Blue Plus
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
Blue Plus
Childhood Immunization Status
Data Last Refreshed:
Jan 10, 2011 9:46 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
456
77.82%
507
86.52%
550
93.86%
543
92.66%
499
85.15%
533
90.96%
465
79.35%
407
69.45%
388
66.21%
352
81.48%
375
86.81%
409
94.68%
404
93.52%
382
88.43%
393
90.97%
341
78.94%
321
74.31%
303
70.14%
336
35
90.27%
87.28%
93.25%
356
38
95.86%
93.82%
97.91%
391
3
95.86%
93.82%
97.91%
385
20
98.54%
97.26%
99.82%
364
31
96.11%
94.12%
98.10%
374
5
92.21%
89.50%
94.93%
324
34
87.10%
83.74%
90.47%
307
43
85.16%
81.60%
88.72%
289
44
81.02%
77.11%
84.93%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
HEDIS 2009 (Reporting Year 2008)
MMR
411
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
IPV
2008
H
586
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
Blue Plus
Childhood Immunization Status
Data Last Refreshed:
Jan 10, 2011 9:46 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
1578
76.98%
1731
84.44%
1878
91.61%
1897
92.54%
1576
76.88%
1813
88.44%
1603
78.20%
1261
61.51%
1205
58.78%
337
78.01%
372
86.11%
390
90.28%
404
93.52%
375
86.81%
377
87.27%
340
78.70%
297
68.75%
284
65.74%
337
33
85.65%
82.23%
89.07%
372
33
93.75%
91.35%
96.15%
390
7
91.90%
89.21%
94.59%
404
14
96.76%
94.97%
98.54%
375
32
94.21%
91.90%
96.53%
377
7
88.89%
85.81%
91.97%
340
32
86.11%
82.73%
89.49%
297
49
80.09%
76.21%
83.97%
284
52
77.78%
73.74%
81.81%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
HEDIS 2009 (Reporting Year 2008)
MMR
411
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
IPV
2008
H
2050
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
432
Page 4
Effectiveness of Care
Blue Plus
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 9:46 AM
Commercial
2008
A
9927
7288
73.42%
72.54%
74.29%
Medicare
Advantage
NR
NR
NR
MSHO
2008
A
453
261
57.62%
52.95%
62.28%
MnDHO
SNBC
MHCP-MC
NR
NR
NR
2008
A
2
0
NA
NA
NA
2008
A
4499
2771
61.59%
60.16%
63.02%
Page 5
Effectiveness of Care
Blue Plus
Cervical Cancer Screening
Data Elements
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Commercial
MHCP-MC
Measurement Year
Data Collection Methodology
Eligible Member Population
2008
H
11990
2008
H
14147
Numerator Events by Admin Data on Eligible
Population (before exclusions)
8932
10054
Records Excluded because of Valid Data Errors
74.50%
411
10.00%
453
337
74.39%
0
71.07%
411
10.00%
453
314
69.32%
0
Number of administrative data records excluded
0
0
Number of medical record data records excluded
19
9
Number of employee/dependent medical records
excluded
0
0
17
411
323
13
81.75%
77.90%
85.61%
0
444
314
14
73.87%
69.67%
78.07%
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 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
Blue Plus
Colorectal Cancer Screening
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Data Elements
Commercial
Medicare
Advantage
MSHO
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
2008
H
11033
2008
H
3098
Number of numerator events by administrative data in eligible population
(before exclusions)
6293
1087
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)
57.04%
411
0.1
453
285
62.91%
0
0
0
0
0
411
256
31
69.83%
65.27%
74.39%
NR
NR
NR
NR
NR
35.09%
411
0.05
432
177
40.97%
0
0
1
0
1
411
173
39
51.58%
46.63%
56.53%
MnDHO
SNBC
2008
A
2
NR
NR
NR
NR
1
NR
NR
NR
NA
NA
NA
Page 7
Effectiveness of Care
Blue Plus
Chlamydia Screening in Women
Data Last Refreshed:
Jan 10, 2011 9:46 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
861
315
36.59%
33.31%
39.86%
830
371
44.70%
41.26%
48.14%
1691
686
40.57%
38.20%
42.94%
Page 8
Effectiveness of Care
Blue Plus
Chlamydia Screening in Women
Data Last Refreshed:
Jan 10, 2011 9:46 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
1718
1634
Numerator Events by Admin Data
800
801
Reported Rate
46.57%
49.02%
Lower 95% Confidence Interval
44.18%
46.57%
Upper 95% Confidence Interval
48.95%
51.48%
HEDIS 2009 (Reporting Year 2008)
Total
3352
1601
47.76%
46.06%
49.47%
Page 9
Effectiveness of Care
Blue Plus
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 9:46 AM
Medicare
Advantage
NR
NR
NR
MSHO
2008
A
6579
4706
71.53%
70.43%
72.63%
Page 10
Effectiveness of Care
Blue Plus
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Lead Screening in Children
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Commercial
MHCP-MC
2008
A
586
2008
H
2050
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
1652
NR
80.59%
NR
411
5.00%
432
351
81.25%
Records Excluded because of Valid Data
Errors
0
Number of administrative data records
excluded
0
Number of medical record data records
excluded
0
Number of employee/dependent medical
records excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
366
0
432
351
0
Reported Rate
62.46%
81.25%
Lower 95% Confidence Interval
58.45%
77.45%
Upper 95% Confidence Interval
66.46%
85.05%
HEDIS 2009 (Reporting Year 2008)
Page 11
Effectiveness of Care
Blue Plus
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
959
111
88.43%
86.35%
90.50%
2008
A
4410
796
81.95%
80.80%
83.10%
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Page 12
Effectiveness of Care
Blue Plus
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 9:46 AM
MSHO
Data Elements
General
Measure Data
Measurement Year
Data Collection Methodology
Eligible Member Population
2008
A
280
Exclusions based on direct transfers to
another facility
124
Exclusions based on readmissions
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2009 (Reporting Year 2008)
Systemic
corticosteroid
Bronchodilator
173
61.79%
55.92%
67.66%
233
83.21%
78.66%
87.77%
103
Page 14
Effectiveness of Care
Blue Plus
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Pharmacotherapy Management of COPD Exacerbation
Data Last Refreshed:
Jan 10, 2011 9:46 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
6
NA
NA
NA
9
NA
NA
NA
2008
A
10
0
0
Page 16
Effectiveness of Care
Blue Plus
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
243
50
20.58%
15.29%
25.86%
Data Last Refreshed:
Jan 10, 2011 9:46 AM
MnDHO
SNBC
NR
NR
NR
2008
A
0
0
NA
NA
NA
Page 17
Effectiveness of Care
Blue Plus
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jan 10, 2011 9:46 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
76
75
98.68%
95.46%
100.00%
128
125
97.66%
94.64%
100.00%
508
465
91.54%
89.02%
94.05%
712
665
93.40%
91.50%
95.29%
2008
A
Page 18
Effectiveness of Care
Blue Plus
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Jan 10, 2011 9:46 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
188
182
96.81%
94.03%
99.59%
312
283
90.71%
87.32%
94.09%
551
485
88.02%
85.22%
90.82%
1051
950
90.39%
88.56%
92.22%
2008
A
Page 19
Effectiveness of Care
Blue Plus
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 9:46 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
326
1
88.35%
0.27%
325
1
88.08%
0.27%
325
14
1
247
92.12%
89.23%
95.01%
67.39%
62.47%
72.32%
2008
H
369
369
10.00%
369
1
0
0
368
Page 20
Effectiveness of Care
Blue Plus
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 9:46 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
169
8
73.80%
3.49%
169
8
73.80%
3.49%
169
15
8
120
80.70%
75.36%
86.04%
56.14%
49.48%
62.80%
2008
H
229
229
10.00%
229
1
0
0
228
Page 22
Effectiveness of Care
Blue Plus
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Cholesterol Management for Patients with Cardiovascular Conditions
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
General
Measure
Data
2008
H
190
LDL-C
screening
LDL-C Level of
<100 mg/dL
158
0
83.16%
0.00%
157
0
82.63%
0.00%
157
9
0
103
87.83%
54.50%
Lower 95% Confidence Interval
82.91%
47.13%
Upper 95% Confidence Interval
92.76%
61.86%
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)
190
10.00%
190
1
0
0
189
Page 25
Effectiveness of Care
Blue Plus
Controlling High Blood Pressure
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Data Elements
Commercial
Medicare
Advantage
MSHO
MnDHO
SNBC
MHCP-MC
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
2008
H
3215
2008
H
1918
2008
H
4
2008
H
2187
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
0
0
0
0.00%
4
50.00%
4
0.00%
411
10.00%
453
0
0.00%
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%
411
10.00%
453
0
0.00%
NR
NR
0.00%
411
10.00%
453
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
1
0
0
2
Number of administrative data records
excluded
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
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
1
411
0
288
70.07%
65.52%
74.62%
0
411
0
274
66.67%
61.99%
71.35%
0
4
0
0
NA
NA
NA
0
451
0
267
59.20%
54.56%
63.85%
