UCare of Minnesota
General Info
Disclaimers
Data Last Refreshed: 1/10/2011
2
Effectiveness of Care Measures
Code
HEDIS 2009 (Reporting Year 2008)
Page
Page
Prevention and Screening
0 Code
Access / Availability of Care Measures
Page
25 AAP
Adult's Access to Preventive/Ambulatory Health Services
57
Children's and Adolescents' Access to Primary Care Practitioners
63
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
65
Prenatal and Postpartum Care
71
CIS
Childhood Immunization Status
3
26 CAP
BCS
Breast Cancer Screening
5
27
CCS
Cervical Cancer Screening
6
28 PPC
COL
Colorectal Cancer Screening
7
CHL
Chlamydia Screening in Women
8
GSO
Glaucoma Screening in Older Adults
10
29 W15
Well Child Visits in the First 15 Months of Life
73
LSC
Lead Screening in Children
11
30 W34
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
75
31 AWC
Adolescent Well-Care Visits
76
Respiratory Conditions
IET
Use of Services Measures
0 Code
Page
URI
Appropriate Treatment for Children with Upper Respiratory Infection
12
32 FSP
Frequency of Selected Procedures
77
PCE
Pharmacotherapy Management of COPD Exacerbation
13
33 AMB
Ambulatory Care
83
SPR
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
17
34
Inpatient Utilization - General Hospital/Acute Care
89
ASM
Use of Appropriate Medications for People with Asthma
18
35 NON
Inpatient Utilization - Nonacute Care
95
Identification of Alcohol and Other Drug Services
101
36 IAD
Cardiovascular
CMC
Cholesterol Management for Patients with Cardiovascular Conditions
20
CBP
Controlling High Blood Pressure
26
PBH
Persistence of Beta Blocker Treatment After Hearth Attack
27
Diabetes
CDC
Comprehensive Diabetes Care
Osteoporosis Management in Women Who had a Fracture
37
MPT
38 ORX
0 Code
28
Musculoskeletal
OMW
IPU
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Outpatient Drug Utilization
Health Plan Descriptive Information Measures
107
113
Page
39 BCR
Board Certification
119
40 ENP
Enrollment by Product Line (Age & Sex)
122
34
Behavioral Health
0 Code
AMM
Antidepressant Medication Management
35
ADD
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
41
FUH
Follow-up After Hospitalization for Mental Illness
43
Medication Management
MPM
Annual Monitoring for Patients on Persistent Medications
47
DDE
Potentially Harmful Drug-Disease Interactions in the Elderly
53
DAE
Use of High Risk Medications in the Elderly
55
41
YIB
Health Plan Stability Measures
Years in Business / Total Membership
Page
128
DISCLAIMERS
-1
0. Disclaimer Query located below
1. In January 2011, it was discovered that the Good HbA1c Control (<7.0%) was not displayed in
comprehensive diabetes care measure and Adequate HbA1c Control (<8.0%) data was displayed
under Good HbA1c Control. This issue was corrected on January 10,2011.
HEDIS 2009 (Reporting Year 2008)
Page 2
Effectiveness of Care
UCare of Minnesota
Childhood Immunization Status
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Commercial
Data Elements
General
Measure
Data
DTaP
IPV
MMR
HiB
Hepatitis B
VZV
Pneumococcal
Conjugate
Combo 2
Combo 3
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 2009 (Reporting Year 2008)
Page 3
Effectiveness of Care
UCare of Minnesota
Childhood Immunization Status
Data Last Refreshed:
Jan 10, 2011 10:12 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
Pneumococcal
Conjugate
Combo 2
Combo 3
1374
72.66%
1548
81.86%
1667
88.15%
1700
89.90%
1433
75.78%
1633
86.36%
1382
73.08%
1147
60.66%
1079
57.06%
320
74.07%
372
86.11%
389
90.05%
394
91.20%
353
81.71%
384
88.89%
334
77.31%
290
67.13%
276
63.89%
305
41
84.18%
80.54%
87.83%
357
38
96.11%
94.12%
98.10%
372
14
93.92%
91.48%
96.35%
378
22
97.32%
95.64%
99.01%
341
49
94.89%
92.64%
97.14%
367
16
93.19%
90.63%
95.74%
321
33
86.13%
82.67%
89.59%
278
49
79.56%
75.54%
83.58%
266
46
75.91%
71.66%
80.17%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
1
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 2009 (Reporting Year 2008)
MMR
411
5.00%
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
2008
H
1891
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
DTaP
411
Page 4
Effectiveness of Care
UCare of Minnesota
Breast Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Commercial
NR
NR
NR
Medicare
Advantage
MSHO
MnDHO
SNBC
MHCP-MC
2008
A
3494
2806
80.31%
78.98%
81.64%
2008
A
462
253
54.76%
50.12%
59.41%
2008
A
248
159
64.11%
57.94%
70.28%
2008
A
0
0
NA
NA
NA
2008
A
2413
1376
57.02%
55.03%
59.02%
Page 5
Effectiveness of Care
UCare of Minnesota
Cervical Cancer Screening
Data Elements
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Commercial
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
2008
H
9025
Numerator Events by Admin Data on Eligible
Population (before exclusions)
6130
Current Year's Admin Rate
NR
Records Excluded because of Valid Data Errors
67.92%
411
5.00%
432
298
68.98%
0
Number of administrative data records excluded
54
Number of medical record data records excluded
8
Number of employee/dependent medical records
excluded
0
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
NR
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 2009 (Reporting Year 2008)
NR
NR
NR
8
411
291
16
74.70%
70.37%
79.02%
Page 6
Effectiveness of Care
UCare of Minnesota
Colorectal Cancer Screening
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Data Elements
Commercial
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
Number of numerator events by administrative data in eligible population
(before exclusions)
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
NR
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
NR
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 2009 (Reporting Year 2008)
NR
NR
NR
Medicare
Advantage
2008
H
20913
MSHO
MnDHO
SNBC
2008
H
3246
2008
H
287
2008
H
1
8538
898
111
1
40.83%
411
0.05
432
181
41.90%
0
59
1
0
1
411
174
67
58.64%
53.75%
63.52%
27.66%
411
0.05
432
123
28.47%
0
15
0
0
0
411
120
40
38.93%
34.09%
43.77%
38.68%
286
0
286
111
38.81%
0
1
0
0
0
286
111
17
44.76%
38.82%
50.69%
100.00%
1
0
1
1
100.00%
0
0
0
0
0
1
1
0
NA
NA
NA
Page 7
Effectiveness of Care
UCare of Minnesota
Chlamydia Screening in Women
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Commercial
Data Elements
General
Measure Ages 16-20 Ages 21-24
Data
Total
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 8
Effectiveness of Care
UCare of Minnesota
Chlamydia Screening in Women
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Data Elements
Measure Ages 16-20 Ages 21-24
Data
Measurement Year
2008
Data Collection Methodology
A
Eligible Member Population
1299
1231
Numerator Events by Admin Data
725
733
Reported Rate
55.81%
59.55%
Lower 95% Confidence Interval
53.07%
56.76%
Upper 95% Confidence Interval
58.55%
62.33%
HEDIS 2009 (Reporting Year 2008)
Total
2530
1458
57.63%
55.68%
59.57%
Page 9
Effectiveness of Care
UCare of Minnesota
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare
Advantage
MSHO
2008
A
30119
23639
78.49%
78.02%
78.95%
2008
A
5746
4196
73.02%
71.87%
74.18%
Page 10
Effectiveness of Care
UCare of Minnesota
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Lead Screening in Children
Data Elements
Commercial
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
2008
H
1891
Numerator Events by Admin Data on Eligible
Population (before exclusions)
1647
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
NR
87.10%
NR
411
5.00%
432
388
89.81%
Records Excluded because of Valid Data
Errors
0
Number of administrative data records
excluded
0
Number of medical record data records
excluded
0
Number of employee/dependent medical
records excluded
0
Records Added from the Oversample List
0
411
370
1
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
NR
90.27%
Lower 95% Confidence Interval
NR
87.28%
Upper 95% Confidence Interval
NR
93.25%
HEDIS 2009 (Reporting Year 2008)
Page 11
Effectiveness of Care
UCare of Minnesota
Appropriate Treatment for Children with Upper Respiratory Infection
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 2009 (Reporting Year 2008)
Commercial
MHCP-MC
NR
NR
NR
2008
A
3610
435
87.95%
86.87%
89.03%
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Page 12
Effectiveness of Care
UCare of Minnesota
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure Data
Systemic
corticosteroid
Bronchodilator
251
76.52%
71.78%
81.26%
286
87.20%
83.43%
90.96%
2008
A
328
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 2009 (Reporting Year 2008)
Page 13
Effectiveness of Care
UCare of Minnesota
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure Data
Systemic
corticosteroid
Bronchodilator
141
72.31%
65.77%
78.84%
161
82.56%
76.98%
88.15%
2008
A
195
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 2009 (Reporting Year 2008)
Page 14
Effectiveness of Care
UCare of Minnesota
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure Data
Systemic
corticosteroid
Bronchodilator
11
NA
NA
NA
15
NA
NA
NA
2008
A
15
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 2009 (Reporting Year 2008)
Page 15
Effectiveness of Care
UCare of Minnesota
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 10:12 AM
SNBC
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure Data
Systemic
corticosteroid
Bronchodilator
0
NR
NR
NR
0
NR
NR
NR
2008
A
0
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 2009 (Reporting Year 2008)
