Sanford Health Plan
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
Sanford Health Plan
Weight Assessment and Counseling for Nutrition and Physical Activity
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
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
2376
1617
3993
2376
1617
3993
2376
1617
3993
0
0.00%
0
0.00%
0
0.00%
1
0.04%
0
0.00%
1
0.03%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
411
5.00%
411
5.00%
432
411
5.00%
432
0
0.00%
0
0.00%
0
0.00%
432
1
0.23%
0
0.00%
1
0.23%
Number of Records Excluded Because of
Valid Data Errors
0
0
0
Number of administrative data records
excluded
3
3
3
Number of medical records excluded
0
0
0
Number of employee/dependent records
excluded
0
0
0
Records Added from the Oversample List
3
3
3
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)
245
166
411
245
166
411
245
166
411
0
75
30.61%
24.64%
36.59%
0
55
33.13%
25.67%
40.59%
0
130
31.63%
27.01%
36.25%
1
58
24.08%
18.52%
29.64%
0
45
27.11%
20.04%
34.17%
1
103
25.30%
20.98%
29.63%
0
49
20.00%
14.79%
25.21%
0
72
43.37%
35.53%
51.21%
0
121
29.44%
24.91%
33.97%
Page 3
Effectiveness of Care
Sanford Health Plan
Weight Assessment and Counseling for Nutrition and Physical Activity
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
BMI Percentile
Data Elements
General
Measure
Data
Ages 3-11 Ages 12-17
Counseling for Nutrition
Total
General
Measure
Data
Ages 3-11 Ages 12-17
Total
Counseling for Physical Activity
General
Ages 12Measure
Ages 3-11
Total
17
Data
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 4
Effectiveness of Care
Sanford Health Plan
Childhood Immunization Status
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Influenza
281
77.62%
316
87.29%
309
85.36%
325
89.78%
319
88.12%
299
82.60%
273
75.41%
98
27.07%
186
51.38%
200
55.25%
281
77.62%
316
87.29%
309
85.36%
325
89.78%
319
88.12%
299
82.60%
273
75.41%
98
27.07%
186
51.38%
200
55.25%
281
22
83.70%
79.76%
87.64%
316
19
92.54%
89.70%
95.39%
309
17
90.06%
86.83%
93.28%
325
18
94.75%
92.32%
97.19%
319
21
93.92%
91.32%
96.52%
299
16
87.02%
83.42%
90.62%
273
21
81.22%
77.05%
85.38%
98
3
27.90%
23.14%
32.66%
186
12
54.70%
49.43%
59.96%
200
15
59.39%
54.20%
64.59%
362
0
Number of Records Excluded because of
Contraindications by Admin Data
0
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
362
0.00%
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
362
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
362
Page 5
Effectiveness of Care
Sanford Health Plan
Childhood Immunization Status
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Combo 5
Combo 6
Combo 7
Combo 8
Combo 9
Combo10
256
70.72%
234
64.64%
86
23.76%
151
41.71%
160
44.20%
58
16.02%
64
17.68%
105
29.01%
43
11.88%
256
70.72%
234
64.64%
86
23.76%
151
41.71%
160
44.20%
58
16.02%
64
17.68%
105
29.01%
43
11.88%
256
27
78.18%
73.78%
82.57%
234
26
71.82%
67.05%
76.60%
86
9
26.24%
21.57%
30.91%
151
18
46.69%
41.41%
51.96%
160
18
49.17%
43.88%
54.46%
58
8
18.23%
14.12%
22.35%
64
7
19.61%
15.38%
23.84%
105
13
32.60%
27.63%
37.56%
43
6
13.54%
9.87%
17.20%
362
0
Number of Records Excluded because of
Contraindications by Admin Data
0
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
362
0.00%
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
362
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
362
Page 6
Effectiveness of Care
Sanford Health Plan
Childhood Immunization Status
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
General
Measure
Data
Pneumococcal
Hepatitis A Rotavirus
Conjugate
DTaP
IPV
MMR
HiB
Hepatitis B
VZV
Influenza
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of 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 7
Effectiveness of Care
Sanford Health Plan
Childhood Immunization Status
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Minnesota Health Care Programs - Managed Care (MHC
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 8
Effectiveness of Care
Sanford Health Plan
Breast Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
2009
A
4511
3449
76.46%
75.21%
77.71%
Medicare
Advantage
MSHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 9
Effectiveness of Care
Sanford Health Plan
Cervical Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
MHCP-MC
2009
A
5793
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
NR
NR
NR
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
Number of medical record data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
78.80%
NR
Lower 95% Confidence Interval
Upper 95% Confidence Interval
77.74%
79.86%
NR
NR
HEDIS 2010 (Reporting Year 2009)
4565
Page 10
Effectiveness of Care
Sanford Health Plan
Colorectal Cancer Screening
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Data Elements
Commercial
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
2009
H
4864
Number of numerator events by administrative data in eligible population
(before exclusions)
177
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid data errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical records
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2010 (Reporting Year 2009)
3.64%
411
0.05
432
177
40.97%
2
0
1
0