HEDIS 2009 (Reporting Year 2008)
NR
NR
NR
NR
NR
NR
Page 26
Effectiveness of Care
Blue Plus
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Measurement Year
Commercial
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Medicare
Advantage
MSHO
MnDHO
SNBC
MHCP-MC
2008
A
27
2008
A
82
2008
A
0
2008
A
34
Numerator Events by Admin Data on
Eligible Population
22
70
0
28
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NA
NA
NA
NR
NR
NR
82.35%
68.07%
96.64%
Data Collection Methodology
Eligible Member Population
HEDIS 2009 (Reporting Year 2008)
NR
NR
NR
85.37%
77.11%
93.63%
NR
NR
NR
Page 27
Effectiveness of Care
Blue Plus
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
1793
2008
H
1793
1579
88.06%
411
10%
453
407
89.85%
1790
99.83%
411
10%
453
453
100.00%
Good HbA1c
Control
(<7.0%)
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
1793
2008
H
1793
2008
H
1793
2008
H
1793
2008
H
1793
2008
H
1793
2008
H
1793
2
0.11%
411
10%
453
0
0.00%
989
55.16%
411
10%
453
265
58.50%
1480
82.54%
411
10%
453
383
84.55%
5
0.28%
411
10%
453
0
0.00%
1470
81.99%
411
10%
453
378
83.44%
7
0.39%
411
10%
453
0
0.00%
7
0.39%
411
10%
453
0
0.00%
1
1
1
1
1
1
1
1
1
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
1
411
372
10
92.94%
90.35%
95.54%
1
411
54
46
24.33%
20.06%
28.60%
1
411
0
277
67.40%
62.74%
72.05%
1
411
242
53
71.78%
67.30%
76.25%
1
411
348
11
87.35%
84.01%
90.68%
1
411
0
229
55.72%
50.79%
60.64%
1
411
346
7
85.89%
82.40%
89.38%
1
411
0
316
76.89%
72.69%
81.08%
1
411
0
225
54.74%
49.81%
59.68%
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
Blue Plus
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
859
2008
H
859
776
90.34%
411
5%
432
394
91.20%
822
95.69%
411
5%
432
417
96.53%
Good HbA1c
Control
(<7.0%)
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2008
H
859
2008
H
859
2008
H
859
2008
H
859
2008
H
859
2008
H
859
2008
H
859
22
2.56%
411
5%
432
8
1.85%
574
66.82%
411
5%
432
284
65.74%
661
76.95%
411
5%
432
341
78.94%
36
4.19%
411
5%
432
16
3.70%
771
89.76%
411
5%
432
396
91.67%
64
7.45%
411
5%
432
9
2.08%
47
5.47%
411
5%
432
8
1.85%
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
411
375
5
92.46%
89.78%
95.13%
0
411
84
26
26.76%
22.36%
31.17%
0
411
8
267
66.91%
62.24%
71.58%
0
411
270
32
73.48%
69.09%
77.87%
0
411
327
9
81.75%
77.90%
85.61%
0
411
16
181
47.93%
42.98%
52.88%
0
411
378
2
92.46%
89.78%
95.13%
0
411
9
281
70.56%
66.03%
75.09%
0
411
8
211
53.28%
48.34%
58.23%
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
Blue Plus
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
11
2008
A
11
NR
NR
NR
NR
9
11
NA
NA
NA
NA
NA
NA
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2008
A
11
2008
A
11
2008
A
11
2008
A
11
2008
A
11
2008
A
11
2008
A
11
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
0
7
6
0
9
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
Blue Plus
Comprehensive Diabetes Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
1714
2008
H
1714
1501
87.57%
411
10%
453
413
91.17%
1702
99.30%
411
10%
453
450
99.34%
Good HbA1c
Control
(<7.0%)
NR
NR
Adequate
HbA1c
Control
(<8.0%)
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
2008
H
1714
2008
H
1714
2008
H
1714
2008
H
1714
2008
H
1714
2008
H
1714
2008
H
1714
6
0.35%
411
10%
453
1
0.22%
975
56.88%
411
10%
453
252
55.63%
1320
77.01%
411
10%
453
361
79.69%
14
0.82%
411
10%
453
1
0.22%
1332
77.71%
411
10%
453
352
77.70%
19
1.11%
411
10%
453
0
0.00%
16
0.93%
411
10%
453
0
0.00%
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
Number of medical record data records
excluded
0
0
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
0
0
453
413
6
92.49%
89.96%
95.03%
0
453
71
65
30.02%
25.69%
34.35%
0
453
1
272
60.26%
55.65%
64.88%
0
453
252
54
67.55%
63.13%
71.97%
0
453
361
8
81.46%
77.77%
85.15%
0
453
1
196
43.49%
38.81%
48.16%
0
453
352
9
79.69%
75.88%
83.51%
0
453
0
350
77.26%
73.29%
81.23%
0
453
0
236
52.10%
47.39%
56.81%
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
Blue Plus
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 9:46 AM
MSHO
2008
A
358
54
15.08%
11.24%
18.93%
Page 34
Effectiveness of Care
Blue Plus
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 9:46 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
542
389
71.77%
67.89%
75.65%
300
55.35%
51.07%
59.63%
Page 35
Effectiveness of Care
Blue Plus
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 9:46 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
140
104
74.29%
66.69%
81.88%
90
64.29%
55.99%
72.58%
Page 37
Effectiveness of Care
Blue Plus
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Antidepressant Medication Management
Data Last Refreshed:
Jan 10, 2011 9:46 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
747
425
56.89%
53.28%
60.51%
294
39.36%
35.79%
42.93%
Page 40
Effectiveness of Care
Blue Plus
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jan 10, 2011 9:46 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
144
53
36.81%
28.58%
45.03%
49
17
34.69%
20.35%
49.04%
2008
A
Page 41
Effectiveness of Care
Blue Plus
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Jan 10, 2011 9:46 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
390
164
42.05%
37.02%
47.08%
114
49
42.98%
33.46%
52.51%
2008
A
Page 42
Effectiveness of Care
Blue Plus
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 9:46 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
30
44.12%
31.58%
56.65%
14
20.59%
10.24%
30.93%
2008
A
68
Page 44
Effectiveness of Care
Blue Plus
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Follow-up After Hospitalization for Mental Illness
Data Last Refreshed:
Jan 10, 2011 9:46 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
30
76.92%
62.42%
91.43%
19
48.72%
31.75%
65.69%
2008
A
39
Page 46
Effectiveness of Care
Blue Plus
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 9:46 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
3249
2567
79.01%
77.59%
80.42%
40
32
80.00%
66.35%
93.65%
2687
2148
79.94%
78.41%
81.47%
174
109
62.64%
55.17%
70.12%
6150
4856
78.96%
77.93%
79.99%
2008
A
Page 47
Effectiveness of Care
Blue Plus
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 9:46 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
3305
3117
94.31%
93.51%
95.12%
498
480
96.39%
94.65%
98.13%
3791
3606
95.12%
94.42%
95.82%
444
397
89.41%
86.44%
92.39%
8038
7600
94.55%
94.05%
95.05%
2008
A
Page 49
Effectiveness of Care
Blue Plus
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 9:46 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
12
11
NA
NA
NA
0
0
NA
NA
NA
3
3
NA
NA
NA
3
3
NA
NA
NA
18
17
NA
NA
NA
2008
A
Page 51
Effectiveness of Care
Blue Plus
Annual Monitoring for Patients on Persistent Medications
Data Last Refreshed:
Jan 10, 2011 9:46 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
1964
1610
81.98%
80.25%
83.70%
35
31
88.57%
76.60%
100.00%
1576
1289
81.79%
79.85%
83.73%
237
165
69.62%
63.55%
75.69%
3812
3095
81.19%
79.94%
82.44%
2008
A
Page 52
Effectiveness of Care
Blue Plus
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Jan 10, 2011 9:46 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
617
143
23.18%
19.77%
26.59%
2064
523
25.34%
23.44%
27.24%
122
14
11.48%
5.41%
17.54%
2803
680
24.26%
22.65%
25.86%
Page 54
Effectiveness of Care
Blue Plus
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Jan 10, 2011 9:46 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
8267
At least 1
Prescription
At least 2
Prescriptions
2034
24.60%
23.67%
25.54%
377
4.56%
4.10%
5.02%
Page 56
Access/Availability of Care
Blue Plus
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 9:46 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+
9558
13447
590
9100
12950
571
95.21%
94.77%
95.64%
96.30%
95.98%
96.63%
96.78%
95.27%
98.29%
2008
A
Page 57
Access/Availability of Care
Blue Plus
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 9:46 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
8267
0
0
8114
NA
NA
NA
NA
NA
NA
98.15%
97.85%
98.45%
2008
A
Page 59
Access/Availability of Care
Blue Plus
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 9:46 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+
10
19
0
10
19
0
NA
NA
NA
NA
NA
NA
NA
NA
NA
2008
A
Page 61
Access/Availability of Care
Blue Plus
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Jan 10, 2011 9:46 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+
15750
8912
232
14081
8037
215
89.40%
88.92%
89.89%
90.18%
89.56%
90.81%
92.67%
89.10%
96.24%
2008
A
Page 62
Access/Availability of Care
Blue Plus
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jan 10, 2011 9:46 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.