Page 16
Effectiveness of Care
UCare of Minnesota
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare
Advantage
MSHO
MnDHO
SNBC
2008
A
865
276
31.91%
28.74%
35.07%
2008
A
193
32
16.58%
11.07%
22.09%
2008
A
11
4
NA
NA
NA
2008
A
0
0
NA
NA
NA
Page 17
Effectiveness of Care
UCare of Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure Data
Ages 5-9
NR
NR
NR
Ages 10-17
NR
NR
NR
Ages 18-56
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 18
Effectiveness of Care
UCare of Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
Total
127
114
89.76%
84.10%
95.43%
205
189
92.20%
88.28%
96.11%
349
286
81.95%
77.77%
86.13%
681
589
86.49%
83.85%
89.13%
2008
A
Page 19
Effectiveness of Care
UCare of Minnesota
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 20
Effectiveness of Care
UCare of Minnesota
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
970
2
90.49%
0.19%
390
1
90.28%
0.23%
24
354
1
256
91.97%
89.22%
94.72%
62.53%
57.73%
67.33%
2008
H
1072
411
5.00%
432
2
0
2
411
Page 21
Effectiveness of Care
UCare of Minnesota
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MSHO
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 2009 (Reporting Year 2008)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
141
6
75.81%
3.23%
140
6
75.68%
3.24%
24
124
6
87
80.00%
73.97%
86.03%
50.27%
42.80%
57.75%
2008
H
186
185
0.00%
185
0
0
0
185
Page 22
Effectiveness of Care
UCare of Minnesota
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
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 2009 (Reporting Year 2008)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
17
0
68.00%
0.00%
17
0
68.00%
0.00%
2
15
0
11
NA
NA
NA
NA
NA
NA
2008
H
25
25
0.00%
25
0
0
0
25
Page 23
Effectiveness of Care
UCare of Minnesota
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 10:12 AM
SNBC
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 2009 (Reporting Year 2008)
General
Measure
Data
2008
H
0
LDL-C
screening
LDL-C Level of
<100 mg/dL
0
0
NA
NA
0
0.00%
0
0
0
NA
NA
0
0
0
0
NA
NA
NA
NA
NA
NA
0
0
0
0
Page 24
Effectiveness of Care
UCare of Minnesota
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Measure
Data
2008
H
109
LDL-C
screening
LDL-C Level of
<100 mg/dL
91
2
83.49%
1.83%
91
2
83.49%
1.83%
8
87
2
57
87.16%
54.13%
Lower 95% Confidence Interval
80.42%
44.32%
Upper 95% Confidence Interval
93.90%
63.94%
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
HEDIS 2009 (Reporting Year 2008)
109
0.00%
109
0
0
0
109
Page 25
Effectiveness of Care
UCare of Minnesota
Controlling High Blood Pressure
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare
Advantage
MSHO
MnDHO
SNBC
MHCP-MC
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2008
H
12051
2008
H
1878
2008
H
186
2008
H
2
2008
H
1602
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
0
0
0
0
0.00%
411
10.00%
453
0.00%
411
10.00%
453
0.00%
168
0.00%
168
0.00%
1
0.00%
1
0.00%
411
15.00%
473
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
Records Excluded because of Valid Data
Errors
18
18
7
0
29
Number of records excluded because of
false positive diagnoses
0
0
0
0
0
Number of administrative data records
excluded
830
219
18
1
70
Number of medical record data records
excluded
2
3
1
0
2
Number of employee/dependent medical
records excluded
0
0
0
0
0
Records Added from the OverSample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
20
411
0
250
60.83%
55.99%
65.67%
21
411
0
260
63.26%
58.48%
68.04%
0
160
0
114
71.25%
63.92%
78.58%
0
1
0
1
NA
NA
NA
31
411
0
241
58.64%
53.75%
63.52%
Data Elements
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
HEDIS 2009 (Reporting Year 2008)
Commercial
NR
NR
NR
NR
NR
Page 26
Effectiveness of Care
UCare of Minnesota
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Commercial
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 2009 (Reporting Year 2008)
NR
NR
NR
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare
Advantage
MSHO
MnDHO
SNBC
MHCP-MC
2008
A
215
2008
A
51
2008
A
2
2008
A
0
2008
A
27
176
40
1
0
12
81.86%
76.48%
87.24%
78.43%
66.16%
90.70%
NA
NA
NA
NR
NR
NR
NA
NA
NA
Page 27
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Commercial
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
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 2009 (Reporting Year 2008)
Page 28
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
HbA1c
Testing
Poor HbA1c
Control
2008
H
3707
2008
H
3707
3430
92.53%
411
5%
432
406
93.98%
3662
98.79%
411
5%
432
428
99.07%
Good HbA1c
Control
(<7.0%)
2008
H
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2008
H
3707
2008
H
3707
2008
H
3707
2008
H
3707
2008
H
3707
2008
H
3707
2008
H
3707
35
0.94%
411
5%
432
4
0.93%
2669
72.00%
411
5%
432
313
72.45%
3329
89.80%
411
5%
432
382
88.43%
42
1.13%
411
5%
432
2
0.46%
3245
87.54%
411
5%
432
376
87.04%
151
4.07%
411
5%
432
19
4.40%
130
3.51%
411
5%
432
15
3.47%
2
2
2
2
2
2
2
2
2
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
2
411
60
332
95.38%
93.23%
97.53%
2
411
119
3
29.68%
25.15%
34.22%
2
411
4
273
67.40%
62.74%
72.05%
2
411
138
181
77.62%
73.46%
81.77%
2
411
28
343
90.27%
87.28%
93.25%
2
411
2
222
54.50%
49.57%
59.44%
2
411
46
328
91.00%
88.11%
93.89%
2
411
1
309
75.43%
71.14%
79.71%
2
411
0
216
52.55%
47.61%
57.50%
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 2009 (Reporting Year 2008)
NR
NR
NR
Page 29
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 10:12 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
2008
H
947
2008
H
947
855
90.29%
411
5%
432
397
91.90%
925
97.68%
411
5%
432
424
98.15%
Good HbA1c
Control
(<7.0%)
2008
H
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2008
H
947
2008
H
947
2008
H
947
2008
H
947
2008
H
947
2008
H
947
2008
H
947
10
1.06%
411
5%
432
3
0.69%
633
66.84%
411
5%
432
287
66.44%
760
80.25%
411
5%
432
347
80.32%
26
2.75%
411
5%
432
13
3.01%
814
85.96%
411
5%
432
367
84.95%
45
4.75%
411
5%
432
20
4.63%
34
3.59%
411
5%
432
12
2.78%
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
411
86
298
93.43%
90.91%
95.95%
0
411
142
5
35.77%
31.01%
40.52%
0
411
3
234
57.66%
52.77%
62.56%
0
411
130
161
70.80%
66.29%
75.32%
0
411
53
293
84.18%
80.54%
87.83%
0
411
13
193
50.12%
45.17%
55.08%
0
411
55
301
86.62%
83.20%
90.03%
0
411
3
292
71.78%
67.30%
76.25%
0
411
0
208
50.61%
45.65%
55.56%
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 2009 (Reporting Year 2008)
NR
NR
NR
Page 30
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
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
2008
H
215
2008
H
215
187
86.98%
213
0%
213
187
87.79%
215
100.00%
213
0%
213
213
100.00%
Good HbA1c
Control
(<7.0%)
2008
H
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2008
H
215
2008
H
215
2008
H
215
2008
H
215
2008
H
215
2008
H
215
2008
H
215
0
0.00%
213
0%
213
0
0.00%
170
79.07%
213
0%
213
169
79.34%
172
80.00%
213
0%
213
172
80.75%
0
0.00%
213
0%
213
0
0.00%
175
81.40%
213
0%
213
175
82.16%
0
0.00%
213
0%
213
0
0.00%
0
0.00%
213
0%
213
0
0.00%
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
1
1
1
1
1
1
1
1
1
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
212
38
154
90.57%
86.40%
94.74%
0
212
84
0
39.62%
32.80%
46.44%
0
212
0
113
53.30%
46.35%
60.25%
0
212
101
72
81.60%
76.15%
87.06%
0
212
23
151
82.08%
76.68%
87.47%
0
212
0
101
47.64%
40.68%
54.60%
0
212
30
149
84.43%
79.32%
89.55%
0
212
0
168
79.25%
73.55%
84.94%
0
212
0
122
57.55%
50.66%
64.44%
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 2009 (Reporting Year 2008)
NR
NR
NR
Page 31
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 10:12 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
2008
H
1
2008
H
1
1
100.00%
1
0%
1
1
100.00%
1
100.00%
1
0%
1
1
100.00%
Good HbA1c
Control
(<7.0%)
2008
H
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2008
H
1
2008
H
1
2008
H
1
2008
H
1
2008
H
1
2008
H
1
2008
H
1
0
0.00%
1
0%
1
0
0.00%
1
100.00%
1
0%
1
1
100.00%
1
100.00%
1
0%
1
1
100.00%
0
0.00%
1
0%
1
0
0.00%
1
100.00%
1
0%
1
1
100.00%
0
0.00%
1
0%
1
0
0.00%
0
0.00%
1
0%
1
0
0.00%
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
1
0
1
NA
NA
NA
0
1
0
0
NA
NA
NA
0
1
0
1
NA
NA
NA
0
1
1
0
NA
NA
NA
0
1
0
1
NA
NA
NA
0
1
0
1
NA
NA
NA
0
1
0
1
NA
NA
NA
0
1
0
1
NA
NA
NA
0
1
0
1
NA
NA
NA
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 2009 (Reporting Year 2008)
NR
NR
NR
Page 32
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 10:12 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
HbA1c
Testing
Poor HbA1c
Control
2008
H
1418
2008
H
1418
1206
85.05%
411
5%
432
384
88.89%
1366
96.33%
411
5%
432
427
98.84%
Good HbA1c
Control
(<7.0%)
2008
H
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2008
H
1418
2008
H
1418
2008
H
1418
2008
H
1418
2008
H
1418
2008
H
1418
2008
H
1418
12
0.85%
411
5%
432
3
0.69%
760
53.60%
411
5%
432
246
56.94%
1097
77.36%
411
5%
432
358
82.87%
23
1.62%
411
5%
432
8
1.85%
1072
75.60%
411
5%
432
333
77.08%
21
1.48%
411
5%
432
5
1.16%
13
0.92%
411
5%
432
5
1.16%
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
2
2
2
2
2
2
2
2
2
Number of administrative data records
excluded
33
33
33
33
33
33
33
33
33
Number of medical record data records
excluded
2
2
2
2
2
2
2
2
2
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
4
411
70
311
92.70%
90.06%
95.34%
4
411
137
2
33.82%
29.12%
38.52%
4
411
3
214
52.80%
47.85%