3
411
177
48
54.74%
49.81%
59.68%
Medicare
Advantage
MSHO
SNBC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 11
Effectiveness of Care
Sanford Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Jan 6, 2011 10:26 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
Ages 2124
Total
396
116
29.29%
24.68%
33.90%
482
160
33.20%
28.89%
37.50%
878
276
31.44%
28.31%
34.56%
2009
A
Page 12
Effectiveness of Care
Sanford Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Ages 16Data Elements
Measure
20
Data
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
NR
Lower 95% Confidence Interval
NR
Upper 95% Confidence Interval
NR
HEDIS 2010 (Reporting Year 2009)
Ages 2124
NR
NR
NR
Total
NR
NR
NR
NR
NR
Page 13
Effectiveness of Care
Sanford Health Plan
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Medicare
Advantage
MSHO
NR
NR
NR
NR
NR
NR
Page 14
Effectiveness of Care
Sanford Health Plan
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Lead Screening in Children
Data Elements
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
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
Reported Rate
NR
Lower 95% Confidence Interval
NR
Upper 95% Confidence Interval
NR
HEDIS 2010 (Reporting Year 2009)
Page 15
Effectiveness of Care
Sanford Health Plan
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 6, 2011 10:26 AM
MSHO
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 18
Effectiveness of Care
Sanford Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 6, 2011 10:26 AM
SNBC
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 19
Effectiveness of Care
Sanford Health Plan
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Medicare
Advantage
MSHO
SNBC
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 20
Effectiveness of Care
Sanford Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jan 6, 2011 10:26 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
Ages 12-50
Total
45
44
97.78%
92.36%
100.00%
192
173
90.10%
85.62%
94.59%
237
217
91.56%
87.81%
95.31%
2009
A
`
Page 21
Effectiveness of Care
Sanford Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jan 6, 2011 10:26 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
NR
NR
NR
Ages 12-50
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 22
Effectiveness of Care
Sanford Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 6, 2011 10:26 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
160
47
76.19%
22.38%
160
47
76.19%
22.38%
160
24
47
85
90.20%
85.87%
94.52%
64.71%
57.90%
71.51%
2009
H
210
210
0.00%
210
6
0
0
204
Page 23
Effectiveness of Care
Sanford Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
Page 25
Effectiveness of Care
Sanford Health Plan
Controlling High Blood Pressure
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Data Elements
Commercial
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2009
H
1612
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
0.00%
392
15.00%
451
0
0.00%
Records Excluded because of Valid Data
Errors
8
Number of records excluded because of
false positive diagnoses
0
Number of administrative data records
excluded
14
Number of medical record data records
excluded
3
Number of employee/dependent medical
records excluded
0
Records Added from the OverSample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
25
392
0
259
66.07%
61.26%
70.89%
HEDIS 2010 (Reporting Year 2009)
Medicare
Advantage
MSHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 26
Effectiveness of Care
Sanford Health Plan
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
Medicare
Advantage
MSHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
2009
A
14
Numerator Events by Admin Data on
Eligible Population
11
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NA
NA
NA
HEDIS 2010 (Reporting Year 2009)
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Page 27
Effectiveness of Care
Sanford Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
HbA1c
Testing
Poor HbA1c 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
2009
H
926
2009
H
926
2009
H
926
2009
H
926
2009
H
926
2009
H
926
2009
H
926
2009
H
926
2009
H
926
2009
H
926
460
49.68%
548
10%
603
460
76.29%
926
100.00%
548
10%
603
603
100.00%
49
5.29%
411
10%
484
49
10.12%
114
12.31%
548
10%
603
114
18.91%
286
30.89%
548
10%
603
286
47.43%
418
45.14%
548
10%
603
418
69.32%
86
9.29%
548
10%
603
86
14.26%
411
44.38%
548
10%
603
411
68.16%
0
0.00%
548
10%
603
0
0.00%
0
0.00%
548
10%
603
0
0.00%
10
10
3
10
10
10
10
10
10
10
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
15
15
12
15
15
15
15
15
15
15
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
25
548
114
274
70.80%
66.90%
74.70%
25
548
286
63
63.69%
59.57%
67.80%
25
548
418
29
81.57%
78.23%
84.91%
25
548
86
167
46.17%
41.90%
50.43%
25
548
411
61
86.13%
83.15%
89.12%
25
548
0
409
74.64%
70.90%
78.37%
25
548
0
235
42.88%
38.65%
47.12%
Number of Administrative required exclusions
118
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
20
25
548
460
50
93.07%
90.85%
95.28%
25
548
16
89
19.16%
15.77%
22.55%
35
411
49
140
45.99%
41.05%
50.93%
Page 28
Effectiveness of Care
Sanford Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 6, 2011 10:26 AM
