Preferred One Community Health Plan
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
Preferred One Community Health Plan
Childhood Immunization Status
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Pneumococcal
Conjugate
Combo 2
Combo 3
336
73.52%
348
76.15%
411
89.93%
396
86.65%
341
74.62%
385
84.25%
333
72.87%
283
61.93%
274
59.96%
320
74.07%
333
77.08%
388
89.81%
375
86.81%
325
75.23%
361
83.56%
317
73.38%
268
62.04%
260
60.19%
307
53
87.59%
84.28%
90.90%
320
64
93.43%
90.91%
95.95%
369
6
91.24%
88.39%
94.10%
360
30
94.89%
92.64%
97.14%
311
69
92.46%
89.78%
95.13%
346
11
86.86%
83.47%
90.25%
306
55
87.83%
84.55%
91.12%
258
75
81.02%
77.11%
84.93%
251
76
79.56%
75.54%
83.58%
432
3
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
3
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
457
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 3
Effectiveness of Care
Preferred One Community Health Plan
Childhood Immunization Status
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 4
Effectiveness of Care
Preferred One Community Health Plan
Breast Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
2008
A
5464
3878
70.97%
69.76%
72.19%
Medicare
Advantage
MSHO
MnDHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 5
Effectiveness of Care
Preferred One Community Health Plan
Cervical Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
MHCP-MC
2008
A
5682
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
NR
NR
NR
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
4349
76.54%
75.43%
77.65%
NR
NR
NR
Page 6
Effectiveness of Care
Preferred One Community Health Plan
Colorectal Cancer Screening
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Data Elements
Commercial
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
2008
H
5985
Number of numerator events by administrative data in eligible population
(before exclusions)
2411
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid data errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical records
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
40.28%
411
0.05
432
188
43.52%
0
0
0
0
0
411
179
61
58.39%
53.51%
63.28%
Medicare
Advantage
MSHO
MnDHO
SNBC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 7
Effectiveness of Care
Preferred One Community Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Jan 10, 2011 10:02 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 Ages 16-20 Ages 21-24
Data
Total
2008
A
640
256
40.00%
36.13%
43.87%
597
263
44.05%
39.99%
48.12%
1237
519
41.96%
39.17%
44.75%
Page 8
Effectiveness of Care
Preferred One Community Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Data Elements
Measure Ages 16-20 Ages 21-24
Data
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
NR
NR
Lower 95% Confidence Interval
NR
NR
Upper 95% Confidence Interval
NR
NR
HEDIS 2009 (Reporting Year 2008)
Total
NR
NR
NR
NR
NR
Page 9
Effectiveness of Care
Preferred One Community Health Plan
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare
Advantage
MSHO
NR
NR
NR
NR
NR
NR
Page 10
Effectiveness of Care
Preferred One Community Health Plan
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Lead Screening in Children
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
MHCP-MC
2009
A
458
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
NR
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
NR
NR
Records Excluded because of Valid Data
Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
275
Reported Rate
60.04%
NR
Lower 95% Confidence Interval
55.45%
NR
Upper 95% Confidence Interval
64.64%
NR
HEDIS 2009 (Reporting Year 2008)
Page 11
Effectiveness of Care
Preferred One Community Health Plan
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
2008
A
812
127
84.36%
81.80%
86.92%
NR
NR
NR
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Page 12
Effectiveness of Care
Preferred One Community Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare Advantage
Data Elements
General
Measure Data
Systemic
corticosteroid
Bronchodilator
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Exclusions based on direct transfers to
another facility
Exclusions based on readmissions
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Page 13
Effectiveness of Care
Preferred One Community Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MSHO
Data Elements
General
Measure Data
Systemic
corticosteroid
Bronchodilator
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Exclusions based on direct transfers to
another facility
Exclusions based on readmissions
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Page 14
Effectiveness of Care
Preferred One Community Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MnDHO
Data Elements
General
Measure Data
Systemic
corticosteroid
Bronchodilator
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Exclusions based on direct transfers to
another facility
Exclusions based on readmissions
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Page 15
Effectiveness of Care
Preferred One Community Health Plan
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 10:02 AM
SNBC
Data Elements
General
Measure Data
Systemic
corticosteroid
Bronchodilator
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Exclusions based on direct transfers to
another facility
Exclusions based on readmissions
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Page 16
Effectiveness of Care
Preferred One Community Health Plan
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare
Advantage
MSHO
MnDHO
SNBC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 17
