Medica Health Plans
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
Medica Health Plans
Childhood Immunization Status
Data Last Refreshed:
Jan 10, 2011 9:56 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
2381
73.28%
2496
76.82%
2945
90.64%
2475
76.18%
2457
75.62%
2857
87.93%
2338
71.96%
2081
64.05%
1984
61.06%
321
70.86%
347
76.60%
412
90.95%
335
73.95%
338
74.61%
395
87.20%
324
71.52%
281
62.03%
272
60.04%
337
26
88.32%
85.09%
91.55%
339
51
94.89%
92.64%
97.14%
353
39
95.38%
93.23%
97.53%
341
33
91.00%
88.11%
93.89%
335
39
91.00%
88.11%
93.89%
346
30
91.48%
88.66%
94.30%
339
6
83.94%
80.27%
87.61%
322
13
81.51%
77.63%
85.38%
312
4
76.89%
72.69%
81.08%
453
0
Number of Records Excluded because of
Contraindications by Admin Data
1
Number of Records Excluded because of
Contraindications by Medical Record
Review
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
1
HEDIS 2009 (Reporting Year 2008)
MMR
411
10.00%
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
2007
H
3249
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
Medica Health Plans
Childhood Immunization Status
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Pneumococcal
Conjugate
Combo 2
Combo 3
2040
75.78%
2224
82.62%
2434
90.42%
2133
79.23%
2195
81.54%
2372
88.11%
2036
75.63%
1723
64.00%
1632
60.62%
345
76.16%
373
82.34%
417
92.05%
360
79.47%
371
81.90%
404
89.18%
345
76.16%
284
62.69%
266
58.72%
350
8
87.10%
83.74%
90.47%
368
15
93.19%
90.63%
95.74%
377
14
95.13%
92.93%
97.34%
366
11
91.73%
88.94%
94.51%
371
9
92.46%
89.78%
95.13%
364
12
91.48%
88.66%
94.30%
336
4
82.73%
78.95%
86.50%
319
5
78.83%
74.76%
82.90%
298
2
72.99%
68.58%
77.41%
453
0
Number of Records Excluded because of
Contraindications by Admin Data
6
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
1
HEDIS 2009 (Reporting Year 2008)
MMR
411
10.00%
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
2007
H
2692
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
DTaP
411
Page 4
Effectiveness of Care
Medica Health Plans
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 9:56 AM
Commercial
2008
A
41327
29642
71.73%
71.29%
72.16%
Medicare
Advantage
NR
NR
NR
MSHO
2008
A
467
270
57.82%
53.23%
62.40%
MnDHO
SNBC
MHCP-MC
NR
NR
NR
2008
A
1
1
NA
NA
NA
2008
A
3236
1961
60.60%
58.90%
62.30%
Page 5
Effectiveness of Care
Medica Health Plans
Cervical Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Commercial
MHCP-MC
2008
A
42345
2008
A
13906
NR
NR
NR
NR
33583
10529
79.31%
78.92%
79.70%
75.72%
75.00%
76.43%
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
Number of 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)
Page 6
Effectiveness of Care
Medica Health Plans
Colorectal Cancer Screening
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Data Elements
Commercial
Medicare
Advantage
MSHO
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
2008
H
47425
2008
H
3536
Number of numerator events by administrative data in eligible population
(before exclusions)
23921
1413
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)
50.44%
411
0.05
432
213
49.31%
0
57
0
0
0
411
204
42
59.85%
54.99%
64.71%
NR
NR
NR
NR
NR
39.96%
411
0.05
432
176
40.74%
0
21
0
0
0
411
165
27
46.72%
41.77%
51.66%
MnDHO
SNBC
2008
A
0
NR
NR
NR
NR
0
NR
NR
NR
NA
NA
NA
Page 7
Effectiveness of Care
Medica Health Plans
Chlamydia Screening in Women
Data Last Refreshed:
Jan 10, 2011 9:56 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
4331
1780
41.10%
39.62%
42.58%
4387
2064
47.05%
45.56%
48.54%
8718
3844
44.09%
43.04%
45.14%
Page 8
Effectiveness of Care
Medica Health Plans
Chlamydia Screening in Women
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Data Elements
Measure Ages 16-20 Ages 21-24
Data
Measurement Year
2008
Data Collection Methodology
A
Eligible Member Population
1859
1734
Numerator Events by Admin Data
1105
1060
Reported Rate
59.44%
61.13%
Lower 95% Confidence Interval
57.18%
58.81%
Upper 95% Confidence Interval
61.70%
63.45%
HEDIS 2009 (Reporting Year 2008)
Total
3593
2165
60.26%
58.64%
61.87%
Page 9
Effectiveness of Care
Medica Health Plans
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 9:56 AM
Medicare
Advantage
NR
NR
NR
MSHO
2008
A
6579
4875
74.10%
73.03%
75.17%
Page 10
Effectiveness of Care
Medica Health Plans
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Lead Screening in Children
Data Elements
Commercial
MHCP-MC
2008
A
3140
2008
A
2792
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
1862
2570
Reported Rate
59.30%
92.05%
Lower 95% Confidence Interval
57.57%
91.03%
Upper 95% Confidence Interval
61.03%
93.07%
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population (before exclusions)
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
HEDIS 2009 (Reporting Year 2008)
Page 11
Effectiveness of Care
Medica Health Plans
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
5328
643
87.93%
87.05%
88.82%
2008
A
5132
478
90.69%
89.88%
91.49%
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Page 12
Effectiveness of Care
Medica Health Plans
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure Data
Systemic
corticosteroid
Bronchodilator
121
59.90%
52.89%
66.91%
169
83.66%
78.32%
89.01%
2008
A
202
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
Medica Health Plans
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 9:56 AM
SNBC
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Exclusions based on direct transfers to
another facility
Exclusions based on readmissions
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
General
Measure Data
Systemic
corticosteroid
Bronchodilator
3
NA
NA
NA
4
NA
NA
NA
2008
A
4
0
0
Page 16
Effectiveness of Care
Medica Health Plans
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)
Medicare
Advantage
NR
NR
NR
MSHO
2008
A
314
51
16.24%
12.00%
20.48%
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MnDHO
SNBC
NR
NR
NR
2008
A
0
0
NA
NA
NA
Page 17
Effectiveness of Care
Medica Health Plans
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jan 10, 2011 9:56 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
333
323
97.00%
95.01%
98.98%
556
524
94.24%
92.22%
96.27%
2224
2044
91.91%
90.75%
93.06%
3113
2891
92.87%
91.95%
93.79%
2008
A
Page 18
Effectiveness of Care
Medica Health Plans
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
Total
275
257
93.45%
90.35%
96.56%
377
335
88.86%
85.55%
92.17%
588
490
83.33%
80.24%
86.43%
1240
1082
87.26%
85.36%
89.15%
2008
A
Page 19
Effectiveness of Care
Medica Health Plans
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 9:56 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
1559
34
85.99%
1.88%
372
7
86.11%
1.62%
40
325
7
239
88.81%
85.64%
91.98%
59.85%
54.99%
64.71%
2008
H
1813
411
5.00%
432
0
0
0
411
Page 20
Effectiveness of Care
Medica Health Plans
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 9:56 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
183
3
73.20%
1.20%
182
3
73.09%
1.20%
16
178
0
130
77.91%
72.56%
83.27%
52.21%
45.80%
58.61%
2008
H
250
249
0.00%
249
0
0
0
249
Page 22
Effectiveness of Care
Medica Health Plans
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 9:56 AM
SNBC
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
General
Measure