57.75%
4
411
112
145
62.53%
57.73%
67.33%
4
411
45
306
85.40%
81.87%
88.94%
4
411
8
147
37.71%
32.91%
42.52%
4
411
40
308
84.67%
81.07%
88.28%
4
411
0
317
77.13%
72.95%
81.31%
4
411
0
200
48.66%
43.71%
53.62%
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 2009 (Reporting Year 2008)
NR
NR
NR
Page 33
Effectiveness of Care
UCare of Minnesota
Osteoporosis Management in Women Who had a Fracture
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare
Advantage
MSHO
2008
A
734
136
18.53%
15.65%
21.41%
2008
A
281
42
14.95%
10.60%
19.29%
Page 34
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General Effective Acute
Measure
Phase
Data
Treatment
NR
NR
NR
Effective
Continuation
Phase
Treatment
NR
NR
NR
Page 35
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General Effective Acute
Measure
Phase
Data
Treatment
Effective
Continuation
Phase
Treatment
2008
A
385
276
71.69%
67.06%
76.32%
225
58.44%
53.39%
63.49%
Page 36
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General Effective Acute
Measure
Phase
Data
Treatment
Effective
Continuation
Phase
Treatment
2008
A
110
74
67.27%
58.05%
76.50%
64
58.18%
48.51%
67.85%
Page 37
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
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 2009 (Reporting Year 2008)
General Effective Acute
Measure
Phase
Data
Treatment
Effective
Continuation
Phase
Treatment
2008
A
11
8
NA
NA
NA
6
NA
NA
NA
Page 38
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General Effective Acute
Measure
Phase
Data
Treatment
Effective
Continuation
Phase
Treatment
2008
A
0
0
NA
NA
NA
0
NA
NA
NA
Page 39
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General Effective Acute
Measure
Phase
Data
Treatment
Effective
Continuation
Phase
Treatment
2008
A
528
255
48.30%
43.94%
52.65%
169
32.01%
27.93%
36.08%
Page 40
Effectiveness of Care
UCare of Minnesota
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
NR
NR
NR
NR
NR
NR
Page 41
Effectiveness of Care
UCare of Minnesota
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
341
148
43.40%
37.99%
48.81%
78
35
44.87%
33.19%
56.55%
2008
A
Page 42
Effectiveness of Care
UCare of Minnesota
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure
Data
30 Days
7 Days
60
62.50%
52.29%
72.71%
46
47.92%
37.40%
58.43%
2008
A
96
Page 43
Effectiveness of Care
UCare of Minnesota
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure
Data
30 Days
7 Days
19
NA
NA
NA
15
NA
NA
NA
2008
A
28
Page 44
Effectiveness of Care
UCare of Minnesota
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
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 2009 (Reporting Year 2008)
General
Measure
Data
30 Days
7 Days
16
NA
NA
NA
15
NA
NA
NA
2008
A
18
Page 45
Effectiveness of Care
UCare of Minnesota
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure
Data
30 Days
7 Days
9
NA
NA
NA
5
NA
NA
NA
2008
A
11
Page 46
Effectiveness of Care
UCare of Minnesota
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
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
UCare of Minnesota
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
11883
10815
91.01%
90.49%
91.53%
864
811
93.87%
92.21%
95.52%
12662
11592
91.55%
91.06%
92.04%
412
315
76.46%
72.24%
80.67%
25821
23533
91.14%
90.79%
91.49%
2008
A
Page 48
Effectiveness of Care
UCare of Minnesota
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
2672
2478
92.74%
91.74%
93.74%
303
291
96.04%
93.68%
98.40%
2816
2621
93.08%
92.12%
94.03%
353
301
85.27%
81.43%
89.11%
6144
5691
92.63%
91.97%
93.29%
2008
A
Page 49
Effectiveness of Care
UCare of Minnesota
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
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 2009 (Reporting Year 2008)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
169
163
96.45%
93.36%
99.54%
5
5
NA
NA
NA
165
162
98.18%
95.84%
100.00%
110
94
85.45%
78.41%
92.50%
449
424
94.43%
92.20%
96.66%
2008
A
Page 50
Effectiveness of Care
UCare of Minnesota
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
1
1
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
1
1
NA
NA
NA
2008
A
Page 51
Effectiveness of Care
UCare of Minnesota
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
1148
972
84.67%
82.54%
86.80%
11
9
NA
NA
NA
936
780
83.33%
80.89%
85.77%
175
126
72.00%
65.06%
78.94%
2270
1887
83.13%
81.57%
84.69%
2008
A
Page 52
Effectiveness of Care
UCare of Minnesota
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
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
2008
A
1468
184
12.53%
10.81%
14.26%
2275
412
18.11%
16.51%
19.71%
234
14
5.98%
2.73%
9.24%
3977
610
15.34%
14.21%
16.47%
Page 53
Effectiveness of Care
UCare of Minnesota
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
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
2008
A
440
86
19.55%
15.73%
23.36%
1724
425
24.65%
22.59%
26.72%
107
10
9.35%
3.36%
15.33%
2271
521
22.94%
21.19%
24.69%
Page 54
Effectiveness of Care
UCare of Minnesota
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure
Data
2008
A
37144
At least 1
Prescription
At least 2
Prescriptions
6078
16.36%
15.99%
16.74%
1009
2.72%
2.55%
2.88%
Page 55
Effectiveness of Care
UCare of Minnesota
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General
Measure
Data
2008
A
7362
At least 1
Prescription
At least 2
Prescriptions
1784
24.23%
23.25%
25.22%
336
4.56%
4.08%
5.05%
Page 56
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Commercial
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 2009 (Reporting Year 2008)
Page 57
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare Advantage
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
34
904
39062
32
871
37662
94.12%
84.74%
100.00%
96.35%
95.07%
97.63%
96.42%
96.23%
96.60%
2008
A
Page 58
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
0
0
7362
0
0
7209
NA
NA
NA
NA
NA
NA
97.92%
97.59%
98.25%
2008
A
Page 59
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
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 2009 (Reporting Year 2008)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
322
516
35
317
513
35
98.45%
96.94%
99.95%
99.42%
98.67%
100.00%
100.00%
98.57%
100.00%
2008
A
Page 60
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
1
4
0
1
4
0
NA
NA
NA
NA
NA
NA
NA
NA
NA
2008
A
Page 61
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
10740
5342
885
9475
4813
819
88.22%
87.61%
88.84%
90.10%
89.29%
90.91%
92.54%
90.76%
94.33%
2008
A
Page 62
Access/Availability of Care
UCare of Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Commercial
Data Elements
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
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 2009 (Reporting Year 2008)
Page 63
Access/Availability of Care
UCare of Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
General Measure
Data
12-24 months
25 months 6 yrs.
7-11 yrs.
12-19 yrs.
2847
2794
7499
6687
4632
4055
6832
6016
98.14%
97.62%
98.65%
89.17%
88.46%
89.88%
87.54%
86.58%
88.50%
88.06%
87.28%
88.83%
2008
A
Page 64
Access/Availability of Care
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
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
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare Advantage
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology (Administrative
only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
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
2008
A
0
301
301
0
0
151
16
151
16
NA
NA
NA
NA
NA
NA
50.17%
44.35%
55.98%
5.32%
2.62%
8.02%
50.17%
44.35%
55.98%
5.32%
2.62%
8.02%
Page 66
Access/Availability of Care
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
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
2008
A
0
87
87
0
0
46
5
46
5
NA
NA
NA
NA
NA
NA
52.87%
41.81%
63.94%
5.75%
0.28%
11.21%
52.87%
41.81%
63.94%
5.75%
0.28%
11.21%
Page 67
Access/Availability of Care
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
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 2009 (Reporting Year 2008)
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
2008
A
0
71
71
0
0
29
5
29
5
NA
NA
NA
NA
NA
NA
40.85%
28.71%
52.98%
7.04%
0.39%
13.70%
40.85%
28.71%
52.98%
7.04%
0.39%
13.70%
Page 68
Access/Availability of Care
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
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
2008
A
0
1
1
0
0
0
0
0
0
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Page 69
Access/Availability of Care
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
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
2008
A
155
1681
1836
61
40
613
286
674
326
39.35%
31.34%
47.37%
25.81%
18.60%
33.02%
36.47%
34.14%
38.80%
17.01%
15.19%
18.84%
36.71%
34.48%
38.94%
17.76%
15.98%
19.53%
Page 70
Access/Availability of Care
UCare of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
Page 71
Access/Availability of Care
UCare of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Jan 10, 2011 10:12 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
3633
2008
H
3633
Number of numerator events by administrative data in eligible
population (before exclusions)
1879
2121
51.72%
411
5%
432
220
58.38%
411
5%
432
250
50.93%
57.87%
0
0
0
0
411
155
165
0
0
411
168
117
77.86%
73.72%
81.99%
69.34%
64.76%
73.92%
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 2009 (Reporting Year 2008)
Page 72
Use of Services