Effectiveness of Care
Preferred One Community Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jan 10, 2011 10:02 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
Ages 10-17
Ages 18-56
Total
48
48
100.00%
98.96%
100.00%
75
71
94.67%
88.91%
100.00%
279
240
86.02%
81.77%
90.27%
402
359
89.30%
86.16%
92.45%
2008
A
Page 18
Effectiveness of Care
Preferred One Community Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
Ages 10-17
NR
NR
NR
Ages 18-56
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 19
Effectiveness of Care
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 10:02 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
164
2
85.86%
1.05%
164
2
85.86%
1.05%
164
5
2
113
88.48%
83.69%
93.27%
60.21%
53.01%
67.41%
2008
H
191
191
0.00%
191
0
0
0
191
Page 20
Effectiveness of Care
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 21
Effectiveness of Care
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 22
Effectiveness of Care
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 23
Effectiveness of Care
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 10:02 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
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 24
Effectiveness of Care
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
Number of employee/dependent medical records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
NR
NR
Lower 95% Confidence Interval
NR
NR
Upper 95% Confidence Interval
NR
NR
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
HEDIS 2009 (Reporting Year 2008)
Page 25
Effectiveness of Care
Preferred One Community Health Plan
Controlling High Blood Pressure
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Data Elements
Commercial
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2008
H
2146
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
0.00%
411
15.00%
473
0
0.00%
Records Excluded because of Valid Data
Errors
4
Number of records excluded because of
false positive diagnoses
7
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
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
4
411
0
280
68.13%
63.50%
72.75%
HEDIS 2009 (Reporting Year 2008)
Medicare
Advantage
MSHO
MnDHO
SNBC
MHCP-MC
NR
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 26
Effectiveness of Care
Preferred One Community Health Plan
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
Medicare
Advantage
MSHO
MnDHO
SNBC
MHCP-MC
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
2008
A
27
Numerator Events by Admin Data on
Eligible Population
20
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NA
NA
NA
HEDIS 2009 (Reporting Year 2008)
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Page 27
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
2008
H
1133
2008
H
1133
2008
H
1133
1019
89.94%
548
0%
548
496
90.51%
1131
99.82%
548
0%
548
547
99.82%
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
1133
2008
H
1133
2008
H
1133
2008
H
1133
2008
H
1133
2008
H
1133
2008
H
1133
0
0.00%
548
0%
548
0
0.00%
2
0.18%
548
0%
548
1
0.18%
609
53.75%
548
0%
548
298
54.38%
948
83.67%
548
0%
548
459
83.76%
2
0.18%
548
0%
548
1
0.18%
961
84.82%
548
0%
548
456
83.21%
4
0.35%
548
0%
548
3
0.55%
3
0.26%
548
0%
548
2
0.36%
0
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
3
3
45
3
3
3
3
3
3
3
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
0
545
495
15
93.58%
91.43%
95.73%
0
545
35
86
22.20%
18.62%
25.78%
0
423
0
183
43.26%
38.42%
48.10%
0
545
1
362
66.61%
62.55%
70.66%
0
545
298
58
65.32%
61.23%
69.41%
0
545
459
12
86.42%
83.45%
89.39%
0
545
1
275
50.64%
46.35%
54.93%
0
545
456
15
86.42%
83.45%
89.39%
0
545
3
398
73.58%
69.78%
77.37%
0
545
2
278
51.38%
47.09%
55.66%
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
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare Advantage
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 29
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MSHO
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
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 30
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MnDHO
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
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 31
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
SNBC
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
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 32
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Good HbA1c
Control
(<7.0%)
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
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 33
Effectiveness of Care
Preferred One Community Health Plan
Osteoporosis Management in Women Who had a Fracture
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare
Advantage
MSHO
NR
NR
NR
NR
NR
NR
Page 34
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 10:02 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
Effective
Continuation
Phase
Treatment
2008
A
340
207
60.88%
55.55%
66.22%
161
47.35%
41.90%
52.81%
Page 35
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
Effective
Continuation
Phase
Treatment
NR
NR
NR
Page 36
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
Effective
Continuation
Phase
Treatment
NR
NR
NR
Page 37
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
Effective
Continuation
Phase
Treatment
NR
NR
NR
Page 38
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
Effective
Continuation
Phase
Treatment
NR
NR
NR
Page 39
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
Effective
Continuation
Phase
Treatment
NR
NR
NR
Page 40
