UCare of Minnesota
Plan Name
2007
Reporting Year
Submission #
General Info
Disclaimers
Code
CIS
Plan ID
1
Last Refreshed:
Page
Childhood Immunization Status
10/7/2009 1:38:53 PM
Use of Services Measures
Code
Page
21 W15
Well Child Visits in the First 15 Months of Life
39
22 W34
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
41
Page
23 AWC
Adolescent Well-Care Visits
42
3
24 FSP
2
Effectiveness of Care Measures
17
Frequency of Selected Procedures
43
Inpatient Utilization - General Hospital/Acute Care
47
URI
Appropriate Treatment for Children with Upper Respiratory Infection
5
25
COL
Colorectal Cancer Screening
6
26 AMB
Ambulatory Care
51
55
IPU
BCS
Breast Cancer Screening
7
27 NON
Inpatient Utilization - Nonacute Care
CCS
Cervical Cancer Screening
11
28
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
59
29 IAD
Identification of Alcohol and Other Drug Services
63
30 ORX
Outpatient Drug Utilization
67
MPT
CHL
Chlamydia Screening in Women
12
OMW
Osteoporosis Management in Women Who had a Fracture
13
CBP
Controlling High Blood Pressure
14
PBH
Persistence of Beta Blocker Treatment After Hearth Attack
15
CMC
Cholesterol Management for Patients with Cardiovascular Conditions
16
Code
CDC
Comprehensive Diabetes Care
20
31 AAP
Adult's Access to Preventive/Ambulatory Health Services
71
ASM
Use of Appropriate Medications for People with Asthma
24
32 CAP
Children's and Adolescents' Access to Primary Care Practitioners
75
AMM
Antidepressant Medication Management
26
33 PPC
ADD
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
30
GSO
Glaucoma Screening in Older Adults
31
34
Code
35
MPM
Annual Monitoring for Patients on Persistent Medications
32
DAE
Use of High Risk Medications in the Elderly
36
DDE
Potentially Harmful Drug-Disease Interactions in the Elderly
HEDIS 2008 (Reporting Year 2007)
37
IET
YIB
Code
36 ENP
Access / Availability of Care Measures
Page
Prenatal and Postpartum Care
77
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
79
Health Plan Stability Measures
Page
Years in Business / Total Membership
Health Plan Descriptive Information Measures
Enrollment by Product Line (Age & Sex)
83
Page
87
Page 1
DISCLAIMERS
-1
0. Disclaimer Query located below
1. In October 2009, it was discoverd that the formulas in the Inpatient Utilization: General
Hospital/Acute Care measure contained error. The formula was fixed and the data displayed now
correctly reflects the rest of the data on the sheet.
HEDIS 2008 (Reporting Year 2007)
Page 2
Effectiveness of Care
UCare of Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Data Elements
General
Measure
Data
DTaP/DT
IPV
MMR
HiB
Hepatitis B
VZV
Pneumococcal
Conjugate
Combo 2
Combo 3
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of Records Excluded because of
Contraindications by Admin Data
Number of Records Excluded because of
Contraindications by Medical Record
Review
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2008 (Reporting Year 2007)
Page 3
Effectiveness of Care
UCare of Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Pneumococcal
Conjugate
Combo 2
Combo 3
1146
68.75%
1300
77.98%
1435
86.08%
1247
74.81%
1198
71.87%
1384
83.02%
1132
67.91%
867
52.01%
789
47.33%
297
68.75%
331
76.62%
375
86.81%
328
75.93%
299
69.21%
357
82.64%
296
68.52%
230
53.24%
211
48.84%
287
47
81.27%
77.37%
85.16%
320
57
91.73%
88.94%
94.51%
360
17
91.73%
88.94%
94.51%
315
47
88.08%
84.82%
91.33%
290
79
89.78%
86.73%
92.83%
342
17
87.35%
84.01%
90.68%
289
35
78.83%
74.76%
82.90%
222
77
72.75%
68.32%
77.18%
205
76
68.37%
63.75%
72.99%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
1
Number of Records Excluded because of
Contraindications by Medical Record
Review
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
1
HEDIS 2008 (Reporting Year 2007)
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
2007
H
1667
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/DT
411
Page 4
Effectiveness of Care
UCare of Minnesota