UCare of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
Page 73
Use of Services
UCare of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
35
1.43%
56
2.28%
97
3.95%
153
6.24%
332
13.53%
584
23.81%
1196
48.76%
9
2.08%
8
1.85%
15
3.47%
27
6.25%
61
14.12%
104
24.07%
208
48.15%
3
0
0.73%
0.00%
1.67%
2
2
0.97%
0.00%
2.04%
5
5
2.43%
0.82%
4.04%
11
7
4.38%
2.28%
6.48%
29
10
9.49%
6.53%
12.44%
52
23
18.25%
14.39%
22.10%
200
62
63.75%
58.98%
68.52%
411
5.00%
432
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
1 visit
2008
H
2453
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 74
Use of Services
UCare of Minnesota
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Commercial
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
2008
H
5892
Numerator events by admin data in eligible
population
3834
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
NR
65.07%
411
5.00%
432
279
NR
64.58%
0
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 2009 (Reporting Year 2008)
0
NR
NR
NR
0
411
263
24
69.83%
65.27%
74.39%
Page 75
Use of Services
UCare of Minnesota
Adolescent Well-Care Visits
Data Elements
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Commercial
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
2008
H
10936
Numerator events by admin data in eligible
population
4160
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
38.04%
411
5.00%
432
163
NR
37.73%
1
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 2009 (Reporting Year 2008)
0
NR
NR
NR
1
411
153
36
45.99%
41.05%
50.93%
Page 76
Use of Services
UCare of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Commercial
Member Months
Total
Age
0-4
0-9
5-19
10-19
Total
Number of
Procedures
Procedures /
1,000 Member
Months
Procedure
Myringotomy
Age
0-4
5-19
NR
NR
Tonsillectomy
0-9
10-19
NR
NR
Member Months
Age
Male
Female
15-44
20-44
30-64
45-64
65+
Female
Male
Procedure
Age
Dilation & Curettage 15-44
45-64
Hysterectomy,
15-44
Abdominal
45-64
Number of
Procedures
Procedures /
1,000 Member
Months
Number of
Procedures
Procedures /
1,000 Member
Months
NR
NR
65+
NR
NR
NR
Hysterectomy,
Vaginal
15-44
45-64
65+
NR
NR
NR
Cholecystectomy,
Open
30-64
15-44
45-64
65+
NR
30-64
15-44
45-64
65+
20-44
Back Surgery
45-64
65+
Angioplasty (PTCA) 45-64
65+
45-64
Cardiac
Catheterization
65+
45-64
CABG
65+
NR
Prostatectomy
45-64
65+
NR
NR
Mastectomy
15-44
45-64
65+
NR
NR
NR
Lumpectomy
15-44
45-64
65+
NR
NR
NR
Cholecystectomy,
Closed
HEDIS 2009 (Reporting Year 2008)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 77
Use of Services
UCare of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare Advantage
Member Months
Age
< 65
65-74
75-84
85+
Male
6527
112442
66695
22302
Female
7815
147162
102394
55012
Male
Procedure
Age
CABG
<65
65-74
75-84
85+
Angioplasty
(PTCA)
<65
65-74
75-84
85+
Cardiac
Catheterization
<65
65-74
75-84
85+
Carotid
Endarterectomy
<65
65-74
75-84
85+
Reduction of
Fracture of Femur
<65
65-74
75-84
85+
Total Hip
Replacement
<65
65-74
75-84
85+
Total Knee
Replacement
<65
65-74
75-84
85+
Partial Excision of
Large Inestine
<65
65-74
75-84
85+
Cholecystectomy,
Open
<65
65-74
75-84
85+
Cholecystectomy,
Closed
(laparoscopic)
<65
65-74
75-84
85+
Back Surgery
<65
65-74
75-84
85+
Hysterectomy
Abdominal
<65
65-74
75-84
85+
Hysterectomy,
Vaginal
<65
65-74
75-84
85+
Mastectomy
<65
65-74
75-84
85+
Lumpectomy
<65
65-74
75-84
85+
HEDIS 2009 (Reporting Year 2008)
Number of
Procedures
1
55
47
3
7
154
90
19
11
171
115
22
0
22
16
11
2
20
40
28
6
65
27
9
8
109
83
14
1
26
20
3
0
8
4
2
0
34
29
14
12
62
54
4
Female
Procedures /
1,000 Member
Months
0.15
0.49
0.70
0.13
1.07
1.37
1.35
0.85
1.69
1.52
1.72
0.99
0.00
0.20
0.24
0.49
0.31
0.18
0.60
1.26
0.92
0.58
0.40
0.40
1.23
0.97
1.24
0.63
0.15
0.23
0.30
0.13
0.00
0.07
0.06
0.09
0.00
0.30
0.43
0.63
1.84
0.55
0.81
0.18
Number of
Procedures
1
13
20
4
10
80
65
21
9
142
113
24
1
17
24
2
3
24
85
135
7
74
63
22
13
197
115
21
1
38
34
9
0
10
9
4
5
74
35
20
5
101
69
34
3
32
16
7
0
28
14
1
0
58
23
4
2
96
49
15
Procedures /
1,000 Member
Months
0.13
0.09
0.20
0.07
1.28
0.54
0.63
0.38
1.15
0.96
1.10
0.44
0.13
0.12
0.23
0.04
0.38
0.16
0.83
2.45
0.90
0.50
0.62
0.40
1.66
1.34
1.12
0.38
0.13
0.26
0.33
0.16
0.00
0.07
0.09
0.07
0.64
0.50
0.34
0.36
0.64
0.69
0.67
0.62
0.38
0.22
0.16
0.13
0.00
0.19
0.14
0.02
0.00
0.39
0.22
0.07
0.26
0.65
0.48
0.27
Page 78
Use of Services
UCare of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MSHO
Member Months
Age
Male
3
13513
10170
5661
< 65
65-74
75-84
85+
Female
0
23295
24707
25946
Male
Procedure
Age
CABG
<65
65-74
75-84
85+
Angioplasty
(PTCA)
<65
65-74
75-84
85+
Cardiac
Catheterization
<65
65-74
75-84
85+
Carotid
Endarterectomy
<65
65-74
75-84
85+
Reduction of
Fracture of Femur
<65
65-74
75-84
85+
Total Hip
Replacement
<65
65-74
75-84
85+
Total Knee
Replacement
<65
65-74
75-84
85+
Partial Excision of
Large Inestine
<65
65-74
75-84
85+
Cholecystectomy,
Open
<65
65-74
75-84
85+
Cholecystectomy,
Closed
(laparoscopic)
<65
65-74
75-84
85+
Back Surgery
<65
65-74
75-84
85+
Hysterectomy
Abdominal
<65
65-74
75-84
85+
Hysterectomy,
Vaginal
<65
65-74
75-84
85+
Mastectomy
<65
65-74
75-84
85+
Lumpectomy
<65
65-74
75-84
85+
HEDIS 2009 (Reporting Year 2008)
Number of
Procedures
0
5
0
0
0
11
14
3
0
16
8
3
0
0
0
0
0
8
9
5
0
2
3
1
0
2
4
1
0
1
2
1
0
3
1
0
0
6
7
0
0
3
3
0
Female
Procedures /
1,000 Member
Months
0.00
0.37
0.00
0.00
0.00
0.81
1.38
0.53
0.00
1.18
0.79
0.53
0.00
0.00
0.00
0.00
0.00
0.59
0.88
0.88
0.00
0.15
0.29
0.18
0.00
0.15
0.39
0.18
0.00
0.07
0.20
0.18
0.00
0.22
0.10
0.00
0.00
0.44
0.69
0.00
0.00
0.22
0.29
0.00
Number of
Procedures
0
1
1
0
0
16
11
2
0
26
18
6
0
1
0
0
0
10
27
63
0
8
9
3
0
25
13
4
0
5
10
4
0
1
2
0
0
10
5
7
0
9
4
9
0
6
1
1
0
2
0
0
0
2
3
2
0
11
10
1
Procedures /
1,000 Member
Months
NA
0.04
0.04
0.00
NA
0.69
0.45
0.08
NA
1.12
0.73
0.23
NA
0.04
0.00
0.00
NA
0.43
1.09
2.43
NA
0.34
0.36
0.12
NA
1.07
0.53
0.15
NA
0.21
0.40
0.15
NA
0.04
0.08
0.00
NA
0.43
0.20
0.27
NA
0.39
0.16
0.35
NA
0.26
0.04
0.04
NA
0.09
0.00
0.00
NA
0.09
0.12
0.08
NA
0.47
0.40
0.04
Page 79
Use of Services
UCare of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
Member Months
Age
Male
5811
163
0
0
< 65
65-74
75-84
85+
Female
6274
203
0
0
Male
Procedure
Age
CABG
<65
65-74
75-84
85+
Angioplasty
(PTCA)
<65
65-74
75-84
85+
Cardiac
Catheterization
<65
65-74
75-84
85+
Carotid
Endarterectomy
<65
65-74
75-84
85+
Reduction of
Fracture of Femur
<65
65-74
75-84
85+
Total Hip
Replacement
<65
65-74
75-84
85+
Total Knee
Replacement
<65
65-74
75-84
85+
Partial Excision of
Large Inestine
<65
65-74
75-84
85+
Cholecystectomy,
Open
<65
65-74
75-84
85+
Cholecystectomy,
Closed
(laparoscopic)
<65
65-74
75-84
85+
Back Surgery
<65
65-74
75-84
85+
Hysterectomy
Abdominal
<65
65-74
75-84
85+
Hysterectomy,
Vaginal
<65
65-74
75-84
85+
Mastectomy
<65
65-74
75-84
85+
Lumpectomy
<65
65-74
75-84
85+
HEDIS 2009 (Reporting Year 2008)
Number of
Procedures
0
0
0
0
2
0
0
0
6
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
2
0
0
0
5
0
0
0
Female
Procedures /
1,000 Member
Months
0.00
0.00
NA
NA
0.34
0.00
NA
NA
1.03
0.00
NA
NA
0.00
0.00
NA
NA
0.00
6.13
NA
NA
0.00
0.00
NA
NA
0.00
0.00
NA
NA
0.17
0.00
NA
NA
0.17
0.00
NA
NA
0.34
0.00
NA
NA
0.86
0.00
NA
NA
Number of
Procedures
0
0
0
0
1
0
0
0
2
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
1
0
0
0
0
0
0
2
0
0
0
3
0
0
0
6
0
0
0
4
0
0
0
1
0
0
0
1
0
0
0
2
0
0
0
Procedures /
1,000 Member
Months
0.00
0.00
NA
NA
0.16
0.00
NA
NA
0.32
0.00
NA
NA
0.00
0.00
NA
NA
0.16
0.00
NA
NA
0.00
0.00
NA
NA
0.32
4.93
NA
NA
0.00
0.00
NA
NA
0.32
0.00
NA
NA
0.48
0.00
NA
NA
0.96
0.00
NA
NA
0.64
0.00
NA
NA
0.16
0.00
NA
NA
0.16
0.00
NA
NA
0.32
0.00
NA
NA
Page 80
Use of Services
UCare of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 10:12 AM
SNBC
Member Months
Age
Male
222
0
0
0
< 65
65-74
75-84
85+
Female
352
0
0
0
Male
Procedure
Age
CABG
<65
65-74
75-84
85+
Angioplasty
(PTCA)
<65
65-74
75-84
85+
Cardiac
Catheterization
<65
65-74
75-84
85+
Carotid
Endarterectomy
<65
65-74
75-84
85+
Reduction of
Fracture of Femur
<65
65-74
75-84
85+
Total Hip
Replacement
<65
65-74
75-84
85+
Total Knee
Replacement
<65
65-74
75-84
85+
Partial Excision of
Large Inestine
<65
65-74
75-84
85+
Cholecystectomy,
Open
<65
65-74
75-84
85+
Cholecystectomy,
Closed
(laparoscopic)
<65
65-74
75-84
85+
Back Surgery
<65
65-74
75-84
85+
Hysterectomy
Abdominal
<65
65-74
75-84
85+
Hysterectomy,
Vaginal
<65
65-74
75-84
85+
Mastectomy
<65
65-74
75-84
85+
Lumpectomy
<65
65-74
75-84
85+
HEDIS 2009 (Reporting Year 2008)
Number of
Procedures
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
0
0
0
0
0
0
Female
Procedures /
1,000 Member
Months
0.00
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
Number of
Procedures
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
0
0
0
2
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
1
0
0
0
0
0
0
0
0
0
0
0
Procedures /
1,000 Member
Months
0.00
NA
NA
NA
0.00
NA
NA
NA
2.84
NA
NA
NA
0.00
NA
NA
NA
5.68
NA
NA
NA
5.68
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
2.84
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
Page 81
Use of Services
UCare of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC
Member Months
Total
Age
209619
0-4
352165
0-9
383479
5-19
240933
10-19
Total
Number of
Procedures
Procedure
Myringotomy
Age
Tonsillectomy
0-9
10-19
Procedures /
1,000 Member