Effectiveness of Care
Preferred One Community Health Plan
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jan 10, 2011 10:02 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
105
36
34.29%
24.73%
43.84%
28
8
NA
NA
NA
2008
A
Page 41
Effectiveness of Care
Preferred One Community Health Plan
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
Page 42
Effectiveness of Care
Preferred One Community Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
Page 43
Effectiveness of Care
Preferred One Community Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
Page 44
Effectiveness of Care
Preferred One Community Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
Page 45
Effectiveness of Care
Preferred One Community Health Plan
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
Page 46
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 10:02 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
2020
1588
78.61%
76.80%
80.43%
30
22
73.33%
55.84%
90.82%
1637
1290
78.80%
76.79%
80.81%
111
82
73.87%
65.25%
82.50%
3798
2982
78.52%
77.20%
79.83%
2008
A
Page 47
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 48
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 49
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 50
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 51
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
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
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)
Page 52
Effectiveness of Care
Preferred One Community Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
Page 53
Effectiveness of Care
Preferred One Community Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
Page 54
Effectiveness of Care
Preferred One Community Health Plan
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare Advantage
Data Elements
General
Measure
Data
At least 1
Prescription
At least 2
Prescriptions
NR
NR
NR
NR
NR
NR
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)
Page 55
Effectiveness of Care
Preferred One Community Health Plan
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jan 10, 2011 10:02 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
At least 1
Prescription
At least 2
Prescriptions
NR
NR
NR
NR
NR
NR
Page 56
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
5642
6425
235
5235
6123
229
92.79%
92.10%
93.47%
95.30%
94.77%
95.82%
97.45%
95.22%
99.68%
2008
A
Page 57
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare Advantage
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 58
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MSHO
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 59
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MnDHO
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 60
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
SNBC
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 61
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 62
Access/Availability of Care
Preferred One Community Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
Data Elements
Measurement Year
Data collection methodology (Administrative
only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
General Measure
Data
12-24 months
25 months 6 yrs.
7-11 yrs.
12-19 yrs.
529
508
2594
2247
1911
1656
3469
2950
96.03%
94.27%
97.79%
86.62%
85.29%
87.95%
86.66%
85.11%
88.21%
85.04%
83.84%
86.24%
2008
A
Page 63
Access/Availability of Care
Preferred One Community Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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 64
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology (Administrative
only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 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
38
419
457
15
4
185
50
200
54
39.47%
22.62%
56.33%
10.53%
0.00%
21.60%
44.15%
39.28%
49.03%
11.93%
8.71%
15.16%
43.76%
39.11%
48.42%
11.82%
8.75%
14.89%
Page 65
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare Advantage
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative
only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 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 66
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MSHO
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative
only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 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 67
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MnDHO
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 68
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 10:02 AM
SNBC
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative
only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 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 69
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology (Administrative
only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 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 70
Access/Availability of Care
Preferred One Community Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
2008
H
598
2008
H
598
Number of numerator events by administrative data in eligible
population (before exclusions)
467
338
78.09%
411
5%
432
335
56.52%
411
5%
432
244
77.55%
56.48%
12
12
0
12
411
326
57
0
12
411
240
77
93.19%
90.63%
95.74%
77.13%
72.95%
81.31%
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 71
Access/Availability of Care
Preferred One Community Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Timeliness of
Prenatal Care
Postpartum
Care
Current year's administrative rate (before exclusions)
NR