655
629
3035
2771
2774
2517
5099
4676
96.03%
94.46%
97.60%
91.30%
90.28%
92.32%
90.74%
89.64%
91.83%
91.70%
90.94%
92.47%
2008
A
Page 63
Access/Availability of Care
Blue Plus
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Jan 10, 2011 9:46 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.
3003
2948
8354
7661
5595
5124
8289
7635
98.17%
97.67%
98.66%
91.70%
91.11%
92.30%
91.58%
90.85%
92.32%
92.11%
91.52%
92.70%
2008
A
Page 64
Access/Availability of Care
Blue Plus
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 9:46 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
40
476
516
14
5
164
53
178
58
35.00%
18.97%
51.03%
12.50%
1.00%
24.00%
34.45%
30.08%
38.83%
11.13%
8.20%
14.07%
34.50%
30.30%
38.69%
11.24%
8.42%
14.06%
Page 65
Access/Availability of Care
Blue Plus
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 9:46 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
127
127
0
0
64
2
64
2
NA
NA
NA
NA
NA
NA
50.39%
41.30%
59.48%
1.57%
0.00%
4.13%
50.39%
41.30%
59.48%
1.57%
0.00%
4.13%
Page 67
Access/Availability of Care
Blue Plus
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 9:46 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
33
33
0
0
10
4
10
4
NA
NA
NA
NA
NA
NA
30.30%
13.11%
47.50%
12.12%
0.00%
24.77%
30.30%
13.11%
47.50%
12.12%
0.00%
24.77%
Page 69
Access/Availability of Care
Blue Plus
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Jan 10, 2011 9:46 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
194
1868
2062
86
29
776
237
862
266
44.33%
37.08%
51.58%
14.95%
9.67%
20.22%
41.54%
39.28%
43.80%
12.69%
11.15%
14.22%
41.80%
39.65%
43.96%
12.90%
11.43%
14.37%
Page 70
Access/Availability of Care
Blue Plus
Prenatal and Postpartum Care
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
Measurement Year
Data collection methodology (Administrative or Hybrid)
Eligible member population
2008
H
760
2008
H
760
Number of numerator events by administrative data in eligible
population (before exclusions)
563
450
74.08%
411
10%
453
352
59.21%
411
10%
453
275
77.70%
60.71%
1
1
0
1
411
319
66
0
1
411
250
87
93.67%
91.20%
96.15%
82.00%
78.16%
85.83%
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
Blue Plus
Prenatal and Postpartum Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
3707
2008
H
3707
Number of numerator events by administrative data in eligible
population (before exclusions)
2133
2202
57.54%
411
10%
453
290
59.40%
411
10%
453
301
64.02%
66.45%
3
3
0
0
450
290
119
0
0
450
301
45
90.89%
88.12%
93.66%
76.89%
72.88%
80.89%
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
Blue Plus
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
0
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Oversample List
0
HEDIS 2009 (Reporting Year 2008)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
25
4.30%
4
0.69%
3
0.52%
7
1.20%
16
2.75%
83
14.29%
443
76.25%
19
4.40%
4
0.93%
3
0.69%
5
1.16%
13
3.01%
66
15.28%
322
74.54%
3
0
0.73%
0.00%
1.67%
3
1
0.97%
0.00%
2.04%
0
0
0.00%
0.00%
0.12%
3
1
0.97%
0.00%
2.04%
10
3
3.16%
1.35%
4.98%
52
7
14.36%
10.84%
17.87%
310
18
79.81%
75.80%
83.81%
411
5.00%
432
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
1 visit
2008
H
581
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Zero Visits
411
Page 73
Use of Services
Blue Plus
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Jan 10, 2011 9:46 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
40
44
63
127
306
612
1500
1.49%
1.01%
1.96%
1.63%
1.14%
2.13%
2.34%
1.75%
2.93%
4.72%
3.90%
5.54%
11.37%
10.15%
12.58%
22.73%
21.13%
24.34%
55.72%
53.83%
57.62%
2008
A
2692
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
Blue Plus
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 9:46 AM
Commercial
MHCP-MC
2008
A
2477
2008
A
6677
NR
NR
NR
NR
1649
4300
66.57%
64.69%
68.45%
64.40%
63.24%
65.56%
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
Blue Plus
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Commercial
MHCP-MC
2008
A
7207
2008
A
12598
NR
NR
NR
NR
2381
4169
33.04%
31.94%
34.13%
33.09%
32.27%
33.92%
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
Blue Plus
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Commercial
Member Months
Total
44573
90780
149843
103636
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
291
75
93
38
0-4
5-19
6.53
0.50
1.02
0.37
Member Months
Age
15-44
20-44
30-64
45-64
65+
Male
109625
177608
106193
4751
Female
161542
135160
129362
3452
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+
2
0
0.00
30-64
15-44
45-64
65+
Back Surgery
20-44
45-64
65+
Angioplasty (PTCA) 45-64
65+
45-64
Cardiac
Catheterization
65+
38
0.21
Cholecystectomy,
Closed
CABG
45-64
65+
Prostatectomy
45-64
65+
Mastectomy
15-44
45-64
65+
Lumpectomy
15-44
45-64
65+
HEDIS 2009 (Reporting Year 2008)
1
23
61
5
46
12
53
6
9
2
22
8
Number of
Procedures
Procedures /
1,000 Member
Months
15
25
49
59
0
23
41
0
0.09
0.19
1
3
0
0.01
0.02
0.00
72
62
1
29
44
3
18
1
45
0.45
0.48
0.29
0.30
0.46
0.00
0.14
0.32
0.00
0.01
0.21
0.21
0.57
1.05
0.43
2.53
0.50
1.26
0.08
0.42
1
2
0
0.21
0.34
0.87
0.14
0.29
0.35
0.29
0.02
0.00
0.21
1.68
10
30
0
24
69
3
0.06
0.23
0.00
0.15
0.53
0.87
Page 77
Use of Services
Blue Plus
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 9:46 AM
MSHO
Member Months
Age
Male
2
11419
11075
8399
< 65
65-74
75-84
85+
Female
0
20001
27996
38432
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
2
2
0
0
12
7
8
0
9
10
2
0
2
0
0
0
6
16
13
0
6
2
2
0
2
3
0
0
4
4
4
0
0
1
1
0
5
8
4
0
4
3
2
Female
Procedures /
1,000 Member
Months
0.00
0.18
0.18
0.00
0.00
1.05
0.63
0.95
0.00
0.79
0.90
0.24
0.00
0.18
0.00
0.00
0.00
0.53
1.44
1.55
0.00
0.53
0.18
0.24
0.00
0.18
0.27
0.00
0.00
0.35
0.36
0.48
0.00
0.00
0.09
0.12
0.00
0.44
0.72
0.48
0.00
0.35
0.27
0.24
Number of
Procedures
0
10
4
1
0
18
18
16
0
36
38
9
0
1
0
1
0
20
33
114
0
10
12
6
0
24
30
9
0
6
12
6
0
4
2
1
0
19
11
11
0
21
8
7
0
3
5
1
0
1
1
1
0
8
9
3
0
7
12
2
Procedures /
1,000 Member
Months
NA
0.50
0.14
0.03
NA
0.90
0.64
0.42
NA
1.80
1.36
0.23
NA
0.05
0.00
0.03
NA
1.00
1.18
2.97
NA
0.50
0.43
0.16
NA
1.20
1.07
0.23
NA
0.30
0.43
0.16
NA
0.20
0.07
0.03
NA
0.95
0.39
0.29
NA
1.05
0.29
0.18
NA
0.15
0.18
0.03
NA
0.05
0.04
0.03
NA
0.40
0.32
0.08
NA
0.35