Months
855
193
296
122
0-4
5-19
4.08
0.50
0.84
0.51
Member Months
Age
15-44
20-44
30-64
45-64
Male
91204
99599
48930
Female
249797
189035
56913
Male
Procedure
Age
Dilation & Curettage 15-44
45-64
Hysterectomy,
15-44
Abdominal
45-64
Number of
Procedures
Hysterectomy,
Vaginal
15-44
45-64
Cholecystectomy,
Open
30-64
15-44
45-64
5
Cholecystectomy,
Closed
30-64
15-44
45-64
20-44
45-64
32
Back Surgery
Mastectomy
15-44
45-64
Lumpectomy
15-44
45-64
HEDIS 2009 (Reporting Year 2008)
44
31
Female
Procedures /
1,000 Member
Months
Number of
Procedures
Procedures /
1,000 Member
Months
28
9
58
30
54
6
0.23
0.53
4
6
0.02
0.11
181
36
51
45
4
8
36
22
0.72
0.63
0.11
0.16
0.22
0.11
0.05
0.32
0.48
0.63
0.27
0.79
0.02
0.14
0.14
0.39
Page 82
Use of Services
UCare of Minnesota
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Commercial
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
Visits/ 1,000
Member
Months
NR
NR
Emergency Room Visits
Visits
NR
NR
NR
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
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 83
Use of Services
UCare of Minnesota
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare Advantage
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
0
652
13690
259604
169089
77314
0
520349
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
428
11235
146872
125092
55930
0
339557
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
NA
NA
NA
656.44
820.67
565.75
739.80
723.41
652.56
Emergency Room Visits
Visits
0
0
0
45
446
3771
3636
2246
0
10144
Visits/ 1,000
Member
Months
NA
NA
NA
69.02
32.58
14.53
21.50
29.05
19.49
Ambulatory
Surgery/Procedures
Procedures
0
0
0
42
761
9688
6812
1964
0
19267
Procedures/
1,000 Member
Months
NA
NA
NA
64.42
55.59
37.32
40.29
25.40
37.03
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
1
28
268
384
221
0
902
Stays/ 1,000
Member
Months
NA
NA
NA
1.53
2.05
1.03
2.27
2.86
1.73
Page 84
Use of Services
UCare of Minnesota
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 10:12 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
36808
34877
31607
0
103295
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
3
30102
26682
20569
0
77356
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
1000.00
817.81
765.03
650.77
748.88
Emergency Room Visits
Visits
0
0
0
0
0
1500
1279
982
0
3761
Visits/ 1,000
Member
Months
NA
NA
NA
NA
0.00
40.75
36.67
31.07
36.41
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
1
1220
1194
539
0
2954
Procedures/
1,000 Member
Months
NA
NA
NA
NA
333.33
33.14
34.23
17.05
28.60
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
97
111
89
0
297
Stays/ 1,000
Member
Months
NA
NA
NA
NA
0.00
2.64
3.18
2.82
2.88
Page 85
Use of Services
UCare of Minnesota
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
59
4656
7370
366
0
0
0
12451
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
57
4670
8536
350
0
0
0
13613
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
NA
NA
966.10
1003.01
1158.21
956.28
NA
NA
1093.33
Emergency Room Visits
Visits
0
0
3
513
653
15
0
0
0
1184
Visits/ 1,000
Member
Months
NA
NA
50.85
110.18
88.60
40.98
NA
NA
95.09
Ambulatory
Surgery/Procedures
Procedures
0
0
1
369
430
13
0
0
0
813
Procedures/
1,000 Member
Months
NA
NA
16.95
79.25
58.34
35.52
NA
NA
65.30
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
10
32
0
0
0
0
42
Stays/ 1,000
Member
Months
NA
NA
0.00
2.15
4.34
0.00
NA
NA
3.37
Page 86
Use of Services
UCare of Minnesota
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
7
235
332
0
0
0
0
574
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
160
316
0
0
0
0
476
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
NA
NA
0.00
680.85
951.81
NA
NA
NA
829.27
Emergency Room Visits
Visits
0
0
0
53
28
0
0
0
0
81
Visits/ 1,000
Member
Months
NA
NA
0.00
225.53
84.34
NA
NA
NA
141.11
Ambulatory
Surgery/Procedures
Procedures
0
0
0
8
14
0
0
0
0
22
Procedures/
1,000 Member
Months
NA
NA
0.00
34.04
42.17
NA
NA
NA
38.33
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
3
0
0
0
0
0
3
Stays/ 1,000
Member
Months
NA
NA
0.00
12.77
0.00
NA
NA
NA
5.23
Page 87
Use of Services
UCare of Minnesota
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 10:12 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
61491
290674
240933
280239
105843
9537
4397
3732
0
996846
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
44447
83116
53859
127526
59438
5838
2611
1583
0
378418
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
722.82
285.94
223.54
455.06
561.57
612.14
593.81
424.17
379.62
Emergency Room Visits
Visits
6376
13920
7233
21903
5341
440
177
137
0
55527
Visits/ 1,000
Member
Months
103.69
47.89
30.02
78.16
50.46
46.14
40.25
36.71
55.70
Ambulatory
Surgery/Procedures
Procedures
467
1655
1015
5013
2823
296
114
44
0
11427
Procedures/
1,000 Member
Months
7.59
5.69
4.21
17.89
26.67
31.04
25.93
11.79
11.46
Observation Room Stays
Resulting in Discharge
Stays
91
175
224
1191
159
20
15
11
0
1886
Stays/ 1,000
Member
Months
1.48
0.60
0.93
4.25
1.50
2.10
3.41
2.95
1.89
Page 88
Use of Services
UCare of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 89
Use of Services
UCare of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare Advantage
Age
Member Months
<1
0
1-9
0
10-19
0
20-44
652
45-64
13690
65-74
259604
75-84
169089
85+
77314
Unknown
0
Total
520349
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Discharges
0
0
0
15
381
4153
4720
3206
0
12475
Discharges /
1,000 Member
Months
NA
NA
NA
23.01
27.83
16.00
27.91
41.47
23.97
0
0
0
10
232
2212
3013
2464
0
7931
NA
NA
NA
15.34
16.95
8.52
17.82
31.87
0
0
0
5
149
1941
1707
742
0
4544
NA
NA
NA
7.67
10.88
7.48
10.10
9.60
0
0
0
0
0
NA
0.00
0.00
HEDIS 2009 (Reporting Year 2008)
15.24
8.73
0.00
Days
0
0
0
62
1936
17250
20555
13999
0
53802
Days / 1,000
Member
Months
NA
NA
NA
95.09
141.42
66.45
121.56
181.07
103.40
0
0
0
31
1052
7605
11424
9712
0
29824
NA
NA
NA
47.55
76.84
29.29
67.56
125.62
0
0
0
31
884
9645
9131
4287
0
23978
NA
NA
NA
47.55
64.57
37.15
54.00
55.45
0
0
0
0
0
57.32
46.08
NA
0.00
0.00
0.00
Average
Length of Stay
NA
NA
NA
4.13
5.08
4.15
4.35
4.37
NA
4.31
NA
NA
NA
3.10
4.53
3.44
3.79
3.94
NA
3.76
NA
NA
NA
6.20
5.93
4.97
5.35
5.78
NA
5.28
NA
NA
NA
NA
NA
Page 90
Use of Services
UCare of Minnesota
Inpatient Utilization - General Hospital/Acute Care
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Member Months
0
0
0
0
3
36808
34877
31607
0
103295
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
1235
1407
1196
0
3838
NA
NA
NA
NA
0.00
33.55
40.34
37.84
0
0
0
0
0
880
1042
959
0
2881
NA
NA
NA
NA
0.00
23.91
29.88
30.34
0
0
0
0
0
355
365
237
0
957
NA
NA
NA
NA
0.00
9.64
10.47
7.50
0
0
0
0
0
NA
NA
0.00
HEDIS 2009 (Reporting Year 2008)
37.16
27.89
9.26
0.00
Days
0
0
0
0
0
5753
6785
5462
0
18000
0
0
0
0
0
3564
4080
4039
0
11683
Days / 1,000
Member
Months
NA
NA
NA
NA
0.00
156.30
194.54
172.81
174.26
NA
NA
NA
NA
0.00
96.83
116.98
127.79
113.10
0
0
0
0
0
2189
2705
1423
0
6317
NA
NA
NA
NA
0.00
59.47
77.56
45.02
0
0
0
0
0
NA
NA
0.00
61.15
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
4.66
4.82
4.57
NA
4.69
NA
NA
NA
NA
NA
4.05
3.92
4.21
NA
4.06
NA
NA
NA
NA
NA
6.17
7.41
6.00
NA
6.60
NA
NA
NA
NA
NA
Page 91
Use of Services
UCare of Minnesota
Inpatient Utilization - General Hospital/Acute Care
MnDHO
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 10, 2011 10:12 AM
Member Months
0
0
59
4656
7370
366
0
0
0
12451
Discharges
Discharges /
1,000 Member
Months
0
0
1
226
384
18
0
0
0
629
NA
NA
16.95
48.54
52.10
49.18
NA
NA
0
0
0
134
277
15
0
0
0
426
NA
NA
0.00
28.78
37.58
40.98
NA
NA
0
0
1
91
107
3
0
0
0
202
NA
NA
16.95
19.54
14.52
8.20
NA
NA
0
1
0
0
1
0.00
0.21
0.00
HEDIS 2009 (Reporting Year 2008)
50.52
34.21
16.22
0.08
Days
Days / 1,000
Member
Months
0
0
36
1821
2043
90
0
0
0
3990
NA
NA
610.17
391.11
277.20
245.90
NA
NA
0
0
0
818
1264
52
0
0
0
2134
NA
NA
0.00
175.69
171.51
142.08
NA
NA
0
0
36
954
779
38
0
0
0
1807
NA
NA
610.17
204.90
105.70
103.83
NA
NA
0
49
0
0
49
320.46
171.39
145.13
0.00
10.52
0.00
4.05
Average
Length of Stay
NA
NA
36.00
8.06
5.32
5.00
NA
NA
NA
6.34
NA
NA
NA
6.10
4.56
3.47
NA
NA
NA
5.01
NA
NA
36.00
10.48
7.28
12.67
NA
NA
NA
8.95
NA
49.00
NA
NA
49.00
Page 92
Use of Services
UCare of Minnesota
Inpatient Utilization - General Hospital/Acute Care
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Member Months
0
0
7
235
332
0
0
0
0
574
Discharges
0
0
0
6
8
0
0
0
0
14
0
0
0
4
6
0
0
0
0
10
Discharges /
1,000 Member
Months
NA
NA
0.00
25.53
24.10
NA
NA
NA
24.39
NA
NA
0.00
17.02
18.07
NA
NA
NA
17.42
0
0
0
2
2
0
0
0
0
4
NA
NA
0.00
8.51
6.02
NA
NA
NA
0
0
0
0
0
0.00
0.00
0.00
HEDIS 2009 (Reporting Year 2008)
6.97
0.00
Days
Days / 1,000
Member
Months
0
0
0
12
42
0
0
0
0
54
NA
NA
0.00
51.06
126.51
NA
NA
NA
0
0
0
7
16
0
0
0
0
23
NA
NA
0.00
29.79
48.19
NA
NA
NA
94.08
40.07
0
0
0
5
26
0
0
0
0
31
NA
NA
0.00
21.28
78.31
NA
NA
NA
0
0
0
0
0
0.00
0.00
0.00
54.01
0.00
Average
Length of Stay
NA
NA
NA
2.00
5.25
NA
NA
NA
NA
3.86
NA
NA
NA
1.75
2.67
NA
NA
NA
NA
2.30
NA
NA
NA
2.50
13.00
NA
NA
NA
NA
7.75
NA
NA
NA
NA
NA
Page 93
Use of Services
UCare of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
<1
61491
1-9
290674
10-19
240933
20-44
280239
45-64
105843
65-74
9537
75-84
4397
85+
3732
Unknown
0
Total
996846
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
804
625
966
5546
1494
204
109
90
0
9838