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
NR
NR
NR
NR
NR
NR
NR
NR
Data Elements
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
Number of numerator events by administrative data in eligible
population (before exclusions)
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
Page 72
Use of Services
Preferred One Community Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
15
4
2
6
28
60
284
3.76%
1.77%
5.75%
1.00%
0.00%
2.11%
0.50%
0.00%
1.32%
1.50%
0.18%
2.82%
7.02%
4.39%
9.65%
15.04%
11.40%
18.67%
71.18%
66.61%
75.75%
2008
A
399
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
Preferred One Community Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of employee/dependent medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Page 74
Use of Services
Preferred One Community Health Plan
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MHCP-MC
2008
A
2105
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
NR
NR
NR
NR
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)
1314
62.42%
60.33%
64.52%
NR
NR
NR
Page 75
Use of Services
Preferred One Community Health Plan
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
MHCP-MC
2008
A
6002
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
NR
NR
NR
NR
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
1772
29.52%
28.36%
30.69%
NR
NR
NR
Page 76
Use of Services
Preferred One Community Health Plan
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
Member Months
Total
40997
83831
135564
92730
Age
0-4
0-9
5-19
10-19
Total
Number of
Procedures
Procedure
Myringotomy
Age
Tonsillectomy
0-9
10-19
Procedures /
1,000 Member
Months
197
57
76
24
0-4
5-19
4.81
0.42
0.91
0.26
Member Months
Age
15-44
20-44
30-64
45-64
65+
Male
128216
172316
93868
3173
Female
138789
115279
89810
2567
Female
Male
Procedure
Age
Dilation & Curettage 15-44
45-64
Hysterectomy,
15-44
Abdominal
45-64
Number of
Procedures
Procedures /
1,000 Member
Months
65+
Hysterectomy,
Vaginal
15-44
45-64
65+
Cholecystectomy,
Open
30-64
15-44
45-64
65+
4
0
0.00
30-64
15-44
45-64
65+
Back Surgery
20-44
45-64
65+
Angioplasty (PTCA) 45-64
65+
45-64
Cardiac
Catheterization
65+
50
0.29
Cholecystectomy,
Closed
CABG
45-64
65+
Prostatectomy
45-64
65+
Mastectomy
15-44
45-64
65+
Lumpectomy
15-44
45-64
65+
HEDIS 2009 (Reporting Year 2008)
6
48
49
4
73
7
62
8
13
0
48
3
Number of
Procedures
Procedures /
1,000 Member
Months
8
12
67
67
0
47
41
2
0.06
0.13
0
4
0
0.00
0.04
0.00
100
49
1
49
77
4
8
0
31
0.72
0.55
0.39
0.48
0.75
0.00
0.34
0.46
0.78
0.02
1.89
0.37
0.52
1.26
0.78
2.21
0.66
2.52
0.14
0.00
4
3
0
0.43
0.86
1.56
0.09
0.00
0.35
1.56
0.03
0.00
0.51
0.95
9
27
0
25
36
2
0.06
0.30
0.00
0.18
0.40
0.78
Page 77
Use of Services
Preferred One Community Health Plan
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare Advantage
Member Months
Age
Male
Female
< 65
65-74
75-84
85+
Male
Number of
Procedures
Female
Procedures /
1,000 Member
Months
Number of
Procedures
Procedures /
1,000 Member
Months
Procedure
Age
CABG
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Angioplasty
(PTCA)
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Cardiac
Catheterization
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Carotid
Endarterectomy
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Reduction of
Fracture of Femur
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Total Hip
Replacement
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Total Knee
Replacement
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Partial Excision of
Large Inestine
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Cholecystectomy,
Open
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Cholecystectomy,
Closed
(laparoscopic)
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Back Surgery
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Hysterectomy
Abdominal
<65
65-74
75-84
85+
NR
NR
NR
NR
Hysterectomy,
Vaginal
<65
65-74
75-84
85+
NR
NR
NR
NR
Mastectomy
<65
65-74
75-84
85+
NR
NR
NR
NR
Lumpectomy
<65
65-74
75-84
85+
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
Page 78
Use of Services
Preferred One Community Health Plan
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MSHO
Member Months
Age
Male
Female
< 65
65-74
75-84
85+
Male
Number of
Procedures
Female
Procedures /
1,000 Member
Months
Number of
Procedures
Procedures /
1,000 Member
Months
Procedure
Age
CABG
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Angioplasty
(PTCA)
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Cardiac
Catheterization
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Carotid
Endarterectomy
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Reduction of
Fracture of Femur
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Total Hip
Replacement
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Total Knee
Replacement
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Partial Excision of
Large Inestine
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Cholecystectomy,
Open
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Cholecystectomy,
Closed
(laparoscopic)
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Back Surgery
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Hysterectomy
Abdominal
<65
65-74
75-84
85+
NR
NR
NR
NR
Hysterectomy,
Vaginal
<65
65-74
75-84
85+
NR
NR
NR
NR
Mastectomy
<65
65-74
75-84
85+
NR
NR
NR
NR
Lumpectomy
<65
65-74
75-84
85+
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
Page 79
Use of Services
Preferred One Community Health Plan
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MnDHO
Member Months
Male
Female
Age