Data
2008
A
0
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
0
0
NA
NA
NA
NA
NA
NA
Page 24
Effectiveness of Care
Medica Health Plans
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Measure
Data
2008
H
193
LDL-C
screening
LDL-C Level of
<100 mg/dL
143
15
74.09%
7.77%
143
15
74.09%
7.77%
25
138
0
95
84.46%
49.22%
Lower 95% Confidence Interval
79.09%
41.91%
Upper 95% Confidence Interval
89.83%
56.54%
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
HEDIS 2009 (Reporting Year 2008)
193
0.00%
193
0
0
0
193
Page 25
Effectiveness of Care
Medica Health Plans
Controlling High Blood Pressure
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Data Elements
Commercial
Medicare
Advantage
MSHO
MnDHO
SNBC
MHCP-MC
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2008
H
16883
2008
H
2096
2008
H
0
2008
H
2879
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
0
0
0
NA
0
0.00%
0
0.00%
401
10.00%
442
0
NR
0
0.00%
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%
395
10.00%
435
0
0.00%
NR
NR
0.00%
392
10.00%
432
0
0.00%
NR
NR
Records Excluded because of Valid Data
Errors
0
0
0
0
Number of records excluded because of
false positive diagnoses
0
0
0
0
Number of administrative data records
excluded
268
86
0
116
Number of medical record data records
excluded
18
10
0
20
Number of employee/dependent medical
records excluded
0
0
0
0
Records Added from the OverSample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
18
395
0
257
65.06%
60.23%
69.89%
10
392
0
246
62.76%
57.84%
67.67%
0
0
0
0
NA
NA
NA
20
401
0
226
56.36%
51.38%
61.34%
HEDIS 2009 (Reporting Year 2008)
NR
NR
NR
NR
NR
NR
Page 26
Effectiveness of Care
Medica Health Plans
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Commercial
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Medicare
Advantage
MSHO
MnDHO
SNBC
MHCP-MC
2008
A
257
2008
A
63
2008
A
0
2008
A
46
195
55
0
24
NR
NR
NR
52.17%
36.65%
67.70%
75.88%
70.45%
81.30%
NR
NR
NR
87.30%
78.29%
96.32%
NR
NR
NR
Page 27
Effectiveness of Care
Medica Health Plans
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 9:56 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
2008
H
8963
2008
H
8963
7858
87.67%
548
0%
548
479
87.41%
8645
96.45%
548
0%
548
535
97.63%
Good HbA1c
Control
(<7.0%)
2008
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2008
H
8963
2008
H
8963
2008
H
8963
2008
H
8963
2008
H
8963
2008
H
8963
2008
H
8963
207
2.31%
548
0%
548
10
1.82%
4659
51.98%
548
0%
548
278
50.73%
7217
80.52%
548
0%
548
450
82.12%
165
1.84%
548
0%
548
9
1.64%
7276
81.18%
548
0%
548
428
78.10%
93
1.04%
548
0%
548
6
1.09%
66
0.74%
548
0%
548
5
0.91%
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
93
93
93
93
93
93
93
93
93
Number of medical record data records
excluded
10
10
10
10
10
10
10
10
10
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
538
26
458
89.96%
87.33%
92.59%
0
538
139
3
26.39%
22.58%
30.21%
0
538
0
351
65.24%
61.12%
69.36%
0
538
15
300
58.55%
54.29%
62.81%
0
538
32
425
84.94%
81.83%
88.06%
0
538
0
263
48.88%
44.57%
53.20%
0
538
12
432
82.53%
79.23%
85.83%
0
538
0
397
73.79%
69.98%
77.60%
0
538
0
266
49.44%
45.12%
53.76%
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
NR
NR
NR
Page 28
Effectiveness of Care
Medica Health Plans
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
HbA1c
Testing
Poor HbA1c
Control
2008
H
1002
2008
H
1002
900
89.82%
411
5%
432
386
89.35%
936
93.41%
411
5%
432
402
93.06%
Good HbA1c
Control
(<7.0%)
2008
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2008
H
1002
2008
H
1002
2008
H
1002
2008
H
1002
2008
H
1002
2008
H
1002
2008
H
1002
59
5.89%
411
5%
432
26
6.02%
664
66.27%
411
5%
432
291
67.36%
778
77.64%
411
5%
432
344
79.63%
68
6.79%
411
5%
432
32
7.41%
875
87.33%
411
5%
432
379
87.73%
67
6.69%
411
5%
432
30
6.94%
49
4.89%
411
5%
432
26
6.02%
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
7
7
7
7
7
7
7
7
7
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
7
411
40
338
91.97%
89.22%
94.72%
7
411
105
9
27.74%
23.29%
32.19%
7
411
0
278
67.64%
63.00%
72.28%
7
411
5
281
69.59%
65.02%
74.16%
7
411
35
304
82.48%
78.69%
86.28%
7
411
2
218
53.53%
48.58%
58.47%
7
411
5
372
91.73%
88.94%
94.51%
7
411
3
287
70.56%
66.03%
75.09%
7
411
3
217
53.53%
48.58%
58.47%
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
NR
NR
NR
Page 30
Effectiveness of Care
Medica Health Plans
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 9:56 AM
SNBC
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
HbA1c
Testing
Poor HbA1c
Control
2008
A
2
2008
A
2
NR
NR
NR
NR
2
2
NA
NA
NA
NA
NA
NA
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2008
A
2
2008
A
2
2008
A
2
2008
A
2
2008
A
2
2008
A
2
2008
A
2
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
0
2
2
0
1
0
0
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Good HbA1c
Control
(<7.0%)
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
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)
NR
NR
NR
Page 32
Effectiveness of Care
Medica Health Plans
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
HbA1c
Testing
Poor HbA1c
Control
2008
H
2173
2008
H
2173
1713
78.83%
548
0%
548
444
81.02%
2021
93.01%
548
0%
548
523
95.44%
Good HbA1c
Control
(<7.0%)
2008
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2008
H
2173
2007
H
2017
2008
H
2173
2008
H
2173
2008
H
2173
2007
H
2017
2007
H
2017
76
3.50%
548
0%
548
17
3.10%
1059
52.50%
411
10%
453
249
54.97%
1498
68.94%
548
0%
548
394
71.90%
106
4.88%
548
0%
548
29
5.29%
1544
71.05%
548
0%
548
389
70.99%
31
1.54%
411
10%
453
9
1.99%
22
1.09%
411
10%
453
8
1.77%
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
50
50
50
55
50
50
50
55
55
Number of medical record data records
excluded
16
16
16
6
16
16
16
6
6
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
531
68
392
86.63%
83.64%
89.62%
0
531
191
5
36.91%
32.71%
41.11%
0
531
0
287
54.05%
49.72%
58.38%
6
411
14
225
58.15%
53.26%
63.04%
0
531
83
336
78.91%
75.34%
82.47%
0
531
0
204
38.42%
34.19%
42.65%
0
531
42
376
78.72%
75.14%
82.29%
6
411
1
295
72.02%
67.56%
76.48%
6
411
1
199
48.66%
43.71%
53.62%
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
NR
NR
NR
Page 33
Effectiveness of Care
Medica Health Plans
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)
Medicare
Advantage
NR
NR
NR
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
2008
A
370
37
10.00%
6.81%
13.19%
Page 34
Effectiveness of Care
Medica Health Plans
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 9:56 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
2537
1758
69.29%
67.48%
71.11%
1341
52.86%
50.90%
54.82%
Page 35
Effectiveness of Care
Medica Health Plans
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
General Effective Acute
Measure
Phase
Data
Treatment
Effective
Continuation
Phase
Treatment
2008
A
97
64
65.98%
56.04%
75.92%
53
54.64%
44.22%
65.06%
Page 37
Effectiveness of Care
Medica Health Plans
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 9:56 AM
SNBC
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
General Effective Acute
Measure
Phase
Data
Treatment
Effective
Continuation
Phase
Treatment
2008
A
0
0
NA
NA
NA
0
NA
NA
NA
Page 39
Effectiveness of Care
Medica Health Plans
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