MSHO
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
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 30
Effectiveness of Care
Sanford Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 6, 2011 10:26 AM
SNBC
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Number of Administrative required exclusions
Number of Hybrid required exclusions
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
Page 31
Effectiveness of Care
Sanford Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
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 32
Effectiveness of Care
Sanford Health Plan
Osteoporosis Management in Women Who had a Fracture
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Medicare
Advantage
MSHO
NR
NR
NR
NR
NR
NR
Page 33
Effectiveness of Care
Sanford Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jan 6, 2011 10:26 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
Effective
Continuation
Phase
Treatment
2009
A
150
88
58.67%
50.45%
66.88%
54
36.00%
27.99%
44.01%
Page 34
Effectiveness of Care
Sanford Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jan 6, 2011 10:26 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
NR
NR
NR
Effective
Continuation
Phase
Treatment
NR
NR
NR
Page 36
Effectiveness of Care
Sanford Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jan 6, 2011 10:26 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
NR
NR
NR
Effective
Continuation
Phase
Treatment
NR
NR
NR
Page 37
Effectiveness of Care
Sanford Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jan 6, 2011 10:26 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
NR
NR
NR
Effective
Continuation
Phase
Treatment
NR
NR
NR
Page 38
Effectiveness of Care
Sanford Health Plan
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jan 6, 2011 10:26 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
24
3
NA
NA
NA
7
2
NA
NA
NA
2009
A
Page 39
Effectiveness of Care
Sanford Health Plan
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jan 6, 2011 10:26 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
NR
NR
NR
NR
NR
NR
Page 40
Effectiveness of Care
Sanford Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 6, 2011 10:26 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
NR
NR
NR
NR
NR
NR
Page 42
Effectiveness of Care
Sanford Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 6, 2011 10:26 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
NR
NR
NR
NR
NR
NR
Page 43
Effectiveness of Care
Sanford Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 6, 2011 10:26 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
1578
1230
77.95%
75.87%
80.02%
31
25
80.65%
65.12%
96.17%
1210
977
80.74%
78.48%
83.01%
78
55
70.51%
59.75%
81.27%
2897
2287
78.94%
77.44%
80.45%
2009
A
Page 44
Effectiveness of Care
Sanford Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 6, 2011 10:26 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 46
Effectiveness of Care
Sanford Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 6, 2011 10:26 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 47
Effectiveness of Care
Sanford Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 6, 2011 10:26 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 48
Access/Availability of Care
Sanford Health Plan
Medication Reconciliation Post Discharge
Data Elements
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jan 6, 2011 10:26 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
Page 51
Effectiveness of Care
Sanford Health Plan
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jan 6, 2011 10:26 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
At least 1
Prescription
At least 2
Prescriptions
NR
NR
NR
NR
NR
NR
Page 53
Access/Availability of Care
Sanford Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2010 (Reporting Year 2009)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
5060
6060
343
11463
4802
5815
332
94.90%
94.29%
95.52%
95.96%
95.45%
96.46%
96.79%
94.78%
98.80%
10949
95.52%
95.13%
95.90%
2009
A
Page 54
Access/Availability of Care
Sanford Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 6, 2011 10:26 AM
MSHO
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
NR
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
NR
NR
NR
NR
HEDIS 2010 (Reporting Year 2009)
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 56
Access/Availability of Care
Sanford Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 6, 2011 10:26 AM
SNBC
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
NR
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
NR
NR
NR
NR
HEDIS 2010 (Reporting Year 2009)
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 57
Access/Availability of Care
Sanford Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
Total
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
NR
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
NR
NR
NR
NR
HEDIS 2010 (Reporting Year 2009)
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 58
Access/Availability of Care
Sanford Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jan 6, 2011 10:26 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.