Appropriate Treatment for Children with Upper
Respiratory Infection
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Data Elements
Commercial
Measurement Year
Medicaid
2007
Data Collection Methodology
A
Eligible Member Population
3622
Numerator Events by Admin Data
478
Reported Rate
NR
86.80%
Lower 95% Confidence Interval
NR
85.69%
Upper 95% Confidence Interval
NR
87.92%
HEDIS 2008 (Reporting Year 2007)
Page 5
Effectiveness of Care
UCare of Minnesota
Colorectal Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare
Advantage
MSHO
2007
2007
H
H
Eligible population
17389
3080
Number of numerator events by administrative data in eligible
population (before exclusions)
6611
773
38.02%
25.10%
Minimum required sample size (MRSS) or other sample size
411
411
Oversampling rate
0.05
0.05
Final sample size (FSS)
432
432
Number of numerator events by administrative data in FSS
157
115
36.34%
26.62%
0
0
Number of administrative data records excluded
60
17
Number of medical record data records excluded
0
0
Number of employee/dependent medical records excluded
0
0
Records added from the oversample list
0
0
Denominator
411
411
Numerator events by administrative data
149
109
Numerator events by medical records
85
33
Data Elements
Commercial
Measurement Year
Data collection methodology (administrative or hybrid)
Current year's administrative rate (before exclusions)
Administrative rate on FSS
NR
NR
Number of original sample records excluded because of valid data
errors
Reported rate
NR
56.93%
34.55%
Lower 95% confidence interval
NR
52.03%
29.83%
Upper 95% confidence interval
NR
61.84%
39.27%
HEDIS 2008 (Reporting Year 2007)
Page 6
Effectiveness of Care
UCare of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Data Elements
General Measure
Data
Ages 42-51
Ages 52-69
Total
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2008 (Reporting Year 2007)
NR
NR
NR
Page 7
Effectiveness of Care
UCare of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
General Measure
Data
Ages 42-51
Ages 52-69
Total
47
28
59.57%
44.48%
74.67%
2637
2104
79.79%
78.24%
81.34%
2684
2132
79.43%
77.89%
80.98%
2007
A
Page 8
Effectiveness of Care
UCare of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
General Measure
Data
Ages 42-51
Ages 52-69
Total
0
0
NA
NA
NA
457
231
50.55%
45.85%
55.24%
457
231
50.55%
45.85%
55.24%
2007
A
Page 9
Effectiveness of Care
UCare of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
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 2008 (Reporting Year 2007)
General Measure
Data
Ages 42-51
Ages 52-69
Total
1309
717
54.77%
52.04%
57.51%
1056
610
57.77%
54.74%
60.79%
2365
1327
56.11%
54.09%
58.13%
2007
A
Page 10
Effectiveness of Care
UCare of Minnesota
Cervical Cancer Screening
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2007
H
8227
Numerator Events by Admin Data on Eligible
Population (before exclusions)
5644
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
NR
NR
68.60%
411
5.00%
432
304
70.37%
0
Number of administrative data records excluded
41
Number of medical record data records excluded
5
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2008 (Reporting Year 2007)
NR
NR
NR
5
411
296
16
75.91%
71.66%
80.17%
Page 11
Effectiveness of Care
UCare of Minnesota
Chlamydia Screening in Women
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
General
Measure Ages 16-20 Ages 21-25
Data
Medicaid
Total
General
Measure Ages 16-20 Ages 21-25
Data
Total
2007
A
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
1221
608
49.80%
46.95%
52.64%
1434
758
52.86%
50.24%
55.48%
2655
1366
51.45%
49.53%
53.37%
Page 12
Effectiveness of Care
UCare of Minnesota
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 Interva
HEDIS 2008 (Reporting Year 2007)
Medicare
Advantage
MSHO
2007
A
582
110
18.90%
15.63%
22.17%
2007
A
246
31
12.60%
8.25%
16.95%
Page 13
Effectiveness of Care
UCare of Minnesota
Controlling High Blood Pressure
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Data Elements