< 65
65-74
75-84
85+
Male
Number of
Procedures
Female
Procedures /
1,000 Member
Months
Number of
Procedures
Procedures /
1,000 Member
Months
Procedure
Age
CABG
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Angioplasty
(PTCA)
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Cardiac
Catheterization
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Carotid
Endarterectomy
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Reduction of
Fracture of Femur
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Total Hip
Replacement
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Total Knee
Replacement
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Partial Excision of
Large Inestine
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Cholecystectomy,
Open
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Cholecystectomy,
Closed
(laparoscopic)
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Back Surgery
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Hysterectomy
Abdominal
<65
65-74
75-84
85+
NR
NR
NR
NR
Hysterectomy,
Vaginal
<65
65-74
75-84
85+
NR
NR
NR
NR
Mastectomy
<65
65-74
75-84
85+
NR
NR
NR
NR
Lumpectomy
<65
65-74
75-84
85+
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
Page 80
Use of Services
Preferred One Community Health Plan
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 10:02 AM
SNBC
Member Months
Male
Female
Age
< 65
65-74
75-84
85+
Male
Number of
Procedures
Female
Procedures /
1,000 Member
Months
Number of
Procedures
Procedures /
1,000 Member
Months
Procedure
Age
CABG
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Angioplasty
(PTCA)
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Cardiac
Catheterization
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Carotid
Endarterectomy
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Reduction of
Fracture of Femur
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Total Hip
Replacement
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Total Knee
Replacement
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Partial Excision of
Large Inestine
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Cholecystectomy,
Open
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Cholecystectomy,
Closed
(laparoscopic)
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Back Surgery
<65
65-74
75-84
85+
NR
NR
NR
NR
NR
NR
NR
NR
Hysterectomy
Abdominal
<65
65-74
75-84
85+
NR
NR
NR
NR
Hysterectomy,
Vaginal
<65
65-74
75-84
85+
NR
NR
NR
NR
Mastectomy
<65
65-74
75-84
85+
NR
NR
NR
NR
Lumpectomy
<65
65-74
75-84
85+
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
Page 81
Use of Services
Preferred One Community Health Plan
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC
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
Male
Procedure
Age
Dilation & Curettage 15-44
45-64
Hysterectomy,
15-44
Abdominal
45-64
Number of
Procedures
Female
Procedures /
1,000 Member
Months
Procedures /
1,000 Member
Months
NR
NR
NR
NR
Hysterectomy,
Vaginal
15-44
45-64
Cholecystectomy,
Open
30-64
15-44
45-64
NR
Cholecystectomy,
Closed
30-64
15-44
45-64
20-44
45-64
NR
Back Surgery
Number of
Procedures
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Mastectomy
15-44
45-64
NR
NR
Lumpectomy
15-44
45-64
NR
NR
HEDIS 2009 (Reporting Year 2008)
Page 82
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
7913
75918
92730
243495
183678
5436
237
67
4
609478
Outpatient Visits
(Excludes MH/CD)
Age
Visits
5149
13628
10-19
20-44
45-64
65-74
75-84
85+
Unknown
11897
36746
37515
1781
84
24
0
106824
<1
1-9
Total
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
650.70
179.51
128.30
150.91
204.24
327.63
354.43
358.21
175.27
Emergency Room Visits
Visits
184
656
616
2204
1535
79
4
1
0
5279
Visits/ 1,000
Member
Months
23.25
8.64
6.64
9.05
8.36
14.53
16.88
14.93
8.66
Ambulatory
Surgery/Procedures
Procedures
41
274
208
1401
2487
104
9
0
0
4524
Procedures/
1,000 Member
Months
5.18
3.61
2.24
5.75
13.54
19.13
37.97
0.00
7.42
Observation Room Stays
Resulting in Discharge
Stays
3
19
13
174
97
11
0
0
0
317
Stays/ 1,000
Member
Months
0.38
0.25
0.14
0.71
0.53
2.02
0.00
0.00
0.52
Page 83
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare Advantage
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
NR
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Emergency Room Visits
Visits
NR
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Ambulatory
Surgery/Procedures
Procedures
NR
Procedures/
1,000 Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Observation Room Stays
Resulting in Discharge
Stays
NR
Stays/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 84
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
NR
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Emergency Room Visits
Visits
NR
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Ambulatory
Surgery/Procedures
Procedures
NR
Procedures/
1,000 Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Observation Room Stays
Resulting in Discharge
Stays
NR
Stays/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 85
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MnDHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
NR
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Emergency Room Visits
Visits
NR
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Ambulatory
Surgery/Procedures
Procedures
NR
Procedures/
1,000 Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Observation Room Stays
Resulting in Discharge
Stays
NR
Stays/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 86