350
343
1759
1579
1284
1115
2269
2025
98.00%
96.39%
99.61%
89.77%
88.32%
91.21%
86.84%
84.95%
88.73%
89.25%
87.95%
90.54%
2009
A
Page 59
Access/Availability of Care
Sanford Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jan 6, 2011 10:26 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.
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 60
Access/Availability of Care
Sanford Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 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
10
83
73
4
3
38
36
42
39
NA
NA
NA
NA
NA
NA
52.05%
39.91%
64.20%
49.32%
37.16%
61.47%
50.60%
39.24%
61.96%
46.99%
35.65%
58.33%
Page 61
Access/Availability of Care
Sanford Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 6, 2011 10:26 AM
MSHO
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 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 63
Access/Availability of Care
Sanford Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 6, 2011 10:26 AM
SNBC
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 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 64
Access/Availability of Care
Sanford Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 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 65
Access/Availability of Care
Sanford Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
population (before exclusions)
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2010 (Reporting Year 2009)
Timeliness of
Prenatal Care
Postpartum
Care
2009
H
412
2009
H
412
44
177
10.68%
240
5%
252
44
42.96%
240
5%
252
177
17.46%
70.24%
0
0
0
0
240
44
181
0
0
240
177
26
93.75%
90.48%
97.02%
84.58%
79.81%
89.36%
Page 66
Access/Availability of Care
Sanford Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Timeliness of
Prenatal Care
Postpartum
Care
Current year's administrative rate (before exclusions)
NR
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
NR
NR
NR
NR
NR
NR
NR
NR
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
population (before exclusions)
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2010 (Reporting Year 2009)
Page 67
Use of Services
Sanford Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
1
3
0
13
24
57
200
0.34%
0.00%
1.16%
1.01%
0.00%
2.31%
0.00%
0.00%
0.17%
4.36%
1.88%
6.85%
8.05%
4.80%
11.31%
19.13%
14.49%
23.76%
67.11%
61.61%
72.62%
2009
A
298
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
Sanford Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of employee/dependent medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2010 (Reporting Year 2009)
Page 69
Use of Services
Sanford Health Plan
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
Data Last Refreshed:
Jan 6, 2011 10:26 AM
MHCP-MC
2009
A
1386
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)
628
45.31%
42.65%
47.97%
NR
NR
NR
Page 70
Use of Services
Sanford Health Plan
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
MHCP-MC
2009
A
3307
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)
953
28.82%
27.26%
30.38%
NR
NR
NR
Page 71
Use of Services
Sanford Health Plan
Ambulatory Care
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
4534
42620
47119
125827
105963
4404
283
0
0
330750
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
Visits
3953
12970
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
10987
32008
35222
1986
174
0
0
97300
HEDIS 2010 (Reporting Year 2009)
Visits/ 1,000
Member
Months
871.86
304.32
233.18
254.38
332.40
450.95
614.84
NA
294.18
Emergency Room Visits
Visits
81
545
527
1411
868
40
4
0
0
3476
Visits/ 1,000
Member
Months
17.87
12.79
11.18
11.21
8.19
9.08
14.13
NA
10.51
Ambulatory
Surgery/Procedures
Procedures
37
235
204
1057
2071
147
13
0
0
3764
Procedures/
1,000 Member
Months
8.16
5.51
4.33
8.40
19.54
33.38
45.94
NA
11.38
Observation Room Stays
Resulting in Discharge
Stays
22
73
50
212
142
11
0
0
0
510
Stays/ 1,000
Member
Months
4.85
1.71
1.06
1.68
1.34
2.50
0.00
NA
1.54
Page 72
Use of Services
Sanford Health Plan
Ambulatory Care
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Ambulatory Care
Data Last Refreshed:
Jan 6, 2011 10:26 AM
MSHO
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 74
Use of Services
Sanford Health Plan
Ambulatory Care
Data Last Refreshed:
Jan 6, 2011 10:26 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Member Months
NR
Total
Outpatient Visits (Excludes
MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 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 75
Use of Services
Sanford Health Plan