Commercial
Medicare Advantage
MSHO
2007
2007
H
H
10554
1843
0
0
0.00%
0.00%
411
411
10.00%
15.00%
453
473
0
0
0.00%
0.00%
0
0
Number of administrative data records
excluded
700
236
Number of medical record data records
excluded
31
33
Number of employee/dependent medical
records excluded
0
0
Records Added from the OverSample List
31
33
Denominator
411
411
0
0
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population (before exclusions)
Current Year's Admin Rate
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
NR
Records Excluded because of Valid Data
Errors
Numerator Events by Admin Data
Numerator Events by Medical Record
234
248
Reported Rate
NR
56.93%
60.34%
Lower 95% Confidence Interval
NR
52.03%
55.49%
Upper 95% Confidence Interval
NR
61.84%
65.19%
HEDIS 2008 (Reporting Year 2007)
Page 14
Effectiveness of Care
UCare of Minnesota
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Commercial
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare Advantage
MSHO
Medicaid
2007
2007
2007
A
A
A
Eligible Member Population
167
45
27
Numerator Events by Admin Data on
Eligible Population
145
35
14
Measurement Year
Data Collection Methodology
Reported Rate
NR
86.83%
77.78%
NA
Lower 95% Confidence Interval
NR
81.40%
64.52%
NA
Upper 95% Confidence Interval
NR
92.26%
91.04%
NA
HEDIS 2008 (Reporting Year 2007)
Page 15
Effectiveness of Care
UCare of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Data Elements
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2008 (Reporting Year 2007)
Page 16
Effectiveness of Care
UCare of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
0
Number of administrative data records excluded
0
Number of medical record data records excluded
0
Number of employee/dependent medical records
excluded
0
HEDIS 2008 (Reporting Year 2007)
770
1
90.27%
0.12%
391
0
90.51%
0.00%
373
5
0
248
91.97%
89.22%
94.72%
60.34%
55.49%
65.19%
411
5.00%
432
Records Excluded because of Valid Data Errors
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
LDL-C Level of
<100 mg/dL
2007
H
853
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
LDL-C
screening
0
411
Page 17
Effectiveness of Care
UCare of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:38 PM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
0
Number of administrative data records excluded
0
Number of medical record data records excluded
0
Number of employee/dependent medical records
excluded
0
HEDIS 2008 (Reporting Year 2007)
152
0
83.52%
0.00%
150
0
83.33%
0.00%
150
6
0
86
86.67%
81.42%
91.91%
47.78%
40.20%
55.35%
180
0.00%
180
Records Excluded because of Valid Data Errors
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
LDL-C Level of
<100 mg/dL
2007
H
182
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
LDL-C
screening
0
180
Page 18
Effectiveness of Care
UCare of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
0
Number of administrative data records excluded
0
Number of medical record data records excluded
0
Number of employee/dependent medical records
excluded
0
HEDIS 2008 (Reporting Year 2007)
70
0
78.65%
0.00%
70
0
78.65%
0.00%
70
2
0
49
81.82%
73.19%
90.44%
55.68%
44.73%
66.63%
89
0.00%
89
Records Excluded because of Valid Data Errors
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
LDL-C Level of
<100 mg/dL
2007
H
89
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
LDL-C
screening
0
88
Page 19
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Data Elements
HbA1c
Testing
Poor HbA1c Good HbA1c
Control
Control
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical 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 2008 (Reporting Year 2007)
Page 20
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2008 (Reporting Year 2007)
HbA1c
Testing
Poor HbA1c Good HbA1c
Control
Control
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
2007
H
2915
2007
H
2915
2007
H
2915
2007
H
2915
2007
H
2915
2007
H
2915
2007
H
2915