0.43
0.05
Page 79
Use of Services
Blue Plus
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 9:46 AM
SNBC
Member Months
Age
Male
3285
21
0
0
< 65
65-74
75-84
85+
Female
4947
12
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
1
0
0
0
1
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
1
0
0
0
2
0
0
0
Female
Procedures /
1,000 Member
Months
0.30
0.00
NA
NA
0.30
0.00
NA
NA
1.52
0.00
NA
NA
0.00
0.00
NA
NA
0.00
0.00
NA
NA
0.00
0.00
NA
NA
0.00
0.00
NA
NA
0.30
0.00
NA
NA
0.30
0.00
NA
NA
0.30
0.00
NA
NA
0.61
0.00
NA
NA
Number of
Procedures
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
4
0
0
0
1
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
5
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
4
0
0
0
Procedures /
1,000 Member
Months
0.00
0.00
NA
NA
0.00
0.00
NA
NA
1.21
0.00
NA
NA
0.00
0.00
NA
NA
0.81
0.00
NA
NA
0.20
0.00
NA
NA
1.62
0.00
NA
NA
0.00
0.00
NA
NA
0.00
0.00
NA
NA
1.62
0.00
NA
NA
1.01
0.00
NA
NA
0.00
0.00
NA
NA
0.20
0.00
NA
NA
0.00
0.00
NA
NA
0.81
0.00
NA
NA
Page 81
Use of Services
Blue Plus
Frequency of Selected Procedures
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC
Member Months
Total
Age
212221
0-4
367480
0-9
414797
5-19
259538
10-19
Total
Number of
Procedures
Procedure
Myringotomy
Age
Tonsillectomy
0-9
10-19
Procedures /
1,000 Member
Months
1453
333
415
156
0-4
5-19
6.85
0.80
1.13
0.60
Member Months
Age
15-44
20-44
30-64
45-64
Male
119256
133302
67318
Female
309038
243272
89756
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
3
Cholecystectomy,
Closed
30-64
15-44
45-64
20-44
45-64
40
Back Surgery
Mastectomy
15-44
45-64
Lumpectomy
15-44
45-64
HEDIS 2009 (Reporting Year 2008)
75
50
Female
Procedures /
1,000 Member
Months
Number of
Procedures
Procedures /
1,000 Member
Months
38
10
80
41
53
29
0.12
0.11
7
3
0.02
0.03
282
68
96
47
14
23
58
40
0.91
0.76
0.26
0.46
0.17
0.32
0.02
0.30
0.63
0.74
0.39
0.52
0.05
0.26
0.19
0.45
Page 82
Use of Services
Blue Plus
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
8732
82048
103636
244785
235555
7754
410
39
0
682959
Outpatient Visits
(Excludes MH/CD)
Age
Visits
7520
24889
10-19
20-44
45-64
65-74
75-84
85+
Unknown
24097
66069
83767
3737
301
16
0
210396
<1
1-9
Total
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
861.20
303.35
232.52
269.91
355.62
481.94
734.15
410.26
308.07
Emergency Room Visits
Visits
305
1538
1500
3455
2579
89
8
0
0
9474
Visits/ 1,000
Member
Months
34.93
18.75
14.47
14.11
10.95
11.48
19.51
0.00
13.87
Ambulatory
Surgery/Procedures
Procedures
87
504
378
2258
5183
247
15
1
0
8673
Procedures/
1,000 Member
Months
9.96
6.14
3.65
9.22
22.00
31.85
36.59
25.64
12.70
Observation Room Stays
Resulting in Discharge
Stays
6
29
23
188
161
2
0
0
0
409
Stays/ 1,000
Member
Months
0.69
0.35
0.22
0.77
0.68
0.26
0.00
0.00
0.60
Page 83
Use of Services
Blue Plus
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
2
31420
39071
46831
0
117324
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
0
0
3
26986
34203
36953
0
98145
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
1500.00
858.88
875.41
789.07
836.53
Emergency Room Visits
Visits
0
0
0
0
0
1326
1582
1722
0
4630
Visits/ 1,000
Member
Months
NA
NA
NA
NA
0.00
42.20
40.49
36.77
39.46
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
0
1468
1477
959
0
3904
Procedures/
1,000 Member
Months
NA
NA
NA
NA
0.00
46.72
37.80
20.48
33.28
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
68
90
115
0
273
Stays/ 1,000
Member
Months
NA
NA
NA
NA
0.00
2.16
2.30
2.46
2.33
Page 85
Use of Services
Blue Plus
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 9:46 AM
SNBC
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
83
3156
4993
33
0
0
0
8265
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
33
2434
5290
61
0
0
0
7818
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
NA
NA
397.59
771.23
1059.48
1848.48
NA
NA
945.92
Emergency Room Visits
Visits
0
0
0
347
432
1
0
0
0
780
Visits/ 1,000
Member
Months
NA
NA
0.00
109.95
86.52
30.30
NA
NA
94.37
Ambulatory
Surgery/Procedures
Procedures
0
0
1
101
268
0
0
0
0
370
Procedures/
1,000 Member
Months
NA
NA
12.05
32.00
53.68
0.00
NA
NA
44.77
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
3
17
1
0
0
0
21
Stays/ 1,000
Member
Months
NA
NA
0.00
0.95
3.40
30.30
NA
NA
2.54
Page 87
Use of Services
Blue Plus
Ambulatory Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
60306
307174
259538
362528
157074
3302
1712
1515
0
1153149
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
50620
104551
72485
163002
78465
2524
1155
1055
0
473857
HEDIS 2009 (Reporting Year 2008)
Visits/ 1,000
Member
Months
839.39
340.36
279.28
449.63
499.54
764.39
674.65
696.37
410.92
Emergency Room Visits
Visits
5395
13636
8148
20752
5121
133
69
63
0
53317
Visits/ 1,000
Member
Months
89.46
44.39
31.39
57.24
32.60
40.28
40.30
41.58
46.24
Ambulatory
Surgery/Procedures
Procedures
449
1900
1364
6273
4444
126
39
45
0
14640
Procedures/
1,000 Member
Months
7.45
6.19
5.26
17.30
28.29
38.16
22.78
29.70
12.70
Observation Room Stays
Resulting in Discharge
Stays
104
106
302
1674
259
7
5
3
0
2460
Stays/ 1,000
Member
Months
1.72
0.35
1.16
4.62
1.65
2.12
2.92
1.98
2.13
Page 88
Use of Services
Blue Plus
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 9:46 AM
Member Months
8732
82048
103636
244785
235555
7754
410
39
0
682959
Discharges
Discharges /
1,000 Member
Months
85
119
126
1478
1547
93
15
2
0
3465
9.73
1.45
1.22
6.04
6.57
11.99
36.59
51.28
70
78
49
284
717
37
12
1
0
1248
8.02
0.95
0.47
1.16
3.04
4.77
29.27
25.64
15
40
62
344
817
54
3
1
0
1336
1.72
0.49
0.60
1.41
3.47
6.96
7.32
25.64
15
849
0
0
864
0.14
3.47
0.00
HEDIS 2009 (Reporting Year 2008)
5.07
1.83
1.96
1.48
Days
Days / 1,000
Member
Months
447
498
391
3907
5268
367
64
8
0
10950
51.19
6.07
3.77
15.96
22.36
47.33
156.10
205.13
324
299
110
745
2463
180
43
2
0
4166
37.10
3.64
1.06
3.04
10.46
23.21
104.88
51.28
123
198
244
901
2693
177
21
6
0
4363
14.09
2.41
2.35
3.68
11.43
22.83
51.22
153.85
37
2260
0
0
2297
0.36
9.23
0.00
16.03
6.10
6.39
3.93
Average
Length of Stay
5.26
4.18
3.10
2.64
3.41
3.95
4.27
4.00
NA
3.16
4.63
3.83
2.24
2.62
3.44
4.86
3.58
2.00
NA
3.34
8.20
4.95
3.94
2.62
3.30
3.28
7.00
6.00
NA
3.27
2.47
2.66
NA
NA
2.66