General Effective Acute
Measure
Phase
Data
Treatment
Effective
Continuation
Phase
Treatment
2008
A
827
441
53.33%
49.86%
56.79%
292
35.31%
31.99%
38.63%
Page 40
Effectiveness of Care
Medica Health Plans
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jan 10, 2011 9:56 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
786
327
41.60%
38.09%
45.11%
211
99
46.92%
39.95%
53.89%
2008
A
Page 41
Effectiveness of Care
Medica Health Plans
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jan 10, 2011 9:56 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
520
293
56.35%
51.99%
60.71%
155
98
63.23%
55.31%
71.14%
2008
A
Page 42
Effectiveness of Care
Medica Health Plans
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 9:56 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
26
54.17%
39.03%
69.30%
19
39.58%
24.71%
54.46%
2008
A
48
Page 44
Effectiveness of Care
Medica Health Plans
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 9:56 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
8
NA
NA
NA
7
NA
NA
NA
2008
A
9
Page 46
Effectiveness of Care
Medica Health Plans
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 9:56 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
13796
11838
85.81%
85.22%
86.39%
194
175
90.21%
85.77%
94.65%
10910
9446
86.58%
85.94%
87.23%
791
633
80.03%
77.18%
82.87%
25691
22092
85.99%
85.56%
86.42%
2008
A
Page 47
Effectiveness of Care
Medica Health Plans
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 9:56 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
2763
2710
98.08%
97.55%
98.61%
309
307
99.35%
98.30%
100.00%
2908
2854
98.14%
97.64%
98.65%
408
398
97.55%
95.93%
99.17%
6388
6269
98.14%
97.80%
98.48%
2008
A
Page 49
Effectiveness of Care
Medica Health Plans
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 9:56 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
0
0
NA
NA
NA
0
0
NA
NA
NA
1
1
NA
NA
NA
0
0
NA
NA
NA
1
1
NA
NA
NA
2008
A
Page 51
Effectiveness of Care
Medica Health Plans
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
1566
1434
91.57%
90.16%
92.98%
30
27
90.00%
77.60%
100.00%
1325
1229
92.75%
91.32%
94.19%
220
191
86.82%
82.12%
91.52%
3141
2881
91.72%
90.74%
92.70%
2008
A
Page 52
Effectiveness of Care
Medica Health Plans
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
Drug-Disease Interactions
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
General
Measure
Data
History of Falls +
Dementia +
Chronic Renal
Tricyclic
Tricyclic
Failure +
Antidepressants, Antidepressants or Nonaspirin NSAIDs
Antipsychotics or
Anticholinergic or Cox-2 Selective
Sleep Agents
Agents
NSAIDs
Total
2008
A
514
106
20.62%
17.03%
24.22%
2279
621
27.25%
25.40%
29.10%
138
13
9.42%
4.18%
14.66%
2931
740
25.25%
23.66%
26.84%
Page 54
Effectiveness of Care
Medica Health Plans
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
General
Measure
Data
2008
A
7711
At least 1
Prescription
At least 2
Prescriptions
1932
25.06%
24.08%
26.03%
417
5.41%
4.90%
5.92%
Page 56
Access/Availability of Care
Medica Health Plans
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 9:56 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+
42287
48877
2601
40156
47146
2542
94.96%
94.75%
95.17%
96.46%
96.29%
96.62%
97.73%
97.14%
98.32%
2008
A
Page 57
Access/Availability of Care
Medica Health Plans
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
0
0
7711
0
0
7541
NA
NA
NA
NA
NA
NA
97.80%
97.46%
98.13%
2008
A
Page 59
Access/Availability of Care
Medica Health Plans
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 9:56 AM
SNBC
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
4
2
0
4
2
0
NA
NA
NA
NA
NA
NA
NA
NA
NA
2008
A
Page 61
Access/Availability of Care
Medica Health Plans
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
16411
7264
1820
14738
6564
1718
89.81%
89.34%
90.27%
90.36%
89.68%
91.05%
94.40%
93.31%
95.48%
2008
A
Page 62
Access/Availability of Care
Medica Health Plans
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jan 10, 2011 9:56 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.
3364
3313
16902
15549
12872
11849
23086
21322
98.48%
98.06%
98.91%
92.00%
91.58%
92.41%
92.05%
91.58%
92.52%
92.36%
92.01%
92.70%
2008
A
Page 63
Access/Availability of Care
Medica Health Plans
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Data Elements
Measurement Year
Data collection methodology (Administrative
only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
General Measure
Data
12-24 months
25 months 6 yrs.
7-11 yrs.
12-19 yrs.
4189
4142
11186
10379
6182
5716
8054
7429
98.88%
98.55%
99.21%
92.79%
92.30%
93.27%
92.46%
91.80%
93.13%
92.24%
91.65%
92.83%
2008
A
Page 64
Access/Availability of Care
Medica Health Plans
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 9:56 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
238
3057
3295
91
35
1085
360
1176
395
38.24%
31.85%
44.62%
14.71%
10.00%
19.42%
35.49%
33.78%
37.20%
11.78%
10.62%
12.94%
35.69%
34.04%
37.34%
11.99%
10.86%
13.11%
Page 65
Access/Availability of Care
Medica Health Plans
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology (Administrative
only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
2008
A
0
113
113
0
0
52
4
52
4
NA
NA
NA
NA
NA
NA
46.02%
36.39%
55.65%
3.54%
0.00%
7.39%
46.02%
36.39%
55.65%
3.54%
0.00%
7.39%
Page 67
Access/Availability of Care
Medica Health Plans
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 9:56 AM
SNBC
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology (Administrative
only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
2008
A
0
9
9
0
0
2
2
2
2
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Page 69
Access/Availability of Care
Medica Health Plans
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology (Administrative
only)
Eligible member population
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Total
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
2008
A
282
3026
3308
101
43
1130
423
1231
466
35.82%
30.04%
41.59%
15.25%
10.88%
19.62%
37.34%
35.60%
39.08%
13.98%
12.73%
15.23%
37.21%
35.55%
38.88%
14.09%
12.89%
15.29%
Page 70
Access/Availability of Care
Medica Health Plans
Prenatal and Postpartum Care
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
2008
H
4189
2008
H
4189
Number of numerator events by administrative data in eligible
population (before exclusions)
3004
2475
71.71%
288
5%
303
224
59.08%
288
5%
303
180
73.93%
59.41%
4
4
0
4
288
125
144
0
4
288
126
100
93.40%
90.36%
96.44%
78.47%
73.55%
83.39%
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
Medica Health Plans
Prenatal and Postpartum Care
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Timeliness of
Prenatal Care
Postpartum
Care
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
2008
H
5102
2008
H
5102
Number of numerator events by administrative data in eligible
population (before exclusions)
3257
2736
63.84%
411
5%
432
293
53.63%
411
5%
432
237
67.82%
54.86%
0
0
1
1
411
166
206
1
1
411
161
113
90.51%
87.56%
93.47%
66.67%
61.99%
71.35%
Data Elements
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid
data errors
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2009 (Reporting Year 2008)
Page 72
Use of Services
Medica Health Plans