2007
H
2915
2007
H
2915
2684
92.08%
411
5%
432
394
92.70%
90.06%
95.34%
2914
99.97%
411
5%
432
432
27.49%
23.06%
31.93%
0
0.00%
411
5%
432
0
54.99%
50.06%
59.92%
2122
72.80%
411
5%
432
295
73.72%
69.35%
78.10%
2549
87.44%
411
5%
432
377
89.54%
86.46%
92.62%
2
0.07%
411
5%
432
0
56.45%
51.53%
61.36%
2548
87.41%
411
5%
432
376
89.78%
86.73%
92.83%
1
0.03%
411
5%
432
0
71.05%
66.54%
75.55%
1
0.03%
411
5%
432
0
47.69%
42.74%
52.64%
Page 21
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
HbA1c
Testing
Poor HbA1c Good HbA1c
Control
Control
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
2007
H
859
2007
H
859
2007
H
859
2007
H
859
2007
H
859
2007
H
859
2007
H
859
2007
H
859
2007
H
859
769
87.27%
858
100.00%
1
0.00%
575
69.21%
656
74.77%
2
0.23%
734
82.87%
3
0.46%
2
0.23%
Number of Records Excluded Because of
Valid Data Errors
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
2
2
2
2
2
2
2
2
2
0
0
0
0
0
0
0
0
0
2
411
360
13
90.75%
87.83%
93.68%
2
411
34
114
36.01%
31.25%
40.77%
2
411
0
182
44.28%
39.36%
49.21%
2
411
287
17
73.97%
69.60%
78.33%
2
411
307
17
78.83%
74.76%
82.90%
2
411
1
172
42.09%
37.20%
46.99%
2
411
341
9
85.16%
81.60%
88.72%
2
411
2
269
65.94%
61.23%
70.64%
2
411
1
181
44.28%
39.36%
49.21%
Numerator events by admin data in eligible
population
Admin rate on FSS
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 2008 (Reporting Year 2007)
Page 22
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
HbA1c
Testing
Poor HbA1c Good HbA1c
Control
Control
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
2007
H
1217
2007
H
1217
2007
H
1217
2007
H
1217
2007
H
1217
2007
H
1217
2007
H
1217
2007
H
1217
2007
H
1217
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
1042
85.62%
411
5%
432
387
89.58%
1183
97.21%
411
5%
432
431
99.77%
2
0.16%
411
5%
432
1
0.23%
645
53.00%
411
5%
432
248
57.41%
908
74.61%
411
5%
432
326
75.46%
6
0.49%
411
5%
432
4
0.93%
931
76.50%
411
5%
432
341
78.94%
4
0.33%
411
5%
432
1
0.23%
2
0.16%
411
5%
432
0
0.00%
Number of Records Excluded Because of
Valid Data Errors
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
29
29
29
29
29
29
29
29
29
10
10
10
10
10
10
10
10
10
0
0
0
0
0
0
0
0
0
10
411
369
5
91.00%
88.11%
93.89%
10
411
30
131
39.17%
34.33%
44.01%
10
411
1
159
38.93%
34.09%
43.77%
10
411
237
22
63.02%
58.23%
67.81%
10
411
312
11
78.59%
74.50%
82.68%
10
411
4
132
33.09%
28.42%
37.76%
10
411
330
18
84.67%
81.07%
88.28%
10
411
0
279
67.88%
63.25%
72.52%
10
411
0
177
43.07%
38.16%
47.97%
Numerator events by admin data in eligible
population
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 2008 (Reporting Year 2007)
Page 23
Effectiveness of Care
UCare of Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
General
Measure Data
Ages 5-9
NR
NR
NR
Ages 10-17
NR
NR
NR
Ages 18-56
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 24
Effectiveness of Care
UCare of Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
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 2008 (Reporting Year 2007)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
Total
138
130
94.20%
89.94%
98.46%
196
183
93.37%
89.63%
97.11%
304
258
84.87%
80.68%
89.06%
638
571
89.50%
87.04%
91.96%
2007
A
Page 25
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 26
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
18
6.32%
3.32%
9.32%
199
69.82%
64.32%
75.33%
155
54.39%
48.43%
60.34%
2007
A
285
Page 27
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
4
3.81%
0.00%
7.95%
67
63.81%
54.14%
73.48%
61
58.10%
48.18%
68.01%
2007
A
105
Page 28
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
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 2008 (Reporting Year 2007)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
129
27.33%
23.20%
31.46%
207
43.86%
39.27%
48.44%
150
31.78%
27.47%
36.09%
2007
A
472
Page 29
Effectiveness of Care
UCare of Minnesota
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
General
Measure
Data