Page 89
Use of Services
Blue Plus
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
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 9:46 AM
Member Months
0
0
0
0
2
31420
39071
46831
0
117324
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
1359
1917
2295
0
5571
NA
NA
NA
NA
0.00
43.25
49.06
49.01
0
0
0
0
0
1045
1578
1975
0
4598
NA
NA
NA
NA
0.00
33.26
40.39
42.17
0
0
0
0
0
305
331
308
0
944
NA
NA
NA
NA
0.00
9.71
8.47
6.58
0
0
0
0
0
NA
NA
0.00
HEDIS 2009 (Reporting Year 2008)
47.48
39.19
8.05
0.00
Days
Days / 1,000
Member
Months
0
0
0
0
0
6801
9030
10156
0
25987
NA
NA
NA
NA
0.00
216.45
231.12
216.86
0
0
0
0
0
4559
6951
8271
0
19781
NA
NA
NA
NA
0.00
145.10
177.91
176.61
221.50
168.60
0
0
0
0
0
2190
2041
1833
0
6064
NA
NA
NA
NA
0.00
69.70
52.24
39.14
0
0
0
0
0
NA
NA
0.00
51.69
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
5.00
4.71
4.43
NA
4.66
NA
NA
NA
NA
NA
4.36
4.40
4.19
NA
4.30
NA
NA
NA
NA
NA
7.18
6.17
5.95
NA
6.42
NA
NA
NA
NA
NA
Page 91
Use of Services
Blue Plus
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 9:46 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
Blue Plus
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 9:46 AM
Member Months
0
0
83
3156
4993
33
0
0
0
8265
Discharges
Discharges /
1,000 Member
Months
0
0
1
53
174
3
0
0
0
231
NA
NA
12.05
16.79
34.85
90.91
NA
NA
0
0
1
34
120
1
0
0
0
156
NA
NA
12.05
10.77
24.03
30.30
NA
NA
0
0
0
15
52
2
0
0
0
69
NA
NA
0.00
4.75
10.41
60.61
NA
NA
0
4
0
0
4
0.00
1.27
0.00
HEDIS 2009 (Reporting Year 2008)
27.95
18.87
8.35
0.49
Days
Days / 1,000
Member
Months
0
0
2
211
689
50
0
0
0
952
NA
NA
24.10
66.86
137.99
1515.15
NA
NA
0
0
2
103
474
6
0
0
0
585
NA
NA
24.10
32.64
94.93
181.82
NA
NA
0
0
0
96
208
44
0
0
0
348
NA
NA
0.00
30.42
41.66
1333.33
NA
NA
0
12
0
0
12
0.00
3.80
0.00
115.18
70.78
42.11
1.46
Average
Length of Stay
NA
NA
2.00
3.98
3.96
16.67
NA
NA
NA
4.12
NA
NA
2.00
3.03
3.95
6.00
NA
NA
NA
3.75
NA
NA
NA
6.40
4.00
22.00
NA
NA
NA
5.04
NA
3.00
NA
NA
3.00
Page 93
Use of Services
Blue Plus
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
<1
60306
1-9
307174
10-19
259538
20-44
362528
45-64
157074
65-74
3302
75-84
1712
85+
1515
Unknown
0
Total
1153149
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
705
700
1043
6137
1874
101
74
76
0
10710
11.69
2.28
4.02
16.93
11.93
30.59
43.22
50.17
605
544
267
1190
1059
70
64
66
0
3865
10.03
1.77
1.03
3.28
6.74
21.20
37.38
43.56
93
151
173
840
799
30
10
10
0
2106
1.54
0.49
0.67
2.32
5.09
9.09
5.84
6.60
598
4098
6
0
4702
HEDIS 2009 (Reporting Year 2008)
9.29
3.35
1.83
2.30
11.30
0.04
6.03
Days
Days / 1,000
Member
Months
2959
1695
2810
15768
7067
398
282
282
0
31261
49.07
5.52
10.83
43.49
44.99
120.53
164.72
186.14
2091
1225
770
3360
3608
250
246
231
0
11781
34.67
3.99
2.97
9.27
22.97
75.71
143.69
152.48
849
444
556
2453
3400
143
36
51
0
7932
14.08
1.45
2.14
6.77
21.65
43.31
21.03
33.66
1466
9919
12
0
11397
5.65
27.36
0.08
27.11
10.22
6.88
14.63
Average
Length of Stay
4.20
2.42
2.69
2.57
3.77
3.94
3.81
3.71
NA
2.92
3.46
2.25
2.88
2.82
3.41
3.57
3.84
3.50
NA
3.05
9.13
2.94
3.21
2.92
4.26
4.77
3.60
5.10
NA
3.77
2.45
2.42
2.00
NA
2.42
Page 94
Use of Services
Blue Plus
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
8732
82048
103636
244785
235555
7754
410
39
0
682959
Discharges
0
0
0
5
45
12
4
1
0
67
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
0.00
0.00
0.00
0.02
0.19
1.55
9.76
25.64
0.10
Days
0
0
0
161
553
343
27
30
0
1114
Days / 1,000
Member
Months
0.00
0.00
0.00
0.66
2.35
44.24
65.85
769.23
1.63
Average Length
of Stay
NA
NA
NA
32.20
12.29
28.58
6.75
30.00
NA
16.63
Page 95
Use of Services
Blue Plus
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
2
31420
39071
46831
0
117324
Discharges
0
0
0
0
0
449
961
1756
0
3166
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
NA
NA
NA
NA
0.00
14.29
24.60
37.50
26.99
Days
0
0
0
0
0
11690
27498
55355
0
94543
Days / 1,000
Member
Months
NA
NA
NA
NA
0.00
372.06
703.80
1182.02
805.83
Average Length
of Stay
NA
NA
NA
NA
NA
26.04
28.61
31.52
NA
29.86
Page 97
Use of Services
Blue Plus
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
83
3156
4993
33
0
0
0
8265
Discharges
0
0
0
3
11
2
0
0
0
16
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
NA
NA
0.00
0.95
2.20
60.61
NA
NA
1.94
Days
0
0
0
31
141
100
0
0
0
272
Days / 1,000
Member
Months
NA
NA
0.00
9.82
28.24
3030.30
NA
NA
32.91
Average Length
of Stay
NA
NA
NA
10.33
12.82
50.00
NA
NA
NA
17.00
Page 99
Use of Services
Blue Plus
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Jan 10, 2011 9:46 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
60306
307174
259538
362528
157074
3302
1712
1515
0
1153149
Discharges
0
0
2
8
15
6
11
18
0
60
HEDIS 2009 (Reporting Year 2008)
Discharges /
1,000 Member
Months
0.00
0.00
0.01
0.02
0.10
1.82
6.43
11.88
0.05
Days
0
0
20
63
147
112
180
639
0
1161
Days / 1,000
Member
Months
0.00
0.00
0.08
0.17
0.94
33.92
105.14
421.78
1.01
Average Length
of Stay
NA
NA
10.00
7.88
9.80
18.67
16.36
35.50
NA
19.35
Page 100
Use of Services
Blue Plus
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
62484
26800
31120
38268
157411
4751
0
320834
Female
58149
25434
34171
51613
189306
3452
0
362125
Total
120633
52234
65291
89881
346717
8203
0
682959
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
2
3
5
57
26
83
123
75
198
68
55
123
237
141
378
3
1
4
0
0
0
490
301
791
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
62484
26800
31120
38268
157411
4751
0
320834
Female
58149
25434
34171
51613
189306
3452
0
362125
Total
120633
52234
65291
89881
346717
8203
0
682959
Inpatient
Percent
0.04%
0.06%
0.05%
2.55%
1.23%
1.91%
4.74%
2.63%
3.64%
2.13%
1.28%
1.64%
1.81%
0.89%
1.31%
0.76%
0.35%
0.59%
NA
NA
NA
1.83%
1.00%
1.39%
Number
0
0
0
13
8
21
26
22
48
12
17
29
59
39
98
0
0
0
0
0
0
110
86
196
Percent
0.00%
0.00%
0.00%
0.58%
0.38%
0.48%
1.00%
0.77%
0.88%
0.38%
0.40%
0.39%
0.45%
0.25%
0.34%
0.00%
0.00%
0.00%
NA
NA
NA
0.41%
0.28%
0.34%
Male
62484
26800
31120
38268
157411
4751
0
320834
Female
58149
25434
34171
51613
189306
3452
0
362125
Total
120633
52234
65291
89881
346717
8203
0
682959
Member Months
(Outpatient/ED)
Male
62484
26800
31120
38268
157411
4751
0
320834
Female
58149
25434
34171
51613
189306