13.08
2.15
4.01
19.79
14.12
21.39
24.79
24.12
689
475
189
1016
916
193
107
88
0
3673
11.20
1.63
0.78
3.63
8.65
20.24
24.33
23.58
115
150
149
719
570
11
2
2
0
1718
1.87
0.52
0.62
2.57
5.39
1.15
0.45
0.54
628
3811
8
0
4447
HEDIS 2009 (Reporting Year 2008)
9.87
3.68
1.72
2.61
13.60
0.08
7.09
Days
Days / 1,000
Member
Months
5992
1909
2694
14897
5662
740
408
344
0
32646
97.45
6.57
11.18
53.16
53.49
77.59
92.79
92.18
3829
1083
533
3004
3108
701
403
339
0
13000
62.27
3.73
2.21
10.72
29.36
73.50
91.65
90.84
32.75
13.04
2163
826
594
2546
2537
39
5
5
0
8715
35.18
2.84
2.47
9.09
23.97
4.09
1.14
1.34
1567
9347
17
0
10931
6.50
33.35
0.16
8.74
17.43
Average
Length of Stay
7.45
3.05
2.79
2.69
3.79
3.63
3.74
3.82
NA
3.32
5.56
2.28
2.82
2.96
3.39
3.63
3.77
3.85
NA
3.54
18.81
5.51
3.99
3.54
4.45
3.55
2.50
2.50
NA
5.07
2.50
2.45
2.13
NA
2.46
Page 94
Use of Services
UCare of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
NR
Discharges
NR
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Days
NR
Days / 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Average Length
of Stay
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 95
Use of Services
UCare of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare Advantage
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
0
652
13690
259604
169089
77314
0
520349
Discharges
0
0
0
0
64
646
1535
1763
0
4008
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
NA
NA
NA
0.00
4.67
2.49
9.08
22.80
7.70
Days
0
0
0
0
847
9169
25174
31539
0
66729
Days / 1,000
Member
Months
NA
NA
NA
0.00
61.87
35.32
148.88
407.93
128.24
Average Length
of Stay
NA
NA
NA
NA
13.23
14.19
16.40
17.89
NA
16.65
Page 96
Use of Services
UCare of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
0
0
3
36808
34877
31607
0
103295
Discharges
0
0
0
0
0
381
653
942
0
1976
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
NA
NA
NA
NA
0.00
10.35
18.72
29.80
19.13
Days
0
0
0
0
0
9668
17515
28462
0
55645
Days / 1,000
Member
Months
NA
NA
NA
NA
0.00
262.66
502.19
900.50
538.70
Average Length
of Stay
NA
NA
NA
NA
NA
25.38
26.82
30.21
NA
28.16
Page 97
Use of Services
UCare of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
59
4656
7370
366
0
0
0
12451
Discharges
0
0
0
28
68
9
0
0
0
105
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
NA
NA
0.00
6.01
9.23
24.59
NA
NA
8.43
Days
0
0
0
258
1760
195
0
0
0
2213
Days / 1,000
Member
Months
NA
NA
0.00
55.41
238.81
532.79
NA
NA
177.74
Average Length
of Stay
NA
NA
NA
9.21
25.88
21.67
NA
NA
NA
21.08
Page 98
Use of Services
UCare of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 10:12 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
7
235
332
0
0
0
0
574
Discharges
0
0
0
1
1
0
0
0
0
2
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
NA
NA
0.00
4.26
3.01
NA
NA
NA
3.48
Days
0
0
0
17
24
0
0
0
0
41
Days / 1,000
Member
Months
NA
NA
0.00
72.34
72.29
NA
NA
NA
71.43
Average Length
of Stay
NA
NA
NA
17.00
24.00
NA
NA
NA
NA
20.50
Page 99
Use of Services
UCare of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 10:12 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
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
61491
290674
240933
280239
105843
9537
4397
3732
0
996846
Discharges
0
0
2
4
15
53
57
70
0
201
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
0.00
0.00
0.01
0.01
0.14
5.56
12.96
18.76
0.20
Days
0
0
53
55
176
1163
1635
1798
0
4880
Days / 1,000
Member
Months
0.00
0.00
0.22
0.20
1.66
121.95
371.84
481.78
4.90
Average Length
of Stay
NA
NA
26.50
13.75
11.73
21.94
28.68
25.69
NA
24.28
Page 100
Use of Services
UCare of Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Commercial
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 2009 (Reporting Year 2008)
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 101
Use of Services
UCare of Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare Advantage
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
18
67
6442
201439
0
207966
Female
0
0
0
40
7775
304568
0
312383
Total
0
0
18
107
14217
506007
0
520349
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
0
0
0
0
0
0
1
0
1
43
35
78
201
198
399
0
0
0
245
233
478
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
0
0
18
67
6442
201439
0
207966
Female
0
0
0
40
7775
304568
0
312383
Total
0
0
18
107
14217
506007
0
520349
Inpatient
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
17.91%
0.00%
11.21%
8.01%
5.40%
6.58%
1.20%
0.78%
0.95%
NA
NA
NA
1.41%
0.90%
1.10%
Number
0
0
0
0
0
0
0
0
0
0
0
0
24
11
35
96
121
217
0
0
0
120
132
252
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
0.00%
0.00%
0.00%
4.47%
1.70%
2.95%
0.57%
0.48%
0.51%
NA
NA
NA
0.69%
0.51%
0.58%
Male
0
0
18
67
6442
201439
0
207966
Female
0
0
0
40
7775
304568
0
312383
Total
0
0
18
107
14217
506007
0
520349
Member Months
(Outpatient/ED)
Male
0
0
18
67
6442
201439
0
207966
Female
0
0
0
40
7775
304568
0
312383
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
1
0
1
29
27
56
122
97
219
0
0
0
152
124
276
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
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
18
107
14217
506007
0
520349
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
17.91%
0.00%
11.21%
5.40%
4.17%
4.73%
0.73%
0.38%
0.52%
NA
NA
NA
0.88%
0.48%
0.64%
Page 102
Use of Services
UCare of Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
0
3
29344
0
29347
Female
0
0
0
0
0
73948
0
73948
Total
0
0
0
0
3
103292
0
103295
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
83
79
162
0
0
0
83
79
162
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
0
0
3
29344
0
29347
Female
0
0
0
0
0
73948
0
73948
Total
0
0
0
0
3
103292
0
103295
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
3.39%
1.28%
1.88%
NA
NA
NA
3.39%
1.28%
1.88%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
39
41
80
0
0
0
39
41
80
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
1.59%
0.67%
0.93%
NA
NA
NA
1.59%
0.67%
0.93%
Male
0
0
0
0
3
29344
0
29347
Female
0
0
0
0
0
73948
0
73948
Total
0
0
0
0
3
103292
0
103295
Member Months
(Outpatient/ED)
Male
0
0
0
0
3
29344
0
29347
Female
0
0
0
0
0
73948
0
73948
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
61
46
107
0
0
0
61
46
107
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Total
0
0
0
0
3
103292
0
103295
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
2.49%
0.75%
1.24%
NA
NA
NA
2.49%
0.75%
1.24%
Page 103
Use of Services
UCare of Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
400
975
4436
163
0
5974
Female
0
0
278
671
5325
203
0
6477
Total
0
0
678
1646
9761
366
0
12451
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
3
1
4
12
6
18
69
38
107
0
1
1
0
0
0
84
46
130
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
0
0
400
975
4436
163
0
5974
Female
0
0
278
671
5325
203
0
6477
Total
0
0
678
1646
9761
366
0
12451
Inpatient
Percent
NA
NA
NA
NA
NA
NA
9.00%
4.32%
7.08%
14.77%
10.73%
13.12%
18.67%
8.56%
13.15%
0.00%
5.91%
3.28%
NA
NA
NA
16.87%
8.52%
12.53%
Number
0
0
0
0
0
0
1
0
1
3
0
3
23
13
36
0
1
1
0
0
0
27
14
41
Percent
NA
NA
NA
NA
NA
NA
3.00%
0.00%
1.77%
3.69%
0.00%
2.19%
6.22%
2.93%
4.43%
0.00%
5.91%
3.28%
NA
NA
NA
5.42%
2.59%
3.95%
Male
0
0
400
975
4436
163
0
5974
Female
0
0
278
671
5325
203
0
6477
Total
0
0
678
1646
9761
366
0
12451
Member Months
(Outpatient/ED)
Male
0
0
400
975
4436
163
0
5974
Female
0
0
278
671
5325
203
0
6477
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
0
0
0
2
0
2
0
0
0
0
0
0
2
0
2
Number
0
0
0
0
0
0
3
1
4
9
6
15
60
35
95
0
0
0
0
0
0
72
42
114
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.54%
0.00%
0.25%
0.00%
0.00%
0.00%
NA
NA
NA
0.40%
0.00%
0.19%
Total
0
0
678
1646
9761
366
0
12451
Percent
NA
NA
NA
NA
NA
NA
9.00%
4.32%
7.08%
11.08%
10.73%
10.94%
16.23%
7.89%
11.68%
0.00%
0.00%
0.00%
NA
NA
NA
14.46%
7.78%
10.99%
Page 104
Use of Services
UCare of Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
SNBC
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
19
38
165
0
0
222
Female
0
0
15
33
304
0
0
352
Total
0
0
34
71
469
0
0
574
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
0
0
0
0
0
0
1
1
2
6
7
13
0
0
0
0
0
0
7
8
15
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
0
0
19
38
165
0
0
222
Female
0
0
15
33
304
0
0
352
Total
0
0
34
71
469
0
0
574
Inpatient
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
31.58%
36.36%
33.80%
43.64%
27.63%
33.26%
NA
NA
NA
NA
NA
NA
37.84%
27.27%
31.36%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
1
1
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
3.95%
2.56%
NA
NA
NA
NA
NA
NA
0.00%
3.41%
2.09%
Male
0
0
19
38
165
0
0
222
Female
0
0
15
33
304
0
0
352
Total
0
0
34
71
469
0
0
574
Member Months
(Outpatient/ED)
Male
0
0
19
38
165
0
0
222
Female
0
0
15
33
304
0
0
352
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
1
0
1
Number
0
0
0
0
0
0
0
0
0
1
1
2
5
7
12
0
0
0
0
0
0
6
8
14
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
7.27%
0.00%
2.56%
NA
NA
NA
NA
NA
NA
5.41%
0.00%
2.09%
Total
0
0
34
71
469
0
0
574
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
31.58%
36.36%
33.80%
36.36%
27.63%
30.70%
NA
NA
NA
NA
NA
NA
32.43%
27.27%
29.27%
Page 105
Use of Services
UCare of Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
216875
62484
39988
35391
83007
6532
0
444277
Female
210281
62099
77769
82361
108925
11134
0
552569
Total
427156
124583
117757
117752
191932
17666