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jan 10, 2011 9:56 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
42
32
42
55
143
403
1984
1.55%
1.07%
2.04%
1.18%
0.76%
1.61%
1.55%
1.07%
2.04%
2.04%
1.49%
2.59%
5.29%
4.43%
6.16%
14.92%
13.56%
16.28%
73.45%
71.77%
75.14%
2008
A
2701
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
Medica Health Plans
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
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
65
118
222
285
462
637
2184
1.64%
1.23%
2.04%
2.97%
2.43%
3.51%
5.59%
4.86%
6.31%
7.17%
6.36%
7.99%
11.63%
10.62%
12.64%
16.03%
14.88%
17.19%
54.97%
53.41%
56.53%
2008
A
3973
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
Medica Health Plans
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Commercial
MHCP-MC
2008
A
13776
2008
A
8798
NR
NR
NR
NR
9177
6161
66.62%
65.82%
67.41%
70.03%
69.06%
70.99%
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
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)
Page 75
Use of Services
Medica Health Plans
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Commercial
MHCP-MC
2008
A
37806
2008
A
13350
NR
NR
NR
NR
12638
5046
33.43%
32.95%
33.91%
37.80%
36.97%
38.62%
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
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)
Page 76
Use of Services
Medica Health Plans
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Commercial
Member Months
Total
264434
535076
851006
580364
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
1188
288
448
189
0-4
5-19
4.49
0.34
0.84
0.33
Member Months
Age
15-44
20-44
30-64
45-64
65+
Male
827384
1163405
641853
29266
Female
931321
785128
631602
22263
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+
Cholecystectomy,
Closed
30-64
15-44
45-64
65+
Back Surgery
20-44
45-64
65+
Angioplasty (PTCA) 45-64
65+
45-64
Cardiac
Catheterization
65+
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)
22
3
0.10
0.18
41
80
9
189
37
Procedures /
1,000 Member
Months
70
72
255
282
5
169
185
6
0.08
0.11
10
24
0
0.01
0.04
0.00
408
266
16
166
264
15
105
8
201
0.44
0.42
0.72
0.27
0.45
0.22
0.18
0.29
0.27
0.02
206
12
176
285
20
408
37
385
Number of
Procedures
0.41
0.21
0.44
0.68
0.64
1.26
0.60
1.40
0.12
0.31
26
12
3
0.21
0.42
0.67
0.17
0.36
0.32
1.17
0.02
0.13
0.29
1.26
67
159
2
163
287
9
0.07
0.25
0.09
0.18
0.45
0.40
Page 77
Use of Services
Medica Health Plans
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
Member Months
Age
Male
0
12200
9845
5290
< 65
65-74
75-84
85+
Female
0
22169
25369
29074
Male
Procedure
Age
CABG
<65
65-74
75-84
85+
Angioplasty
(PTCA)
<65
65-74
75-84
85+
Cardiac
Catheterization
<65
65-74
75-84
85+
Carotid
Endarterectomy
<65
65-74
75-84
85+
Reduction of
Fracture of Femur
<65
65-74
75-84
85+
Total Hip
Replacement
<65
65-74
75-84
85+
Total Knee
Replacement
<65
65-74
75-84
85+
Partial Excision of
Large Inestine
<65
65-74
75-84
85+
Cholecystectomy,
Open
<65
65-74
75-84
85+
Cholecystectomy,
Closed
(laparoscopic)
<65
65-74
75-84
85+
Back Surgery
<65
65-74
75-84
85+
Hysterectomy
Abdominal
<65
65-74
75-84
85+
Hysterectomy,
Vaginal
<65
65-74
75-84
85+
Mastectomy
<65
65-74
75-84
85+
Lumpectomy
<65
65-74
75-84
85+
HEDIS 2009 (Reporting Year 2008)
Number of
Procedures
0
6
2
0
0
6
10
1
0
27
11
1
0
0
0
0
0
3
6
10
0
2
1
1
0
5
6
1
0
2
0
2
0
3
1
2
0
4
1
5
0
9
1
1
Female
Procedures /
1,000 Member
Months
NA
0.49
0.20
0.00
NA
0.49
1.02
0.19
NA
2.21
1.12
0.19
NA
0.00
0.00
0.00
NA
0.25
0.61
1.89
NA
0.16
0.10
0.19
NA
0.41
0.61
0.19
NA
0.16
0.00
0.38
NA
0.25
0.10
0.38
NA
0.33
0.10
0.95
NA
0.74
0.10
0.19
Number of
Procedures
0
2
2
2
0
19
16
3
0
39
20
5
0
4
2
1
0
14
27
59
0
4
5
11
0
23
14
3
0
3
5
4
0
0
1
3
0
9
7
6
0
10
19
0
0
3
3
0
0
2
1
0
0
1
3
8
0
6
9
1
Procedures /
1,000 Member
Months
NA
0.09
0.08
0.07
NA
0.86
0.63
0.10
NA
1.76
0.79
0.17
NA
0.18
0.08
0.03
NA
0.63
1.06
2.03
NA
0.18
0.20
0.38
NA
1.04
0.55
0.10
NA
0.14
0.20
0.14
NA
0.00
0.04
0.10
NA
0.41
0.28
0.21
NA
0.45
0.75
0.00
NA
0.14
0.12
0.00
NA
0.09
0.04
0.00
NA
0.05
0.12
0.28
NA
0.27
0.35
0.03
Page 79
Use of Services
Medica Health Plans
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 9:56 AM
SNBC
Member Months
Age
Male
873
0
0
0
< 65
65-74
75-84
85+
Female
1397
2
0
0
Male
Procedure
Age
CABG
<65
65-74
75-84
85+
Angioplasty
(PTCA)
<65
65-74
75-84
85+
Cardiac
Catheterization
<65
65-74
75-84
85+
Carotid
Endarterectomy
<65
65-74
75-84
85+
Reduction of
Fracture of Femur
<65
65-74
75-84
85+
Total Hip
Replacement
<65
65-74
75-84
85+
Total Knee
Replacement
<65
65-74
75-84
85+
Partial Excision of
Large Inestine
<65
65-74
75-84
85+
Cholecystectomy,
Open
<65
65-74
75-84
85+
Cholecystectomy,
Closed
(laparoscopic)
<65
65-74
75-84
85+
Back Surgery
<65
65-74
75-84
85+
Hysterectomy
Abdominal
<65
65-74
75-84
85+
Hysterectomy,
Vaginal
<65
65-74
75-84
85+
Mastectomy
<65
65-74
75-84
85+
Lumpectomy
<65
65-74
75-84
85+
HEDIS 2009 (Reporting Year 2008)
Number of
Procedures
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
Female
Procedures /
1,000 Member
Months
0.00
NA
NA
NA
1.15
NA
NA
NA
1.15
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
1.15
NA
NA
NA
1.15
NA
NA
NA
0.00
NA
NA
NA
0.00
NA
NA
NA
2.29
NA
NA
NA
0.00
NA
NA
NA
Number of
Procedures
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
3
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
2
0
0
0
0
0
0
0
1
0
0
0
Procedures /
1,000 Member
Months
0.00
0.00
NA
NA
0.00
0.00
NA
NA
2.15
0.00
NA
NA
0.00
0.00
NA
NA
0.72
0.00
NA
NA
0.00
0.00
NA
NA
2.15
0.00
NA
NA
0.72
0.00
NA
NA
0.00
0.00
NA
NA
0.00
0.00
NA
NA
0.72
0.00
NA
NA
0.72
0.00
NA
NA
1.43
0.00
NA
NA
0.00
0.00
NA
NA
0.72
0.00
NA
NA
Page 81
Use of Services
Medica Health Plans
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC
Member Months
Total
Age
312732
0-4
522103
0-9
521349
5-19
311978
10-19
Total
Number of
Procedures
Procedure
Myringotomy
Age
Tonsillectomy
0-9
10-19
Procedures /
1,000 Member
Months
1306
277
387
143
0-4
5-19
4.18
0.53
0.74
0.46
Member Months
Age
15-44
20-44
30-64
45-64
Male
127924
136850
62967
Female
372763
295555
81052
Male
Procedure
Age
Dilation & Curettage 15-44
45-64
Hysterectomy,
15-44
Abdominal
45-64
Number of
Procedures
Hysterectomy,
Vaginal
15-44
45-64
Cholecystectomy,
Open
30-64
15-44
45-64
4
Cholecystectomy,
Closed
30-64
15-44
45-64
20-44
45-64
32
Back Surgery
Mastectomy
15-44
45-64
Lumpectomy
15-44
45-64
HEDIS 2009 (Reporting Year 2008)
66
57
Female
Procedures /
1,000 Member
Months
Number of
Procedures
Procedures /
1,000 Member
Months
52
14
99
56
69
21
0.14
0.17
10
7
0.03
0.09
292
62
112
82
15
15
94
30
0.78
0.76
0.27
0.69
0.19
0.26
0.03
0.23
0.52
0.91
0.38
1.01
0.04
0.19
0.25
0.37
Page 82
Use of Services
Medica Health Plans
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
50596
484480
580364
1612512
1273455
45934
4714
881
0
4052936
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
38978
120507
110355
346338
373724
21142
3253
604
0
1014901
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
770.38
248.73
190.15
214.78
293.47
460.27
690.07
685.58
250.41
Emergency Room Visits
Visits
1349
6858
6729
19556
12650
594
107
24
0
47867
Visits/ 1,000
Member
Months
26.66
14.16
11.59
12.13
9.93
12.93
22.70
27.24
11.81
Ambulatory
Surgery/Procedures
Procedures