Initiation
Phase
Medicaid
Continuation
and
Maintenance
Phase
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
376
154
40.96%
35.85%
46.06%
83
42
50.60%
39.24%
61.96%
2007
A
NR
NR
NR
NR
NR
NR
Page 30
Effectiveness of Care
UCare of Minnesota
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interva
HEDIS 2008 (Reporting Year 2007)
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare
Advantage
MSHO
2007
A
26147
20644
78.95%
78.46%
79.45%
2007
A
5436
3935
72.39%
71.19%
73.59%
Page 31
Effectiveness of Care
UCare of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
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 32
Effectiveness of Care
UCare of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
9214
8257
89.61%
88.99%
90.24%
748
673
89.97%
87.75%
92.19%
10187
9154
89.86%
89.27%
90.45%
357
271
75.91%
71.33%
80.49%
20506
18355
89.51%
89.09%
89.93%
2007
A
Page 33
Effectiveness of Care
UCare of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
2519
2298
91.23%
90.10%
92.35%
319
297
93.10%
90.17%
96.04%
2753
2549
92.59%
91.59%
93.59%
341
303
88.86%
85.37%
92.34%
5932
5447
91.82%
91.12%
92.53%
2007
A
Page 34
Effectiveness of Care
UCare of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
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 2008 (Reporting Year 2007)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
723
589
81.47%
78.56%
84.37%
12
10
NA
NA
NA
579
475
82.04%
78.82%
85.25%
126
101
80.16%
72.80%
87.52%
1440
1175
81.60%
79.56%
83.63%
2007
A
Page 35
Effectiveness of Care
UCare of Minnesota
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
General
Measure
Data
2007
A
27762
MSHO
1 or More
Prescriptions
2 or More
Prescriptions
4611
16.61%
16.17%
17.05%
725
2.61%
2.42%
2.80%
General
Measure
Data
2007
A
7065
1 or More
Prescriptions
2 or More
Prescriptions
1730
24.49%
23.48%
25.50%
354
5.01%
4.49%
5.53%
Page 36
Effectiveness of Care
UCare of Minnesota
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
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
2007
A
1110
153
13.78%
11.71%
15.86%
1818
355
19.53%
17.68%
21.38%
179
5
2.79%
0.10%
5.49%
3107
513
16.51%
15.19%
17.83%
Page 37
Effectiveness of Care
UCare of Minnesota
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
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
2007
A
432
102
23.61%
19.49%
27.73%
1600
402
25.13%
22.97%
27.28%
95
10
10.53%
3.83%
17.22%
2127
514
24.17%
22.32%
26.01%
Page 38
Use of Services
UCare of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Data Elements
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of records excluded because of
contraindications identified through
administrative data
Number of records excluded because of
contraindications identified through medical
record review
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 2008 (Reporting Year 2007)
Page 39
Use of Services
UCare of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
0
Number of records excluded because of
contraindications identified through
administrative data
0
Number of records excluded because of
contraindications identified through medical
record review
0
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Oversample List
0
HEDIS 2008 (Reporting Year 2007)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
52
2.18%
53
2.22%
107
4.49%
185
7.76%
330
13.84%
588
24.65%
1070
44.86%
10
2.31%
9
2.08%
20
4.63%
38
8.80%
59
13.66%
111
25.69%
185
42.82%
9
0
2.19%
0.65%
3.73%
8
0
1.95%
0.49%
3.40%
10
1
2.68%
0.99%
4.36%
24
4
6.81%
4.26%
9.37%
32
4
8.76%
5.90%
11.61%
80
20
24.33%
20.06%
28.60%
178
41
53.28%
48.34%
58.23%
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
2007
H
2385
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Zero Visits
411
Page 40
Use of Services
UCare of Minnesota
Well Child Visits in the 3rd, 4th,
5th and 6th Years of Life
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2007
H
5463
Numerator events by admin data in eligible
population
