ED
Number
931
568
1499
339
415
754
970
2034
3004
34
83
117
0
0
0
2274
3100
5374
Percent
14.32%
9.21%
11.83%
23.97%
28.94%
26.47%
25.79%
28.11%
27.32%
10.59%
12.53%
11.90%
NA
NA
NA
18.96%
20.00%
19.54%
Page 91
Health Plan Descriptive Information
South Country Health Alliance
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 6, 2011 10:21 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
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 6, 2011 10:21 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 2010 (Reporting Year 2009)
Page 95
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 6, 2011 10:21 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
1
0
0.00%
0
0
0
2
0
0.00%
1
0.02%
901
1277
1033
943
980
787
2
0.01%
1495
2072
1823
3068
3780
4466
3
0.01%
5921
99.98%
0
16704
99.99%
0
22625
99.99%
5922
16706
HEDIS 2010 (Reporting Year 2009)
0
0
0
0
0
0
0
0
3
2396
3349
2856
4011
4760
5253
0
22628
Page 96
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 6, 2011 10:21 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
3
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
3
3
0.07%
131
244
224
368
525
0
0.00%
136
337
328
424
517
3
0.03%
1492
36.37%
718
718
571
548
1742
33.35%
894
941
691
843
3234
34.68%
2555
62.29%
52
0
0
0
0
0
3369
64.49%
112
1
0
0
0
0
5924
63.52%
52
1.27%
0
113
2.16%
0
165
1.77%
4102
5224
HEDIS 2010 (Reporting Year 2009)
267
581
552
792
1042
1612
1659
1262
1391
164
1
0
0
0
0
0
9326
Page 97
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 6, 2011 10:21 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
10050
29068
26328
19664
9861
4585
Member Months
Female
9511
27506
24509
19730
9977
6468
Total
19561
56574
50837
39394
19838
11053
99556
69.16%
6582
6894
5758
5451
4633
97701
52.52%
19850
19047
13110
9545
6887
197257
59.78%
29318
20.37%
4955
3296
2028
946
68439
36.79%
5632
3210
1920
1165
97757
29.63%
11225
7.80%
1435
593
514
524
492
293
11927
6.41%
2031
894
871
1206
1433
1512
23152
7.02%
3851
2.68%
0
7947
4.27%
0
11798
3.58%
143950
186014
HEDIS 2010 (Reporting Year 2009)
26432
25941
18868
14996
11520
10587
6506
3948
2111
3466
1487
1385
1730
1925
1805
0
329964
Page 98