513
2434
2138
13178
24979
1412
181
29
0
44864
Procedures/
1,000 Member
Months
10.14
5.02
3.68
8.17
19.62
30.74
38.40
32.92
11.07
Observation Room Stays
Resulting in Discharge
Stays
41
101
84
806
505
26
6
1
0
1570
Stays/ 1,000
Member
Months
0.81
0.21
0.14
0.50
0.40
0.57
1.27
1.14
0.39
Page 83
Use of Services
Medica Health Plans
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
0
0
0
34369
35214
34364
0
103947
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
0
0
1
29915
29430
26075
0
85421
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
870.41
835.75
758.79
821.77
Emergency Room Visits
Visits
0
0
0
0
0
1573
1363
1043
0
3979
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
45.77
38.71
30.35
38.28
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
0
1346
1131
593
0
3070
Procedures/
1,000 Member
Months
NA
NA
NA
NA
NA
39.16
32.12
17.26
29.53
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
90
98
64
0
252
Stays/ 1,000
Member
Months
NA
NA
NA
NA
NA
2.62
2.78
1.86
2.42
Page 85
Use of Services
Medica Health Plans
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 9:56 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
11
758
1501
2
0
0
0
2272
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
1
783
1642
3
0
0
0
2429
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
NA
NA
90.91
1032.98
1093.94
1500.00
NA
NA
1069.10
Emergency Room Visits
Visits
0
0
2
96
146
1
0
0
0
245
Visits/ 1,000
Member
Months
NA
NA
181.82
126.65
97.27
500.00
NA
NA
107.83
Ambulatory
Surgery/Procedures
Procedures
0
0
0
32
78
0
0
0
0
110
Procedures/
1,000 Member
Months
NA
NA
0.00
42.22
51.97
0.00
NA
NA
48.42
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
2
4
0
0
0
0
6
Stays/ 1,000
Member
Months
NA
NA
0.00
2.64
2.66
0.00
NA
NA
2.64
Page 87
Use of Services
Medica Health Plans
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 9:56 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
83387
438716
311978
423479
144019
15260
8481
7880
0
1433200
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
62932
146148
82770
213530
88501
11673
5900
4779
0
616233
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
754.70
333.13
265.31
504.23
614.51
764.94
695.67
606.47
429.97
Emergency Room Visits
Visits
8513
22825
11662
34576
7769
807
362
354
0
86868
Visits/ 1,000
Member
Months
102.09
52.03
37.38
81.65
53.94
52.88
42.68
44.92
60.61
Ambulatory
Surgery/Procedures
Procedures
675
2503
1531
7807
4053
475
174
101
0
17319
Procedures/
1,000 Member
Months
8.09
5.71
4.91
18.44
28.14
31.13
20.52
12.82
12.08
Observation Room Stays
Resulting in Discharge
Stays
95
148
369
1498
190
30
19
27
0
2376
Stays/ 1,000
Member
Months
1.14
0.34
1.18
3.54
1.32
1.97
2.24
3.43
1.66
Page 88
Use of Services
Medica Health Plans
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 9:56 AM
Member Months
50596
484480
580364
1612512
1273455
45934
4714
881
0
4052936
Discharges
Discharges /
1,000 Member
Months
434
661
880
8259
7109
486
89
20
0
17938
8.58
1.36
1.52
5.12
5.58
10.58
18.88
22.70
370
489
414
1675
3248
249
57
17
0
6519
7.31
1.01
0.71
1.04
2.55
5.42
12.09
19.30
64
172
330
1929
3849
237
32
3
0
6616
1.26
0.36
0.57
1.20
3.02
5.16
6.79
3.41
136
4655
11
0
4802
0.23
2.89
0.01
HEDIS 2009 (Reporting Year 2008)
4.43
1.61
1.63
1.39
Days
2486
1828
2651
21790
22068
1590
347
86
0
52846
Days / 1,000
Member
Months
49.13
3.77
4.57
13.51
17.33
34.61
73.61
97.62
13.04
1555
1271
1247
4539
9360
818
173
75
0
19038
30.73
2.62
2.15
2.81
7.35
17.81
36.70
85.13
931
557
1075
4993
12666
772
174
11
0
21179
18.40
1.15
1.85
3.10
9.95
16.81
36.91
12.49
329
12258
40
0
12627
0.57
7.60
0.03
4.70
5.23
3.64
Average
Length of Stay
5.73
2.77
3.01
2.64
3.10
3.27
3.90
4.30
NA
2.95
4.20
2.60
3.01
2.71
2.88
3.29
3.04
4.41
NA
2.92
14.55
3.24
3.26
2.59
3.29
3.26
5.44
3.67
NA
3.20
2.42
2.63
3.64
NA
2.63
Page 89
Use of Services
Medica Health Plans
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
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 9:56 AM
Member Months
0
0
0
0
0
34369
35214
34364
0
103947
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
1029
1031
829
0
2889
NA
NA
NA
NA
NA
29.94
29.28
24.12
0
0
0
0
0
845
887
754
0
2486
NA
NA
NA
NA
NA
24.59
25.19
21.94
27.79
23.92
0
0
0
0
0
184
144
75
0
403
NA
NA
NA
NA
NA
5.35
4.09
2.18
0
0
0
0
0
NA
NA
NA
HEDIS 2009 (Reporting Year 2008)
3.88
NA
Days
0
0
0
0
0
4351
4117
3319
0
11787
0
0
0
0
0
3423
3372
2940
0
9735
0
0
0
0
0
928
745
379
0
2052
0
0
0
0
0
Days / 1,000
Member
Months
NA
NA
NA
NA
NA
126.60
116.91
96.58
113.39
NA
NA
NA
NA
NA
99.60
95.76
85.55
93.65
NA
NA
NA
NA
NA
27.00
21.16
11.03
19.74
NA
NA
NA
NA
Average
Length of Stay
NA
NA
NA
NA
NA
4.23
3.99
4.00
NA
4.08
NA
NA
NA
NA
NA
4.05
3.80
3.90
NA
3.92
NA
NA
NA
NA
NA
5.04
5.17
5.05
NA
5.09
NA
NA
NA
NA
NA
Page 91
Use of Services
Medica Health Plans
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 9:56 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
Medica Health Plans
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 9:56 AM
Member Months
0
0
11
758
1501
2
0
0
0
2272
Discharges
Discharges /
1,000 Member
Months
0
0
0
21
45
0
0
0
0
66
NA
NA
0.00
27.70
29.98
0.00
NA
NA
0
0
0
15
32
0
0
0
0
47
NA
NA
0.00
19.79
21.32
0.00
NA
NA
0
0
0
6
13
0
0
0
0
19
NA
NA
0.00
7.92
8.66
0.00
NA
NA
0
0
0
0
0
0.00
0.00
0.00
HEDIS 2009 (Reporting Year 2008)
29.05
20.69
8.36
0.00
Days
Days / 1,000
Member
Months
0
0
0
57
157
0
0
0
0
214
NA
NA
0.00
75.20
104.60
0.00
NA
NA
0
0
0
35
111
0
0
0
0
146
NA
NA
0.00
46.17
73.95
0.00
NA
NA
0
0
0
22
46
0
0
0
0
68
NA
NA
0.00
29.02
30.65
0.00
NA
NA
0
0
0
0
0
0.00
0.00
0.00
94.19
64.26
29.93
0.00
Average
Length of Stay
NA
NA
NA
2.71
3.49
NA
NA
NA
NA
3.24
NA
NA
NA
2.33
3.47
NA
NA
NA
NA
3.11
NA
NA
NA
3.67
3.54
NA
NA
NA
NA
3.58
NA
NA
NA
NA
NA
Page 93
Use of Services
Medica Health Plans
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
<1
83387
1-9
438716
10-19
311978
20-44
423479
45-64
144019
65-74
15260
75-84
8481
85+
7880
Unknown
0
Total
1433200
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
974
1118
1408
8532
1983
310
197
204
0
14726
Discharges /
1,000 Member
Months
11.68
2.55
4.51
20.15
13.77
20.31
23.23
25.89
10.27
858
945
348
1826
1234
256
164
176
0
5807
10.29
2.15
1.12
4.31
8.57
16.78
19.34
22.34
116
172
202
1028
738
54
33
28
0
2371
1.39
0.39
0.65
2.43
5.12
3.54
3.89
3.55
858
5676
11
0
6545
2.75
13.40
0.08
HEDIS 2009 (Reporting Year 2008)
4.05
1.65
7.44
Days
Days / 1,000
Member
Months
4547
3188
3699
21984
6857
1312
852
843
0
43282
54.53
7.27
11.86
51.91
47.61
85.98
100.46
106.98
3051
2372
841
4857
4035
1072
664
676
0
17568
36.59
5.41
2.70
11.47
28.02
70.25
78.29
85.79
30.20
12.26
1496
812
577
2886
2799
240
188
167
0
9165
17.94
1.85
1.85
6.81
19.43
15.73
22.17
21.19
2281
14210
23
0
16514
7.31
33.56
0.16
6.39
18.78
Average
Length of Stay
4.67
2.85
2.63
2.58
3.46
4.23
4.32
4.13
NA
2.94
3.56
2.51
2.42
2.66
3.27
4.19
4.05
3.84
NA
3.03
12.90
4.72
2.86
2.81
3.79
4.44
5.70
5.96
NA
3.87
2.66
2.50
2.09
NA
2.52
Page 94
Use of Services
Medica Health Plans
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 9:56 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
50596
484480
580364
1612512
1273455
45934
4714
881
0
4052936
Discharges
0
0
5
45
229
36
15
2
0
332