3538
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
NR
64.76%
411
5.00%
432
276
NR
63.89%
0
Records Excluded - Contraindications/Admin Data
0
Records Excluded - Contraindications/Medical
Record Review
0
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2008 (Reporting Year 2007)
NR
NR
NR
0
411
260
14
66.67%
61.99%
71.35%
Page 41
Use of Services
UCare of Minnesota
Adolescent Well-Care Visits
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2007
H
10587
Numerator events by admin data in eligible
population
3754
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
NR
35.46%
411
5.00%
432
160
NR
37.04%
0
Records Excluded because of Valid Data Errors
Records Excluded - Contraindications/Admin Data
0
Records Excluded - Contraindications/Medical
Record Review
0
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2008 (Reporting Year 2007)
NR
NR
NR
0
411
153
20
42.09%
37.20%
46.99%
Page 42
Use of Services
UCare of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Member Months
Total
Age
0-4
0-9
5-19
10-19
Total
Procedure
Myringotomy
Tonsillectomy
Age
15-44
20-44
30-64
45-64
65+
Age
0-4
5-19
0-9
10-19
Number of
Procedures
Procedures /
1,000 Member
Months
NR
NR
NR
NR
Member Months
Male
Female
Female
Male
Procedure
Dilation &
Curettage
Hysterectomy,
Abdominal
Age
15-44
45-64
15-44
45-64
65+
Hysterectomy,
15-44
Vaginal
45-64
65+
Cholecystectomy,
30-64
Open
15-44
45-64
65+
Cholecystectomy,
30-64
Closed
15-44
45-64
65+
20-44
Back Surgery
45-64
65+
Angioplasty (PTCA) 45-64
65+
45-64
Cardiac
Catheterization
65+
45-64
CABG
65+
Prostatectomy
45-64
65+
Mastectomy
15-44
45-64
65+
Lumpectomy
15-44
45-64
65+
HEDIS 2008 (Reporting Year 2007)
Number of
Procedures
Procedures /
1,000 Member
Months
Number of
Procedures
Procedures /
1,000 Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 43
Use of Services
UCare of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare Advantage
Age
< 65
65-74
75-84
85+
Member Months
Male
Female
5018
6353
87824
115146
57587
92557
20575
52031
Male
Procedure
CABG
Angioplasty
(PTCA)
Cardiac
Catheterization
Carotid
Endarterectomy
Reduction of
Fracture of Femur
Total Hip
Replacement
Total Knee
Replacement
Partial Excision of
Large Inestine
Cholecystectomy,
Open
Cholecystectomy,
Closed
(laparoscopic)
Back Surgery
Hysterectomy
Abdominal
Hysterectomy,
Vaginal
Mastectomy
Lumpectomy
Age
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
HEDIS 2008 (Reporting Year 2007)
Number of
Procedures
0
30
29
1
3
110
80
20
6
119
121
16
0
12
13
7
1
13
27
27
2
46
26
8
3
72
74
14
2
24
18
7
0
7
10
6
1
19
34
6
7
70
45
20
Procedures /
1,000 Member
Months
0.00
0.34
0.50
0.05
0.60
1.25
1.39
0.97
1.20
1.35
2.10
0.78
0.00
0.14
0.23
0.34
0.20
0.15
0.47
1.31
0.40
0.52
0.45
0.39
0.60
0.82
1.29
0.68
0.40
0.27
0.31
0.34
0.00
0.08
0.17
0.29
0.20
0.22
0.59
0.29
1.39
0.80
0.78
0.97
Female
Number of
Procedures
0
11
13
3
1
68
69
19
9
108
117
31
0
18
18
3
4
19
79
135
6
73
63
17
14
149
120
17
1
33
37
16
1
6
6
3
5
38
38
12
9
73
73
30
3
21
11
7
0
15
5
2
0
31
19
9
3
53
34
12
Procedures /
1,000 Member
Months
0.00
0.10
0.14
0.06
0.16
0.59
0.75
0.37
1.42
0.94
1.26
0.60
0.00
0.16
0.19
0.06
0.63
0.17
0.85
2.59
0.94
0.63
0.68
0.33
2.20
1.29
1.30
0.33
0.16
0.29
0.40
0.31
0.16
0.05
0.06
0.06
0.79
0.33
0.41
0.23
1.42
0.63
0.79
0.58
0.47
0.18
0.12
0.13
0.00
0.13
0.05
0.04
0.00
0.27
0.21
0.17
0.47
0.46
0.37
0.23
Page 44
Use of Services
UCare of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:38 PM
MSHO
Age
< 65
65-74
75-84
85+
Member Months
Male
Female
8
8
11830
21686
9408
23395
5457
25978
Male
Procedure
CABG
Angioplasty
(PTCA)
Cardiac
Catheterization
Carotid
Endarterectomy
Reduction of
Fracture of Femur
Total Hip
Replacement
Total Knee
Replacement
Partial Excision of
Large Inestine
Cholecystectomy,
Open
Cholecystectomy,
Closed
(laparoscopic)
Back Surgery
Hysterectomy
Abdominal
Hysterectomy,
Vaginal
Mastectomy
Lumpectomy
Age
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
<65