0
996846
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
15
5
20
177
114
291
346
396
742
591
598
1189
1416
916
2332
22
12
34
0
0
0
2567
2041
4608
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
216875
62484
39988
35391
83007
6532
0
444277
Female
210281
62099
77769
82361
108925
11134
0
552569
Total
427156
124583
117757
117752
191932
17666
0
996846
Inpatient
Percent
0.08%
0.03%
0.06%
3.40%
2.20%
2.80%
10.38%
6.11%
7.56%
20.04%
8.71%
12.12%
20.47%
10.09%
14.58%
4.04%
1.29%
2.31%
NA
NA
NA
6.93%
4.43%
5.55%
Number
4
0
4
16
27
43
61
84
145
106
118
224
325
216
541
10
3
13
0
0
0
522
448
970
Percent
0.02%
0.00%
0.01%
0.31%
0.52%
0.41%
1.83%
1.30%
1.48%
3.59%
1.72%
2.28%
4.70%
2.38%
3.38%
1.84%
0.32%
0.88%
NA
NA
NA
1.41%
0.97%
1.17%
Male
216875
62484
39988
35391
83007
6532
0
444277
Female
210281
62099
77769
82361
108925
11134
0
552569
Total
427156
124583
117757
117752
191932
17666
0
996846
Member Months
(Outpatient/ED)
Male
216875
62484
39988
35391
83007
6532
0
444277
Female
210281
62099
77769
82361
108925
11134
0
552569
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
2
4
6
5
5
10
10
8
18
24
12
36
0
0
0
0
0
0
41
29
70
Number
11
5
16
169
99
268
318
347
665
556
558
1114
1318
835
2153
16
9
25
0
0
0
2388
1853
4241
Percent
0.00%
0.00%
0.00%
0.04%
0.08%
0.06%
0.15%
0.08%
0.10%
0.34%
0.12%
0.18%
0.35%
0.13%
0.23%
0.00%
0.00%
0.00%
NA
NA
NA
0.11%
0.06%
0.08%
Total
427156
124583
117757
117752
191932
17666
0
996846
Percent
0.06%
0.03%
0.04%
3.25%
1.91%
2.58%
9.54%
5.35%
6.78%
18.85%
8.13%
11.35%
19.05%
9.20%
13.46%
2.94%
0.97%
1.70%
NA
NA
NA
6.45%
4.02%
5.11%
Page 106
Use of Services
UCare of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 10:12 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
M
Total
F
Total
Age
Number
0-12
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
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 107
Use of Services
UCare of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare Advantage
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
6527
201439
0
207966
Female
0
0
7815
304568
0
312383
Total
0
0
14342
506007
0
520349
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
110
196
306
394
883
1277
0
0
0
504
1079
1583
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
6527
201439
0
207966
Female
0
0
7815
304568
0
312383
Total
0
0
14342
506007
0
520349
Number
0
0
0
0
0
0
11
17
28
69
124
193
0
0
0
80
141
221
Female
0
0
7815
304568
0
312383
Total
0
0
14342
506007
0
520349
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
20.22%
30.10%
25.60%
2.35%
3.48%
3.03%
NA
NA
NA
2.91%
4.14%
3.65%
Male
0
0
6527
201439
0
207966
Percent
NA
NA
NA
NA
NA
NA
2.02%
2.61%
2.34%
0.41%
0.49%
0.46%
NA
NA
NA
0.46%
0.54%
0.51%
Number
0
0
0
0
0
0
12
13
25
4
19
23
0
0
0
16
32
48
Percent
NA
NA
NA
NA
NA
NA
2.21%
2.00%
2.09%
0.02%
0.07%
0.05%
NA
NA
NA
0.09%
0.12%
0.11%
Member Months
(Outpatient/ED)
Male
0
0
6527
201439
0
207966
Female
0
0
7815
304568
0
312383
Total
0
0
14342
506007
0
520349
Outpatient/ED
Number
0
0
0
0
0
0
110
185
295
342
798
1140
0
0
0
452
983
1435
Percent
NA
NA
NA
NA
NA
NA
20.22%
28.41%
24.68%
2.04%
3.14%
2.70%
NA
NA
NA
2.61%
3.78%
3.31%
Page 108
Use of Services
UCare of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
3
29344
0
29347
Female
0
0
0
73948
0
73948
Total
0
0
3
103292
0
103295
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
259
613
872
0
0
0
259
613
872
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
3
29344
0
29347
Female
0
0
0
73948
0
73948
Total
0
0
3
103292
0
103295
Number
0
0
0
0
0
0
0
0
0
29
98
127
0
0
0
29
98
127
Female
0
0
0
73948
0
73948
Total
0
0
3
103292
0
103295
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
10.59%
9.95%
10.13%
NA
NA
NA
10.59%
9.95%
10.13%
Male
0
0
3
29344
0
29347
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
1.19%
1.59%
1.48%
NA
NA
NA
1.19%
1.59%
1.48%
Number
0
0
0
0
0
0
0
0
0
10
32
42
0
0
0
10
32
42
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
0.41%
0.52%
0.49%
NA
NA
NA
0.41%
0.52%
0.49%
Member Months
(Outpatient/ED)
Male
0
0
3
29344
0
29347
Female
0
0
0
73948
0
73948
Total
0
0
3
103292
0
103295
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
232
531
763
0
0
0
232
531
763
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
9.49%
8.62%
8.86%
NA
NA
NA
9.49%
8.62%
8.86%
Page 109
Use of Services
UCare of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
5811
163
0
5974
Female
0
0
6274
203
0
6477
Total
0
0
12085
366
0
12451
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
219
297
516
3
4
7
0
0
0
222
301
523
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
5811
163
0
5974
Female
0
0
6274
203
0
6477
Total
0
0
12085
366
0
12451
Number
0
0
0
0
0
0
10
14
24
0
0
0
0
0
0
10
14
24
Female
0
0
6274
203
0
6477
Total
0
0
12085
366
0
12451
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
45.22%
56.81%
51.24%
22.09%
23.65%
22.95%
NA
NA
NA
44.59%
55.77%
50.41%
Male
0
0
5811
163
0
5974
Percent
NA
NA
NA
NA
NA
NA
2.07%
2.68%
2.38%
0.00%
0.00%
0.00%
NA
NA
NA
2.01%
2.59%
2.31%
Number
0
0
0
0
0
0
13
14
27
0
0
0
0
0
0
13
14
27
Percent
NA
NA
NA
NA
NA
NA
2.68%
2.68%
2.68%
0.00%
0.00%
0.00%
NA
NA
NA
2.61%
2.59%
2.60%
Member Months
(Outpatient/ED)
Male
0
0
5811
163
0
5974
Female
0
0
6274
203
0
6477
Total
0
0
12085
366
0
12451
Outpatient/ED
Number
0
0
0
0
0
0
214
295
509
3
4
7
0
0
0
217
299
516
Percent
NA
NA
NA
NA
NA
NA
44.19%
56.42%
50.54%
22.09%
23.65%
22.95%
NA
NA
NA
43.59%
55.40%
49.73%
Page 110
Use of Services
UCare of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
222
0
0
222
Female
0
0
352
0
0
352
Total
0
0
574
0
0
574
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
24
33
57
0
0
0
0
0
0
24
33
57
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
222
0
0
222
Female
0
0
352
0
0
352
Total
0
0
574
0
0
574
Number
0
0
0
0
0
0
3
7
10
0
0
0
0
0
0
3
7
10
Female
0
0
352
0
0
352
Total
0
0
574
0
0
574
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
129.73%
112.50%
119.16%
NA
NA
NA
NA
NA
NA
129.73%
112.50%
119.16%
Male
0
0
222
0
0
222
Percent
NA
NA
NA
NA
NA
NA
16.22%
23.86%
20.91%
NA
NA
NA
NA
NA
NA
16.22%
23.86%
20.91%
Number
0
0
0
0
0
0
5
5
10
0
0
0
0
0
0
5
5
10
Percent
NA
NA
NA
NA
NA
NA
27.03%
17.05%
20.91%
NA
NA
NA
NA
NA
NA
27.03%
17.05%
20.91%
Member Months
(Outpatient/ED)
Male
0
0
222
0
0
222
Female
0
0
352
0
0
352
Total
0
0
574
0
0
574
Outpatient/ED
Number
0
0
0
0
0
0
23
30
53
0
0
0
0
0
0
23
30
53
Percent
NA
NA
NA
NA
NA
NA
124.32%
102.27%
110.80%
NA
NA
NA
NA
NA
NA
124.32%
102.27%
110.80%
Page 111
Use of Services
UCare of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Minnesota Health Care Programs - Managed Care(MHCP-MC)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
216875
62484
158386
6532
0
444277
Female
210281
62099
269055
11134
0
552569
Total
427156
124583
427441
17666
0
996846
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
1547
1005
2552
750
783
1533
3048
5445
8493
65
133
198
0
0
0
5410
7366
12776
HEDIS 2009 (Reporting Year 2008)
Male
216875
62484
158386
6532
0
444277
Female
210281
62099
269055
11134
0
552569
Total
427156
124583
427441
17666
0
996846
Percent
8.56%
5.74%
7.17%
14.40%
15.13%
14.77%
23.09%
24.28%
23.84%
11.94%
14.33%
13.45%
NA
NA
NA
14.61%
16.00%
15.38%
Number
24
6
30
27
67
94
276
293
569
4
15
19
0
0
0
331
381
712
Male
216875
62484
158386
6532
0
444277
Female
210281
62099
269055
11134
0
552569
Total
427156
124583
427441
17666
0
996846
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Percent
0.13%
0.03%
0.08%
0.52%
1.29%
0.91%
2.09%
1.31%
1.60%
0.73%
1.62%
1.29%
NA
NA
NA
0.89%
0.83%
0.86%
Number
109
78
187
63
78
141
340
497
837
3
5
8
0
0
0
515
658
1173
Percent
0.60%
0.45%
0.53%
1.21%
1.51%
1.36%
2.58%
2.22%
2.35%
0.55%
0.54%
0.54%
NA
NA
NA
1.39%
1.43%
1.41%
Member Months
(Outpatient/ED)
Male
216875
62484
158386
6532
0
444277
Female
210281
62099
269055
11134
0
552569
Total
427156
124583
427441
17666
0
996846
Outpatient/ED
Number
1517
993
2510
721
751
1472
2873
5263
8136
59
124
183
0
0
0
5170
7131
12301
Percent
8.39%
5.67%
7.05%
13.85%
14.51%
14.18%
21.77%
23.47%
22.84%
10.84%
13.36%
12.43%
NA
NA
NA
13.96%
15.49%
14.81%
Page 112
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
Commercial
Age
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Member Months
NR
Age
Total Cost of
Prescriptions
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
Avg. Cost of
Prescriptions /
Per Member Per
Month
Total Number of
Prescriptions
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
NR
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 113
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
Medicare Advantage
Age
Member Months
0-9
0
10-17
0
18-34
116
35-49
1399
50-64
12240
65-74
247198
75-84
159238
85+
74270
Unknown
0
Total
494461
Age
Total Cost of
Prescriptions
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
$0.00
$0.00
$50,704.31
$465,612.14
$3,427,215.96
$30,642,793.78
$22,672,841.86
$11,536,312.52
$0.00
$68,795,480.57
HEDIS 2009 (Reporting Year 2008)
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
$437.11
$332.82
$280.00
$123.96
$142.38
$155.33
$139.13
Total Number of
Prescriptions
0
0
299
4871
46333
478887
421299
262072
0
1213761
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
30.93
41.78
45.42
23.25
31.75
42.34
29.46
Page 114
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