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
0.00
0.00
0.01
0.03
0.18
0.78
3.18
2.27
0.08
Days
0
0
121
654
2651
407
152
28
0
4013
Days / 1,000
Member
Months
0.00
0.00
0.21
0.41
2.08
8.86
32.24
31.78
0.99
Average Length
of Stay
NA
NA
24.20
14.53
11.58
11.31
10.13
14.00
NA
12.09
Page 95
Use of Services
Medica Health Plans
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
0
0
0
34369
35214
34364
0
103947
Discharges
0
0
0
0
0
204
337
362
0
903
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
NA
NA
NA
NA
NA
5.94
9.57
10.53
8.69
Days
0
0
0
0
0
1430
2077
2016
0
5523
Days / 1,000
Member
Months
NA
NA
NA
NA
NA
41.61
58.98
58.67
53.13
Average Length
of Stay
NA
NA
NA
NA
NA
7.01
6.16
5.57
NA
6.12
Page 97
Use of Services
Medica Health Plans
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 9:56 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
11
758
1501
2
0
0
0
2272
Discharges
0
0
0
0
6
0
0
0
0
6
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
NA
NA
0.00
0.00
4.00
0.00
NA
NA
2.64
Days
0
0
0
0
23
0
0
0
0
23
Days / 1,000
Member
Months
NA
NA
0.00
0.00
15.32
0.00
NA
NA
10.12
Average Length
of Stay
NA
NA
NA
NA
3.83
NA
NA
NA
NA
3.83
Page 99
Use of Services
Medica Health Plans
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 9:56 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
83387
438716
311978
423479
144019
15260
8481
7880
0
1433200
Discharges
0
0
0
13
9
4
1
7
0
34
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
0.00
0.00
0.00
0.03
0.06
0.26
0.12
0.89
0.02
Days
0
0
0
209
95
54
14
68
0
440
Days / 1,000
Member
Months
0.00
0.00
0.00
0.49
0.66
3.54
1.65
8.63
0.31
Average Length
of Stay
NA
NA
NA
16.08
10.56
13.50
14.00
9.71
NA
12.94
Page 100
Use of Services
Medica Health Plans
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
357525
151111
198855
325422
1003343
29266
0
2065522
Female
346051
144911
189988
304553
979648
22263
0
1987414
Total
703576
296022
388843
629975
1982991
51529
0
4052936
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
6
2
8
230
150
380
523
269
792
675
326
1001
1570
937
2507
25
9
34
0
0
0
3029
1693
4722
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
357525
151111
198855
325422
1003343
29266
0
2065522
Female
346051
144911
189988
304553
979648
22263
0
1987414
Total
703576
296022
388843
629975
1982991
51529
0
4052936
Inpatient
Percent
0.02%
0.01%
0.01%
1.83%
1.24%
1.54%
3.16%
1.70%
2.44%
2.49%
1.28%
1.91%
1.88%
1.15%
1.52%
1.03%
0.49%
0.79%
NA
NA
NA
1.76%
1.02%
1.40%
Number
3
0
3
70
48
118
101
66
167
104
67
171
431
300
731
7
6
13
0
0
0
716
487
1203
Percent
0.01%
0.00%
0.01%
0.56%
0.40%
0.48%
0.61%
0.42%
0.52%
0.38%
0.26%
0.33%
0.52%
0.37%
0.44%
0.29%
0.32%
0.30%
NA
NA
NA
0.42%
0.29%
0.36%
Male
357525
151111
198855
325422
1003343
29266
0
2065522
Female
346051
144911
189988
304553
979648
22263
0
1987414
Total
703576
296022
388843
629975
1982991
51529
0
4052936
Member Months
(Outpatient/ED)
Male
357525
151111
198855
325422
1003343
29266
0
2065522
Female
346051
144911
189988
304553
979648
22263
0
1987414
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
1
1
55
28
83
87
43
130
108
29
137
168
89
257
1
0
1
0
0
0
419
190
609
Number
3
2
5
202
127
329
458
232
690
620
288
908
1329
775
2104
20
6
26
0
0
0
2632
1430
4062
Percent
0.00%
0.00%
0.00%
0.44%
0.23%
0.34%
0.53%
0.27%
0.40%
0.40%
0.11%
0.26%
0.20%
0.11%
0.16%
0.04%
0.00%
0.02%
NA
NA
NA
0.24%
0.11%
0.18%
Total
703576
296022
388843
629975
1982991
51529
0
4052936
Percent
0.01%
0.01%
0.01%
1.60%
1.05%
1.33%
2.76%
1.47%
2.13%
2.29%
1.13%
1.73%
1.59%
0.95%
1.27%
0.82%
0.32%
0.61%
NA
NA
NA
1.53%
0.86%
1.20%
Page 101
Use of Services
Medica Health Plans
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
0
0
25472
0
25472
Female
0
0
0
0
0
70702
0
70702
Total
0
0
0
0
0
96174
0
96174
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
107
76
183
0
0
0
107
76
183
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
0
0
0
25472
0
25472
Female
0
0
0
0
0
70702
0
70702
Total
0
0
0
0
0
96174
0
96174
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
5.04%
1.29%
2.28%
NA
NA
NA
5.04%
1.29%
2.28%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
49
49
98
0
0
0
49
49
98
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
2.31%
0.83%
1.22%
NA
NA
NA
2.31%
0.83%
1.22%
Male
0
0
0
0
0
25472
0
25472
Female
0
0
0
0
0
70702
0
70702
Total
0
0
0
0
0
96174
0
96174
Member Months
(Outpatient/ED)
Male
0
0
0
0
0
25472
0
25472
Female
0
0
0
0
0
70702
0
70702
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
82
38
120
0
0
0
82
38
120
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Total
0
0
0
0
0
96174
0
96174
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
3.86%
0.64%
1.50%
NA
NA
NA
3.86%
0.64%
1.50%
Page 103
Use of Services
Medica Health Plans
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 9:56 AM
SNBC
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
59
105
709
0
0
873
Female
0
0
42
165
1190
2
0
1399
Total
0
0
101
270
1899
2
0
2272
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
0
0
0
0
1
1
3
4
7
27
25
52
0
0
0
0
0
0
30
30
60
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
0
0
59
105
709
0
0
873
Female
0
0
42
165
1190
2
0
1399
Total
0
0
101
270
1899
2
0
2272
Inpatient
Percent
NA
NA
NA
NA
NA
NA
0.00%
28.57%
11.88%
34.29%
29.09%
31.11%
45.70%
25.21%
32.86%
NA
0.00%
0.00%
NA
NA
NA
41.24%
25.73%
31.69%
Number
0
0
0
0
0
0
0
0
0
2
0
2
7
3
10
0
0
0
0
0
0
9
3
12
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
22.86%
0.00%
8.89%
11.85%
3.03%
6.32%
NA
0.00%
0.00%
NA
NA
NA
12.37%
2.57%
6.34%
Male
0
0
59
105
709
0
0
873
Female
0
0
42
165
1190
2
0
1399
Total
0
0
101
270
1899
2
0
2272
Member Months
(Outpatient/ED)
Male
0
0
59
105
709
0
0
873
Female
0
0
42
165
1190
2
0
1399
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
1
0
1
2
1
3
0
0
0
0
0
0
3
1
4
Number
0
0
0
0
0
0
0
1
1
3
4
7
25
24
49
0
0
0
0
0
0
28
29
57
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
11.43%
0.00%
4.44%
3.39%
1.01%
1.90%
NA
0.00%
0.00%
NA
NA
NA
4.12%
0.86%
2.11%
Total
0
0
101
270
1899
2
0
2272
Percent
NA
NA
NA
NA
NA
NA
0.00%
28.57%
11.88%
34.29%
29.09%
31.11%
42.31%
24.20%
30.96%
NA
0.00%
0.00%
NA
NA
NA
38.49%
24.87%
30.11%
Page 105
Use of Services
Medica Health Plans
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 9:56 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
314776
78624
48250
51438
112869
10223
0
616180
Female
309791
80452
103915
133923
167541
21398
0
817020
Total
624567
159076
152165
185361
280410
31621
0
1433200
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
19
10
29
325
286
611
650
712
1362
971
1334
2305
2286
1867
4153
40
22
62
0
0
0
4291
4231
8522
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
314776
78624
48250
51438
112869
10223
0
616180
Female
309791
80452
103915
133923
167541
21398
0
817020
Total
624567
159076
152165
185361
280410
31621
0
1433200
Inpatient
Percent
0.07%
0.04%
0.06%
4.96%
4.27%
4.61%
16.17%
8.22%
10.74%
22.65%
11.95%
14.92%
24.30%
13.37%
17.77%
4.70%
1.23%
2.35%
NA
NA
NA
8.36%
6.21%
7.14%
Number
3
3
6
86
94
180
162
163
325
257
338
595
675
521
1196
15
7
22
0
0
0
1198
1126
2324
Percent
0.01%
0.01%
0.01%
1.31%
1.40%
1.36%
4.03%
1.88%
2.56%
6.00%
3.03%
3.85%
7.18%
3.73%
5.12%
1.76%
0.39%
0.83%
NA
NA
NA
2.33%
1.65%