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Member
Months
NR
Total
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Emergency Room Visits
Visits
NR
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Ambulatory
Surgery/Procedures
Procedures
NR
Procedures/
1,000 Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Observation Room Stays
Resulting in Discharge
Stays
NR
Stays/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 87
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 10:02 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
NR
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Emergency Room Visits
Visits
NR
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Ambulatory
Surgery/Procedures
Procedures
NR
Procedures/
1,000 Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Observation Room Stays
Resulting in Discharge
Stays
NR
Stays/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 88
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Member Months
7913
75918
92730
243495
183678
5436
237
67
4
609478
Discharges
Discharges /
1,000 Member
Months
76
88
106
1262
1063
73
3
1
0
2672
9.60
1.16
1.14
5.18
5.79
13.43
12.66
14.93
64
60
47
215
488
42
2
0
0
918
8.09
0.79
0.51
0.88
2.66
7.73
8.44
0.00
12
28
41
345
565
30
1
1
0
1023
1.52
0.37
0.44
1.42
3.08
5.52
4.22
14.93
18
702
10
1
731
0.19
2.88
0.05
HEDIS 2009 (Reporting Year 2008)
4.38
1.51
1.68
1.41
Days
Days / 1,000
Member
Months
387
177
310
3543
4084
271
23
6
0
8801
48.91
2.33
3.34
14.55
22.23
49.85
97.05
89.55
223
124
137
672
1689
147
6
0
0
2998
28.18
1.63
1.48
2.76
9.20
27.04
25.32
0.00
164
53
128
1128
2379
121
17
6
0
3996
20.73
0.70
1.38
4.63
12.95
22.26
71.73
89.55
45
1743
16
3
1807
0.49
7.16
0.09
14.44
4.92
6.56
3.48
Average
Length of Stay
5.09
2.01
2.92
2.81
3.84
3.71
7.67
6.00
NA
3.29
3.48
2.07
2.91
3.13
3.46
3.50
3.00
NA
NA
3.27
13.67
1.89
3.12
3.27
4.21
4.03
17.00
6.00
NA
3.91
2.50
2.48
1.60
3.00
2.47
Page 89
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare Advantage
Age
Member Months
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
NR
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Discharges
Discharges /
1,000 Member
Months
Days
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 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 90
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Jan 10, 2011 10:02 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 91
Use of Services
Preferred One Community Health Plan
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 10:02 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 92
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Jan 10, 2011 10:02 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 93
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
NR
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Discharges
Discharges /
1,000 Member
Months
Days
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 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 94
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 10:02 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
7913
75918
92730
243495
183678
5436
237
67
4
609478
Discharges
0
0
0
7
51
2
1
0
0
61
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
0.00
0.00
0.00
0.03
0.28
0.37
4.22
0.00
0.10
Days
0
0
0
52
1290
34
5
0
0
1381
Days / 1,000
Member
Months
0.00
0.00
0.00
0.21
7.02
6.25
21.10
0.00
2.27
Average Length
of Stay
NA
NA
NA
7.43
25.29
17.00
5.00
NA
NA
22.64
Page 95
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 10:02 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
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 96
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 10:02 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
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 97
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 10:02 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
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 98
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 10:02 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
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 99
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 10:02 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
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 100
Use of Services
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
55533
24358
31837
51101
148490
3173
0
314492
Female
54721
23556
28597
44869
140672
2567
0
294982
Total
110254
47914
60434
95970
289162
5740
0
609474
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
24
22
46
52
33
85
66
42
108
201
114
315
2
0
2
0
0
0
345
211
556
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
55533
24358
31837
51101
148490
3173
0
314492
Female
54721
23556
28597
44869
140672
2567
0
294982
Total
110254
47914
60434
95970
289162
5740
0
609474
Inpatient
Percent
0.00%
0.00%
0.00%
1.18%
1.12%
1.15%
1.96%
1.38%
1.69%
1.55%
1.12%
1.35%
1.62%
0.97%
1.31%
0.76%
0.00%
0.42%
NA
NA
NA
1.32%
0.86%
1.09%
Number
0
0
0
8
9
17
12
11
23
18
12
30
58
47
105
0
0
0
0
0
0
96
79
175
Percent
0.00%
0.00%
0.00%
0.39%
0.46%
0.43%
0.45%
0.46%
0.46%
0.42%
0.32%
0.38%
0.47%
0.40%
0.44%
0.00%
0.00%
0.00%
NA
NA
NA
0.37%
0.32%
0.34%
Male
55533
24358
31837
51101
148490
3173
0
314492
Female
54721
23556
28597
44869
140672
2567
0
294982
Total
110254
47914
60434
95970
289162
5740
0
609474
Member Months
(Outpatient/ED)
Male
55533
24358
31837
51101
148490
3173
0
314492
Female
54721
23556
28597
44869
140672
2567
0
294982
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
1
4
5
3
3
6
3
4
7
9
11