MSHO
Age
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
0
0
3
36808
34877
31607
0
103295
Age
Total Cost of
Prescriptions
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
Data Last Refreshed:
Jan 10, 2011 10:12 AM
$0.00
$0.00
$0.00
$0.00
$379.67
$11,140,295.04
$11,269,826.81
$9,725,505.69
$0.00
$32,136,007.21
HEDIS 2009 (Reporting Year 2008)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
NA
NA
$126.56
$302.66
$323.13
$307.70
$311.11
Total Number of
Prescriptions
0
0
0
0
13
212760
243723
253657
0
710153
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
NA
NA
52.00
69.36
83.86
96.30
82.50
Page 115
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
MnDHO
Age
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Member Months
0
0
2324
4235
5526
366
0
0
0
12451
Age
Total Cost of
Prescriptions
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
$0.00
$0.00
$863,393.44
$2,975,403.51
$3,480,223.82
$177,402.88
$0.00
$0.00
$0.00
$7,496,423.65
HEDIS 2009 (Reporting Year 2008)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
$371.51
$702.57
$629.79
$484.71
NA
NA
$602.07
Total Number of
Prescriptions
0
0
12160
34521
48873
2286
0
0
0
97840
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
62.79
97.82
106.13
74.95
NA
NA
94.30
Page 116
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
SNBC
Age
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
Age
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Member Months
0
0
105
223
246
0
0
0
0
574
Total Cost of
Prescriptions
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
$0.00
$0.00
$35,704.71
$126,478.76
$109,156.31
$0.00
$0.00
$0.00
$0.00
$271,339.78
HEDIS 2009 (Reporting Year 2008)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
$340.04
$567.17
$443.72
NA
NA
NA
$472.72
Total Number of
Prescriptions
0
0
366
1592
1428
0
0
0
0
3386
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
41.83
85.67
69.66
NA
NA
NA
70.79
Page 117
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
0-9
352165
10-17
199574
18-34
235509
35-49
126193
50-64
65739
65-74
9537
75-84
4397
85+
3732
Unknown
0
Total
Age
996846
Total Cost of
Prescriptions
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
$4,490,457.93
$4,346,071.39
$12,130,938.49
$14,445,686.02
$9,877,718.76
$335,451.55
$96,375.58
$36,384.10
$0.00
$45,759,083.82
HEDIS 2009 (Reporting Year 2008)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$12.75
$21.78
$51.51
$114.47
$150.26
$35.17
$21.92
$9.75
$45.90
Total Number of
Prescriptions
122559
66457
225123
237481
182252
12396
6105
5708
0
858081
Avg. Num. Of
Prescriptions /
Per Member Per
Year
4.18
4.00
11.47
22.58
33.27
15.60
16.66
18.35
10.33
Page 118
Health Plan Descriptive Information
UCare of Minnesota
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Board Certification
MSHO
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2009 (Reporting Year 2008)
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
2146
2413
156
4922
1819
2129
121
4337
84.76%
88.23%
77.56%
88.11%
Page 119
Health Plan Descriptive Information
UCare of Minnesota
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Board Certification
MnDHO
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2009 (Reporting Year 2008)
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
1578
1377
93
3164
1344
1226
73
2770
85.17%
89.03%
78.49%
87.55%
Page 120
Health Plan Descriptive Information
UCare of Minnesota
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Board Certification
SNBC
Type of Physician
Family Medicine
Internal Medicine
Geriatricians
Other practitioner Specialists
HEDIS 2009 (Reporting Year 2008)
Number of Physicians in Active Board Certification
Each Practice Area
Percent
Number
2267
2424
160
4955
1928
2137
124
4369
85.05%
88.16%
77.50%
88.17%
Page 121
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 10:12 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 2009 (Reporting Year 2008)
NR
NR
NR
NR
NR
NR
NR
Page 122
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare Advantage
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
18
22
45
71
160
0
0.00%
0
12
28
73
223
0
0.00%
316
0.15%
448
876
1563
3324
336
0.11%
512
1108
2028
3831
652
0.13%
6211
2.99%
61212
51230
37461
29234
15440
6862
7479
2.39%
82769
64393
54501
47893
32388
22624
13690
2.63%
201439
96.86%
0
304568
97.50%
0
207966
312383
HEDIS 2009 (Reporting Year 2008)
18
34
73
144
383
960
1984
3591
7155
143981
115623
91962
77127
47828
29486
506007
97.24%
0
520349
Page 123
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 10:12 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
3
0
0.00%
0
0
0
0
0
0.00%
3
0.01%
6353
7160
5730
4440
3481
2180
0
0.00%
11063
12232
12538
12169
12010
13936
3
0.00%
29344
99.99%
0
73948
100.00%
0
103292
100.00%
29347
73948
HEDIS 2009 (Reporting Year 2008)
0
0
0
0
0
0
0
0
3
17416
19392
18268
16609
15491
16116
0
103295
Page 124
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
<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
24
Member Months
Female
0
0
0
0
0
35
Total
0
0
0
0
0
59
24
0.40%
376
545
430
542
746
35
0.54%
243
348
323
498
605
59
0.47%
2639
44.17%
874
999
756
519
2017
31.14%
970
1209
1021
1022
4656
37.39%
3148
52.70%
151
12
0
0
0
0
4222
65.18%
192
11
0
0
0
0
7370
59.19%
163
2.73%
0
203
3.13%
0
366
2.94%
5974
6477
HEDIS 2009 (Reporting Year 2008)
619
893
753
1040
1351
1844
2208
1777
1541
343
23
0
0
0
0
0
12451
Page 125
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 10:12 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
1
Member Months
Female
0
0
0
0
0
6
Total
0
0
0
0
0
7
1
0.45%
18
19
19
21
47
6
1.70%
9
13
20
36
33
7
1.22%
124
55.86%
29
24
23
21
111
31.53%
57
55
84
39
235
40.94%
97
43.69%
0
0
0
0
0
0
235
66.76%
0
0
0
0
0
0
332
57.84%
0
0.00%
0
0
0.00%
0
0
0.00%
222
352
HEDIS 2009 (Reporting Year 2008)
27
32
39
57
80
86
79
107
60
0
0
0
0
0
0
0
574
Page 126
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 10:12 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
30974
76169
72504
62337
37375
18252
Member Months
Female
30517
71959
70042
62207
37655
23107
Total
61491
148128
142546
124544
75030
41359
297611
66.99%
21736
18799
16592
16758
17319
295487
53.48%
54662
49183
33178
28526
23486
593098
59.50%
91204
20.53%
18491
14455
9962
6022
189035
34.21%
21613
15305
11070
8925
280239
28.11%
48930
11.01%
2751
1337
981
677
470
316
56913
10.30%
3803
1646
1228
1511
1516
1430
105843
10.62%
6532
1.47%
0
11134
2.01%
0
17666
1.77%
444277
552569
HEDIS 2009 (Reporting Year 2008)
76398
67982
49770
45284
40805
40104
29760
21032
14947
6554
2983
2209
2188
1986
1746
0
996846
Page 127
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Commercial
Product/Product Line
Years in Business
Members*
NR
NR
NR
NR
NR
NR
NR
HMO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total HMO:
PPO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total PPO:
POS
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 128
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Medicare Advantage
Product/Product Line
Years in Business
Members*
21.00
0.00
13.00
0.00
21.00
84369
0
55830
0
140199
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
140199
HMO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total HMO:
PPO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total PPO:
POS
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 129
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MSHO
Product/Product Line
Years in Business
Members*
21.00
0.00
13.00
0.00
21.00
84369
0
55830
0
140199
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
140199
HMO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total HMO:
PPO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total PPO:
POS
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 130
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 10:12 AM
MnDHO
Product/Product Line
Years in Business
Members*
21.00
0.00
13.00
0.00
21.00
84369
0
55830
0
140199
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
140199
HMO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total HMO:
PPO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total PPO:
POS
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 131
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 10:12 AM
SNBC
Product/Product Line
Years in Business
Members*
21.00
0.00
13.00
0.00
21.00
84369
0
55830
0
140199
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
HMO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total HMO:
PPO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total PPO:
POS
MHCP_MC
0.00
0
Commercial
0.00
0
Medicare (cost or risk)
0.00
0
Other
0.00
0
Total POS:
0.00
0
Total:
140199
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 132
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 10:12 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Product/Product Line
Years in Business
Members*
21.00
0.00
13.00
0.00
21.00
84369
0
55830
0
140199
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
HMO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total HMO:
PPO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total PPO:
POS
MHCP_MC
0.00
0
Commercial
0.00
0
Medicare (cost or risk)
0.00
0
Other
0.00
0
Total POS:
0.00
0
Total:
140199
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 133