1.95%
Male
314776
78624
48250
51438
112869
10223
0
616180
Female
309791
80452
103915
133923
167541
21398
0
817020
Total
624567
159076
152165
185361
280410
31621
0
1433200
Member Months
(Outpatient/ED)
Male
314776
78624
48250
51438
112869
10223
0
616180
Female
309791
80452
103915
133923
167541
21398
0
817020
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
2
0
2
93
57
150
123
113
236
170
241
411
308
256
564
0
0
0
0
0
0
696
667
1363
Number
15
7
22
290
241
531
550
615
1165
865
1211
2076
2052
1664
3716
31
16
47
0
0
0
3803
3754
7557
Percent
0.01%
0.00%
0.00%
1.42%
0.85%
1.13%
3.06%
1.30%
1.86%
3.97%
2.16%
2.66%
3.27%
1.83%
2.41%
0.00%
0.00%
0.00%
NA
NA
NA
1.36%
0.98%
1.14%
Total
624567
159076
152165
185361
280410
31621
0
1433200
Percent
0.06%
0.03%
0.04%
4.43%
3.59%
4.01%
13.68%
7.10%
9.19%
20.18%
10.85%
13.44%
21.82%
11.92%
15.90%
3.64%
0.90%
1.78%
NA
NA
NA
7.41%
5.51%
6.33%
Page 106
Use of Services
Medica Health Plans
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
357525
151111
1527620
29266
0
2065522
Female
346051
144911
1474189
22263
0
1987414
Total
703576
296022
3001809
51529
0
4052936
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
1653
970
2623
1224
1373
2597
6511
11423
17934
56
59
115
0
0
0
9444
13825
23269
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
357525
151111
1527620
29266
0
2065522
Female
346051
144911
1474189
22263
0
1987414
Total
703576
296022
3001809
51529
0
4052936
Number
27
13
40
99
130
229
290
394
684
1
3
4
0
0
0
417
540
957
Female
346051
144911
1474189
22263
0
1987414
Total
703576
296022
3001809
51529
0
4052936
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
5.55%
3.36%
4.47%
9.72%
11.37%
10.53%
5.11%
9.30%
7.17%
2.30%
3.18%
2.68%
NA
NA
NA
5.49%
8.35%
6.89%
Male
357525
151111
1527620
29266
0
2065522
Percent
0.09%
0.05%
0.07%
0.79%
1.08%
0.93%
0.23%
0.32%
0.27%
0.04%
0.16%
0.09%
NA
NA
NA
0.24%
0.33%
0.28%
Number
123
46
169
120
125
245
304
503
807
0
0
0
0
0
0
547
674
1221
Percent
0.41%
0.16%
0.29%
0.95%
1.04%
0.99%
0.24%
0.41%
0.32%
0.00%
0.00%
0.00%
NA
NA
NA
0.32%
0.41%
0.36%
Member Months
(Outpatient/ED)
Male
357525
151111
1527620
29266
0
2065522
Female
346051
144911
1474189
22263
0
1987414
Total
703576
296022
3001809
51529
0
4052936
Outpatient/ED
Number
1620
963
2583
1191
1335
2526
6350
11266
17616
55
57
112
0
0
0
9216
13621
22837
Percent
5.44%
3.34%
4.41%
9.46%
11.06%
10.24%
4.99%
9.17%
7.04%
2.26%
3.07%
2.61%
NA
NA
NA
5.35%
8.22%
6.76%
Page 107
Use of Services
Medica Health Plans
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
0
25472
0
25472
Female
0
0
0
70702
0
70702
Total
0
0
0
96174
0
96174
Any Services
Sex
M
F
Total
M
13-17
F
Total
M
18-64
F
Total
M
65+
F
Total
Unknown M
F
Total
Total
M
F
Total
Age
0-12
Number
0
0
0
0
0
0
0
0
0
231
620
851
0
0
0
231
620
851
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
0
25472
0
25472
Female
0
0
0
70702
0
70702
Total
0
0
0
96174
0
96174
Number
0
0
0
0
0
0
0
0
0
31
84
115
0
0
0
31
84
115
Female
0
0
0
70702
0
70702
Total
0
0
0
96174
0
96174
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
10.88%
10.52%
10.62%
NA
NA
NA
10.88%
10.52%
10.62%
Male
0
0
0
25472
0
25472
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
1.46%
1.43%
1.43%
NA
NA
NA
1.46%
1.43%
1.43%
Number
0
0
0
0
0
0
0
0
0
25
68
93
0
0
0
25
68
93
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
1.18%
1.15%
1.16%
NA
NA
NA
1.18%
1.15%
1.16%
Member Months
(Outpatient/ED)
Male
0
0
0
25472
0
25472
Female
0
0
0
70702
0
70702
Total
0
0
0
96174
0
96174
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
198
538
736
0
0
0
198
538
736
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
9.33%
9.13%
9.18%
NA
NA
NA
9.33%
9.13%
9.18%
Page 109
Use of Services
Medica Health Plans
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 9:56 AM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
873
0
0
873
Female
0
0
1397
2
0
1399
Total
0
0
2270
2
0
2272
Any Services
Sex
M
F
Total
M
13-17
F
Total
M
18-64
F
Total
M
65+
F
Total
Unknown M
F
Total
Total
M
F
Total
Age
0-12
Number
0
0
0
0
0
0
77
128
205
0
0
0
0
0
0
77
128
205
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
873
0
0
873
Female
0
0
1397
2
0
1399
Total
0
0
2270
2
0
2272
Number
0
0
0
0
0
0
5
8
13
0
0
0
0
0
0
5
8
13
Female
0
0
1397
2
0
1399
Total
0
0
2270
2
0
2272
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
105.84%
109.95%
108.37%
NA
0.00%
0.00%
NA
NA
NA
105.84%
109.79%
108.27%
Male
0
0
873
0
0
873
Percent
NA
NA
NA
NA
NA
NA
6.87%
6.87%
6.87%
NA
0.00%
0.00%
NA
NA
NA
6.87%
6.86%
6.87%
Number
0
0
0
0
0
0
10
13
23
0
0
0
0
0
0
10
13
23
Percent
NA
NA
NA
NA
NA
NA
13.75%
11.17%
12.16%
NA
0.00%
0.00%
NA
NA
NA
13.75%
11.15%
12.15%
Member Months
(Outpatient/ED)
Male
0
0
873
0
0
873
Female
0
0
1397
2
0
1399
Total
0
0
2270
2
0
2272
Outpatient/ED
Number
0
0
0
0
0
0
72
127
199
0
0
0
0
0
0
72
127
199
Percent
NA
NA
NA
NA
NA
NA
98.97%
109.09%
105.20%
NA
0.00%
0.00%
NA
NA
NA
98.97%
108.93%
105.11%
Page 111
Use of Services
Medica Health Plans
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care(MHCP-MC)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
314776
78624
212557
10223
0
616180
Female
309791
80452
405379
21398
0
817020
Total
624567
159076
617936
31621
0
1433200
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
2804
1866
4670
1282
1390
2672
4254
9135
13389
128
213
341
0
0
0
8468
12604
21072
HEDIS 2009 (Reporting Year 2008)
Male
314776
78624
212557
10223
0
616180
Female
309791
80452
405379
21398
0
817020
Total
624567
159076
617936
31621
0
1433200
Percent
10.69%
7.23%
8.97%
19.57%
20.73%
20.16%
24.02%
27.04%
26.00%
15.02%
11.95%
12.94%
NA
NA
NA
16.49%
18.51%
17.64%
Number
43
33
76
70
139
209
428
573
1001
12
19
31
0
0
0
553
764
1317
Male
314776
78624
212557
10223
0
616180
Female
309791
80452
405379
21398
0
817020
Total
624567
159076
617936
31621
0
1433200
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Percent
0.16%
0.13%
0.15%
1.07%
2.07%
1.58%
2.42%
1.70%
1.94%
1.41%
1.07%
1.18%
NA
NA
NA
1.08%
1.12%
1.10%
Number
437
244
681
204
249
453
621
1343
1964
12
16
28
0
0
0
1274
1852
3126
Percent
1.67%
0.95%
1.31%
3.11%
3.71%
3.42%
3.51%
3.98%
3.81%
1.41%
0.90%
1.06%
NA
NA
NA
2.48%
2.72%
2.62%
Member Months
(Outpatient/ED)
Male
314776
78624
212557
10223
0
616180
Female
309791
80452
405379
21398
0
817020
Total
624567
159076
617936
31621
0
1433200
Outpatient/ED
Number
2709
1829
4538
1238
1329
2567
3982
8795
12777
114
194
308
0
0
0
8043
12147
20190
Percent
10.33%
7.08%
8.72%
18.89%
19.82%
19.36%
22.48%
26.03%
24.81%
13.38%
10.88%
11.69%
NA
NA
NA
15.66%
17.84%
16.90%
Page 112
Use of Services
Medica Health Plans
Outpatient Drug Utilization
Commercial
Age
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
Member Months
535076
464522
1018818
1122481
860510
45934
4714
881
0
4052936
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 9:56 AM
$6,994,176.00
$12,951,504.00
$31,575,267.00
$59,870,504.00
$83,560,651.00
$6,856,159.00
$900,590.00
$191,587.00
$0.00
$202,900,438.00
HEDIS 2009 (Reporting Year 2008)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$13.07
$27.88
$30.99
$53.34
$97.11
$149.26
$191.05
$217.47
$50.06
Total Number of
Prescriptions
129435
147632
502552
880963
1260942
100967
14589
3038
0
3040118
Avg. Num. Of