3452
0
362125
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
5
2
7
7
1
8
2
5
7
14
5
19
0
0
0
0
0
0
28
13
41
Number
2
3
5
53
23
76
116
61
177
64
49
113
221
126
347
3
1
4
0
0
0
459
263
722
Percent
0.00%
0.00%
0.00%
0.22%
0.09%
0.16%
0.27%
0.04%
0.15%
0.06%
0.12%
0.09%
0.11%
0.03%
0.07%
0.00%
0.00%
0.00%
NA
NA
NA
0.10%
0.04%
0.07%
Total
120633
52234
65291
89881
346717
8203
0
682959
Percent
0.04%
0.06%
0.05%
2.37%
1.09%
1.75%
4.47%
2.14%
3.25%
2.01%
1.14%
1.51%
1.68%
0.80%
1.20%
0.76%
0.35%
0.59%
NA
NA
NA
1.72%
0.87%
1.27%
Page 101
Use of Services
Blue Plus
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 9:46 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
0
2
30893
0
30895
Female
0
0
0
0
0
86429
0
86429
Total
0
0
0
0
2
117322
0
117324
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
83
92
175
0
0
0
83
92
175
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
0
0
2
30893
0
30895
Female
0
0
0
0
0
86429
0
86429
Total
0
0
0
0
2
117322
0
117324
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
3.22%
1.28%
1.79%
NA
NA
NA
3.22%
1.28%
1.79%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
34
52
86
0
0
0
34
52
86
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
1.32%
0.72%
0.88%
NA
NA
NA
1.32%
0.72%
0.88%
Male
0
0
0
0
2
30893
0
30895
Female
0
0
0
0
0
86429
0
86429
Total
0
0
0
0
2
117322
0
117324
Member Months
(Outpatient/ED)
Male
0
0
0
0
2
30893
0
30895
Female
0
0
0
0
0
86429
0
86429
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
62
55
117
0
0
0
62
55
117
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Total
0
0
0
0
2
117322
0
117324
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
2.41%
0.76%
1.20%
NA
NA
NA
2.41%
0.76%
1.20%
Page 103
Use of Services
Blue Plus
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 9:46 AM
SNBC
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
233
436
2616
21
0
3306
Female
0
0
300
628
4019
12
0
4959
Total
0
0
533
1064
6635
33
0
8265
Any Services
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Number
0
0
0
0
0
0
3
4
7
11
9
20
83
59
142
0
0
0
0
0
0
97
72
169
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Member Months
(Any)
Male
0
0
233
436
2616
21
0
3306
Female
0
0
300
628
4019
12
0
4959
Total
0
0
533
1064
6635
33
0
8265
Inpatient
Percent
NA
NA
NA
NA
NA
NA
15.45%
16.00%
15.76%
30.28%
17.20%
22.56%
38.07%
17.62%
25.68%
0.00%
0.00%
0.00%
NA
NA
NA
35.21%
17.42%
24.54%
Number
0
0
0
0
0
0
2
2
4
3
1
4
18
18
36
0
0
0
0
0
0
23
21
44
Percent
NA
NA
NA
NA
NA
NA
10.30%
8.00%
9.01%
8.26%
1.91%
4.51%
8.26%
5.37%
6.51%
0.00%
0.00%
0.00%
NA
NA
NA
8.35%
5.08%
6.39%
Male
0
0
233
436
2616
21
0
3306
Female
0
0
300
628
4019
12
0
4959
Total
0
0
533
1064
6635
33
0
8265
Member Months
(Outpatient/ED)
Male
0
0
233
436
2616
21
0
3306
Female
0
0
300
628
4019
12
0
4959
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
1
0
1
0
0
0
1
2
3
0
0
0
0
0
0
2
2
4
Number
0
0
0
0
0
0
3
4
7
10
9
19
79
53
132
0
0
0
0
0
0
92
66
158
Percent
NA
NA
NA
NA
NA
NA
5.15%
0.00%
2.25%
0.00%
0.00%
0.00%
0.46%
0.60%
0.54%
0.00%
0.00%
0.00%
NA
NA
NA
0.73%
0.48%
0.58%
Total
0
0
533
1064
6635
33
0
8265
Percent
NA
NA
NA
NA
NA
NA
15.45%
16.00%
15.76%
27.52%
17.20%
21.43%
36.24%
15.82%
23.87%
0.00%
0.00%
0.00%
NA
NA
NA
33.39%
15.97%
22.94%
Page 105
Use of Services
Blue Plus
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Jan 10, 2011 9:46 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
228808
65556
46520
48373
111393
2230
0
502880
Female
221260
66672
90795
104241
163002
4299
0
650269
Total
450068
132228
137315
152614
274395
6529
0
1153149
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
7
2
9
271
183
454
495
512
1007
714
727
1441
1231
995
2226
10
8
18
0
0
0
2728
2427
5155
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
228808
65556
46520
48373
111393
2230
0
502880
Female
221260
66672
90795
104241
163002
4299
0
650269
Total
450068
132228
137315
152614
274395
6529
0
1153149
Inpatient
Percent
0.04%
0.01%
0.02%
4.96%
3.29%
4.12%
12.77%
6.77%
8.80%
17.71%
8.37%
11.33%
13.26%
7.33%
9.73%
5.38%
2.23%
3.31%
NA
NA
NA
6.51%
4.48%
5.36%
Number
1
0
1
84
62
146
137
133
270
195
169
364
418
288
706
4
2
6
0
0
0
839
654
1493
Percent
0.01%
0.00%
0.00%
1.54%
1.12%
1.32%
3.53%
1.76%
2.36%
4.84%
1.95%
2.86%
4.50%
2.12%
3.09%
2.15%
0.56%
1.10%
NA
NA
NA
2.00%
1.21%
1.55%
Male
228808
65556
46520
48373
111393
2230
0
502880
Female
221260
66672
90795
104241
163002
4299
0
650269
Total
450068
132228
137315
152614
274395
6529
0
1153149
Member Months
(Outpatient/ED)
Male
228808
65556
46520
48373
111393
2230
0
502880
Female
221260
66672
90795
104241
163002
4299
0
650269
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
33
13
46
28
26
54
51
39
90
64
69
133
0
0
0
0
0
0
176
147
323
Number
7
2
9
248
166
414
452
461
913
663
679
1342
1118
924
2042
9
6
15
0
0
0
2497
2238
4735
Percent
0.00%
0.00%
0.00%
0.60%
0.23%
0.42%
0.72%
0.34%
0.47%
1.27%
0.45%
0.71%
0.69%
0.51%
0.58%
0.00%
0.00%
0.00%
NA
NA
NA
0.42%
0.27%
0.34%
Total
450068
132228
137315
152614
274395
6529
0
1153149
Percent
0.04%
0.01%
0.02%
4.54%
2.99%
3.76%
11.66%
6.09%
7.98%
16.45%
7.82%
10.55%
12.04%
6.80%
8.93%
4.84%
1.67%
2.76%
NA
NA
NA
5.96%
4.13%
4.93%
Page 106
Use of Services
Blue Plus
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
62484
26800
226799
4751
0
320834
Female
58149
25434
275090
3452
0
362125
Total
120633
52234
501889
8203
0
682959
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
350
233
583
306
288
594
1268
2577
3845
15
11
26
0
0
0
1939
3109
5048
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
62484
26800
226799
4751
0
320834
Female
58149
25434
275090
3452
0
362125
Total
120633
52234
501889
8203
0
682959
Number
4
5
9
16
28
44
52
69
121
0
0
0
0
0
0
72
102
174
Female
58149
25434
275090
3452
0
362125
Total
120633
52234
501889
8203
0
682959
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
6.72%
4.81%
5.80%
13.70%
13.59%
13.65%
6.71%
11.24%
9.19%
3.79%
3.82%
3.80%
NA
NA
NA
7.25%
10.30%
8.87%
Male
62484
26800
226799
4751
0
320834
Percent
0.08%
0.10%
0.09%
0.72%
1.32%
1.01%
0.28%
0.30%
0.29%
0.00%
0.00%
0.00%
NA
NA
NA
0.27%
0.34%
0.31%
Number
2
7
9
6
10
16
13
38
51
0
0
0
0
0
0
21
55
76
Percent
0.04%
0.14%
0.09%
0.27%
0.47%
0.37%
0.07%