20
0
0
0
0
0
0
16
22
38
Number
0
0
0
23
19
42
46
31
77
57
34
91
168
87
255
2
0
2
0
0
0
296
171
467
Percent
0.00%
0.00%
0.00%
0.05%
0.20%
0.13%
0.11%
0.13%
0.12%
0.07%
0.11%
0.09%
0.07%
0.09%
0.08%
0.00%
0.00%
0.00%
NA
NA
NA
0.06%
0.09%
0.07%
Total
110254
47914
60434
95970
289162
5740
0
609474
Percent
0.00%
0.00%
0.00%
1.13%
0.97%
1.05%
1.73%
1.30%
1.53%
1.34%
0.91%
1.14%
1.36%
0.74%
1.06%
0.76%
0.00%
0.42%
NA
NA
NA
1.13%
0.70%
0.92%
Page 101
Use of Services
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare Advantage
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Inpatient
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
Female
NR
NR
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 102
Use of Services
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MSHO
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 103
Use of Services
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MnDHO
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)
Member Months
(Any)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Inpatient
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
Female
NR
NR
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 104
Use of Services
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
SNBC
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)
Member Months
(Any)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Inpatient
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
Female
NR
NR
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 105
Use of Services
Preferred One Community Health Plan
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 10:02 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
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 106
Use of Services
Preferred One Community Health Plan
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
55533
24358
231428
3173
0
314492
Female
54721
23556
214138
2567
0
294982
Total
110254
47914
445566
5740
0
609474
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
0-12
Number
169
94
263
152
174
326
686
1192
1878
9
11
20
0
0
0
1016
1471
2487
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
55533
24358
231428
3173
0
314492
Female
54721
23556
214138
2567
0
294982
Total
110254
47914
445566
5740
0
609474
Number
2
0
2
13
16
29
33
42
75
0
0
0
0
0
0
48
58
106
Female
54721
23556
214138
2567
0
294982
Total
110254
47914
445566
5740
0
609474
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
3.65%
2.06%
2.86%
7.49%
8.86%
8.16%
3.56%
6.68%
5.06%
3.40%
5.14%
4.18%
NA
NA
NA
3.88%
5.98%
4.90%
Male
55533
24358
231428
3173
0
314492
Percent
0.04%
0.00%
0.02%
0.64%
0.82%
0.73%
0.17%
0.24%
0.20%
0.00%
0.00%
0.00%
NA
NA
NA
0.18%
0.24%
0.21%
Number
14
4
18
12
21
33
27
68
95
1
0
1
0
0
0
54
93
147
Percent
0.30%
0.09%
0.20%
0.59%
1.07%
0.83%
0.14%
0.38%
0.26%
0.38%
0.00%
0.21%
NA
NA
NA
0.21%
0.38%
0.29%
Member Months
(Outpatient/ED)
Male
55533
24358
231428
3173
0
314492
Female
54721
23556
214138
2567
0
294982
Total
110254
47914
445566
5740
0
609474
Outpatient/ED
Number
165
94
259
149
168
317
667
1160
1827
9
11
20
0
0
0
990
1433
2423
Percent
3.57%
2.06%
2.82%
7.34%
8.56%
7.94%
3.46%
6.50%
4.92%
3.40%
5.14%
4.18%
NA
NA
NA
3.78%
5.83%
4.77%
Page 107
Use of Services
Preferred One Community Health Plan
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare Advantage
Member Months
(Any)
Age
Male
Female
0-12
13-17
18-64
65+
Unknown
Total
NR
NR
Total
NR
NR
NR
NR
NR
NR
Any Services
Sex
M
F
Total
M
13-17
F
Total
M
18-64
F
Total
M
65+
F
Total
Unknown M
F
Total
Total
M
F
Total
Age
Number
0-12
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 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 108
Use of Services
Preferred One Community Health Plan
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MSHO
Member Months
(Any)
Age
Male
Female
0-12
13-17
18-64
65+
Unknown
Total
NR
NR
Total
NR
NR
NR
NR
NR
NR
Any Services
Sex
M
F
Total
M
13-17
F
Total
M
18-64
F
Total
M
65+
F
Total
Unknown M
F
Total
Total
M
F
Total
Age
Number
0-12
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 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 109
Use of Services
Preferred One Community Health Plan
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MnDHO
Member Months
(Any)
Age
Male
Female
0-12
13-17
18-64
65+
Unknown
Total
NR
NR
Total
NR
NR
NR
NR
NR
NR
Any Services
Sex
M
F
Total
M
13-17
F
Total
M
18-64
F
Total
M
65+
F
Total
Unknown M
F
Total
Total
M
F
Total
Age
Number
0-12
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 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 110
Use of Services
Preferred One Community Health Plan
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
SNBC
Member Months
(Any)
Age
Male
Female
0-12
13-17
18-64
65+
Unknown
Total
NR
NR
Total
NR
NR
NR
NR
NR
NR
Any Services
Sex
M
F
Total
M
13-17
F
Total
M
18-64
F
Total
M
65+
F
Total
Unknown M
F
Total
Total
M
F
Total
Age
Number
0-12
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 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 111
Use of Services
Preferred One Community Health Plan
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care(MHCP-MC)
Member Months
(Any)
Age
Male
Female
0-12
13-17
18-64
65+
Unknown
Total
NR
NR
Total
NR
NR
NR
NR
NR
NR
Sex
M
F
Total
M
13-17
F
Total
M
18-64
F
Total
M
65+
F
Total
Unknown M
F
Total
Total
M
F
Total
Age
Number
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Outpatient/ED
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 112
Use of Services
Preferred One Community Health Plan
Outpatient Drug Utilization
Commercial
Age