Prescriptions /
Per Member Per
Year
2.90
3.81
5.92
9.42
17.58
26.38
37.14
41.38
9.00
Page 113
Use of Services
Medica Health Plans
Outpatient Drug Utilization
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Outpatient Drug Utilization
MSHO
Age
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
Member Months
0
0
0
0
0
34369
35214
34364
0
103947
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 9:56 AM
$0.00
$0.00
$0.00
$0.00
$230.00
$13,465,427.00
$13,936,239.00
$11,774,441.00
$0.00
$39,176,337.00
HEDIS 2009 (Reporting Year 2008)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
NA
NA
NA
$391.79
$395.76
$342.64
$376.89
Total Number of
Prescriptions
0
0
0
0
5
229172
267912
285945
0
783034
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
NA
NA
NA
80.02
91.30
99.85
90.40
Page 115
Use of Services
Medica Health Plans
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 9:56 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
Medica Health Plans
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 9:56 AM
Member Months
0
0
371
860
1039
2
0
0
0
2272
Total Cost of
Prescriptions
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
$0.00
$0.00
$199,354.00
$410,559.00
$591,500.00
$480.00
$0.00
$0.00
$0.00
$1,201,893.00
HEDIS 2009 (Reporting Year 2008)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
$537.34
$477.39
$569.30
$240.00
NA
NA
$529.00
Total Number of
Prescriptions
0
0
1719
4963
8049
11
0
0
0
14742
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
55.60
69.25
92.96
66.00
NA
NA
77.86
Page 117
Use of Services
Medica Health Plans
Outpatient Drug Utilization
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
0-9
522103
10-17
261540
18-34
337526
35-49
194003
50-64
86407
65-74
15260
75-84
8481
85+
7880
Unknown
0
Total
Age
1433200
Total Cost of
Prescriptions
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
$8,139,401.00
$7,980,182.00
$21,070,945.00
$24,421,850.00
$12,886,580.00
$660,841.00
$265,740.00
$254,637.00
$0.00
$75,680,176.00
HEDIS 2009 (Reporting Year 2008)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$15.59
$30.51
$62.43
$125.88
$149.14
$43.31
$31.33
$32.31
$52.81
Total Number of
Prescriptions
190569
114934
387568
402774
257376
23006
13180
15488
0
1404895
Avg. Num. Of
Prescriptions /
Per Member Per
Year
4.38
5.27
13.78
24.91
35.74
18.09
18.65
23.59
11.76
Page 118
Health Plan Descriptive Information
Medica Health Plans
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 9:56 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
25842
107432
137864
146513
90985
58383
Member Months
Female
24754
106406
132778
138290
88734
57459
Total
50596
213838
270642
284803
179719
115842
567019
27.45%
140472
165360
160062
174072
187418
548421
27.59%
132529
155905
148648
165984
182062
1115440
27.52%
827384
40.06%
209466
185400
148077
98910
785128
39.51%
203479
181871
148661
97591
1612512
39.79%
641853
31.07%
20924
5307
1926
709
304
96
631602
31.78%
16036
3667
1442
637
401
80
1273455
31.42%
29266
1.42%
0
22263
1.12%
0
51529
1.27%
2065522
1987414
HEDIS 2009 (Reporting Year 2008)
273001
321265
308710
340056
369480
412945
367271
296738
196501
36960
8974
3368
1346
705
176
0
4052936
Page 122
Health Plan Descriptive Information
Medica Health Plans
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0.00%
0
0
0
0
0
0.00%
0
0
0
0
0
0.00%
0
0.00%
5516
6684
5530
4315
3128
2162
0
0.00%
9955
12214
12778
12591
13868
15206
0
0.00%
27335
100.00%
0
76612
100.00%
0
103947
100.00%
27335
76612
HEDIS 2009 (Reporting Year 2008)
0
0
0
0
0
0
0
0
0
15471
18898
18308
16906
16996
17368
0
103947
Page 124
Health Plan Descriptive Information
Medica Health Plans
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 9:56 AM
SNBC
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
10
Member Months
Female
0
0
0
0
0
1
Total
0
0
0
0
0
11
10
1.15%
49
78
27
45
96
1
0.07%
41
64
101
95
162
11
0.48%
295
33.79%
188
186
115
79
463
33.10%
274
254
205
200
758
33.36%
568
65.06%
0
0
0
0
0
0
933
66.69%
2
0
0
0
0
0
1501
66.07%
0
0.00%
0
2
0.14%
0
2
0.09%
873
1399
HEDIS 2009 (Reporting Year 2008)
90
142
128
140
258
462
440
320
279
2
0
0
0
0
0
0
2272
Page 126
Health Plan Descriptive Information
Medica Health Plans
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
42148
118038
104537
81790
46887
21666
Member Months
Female
41239
111307
104834
84427
48436
28772
Total
83387
229345
209371
166217
95323
50438
415066
67.36%
26584
27457
23981
25254
24648
419015
51.29%
75143
76808
57115
48831
37658
834081
58.20%
127924
20.76%
25203
18874
12073
6817
295555
36.17%
32409
22424
15544
10675
423479
29.55%
62967
10.22%
3905
2139
1573
1143
956
507
81052
9.92%
6054
3162
2567
3198
3130
3287
144019
10.05%
10223
1.66%
0
21398
2.62%
0
31621
2.21%
616180
817020
HEDIS 2009 (Reporting Year 2008)
101727
104265
81096
74085
62306
57612
41298
27617
17492
9959
5301
4140
4341
4086
3794
0
1433200
Page 127
Health Plan Stability
Medica Health Plans
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Commercial
Product/Product Line
Years in Business
Members*
34.00
34.00
24.00
11.00
34.00
119987
33968
50583
8761
213299
HMO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total HMO:
PPO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total PPO:
34.00
34.00
0
250361
2448
0
252809
POS
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total POS:
Total:
34.00
2.00
0.00
34.00
0
41961
431
42392
508500
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 128
Health Plan Stability
Medica Health Plans
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 9:56 AM
MSHO
Product/Product Line
Years in Business
Members*
34.00
34.00
24.00
11.00
34.00
119987
33968
50583
8761
213299
HMO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total HMO:
PPO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total PPO:
34.00
34.00
0
250361
2448
0
252809
POS
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total POS:
Total:
34.00
2.00
0.00
34.00
0
41961
431
42392
508500
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 130
Health Plan Stability
Medica Health Plans
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 9:56 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
Medica Health Plans
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 9:56 AM
SNBC
Product/Product Line
Years in Business
Members*
34.00
34.00
24.00
11.00
34.00
119987
33968
50583
8761
213299
34.00
250361
2448
34.00
252809
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
34.00
41961
Medicare (cost or risk)
2.00
Other
0.00
431
Total POS:
34.00
42392
Total:
508500
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 132
Health Plan Stability
Medica Health Plans
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 9:56 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Product/Product Line
Years in Business
Members*
34.00
34.00
24.00
11.00
34.00
119987
33968
50583
8761
213299
34.00
0
250361
34.00
0
250361
HMO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total HMO:
PPO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total PPO:
POS
MHCP_MC
0
Commercial
34.00
41961
Medicare (cost or risk)
2.00
2448
Other
0.00
431
Total POS:
34.00
44840
Total:
508500
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 133