0.17%
0.12%
0.00%
0.00%
0.00%
NA
NA
NA
0.08%
0.18%
0.13%
Member Months
(Outpatient/ED)
Male
62484
26800
226799
4751
0
320834
Female
58149
25434
275090
3452
0
362125
Total
120633
52234
501889
8203
0
682959
Outpatient/ED
Number
348
232
580
302
288
590
1262
2570
3832
15
11
26
0
0
0
1927
3101
5028
Percent
6.68%
4.79%
5.77%
13.52%
13.59%
13.55%
6.68%
11.21%
9.16%
3.79%
3.82%
3.80%
NA
NA
NA
7.21%
10.28%
8.83%
Page 107
Use of Services
Blue Plus
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 9:46 AM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
2
30893
0
30895
Female
0
0
0
86429
0
86429
Total
0
0
2
117322
0
117324
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
328
828
1156
0
0
0
328
828
1156
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
2
30893
0
30895
Female
0
0
0
86429
0
86429
Total
0
0
2
117322
0
117324
Number
0
0
0
0
0
0
0
0
0
101
239
340
0
0
0
101
239
340
Female
0
0
0
86429
0
86429
Total
0
0
2
117322
0
117324
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
12.74%
11.50%
11.82%
NA
NA
NA
12.74%
11.50%
11.82%
Male
0
0
2
30893
0
30895
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
3.92%
3.32%
3.48%
NA
NA
NA
3.92%
3.32%
3.48%
Number
0
0
0
0
0
0
0
0
0
4
5
9
0
0
0
4
5
9
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
0.16%
0.07%
0.09%
NA
NA
NA
0.16%
0.07%
0.09%
Member Months
(Outpatient/ED)
Male
0
0
2
30893
0
30895
Female
0
0
0
86429
0
86429
Total
0
0
2
117322
0
117324
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
261
661
922
0
0
0
261
661
922
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
10.14%
9.18%
9.43%
NA
NA
NA
10.14%
9.18%
9.43%
Page 109
Use of Services
Blue Plus
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 9:46 AM
SNBC
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
3285
21
0
3306
Female
0
0
4947
12
0
4959
Total
0
0
8232
33
0
8265
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
233
422
655
1
0
1
0
0
0
234
422
656
HEDIS 2009 (Reporting Year 2008)
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Male
0
0
3285
21
0
3306
Female
0
0
4947
12
0
4959
Total
0
0
8232
33
0
8265
Number
0
0
0
0
0
0
30
26
56
0
0
0
0
0
0
30
26
56
Female
0
0
4947
12
0
4959
Total
0
0
8232
33
0
8265
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NA
NA
NA
NA
NA
NA
85.11%
102.37%
95.48%
57.14%
0.00%
36.36%
NA
NA
NA
84.94%
102.12%
95.25%
Male
0
0
3285
21
0
3306
Percent
NA
NA
NA
NA
NA
NA
10.96%
6.31%
8.16%
0.00%
0.00%
0.00%
NA
NA
NA
10.89%
6.29%
8.13%
Number
0
0
0
0
0
0
15
20
35
0
0
0
0
0
0
15
20
35
Percent
NA
NA
NA
NA
NA
NA
5.48%
4.85%
5.10%
0.00%
0.00%
0.00%
NA
NA
NA
5.44%
4.84%
5.08%
Member Months
(Outpatient/ED)
Male
0
0
3285
21
0
3306
Female
0
0
4947
12
0
4959
Total
0
0
8232
33
0
8265
Outpatient/ED
Number
0
0
0
0
0
0
229
421
650
1
0
1
0
0
0
230
421
651
Percent
NA
NA
NA
NA
NA
NA
83.65%
102.12%
94.75%
57.14%
0.00%
36.36%
NA
NA
NA
83.48%
101.88%
94.52%
Page 111
Use of Services
Blue Plus
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Minnesota Health Care Programs - Managed Care(MHCP-MC)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
228808
65556
206286
2230
0
502880
Female
221260
66672
358038
4299
0
650269
Total
450068
132228
564324
6529
0
1153149
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
2229
1459
3688
1186
1288
2474
3044
6669
9713
25
54
79
0
0
0
6484
9470
15954
HEDIS 2009 (Reporting Year 2008)
Male
228808
65556
206286
2230
0
502880
Female
221260
66672
358038
4299
0
650269
Total
450068
132228
564324
6529
0
1153149
Percent
11.69%
7.91%
9.83%
21.71%
23.18%
22.45%
17.71%
22.35%
20.65%
13.45%
15.07%
14.52%
NA
NA
NA
15.47%
17.48%
16.60%
Number
53
29
82
85
114
199
280
408
688
3
6
9
0
0
0
421
557
978
Male
228808
65556
206286
2230
0
502880
Female
221260
66672
358038
4299
0
650269
Total
450068
132228
564324
6529
0
1153149
Intensive Outpatient/Partial
Hospitalization
Inpatient
Any Services
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Member Months
(Inpatient)
Percent
0.28%
0.16%
0.22%
1.56%
2.05%
1.81%
1.63%
1.37%
1.46%
1.61%
1.67%
1.65%
NA
NA
NA
1.00%
1.03%
1.02%
Number
33
6
39
25
27
52
104
196
300
1
1
2
0
0
0
163
230
393
Percent
0.17%
0.03%
0.10%
0.46%
0.49%
0.47%
0.60%
0.66%
0.64%
0.54%
0.28%
0.37%
NA
NA
NA
0.39%
0.42%
0.41%
Member Months
(Outpatient/ED)
Male
228808
65556
206286
2230
0
502880
Female
221260
66672
358038
4299
0
650269
Total
450068
132228
564324
6529
0
1153149
Outpatient/ED
Number
2224
1457
3681
1179
1283
2462
2994
6622
9616
22
49
71
0
0
0
6419
9411
15830
Percent
11.66%
7.90%
9.81%
21.58%
23.09%
22.34%
17.42%
22.19%
20.45%
11.84%
13.68%
13.05%
NA
NA
NA
15.32%
17.37%
16.47%
Page 112
Use of Services
Blue Plus
Outpatient Drug Utilization
Commercial
Age
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
Member Months
90224
81211
152136
179134
163344
7713
410
29
0
674201
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 9:46 AM
$1,573,217.00
$2,678,318.00
$6,029,849.00
$10,992,581.00
$17,338,349.00
$1,084,468.00
$83,759.00
$2,043.00
$0.00
$39,782,584.00
HEDIS 2009 (Reporting Year 2008)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$17.44
$32.98
$39.63
$61.37
$106.15
$140.60
$204.29
$70.45
$59.01
Total Number of
Prescriptions
25904
33553
112726
205190
369569
26625
2100
48
0
775715
Avg. Num. Of
Prescriptions /
Per Member Per
Year
3.45
4.96
8.89
13.75
27.15
41.42
61.46
19.86
13.81
Page 113
Use of Services
Blue Plus
Outpatient Drug Utilization
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
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
2
31420
39071
46831
0
117324
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 9:46 AM
$0.00
$0.00
$0.00
$0.00
$0.00
$8,745,199.00
$10,656,946.00
$11,603,649.00
$0.00
$31,005,794.00
HEDIS 2009 (Reporting Year 2008)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
NA
NA
$0.00
$278.33
$272.76
$247.78
$264.27
Total Number of
Prescriptions
0
0
0
0
0
250159
353840
432930
0
1036929
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
NA
NA
0.00
95.54
108.68
110.93
106.06
Page 115
Use of Services
Blue Plus
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 9:46 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
Blue Plus
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 9:46 AM
Member Months
0