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
Member Months
83831
74337
156404
166403
122759
5436
237
67
4
609478
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 10:02 AM
$1,134,273.00
$2,099,612.00
$4,663,353.00
$8,596,697.00
$12,252,341.00
$727,159.00
$41,734.00
$12,367.00
$0.00
$29,527,536.00
HEDIS 2009 (Reporting Year 2008)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$13.53
$28.24
$29.82
$51.66
$99.81
$133.77
$176.09
$184.58
$48.45
Total Number of
Prescriptions
19754
23733
87037
148028
227650
15875
943
424
0
523444
Avg. Num. Of
Prescriptions /
Per Member Per
Year
2.83
3.83
6.68
10.67
22.25
35.04
47.75
75.94
10.31
Page 113
Use of Services
Preferred One Community Health Plan
Outpatient Drug Utilization
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare Advantage
Age
Member Months
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
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 114
Use of Services
Preferred One Community Health Plan
Outpatient Drug Utilization
MSHO
Age
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
Data Last Refreshed:
Jan 10, 2011 10:02 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 115
Use of Services
Preferred One Community Health Plan
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 10:02 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 116
Use of Services
Preferred One Community Health Plan
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 10:02 AM
Member Months
NR
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 117
Use of Services
Preferred One Community Health Plan
Outpatient Drug Utilization
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
NR
Age
Avg. Cost of
Prescriptions /
Total Cost of
Per Member Per Total Number of
Prescriptions
Prescriptions
Month
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
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 118
Health Plan Descriptive Information
Preferred One Community Health Plan
Data Last Refreshed:
Jan 10, 2011 10:02 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
Preferred One Community Health Plan
Data Last Refreshed:
Jan 10, 2011 10:02 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
Preferred One Community Health Plan
Data Last Refreshed:
Jan 10, 2011 10:02 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
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
3948
16126
21838
23183
14796
9344
Member Months
Female
3965
16958
20996
21897
14461
9049
Total
7913
33084
42834
45080
29257
18393
89235
28.37%
22493
27275
23826
26108
28514
87326
29.60%
19548
23002
21867
24052
26810
176561
28.97%
128216
40.77%
31333
27469
22222
12844
115279
39.08%
29586
26734
20234
13256
243495
39.95%
93868
29.85%
2480
499
86
56
28
24
89810
30.45%
2090
367
68
27
15
0
183678
30.14%
3173
1.01%
2
2567
0.87%
2
5740
0.94%
314494
294984
HEDIS 2009 (Reporting Year 2008)
42041
50277
45693
50160
55324
60919
54203
42456
26100
4570
866
154
83
43
24
4
609478
Page 122
Health Plan Descriptive Information
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare Advantage
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
NR
NR
NR
NR
NR
NR
Age Unknown
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
Page 123
Health Plan Descriptive Information
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MSHO
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
NR
NR
NR
NR
NR
NR
Age Unknown
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
Page 124
Health Plan Descriptive Information
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MnDHO
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
NR
NR
NR
NR
NR
NR
Age Unknown
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
Page 125
Health Plan Descriptive Information
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 10:02 AM
SNBC
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
NR
NR
NR
NR
NR
NR
Age Unknown
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
Page 126
Health Plan Descriptive Information
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
NR
NR
NR
NR
NR
NR
Age Unknown
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2009 (Reporting Year 2008)
Page 127
Health Plan Stability
Preferred One Community Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Commercial
Product/Product Line
Years in Business
Members*
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
0.00
13.00
0.00
0.00
13.00
0
49029
0
0
49029
49029
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
Preferred One Community Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Medicare Advantage
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 129
Health Plan Stability
Preferred One Community Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MSHO
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 130
Health Plan Stability
Preferred One Community Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 10:02 AM
MnDHO
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 131
Health Plan Stability
Preferred One Community Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 10:02 AM
SNBC
Product/Product Line
Years in Business
Members*
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:
NR
NR
Total:
NR
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 132
Health Plan Stability
Preferred One Community Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 10:02 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Product/Product Line
Years in Business
Members*
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:
NR
NR
Total:
NR
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 133