Ambulatory Care
Data Last Refreshed:
Jan 6, 2011 10:26 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
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 76
Use of Services
Sanford Health Plan
Inpatient Utilization - General Hospital/Acute Care
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Member Months
4534
42620
47119
125827
105963
4404
283
0
0
330750
Discharges
Discharges /
1,000 Member
Months
50
85
84
705
597
69
5
0
0
1595
11.03
1.99
1.78
5.60
5.63
15.67
17.67
NA
46
66
34
95
195
22
0
0
0
458
10.15
1.55
0.72
0.76
1.84
5.00
0.00
NA
4
19
33
131
401
47
5
0
0
640
0.88
0.45
0.70
1.04
3.78
10.67
17.67
NA
17
479
1
0
497
0.36
3.81
0.01
HEDIS 2010 (Reporting Year 2009)
4.82
1.38
1.93
1.78
Days
Days / 1,000
Member
Months
338
266
370
1926
2092
292
39
0
0
5323
74.55
6.24
7.85
15.31
19.74
66.30
137.81
NA
167
171
150
288
606
74
0
0
0
1456
36.83
4.01
3.18
2.29
5.72
16.80
0.00
NA
171
95
175
468
1483
218
39
0
0
2649
37.72
2.23
3.71
3.72
14.00
49.50
137.81
NA
45
1170
3
0
1218
0.96
9.30
0.03
16.09
4.40
8.01
4.37
Average
Length of Stay
6.76
3.13
4.40
2.73
3.50
4.23
7.80
NA
NA
3.34
3.63
2.59
4.41
3.03
3.11
3.36
NA
NA
NA
3.18
42.75
5.00
5.30
3.57
3.70
4.64
7.80
NA
NA
4.14
2.65
2.44
3.00
NA
2.45
Page 77
Use of Services
Sanford Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Inpatient Utilization - General Hospital/Acute Care
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Jan 6, 2011 10:26 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 79
Use of Services
Sanford Health Plan
Inpatient Utilization - General Hospital/Acute Care
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Jan 6, 2011 10:26 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 80
Use of Services
Sanford Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
NR
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Discharges
Discharges /
1,000 Member
Months
Days
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 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 81
Use of Services
Sanford Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
31047
12360
14435
23780
69988
2312
0
153922
Female
29407
12189
18567
29072
85218
2375
0
176828
Total
60454
24549
33002
52852
155206
4687
0
330750
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
14
14
28
18
14
32
37
17
54
74
34
108
1
0
1
0
0
0
144
79
223
HEDIS 2010 (Reporting Year 2009)
Male
31047
12360
14435
23780
69988
2312
0
153922
Female
29407
12189
18567
29072
85218
2375
0
176828
Total
60454
24549
33002
52852
155206
4687
0
330750
Percent
0.00%
0.00%
0.00%
1.36%
1.38%
1.37%
1.50%
0.90%
1.16%
1.87%
0.70%
1.23%
1.27%
0.48%
0.84%
0.52%
0.00%
0.26%
NA
NA
NA
1.12%
0.54%
0.81%
Number
0
0
0
8
9
17
3
5
8
12
6
18
32
15
47
0
0
0
0
0
0
55
35
90
Male
31047
12360
14435
23780
69988
2312
0
153922
Female
29407
12189
18567
29072
85218
2375
0
176828
Total
60454
24549
33002
52852
155206
4687
0
330750
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
Age
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Percent
0.00%
0.00%
0.00%
0.78%
0.89%
0.83%
0.25%
0.32%
0.29%
0.61%
0.25%
0.41%
0.55%
0.21%
0.36%
0.00%
0.00%
0.00%
NA
NA
NA
0.43%
0.24%
0.33%
Number
0
0
0
3
3
6
5
4
9
14
4
18
21
10
31
0
0
0
0
0
0
43
21
64
Percent
0.00%
0.00%
0.00%
0.29%
0.30%
0.29%
0.42%
0.26%
0.33%
0.71%
0.17%
0.41%
0.36%
0.14%
0.24%
0.00%
0.00%
0.00%
NA
NA
NA
0.34%
0.14%
0.23%
Member Months
(Outpatient/ED)
Male
31047
12360
14435
23780
69988
2312
0
153922
Female
29407
12189
18567
29072
85218
2375
0
176828
Total
60454
24549
33002
52852
155206
4687
0
330750
Outpatient/ED
Number
0
0
0
11
6
17
14
8
22
25
11
36
51
22
73
1
0
1
0
0
0
102
47
149
Percent
0.00%
0.00%
0.00%
1.07%
0.59%
0.83%
1.16%
0.52%
0.80%
1.26%
0.45%
0.82%
0.87%
0.31%
0.56%
0.52%
0.00%
0.26%
NA
NA
NA
0.80%
0.32%
0.54%
Page 82
Use of Services
Sanford Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 6, 2011 10:26 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
NR
Female
Total
NR
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
NR
Female
Total
NR
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
NR
Female
Total
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
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
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 84
Use of Services
Sanford Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 6, 2011 10:26 AM
SNBC
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
NR
Female
Total
NR
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)
Member Months
(Any)