0
1597
2968
3667
33
0
0
0
8265
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
$546,660.00
$1,328,050.00
$1,557,792.00
$5,244.00
$0.00
$0.00
$0.00
$3,437,746.00
HEDIS 2009 (Reporting Year 2008)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
$342.30
$447.46
$424.81
$158.91
NA
NA
$415.94
Total Number of
Prescriptions
0
0
6304
18783
29532
190
0
0
0
54809
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
47.37
75.94
96.64
69.09
NA
NA
79.58
Page 117
Use of Services
Blue Plus
Outpatient Drug Utilization
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Age
Member Months
0-9
367480
10-17
214816
18-34
289929
35-49
174864
50-64
99531
65-74
3302
75-84
1712
85+
1515
Unknown
0
Total
Age
1153149
Total Cost of
Prescriptions
0-9
10-17
18-34
35-49
50-64
65-74
75-84
85+
Unknown
Total
$5,887,468.00
$7,604,388.00
$15,433,888.00
$17,985,340.00
$12,705,114.00
$177,414.00
$47,796.00
$35,670.00
$0.00
$59,877,078.00
HEDIS 2009 (Reporting Year 2008)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$16.02
$35.40
$53.23
$102.85
$127.65
$53.73
$27.92
$23.54
$51.92
Total Number of
Prescriptions
138706
108578
331226
348510
309472
6539
2761
3546
0
1249338
Avg. Num. Of
Prescriptions /
Per Member Per
Year
4.53
6.07
13.71
23.92
37.31
23.76
19.35
28.09
13.00
Page 118
Health Plan Descriptive Information
Blue Plus
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 9:46 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
4627
18544
23938
25991
16184
10981
Member Months
Female
4105
17297
22269
24098
15814
10568
Total
8732
35841
46207
50089
31998
21549
100265
31.25%
20139
18071
20197
24155
27063
94151
26.00%
23603
25984
25629
27620
32324
194416
28.47%
109625
34.17%
31160
29354
25943
19736
135160
37.32%
37895
35861
32302
23304
244785
35.84%
106193
33.10%
3709
748
201
71
12
10
129362
35.72%
2786
511
96
42
4
13
235555
34.49%
4751
1.48%
0
3452
0.95%
0
8203
1.20%
320834
362125
HEDIS 2009 (Reporting Year 2008)
43742
44055
45826
51775
59387
69055
65215
58245
43040
6495
1259
297
113
16
23
0
682959
Page 122
Health Plan Descriptive Information
Blue Plus
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 9:46 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
2
0
0.00%
0
0
0
0
0
0.00%
2
0.01%
5457
5962
5631
5444
5046
3353
0
0.00%
9917
10084
12670
15326
17450
20982
2
0.00%
30893
99.99%
0
86429
100.00%
0
117322
100.00%
30895
86429
HEDIS 2009 (Reporting Year 2008)
0
0
0
0
0
0
0
0
2
15374
16046
18301
20770
22496
24335
0
117324
Page 124
Health Plan Descriptive Information
Blue Plus
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 9:46 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
40
Member Months
Female
0
0
0
0
0
43
Total
0
0
0
0
0
83
40
1.21%
193
207
229
259
358
43
0.87%
257
281
347
410
615
83
1.00%
1246
37.69%
540
686
483
290
1910
38.52%
786
841
792
575
3156
38.19%
1999
60.47%
21
0
0
0
0
0
2994
60.38%
12
0
0
0
0
0
4993
60.41%
21
0.64%
0
12
0.24%
0
33
0.40%
3306
4959
HEDIS 2009 (Reporting Year 2008)
450
488
576
669
973
1326
1527
1275
865
33
0
0
0
0
0
0
8265
Page 126
Health Plan Descriptive Information
Blue Plus
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Jan 10, 2011 9:46 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
31032
77909
78429
67974
39020
19712
Member Months
Female
29274
74006
76830
67066
40756
25010
Total
60306
151915
155259
135040
79776
44722
314076
62.46%
26808
26464
21909
21329
22746
312942
48.13%
65785
61344
42897
38317
34929
627018
54.37%
119256
23.71%
23849
20232
14475
8762
243272
37.41%
33694
24575
17330
14157
362528
31.44%
67318
13.39%
907
446
345
240
162
130
89756
13.80%
1283
666
547
580
577
646
157074
13.62%
2230
0.44%
0
4299
0.66%
0
6529
0.57%
502880
650269
HEDIS 2009 (Reporting Year 2008)
92593
87808
64806
59646
57675
57543
44807
31805
22919
2190
1112
892
820
739
776
0
1153149
Page 127
Health Plan Stability
Blue Plus
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Commercial
Product/Product Line
Years in Business
Members*
15.00
34.00
0.00
3.00
34.00
95623
3691
0
11009
110323
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0.00
34.00
0.00
0.00
34.00
0
51006
0
0
51006
161329
HMO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total HMO:
PPO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total PPO:
POS
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 128
Health Plan Stability
Blue Plus
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 9:46 AM
MSHO
Product/Product Line
Years in Business
Members*
15.00
34.00
0.00
3.00
34.00
95623
3691
0
11009
110323
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0.00
34.00
0.00
0.00
34.00
0
51006
0
0
51006
161329
HMO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total HMO:
PPO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total PPO:
POS
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 130
Health Plan Stability
Blue Plus
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 9:46 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
Blue Plus
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 9:46 AM
SNBC
Product/Product Line
Years in Business
Members*
15.00
34.00
0.00
3.00
34.00
95623
3691
0
11009
110323
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
HMO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total HMO:
PPO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total PPO:
POS
MHCP_MC
0.00
0
Commercial
34.00
51006
Medicare (cost or risk)
0.00
0
Other
0.00
0
Total POS:
34.00
51006
Total:
161329
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 132
Health Plan Stability
Blue Plus
Years in Business / Total Membership
Data Last Refreshed:
Jan 10, 2011 9:46 AM
Minnesota Health Care Programs - Managed Care (MHCP-MC)
Product/Product Line
Years in Business
Members*
15.00
34.00
0.00
3.00
34.00
95623
3691
0
11009
110323
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
HMO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total HMO:
PPO
MHCP_MC
Commercial
Medicare (cost or risk)
Other
Total PPO:
POS
MHCP_MC
0.00
0
Commercial
34.00
51006
Medicare (cost or risk)
0.00
0
Other
0.00
0
Total POS:
34.00
51006
Total:
161329
* Total number of members in each category as of December 31, 2008
HEDIS 2009 (Reporting Year 2008)
Page 133