65-74
75-84
85+
HEDIS 2008 (Reporting Year 2007)
Number of
Procedures
0
5
1
0
0
7
5
2
0
28
10
3
0
1
0
0
0
7
10
6
0
0
3
0
0
10
2
3
0
2
4
0
0
1
2
0
0
3
3
1
0
5
6
0
Procedures /
1,000 Member
Months
0.00
0.42
0.11
0.00
0.00
0.59
0.53
0.37
0.00
2.37
1.06
0.55
0.00
0.08
0.00
0.00
0.00
0.59
1.06
1.10
0.00
0.00
0.32
0.00
0.00
0.85
0.21
0.55
0.00
0.17
0.43
0.00
0.00
0.08
0.21
0.00
0.00
0.25
0.32
0.18
0.00
0.42
0.64
0.00
Female
Number of
Procedures
0
1
4
0
0
14
18
7
0
19
36
3
0
4
2
0
0
12
33
60
0
11
10
1
0
28
17
6
0
9
9
3
0
1
0
2
0
10
8
4
0
10
11
4
0
2
7
0
0
1
1
0
0
2
4
3
0
5
4
3
Procedures /
1,000 Member
Months
0.00
0.05
0.17
0.00
0.00
0.65
0.77
0.27
0.00
0.88
1.54
0.12
0.00
0.18
0.09
0.00
0.00
0.55
1.41
2.31
0.00
0.51
0.43
0.04
0.00
1.29
0.73
0.23
0.00
0.42
0.38
0.12
0.00
0.05
0.00
0.08
0.00
0.46
0.34
0.15
0.00
0.46
0.47
0.15
0.00
0.09
0.30
0.00
0.00
0.05
0.04
0.00
0.00
0.09
0.17
0.12
0.00
0.23
0.17
0.12
Page 45
Use of Services
UCare of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
Member Months
Total
194020
329526
368412
232906
Age
0-4
0-9
5-19
10-19
Total
Procedure
Myringotomy
Tonsillectomy
Age
15-44
20-44
30-64
45-64
Age
0-4
5-19
0-9
10-19
Number of
Procedures
752
193
294
99
Procedures /
1,000 Member
Months
3.88
0.52
0.89
0.43
Member Months
Male
Female
234892
85198
176362
90746
43306
52468
Male
Procedure
Dilation &
Curettage
Hysterectomy,
Abdominal
Hysterectomy,
Vaginal
Cholecystectomy,
Open
Cholecystectomy,
Closed
Back Surgery
Mastectomy
Lumpectomy
Age
15-44
45-64
15-44
45-64
15-44
45-64
30-64
15-44
45-64
30-64
15-44
45-64
20-44
45-64
15-44
45-64
15-44
45-64
HEDIS 2008 (Reporting Year 2007)
Female
Number of
Procedures
Procedures /
1,000 Member
Months
8
0.09
24
30
35
Number of
Procedures
16
2
51
27
36
14
Procedures /
1,000 Member
Months
0.07
0.04
0.22
0.51
0.15
0.27
5
3
0.02
0.06
157
28
36
35
3
3
28
14
0.67
0.53
0.20
0.67
0.01
0.06
0.12
0.27
0.26
0.35
0.81
Page 46
Use of Services
UCare of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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 2008 (Reporting Year 2007)
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 47
Use of Services
UCare of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare Advantage
Age
Member Months
<1
0
1-9
0
10-19
0
20-44
549
45-64
10822
65-74
202970
75-84
150144
85+
72606
Unknown
0
437091
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
Discharges
0
0
0
9
324
3418
4404
3048
0
11203
Discharges /
1,000 Member
Months
NA
NA
NA
16.39
29.94
16.84
29.33
41.98
25.63
0
0
0
6
187
1857
2844
2322
0
7216
NA
NA
NA
10.93
17.28
9.15
18.94
31.98
0
0
0
3
137
1561
1560
726
0
3987
NA
NA
NA
5.46
12.66
7.69
10.39
10.00
0
0
0
0
0
NA
0.00
0.00
HEDIS 2008 (Reporting Year 2007)
16.51
9.12
0.00
Days
0
0
0
18
1431
14388
19261
13422
0
48520
Days / 1,000
Member
Months
NA
NA
NA
32.79
132.23
70.89
128.28
184.86
111.01
0
0
0
13
720
6356
10672
9017
0
26778
NA
NA
NA
23.68
66.53
31.31
71.08
124.19
0
0
0
5
711
8032
8589
4405
0
21742
NA
NA
NA
9.11
65.70
39.57
57.21
60.67
0
0
0
0
0
NA
0.00
0.00
61.26
49.74
0.00
Average
Length of Stay
NA
NA
NA
2.00
4.42
4.21
4.37
4.40
NA
4.33
NA
NA
NA
2.17
3.85
3.42
3.75
3.88
NA
3.71
NA
NA
NA
1.67
5.19
5.15
5.51
6.07
NA
5.45
NA
NA
NA
NA
NA
Page 48
Use of Services
UCare of Minnesota
Inpatient Utilization - General Hospital/Acute Care
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Member Months
0
0
0
0
16
33516
32803
31435
0
97770
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
1158
1392
1197
0
3747
NA
NA
NA
NA
0.00
34.55
42.44
38.08
0
0
0
0
0
836
1014
963
0
2813
NA
NA
NA
NA
0.00
24.94
30.91
30.63
0
0
0
0
0
322
378
234
0
934
NA
NA
NA
NA
0.00
9.61
11.52
7.44
0
0
0
0
0
NA
NA
0.00
HEDIS 2008 (Reporting Year 2007)
38.32
28.77
9.55
0.00
Days
0
0
0
0
0
5324
6786
5258
0
17368
0
0
0
0
0
3236
4150
3828
0
11214
Days / 1,000
Member
Months
NA
NA
NA
NA
0.00
158.85
206.87
167.27
177.64
NA
NA
NA
NA
0.00
96.55
126.51
121.78
114.70
0
0
0
0
0
2088
2636
1430
0
6154
NA
NA
NA
NA
0.00
62.30