Male
NR
Female
Total
NR
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
NR
Female
Total
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
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
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 85
Use of Services
Sanford Health Plan
Identification of Alcohol and Other Drug Services
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Member Months
(Any)
Age
Male
Female
Male
Total
0-12
NR
13-17
NR
18-24
NR
25-34
NR
35-64
NR
65+
NR
Unknown
NR
Total
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)
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Member Months
(Inpatient)
Female
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
Member Months
(Intensive Outpatient/Partial
Male
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Male
Member Months
(Outpatient/ED)
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 86
Use of Services
Sanford Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
31047
12360
108203
2312
0
153922
Female
29407
12189
132857
2375
0
176828
Total
60454
24549
241060
4687
0
330750
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
116
72
188
102
101
203
345
726
1071
6
1
7
0
0
0
569
900
1469
HEDIS 2010 (Reporting Year 2009)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
31047
12360
108203
2312
0
153922
Female
29407
12189
132857
2375
0
176828
Total
60454
24549
241060
4687
0
330750
Number
4
2
6
9
18
27
24
35
59
0
0
0
0
0
0
37
55
92
Female
29407
12189
132857
2375
0
176828
Total
60454
24549
241060
4687
0
330750
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
4.48%
2.94%
3.73%
9.90%
9.94%
9.92%
3.83%
6.56%
5.33%
3.11%
0.51%
1.79%
NA
NA
NA
4.44%
6.11%
5.33%
Male
31047
12360
108203
2312
0
153922
Percent
0.15%
0.08%
0.12%
0.87%
1.77%
1.32%
0.27%
0.32%
0.29%
0.00%
0.00%
0.00%
NA
NA
NA
0.29%
0.37%
0.33%
Number
0
0
0
1
0
1
3
7
10
0
0
0
0
0
0
4
7
11
Percent
0.00%
0.00%
0.00%
0.10%
0.00%
0.05%
0.03%
0.06%
0.05%
0.00%
0.00%
0.00%
NA
NA
NA
0.03%
0.05%
0.04%
Member Months
(Outpatient/ED)
Male
31047
12360
108203
2312
0
153922
Female
29407
12189
132857
2375
0
176828
Total
60454
24549
241060
4687
0
330750
Outpatient/ED
Number
116
71
187
101
99
200
337
716
1053
6
1
7
0
0
0
560
887
1447
Percent
4.48%
2.90%
3.71%
9.81%
9.75%
9.78%
3.74%
6.47%
5.24%
3.11%
0.51%
1.79%
NA
NA
NA
4.37%
6.02%
5.25%
Page 87
Use of Services
Sanford Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 6, 2011 10:26 AM
MSHO
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 89
Use of Services
Sanford Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 6, 2011 10:26 AM
SNBC
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 90
Use of Services
Sanford Health Plan
Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Minnesota Health Care Programs - Managed Care(MHCP-MC
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 91
Health Plan Descriptive Information
Sanford Health Plan
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Commercial
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
2226
10047
11927
11349
7858
4384
Member Months
Female
2308
9905
10741
11082
7560
4886
Total
4534
19952
22668
22431
15418
9270
47791
31.05%
10051
12314
11466
11394
11126
46482
26.29%
13681
15145
13927
12956
13767
94273
28.50%
56351
36.61%
14840
12856
11681
8091
69476
39.29%
17200
16550
14413
10332
125827
38.04%
47468
30.84%
1739
439
117
17
0
0
58495
33.08%
1817
409
136
13
0
0
105963
32.04%
2312
1.50%
0
2375
1.34%
0
4687
1.42%
153922
176828
HEDIS 2010 (Reporting Year 2009)
23732
27459
25393
24350
24893
32040
29406
26094
18423
3556
848
253
30
0
0
0
330750
Page 94
Health Plan Descriptive Information
Sanford Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 6, 2011 10:26 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
Sanford Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 6, 2011 10:26 AM
MSHO
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 96
Health Plan Descriptive Information
Sanford Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 6, 2011 10:26 AM
SNBC
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
NR
NR
NR
NR
NR
NR
Age Unknown
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2010 (Reporting Year 2009)
Page 97
Health Plan Descriptive Information
Sanford Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 6, 2011 10:26 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
NR
NR
NR
NR
NR
NR
Age Unknown
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2010 (Reporting Year 2009)
Page 98