80.36
45.49
0
0
0
0
0
NA
NA
0.00
62.94
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
4.60
4.88
4.39
NA
4.64
NA
NA
NA
NA
NA
3.87
4.09
3.98
NA
3.99
NA
NA
NA
NA
NA
6.48
6.97
6.11
NA
6.59
NA
NA
NA
NA
NA
Page 49
Use of Services
UCare of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Medicaid
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:
Oct 7, 2009 1:38 PM
Member Months
57300
272226
232906
261560
95774
8961
4722
3967
0
937416
Discharges
Discharges /
1,000 Member
Months
775
615
1013
4940
1303
211
130
92
0
9079
13.53
2.26
4.35
18.89
13.60
23.55
27.53
23.19
659
498
224
904
797
200
128
91
0
3501
11.50
1.83
0.96
3.46
8.32
22.32
27.11
22.94
116
117
179
634
494
11
2
1
0
1554
2.02
0.43
0.77
2.42
5.16
1.23
0.42
0.25
610
3402
12
0
4024
HEDIS 2008 (Reporting Year 2007)
9.69
3.73
1.66
2.62
13.01
0.13
6.82
Days
Days / 1,000
Member
Months
4882
1663
2694
13203
4843
883
583
334
0
29085
85.20
6.11
11.57
50.48
50.57
98.54
123.46
84.19
3109
1116
601
2634
2391
773
573
330
0
11527
54.26
4.10
2.58
10.07
24.97
86.26
121.35
83.19
1773
547
612
2255
2425
110
10
4
0
7736
30.94
2.01
2.63
8.62
25.32
12.28
2.12
1.01
1481
8314
27
0
9822
6.36
31.79
0.28
31.03
12.30
8.25
16.64
Average
Length of Stay
6.30
2.70
2.66
2.67
3.72
4.18
4.48
3.63
NA
3.20
4.72
2.24
2.68
2.91
3.00
3.87
4.48
3.63
NA
3.29
15.28
4.68
3.42
3.56
4.91
10.00
5.00
4.00
NA
4.98
2.43
2.44
2.25
NA
2.44
Page 50
Use of Services
UCare of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
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
Visits
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits/ 1,000
Member
Months
NR
NR
Emergency Room Visits
Visits
NR
NR
NR
NR
NR
NR
NR
HEDIS 2008 (Reporting Year 2007)
NR
Visits/ 1,000
Member
Months
NR
NR
Ambulatory
Surgery/Procedures
Procedures
NR
NR
NR
NR
NR
NR
NR
NR
Procedures/
1,000 Member
Months
NR
NR
Observation Room Stays
Resulting in Discharge
Stays
NR
NR
NR
NR
NR
NR
NR
NR
Stays/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 51
Use of Services
UCare of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare Advantage
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
0
549
10822
202970
150144
72606
0
437091
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
323
8095
109216
102200
43501
0
263335
HEDIS 2008 (Reporting Year 2007)
Visits/ 1,000
Member
Months
NA
NA
NA
588.34
748.01
538.09
680.68
599.14
602.47
Emergency Room Visits
Visits
0
0
0
33
337
2748
2888
1783
0
7789
Visits/ 1,000
Member
Months
NA
NA
NA
60.11
31.14
13.54
19.23
24.56
17.82
Ambulatory
Surgery/Procedures
Procedures
0
0
0
9
424
6563
4945
1532
0
13473
Procedures/
1,000 Member
Months
NA
NA
NA
16.39
39.18
32.33
32.94
21.10
30.82
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
15
165
194
121
0
495
Stays/ 1,000
Member
Months
NA
NA
NA
0.00
1.39
0.81
1.29
1.67
1.13
Page 52
Use of Services
UCare of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
0
0
16
33516
32803
31435
0
97770
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
Visits
0
0
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
0
0
9
22628
18455
10230
0
51322
HEDIS 2008 (Reporting Year 2007)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
562.50
675.14
562.60
325.43
524.93
Emergency Room Visits
Visits
0
0
0
0
1
1173
1044
849
0
3067
Visits/ 1,000
Member
Months
NA
NA
NA
NA
62.50
35.00
31.83
27.01
31.37
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
0
967
798
358
0
2123
Procedures/
1,000 Member
Months
NA
NA
NA
NA
0.00
28.85
24.33
11.39
21.71
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
61
56
52
0
169
Stays/ 1,000
Member
Months
NA
NA
NA
NA
0.00
1.82
1.71
1.65
1.73
Page 53
Use of Services
UCare of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
57300
272226
232906
261560
95774
8961
4722
3967
0
937416
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
Visits
41284
75020
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
48584
105830
49717
4624
1997
1040
0
328096
HEDIS 2008 (Reporting Year 2007)
Visits/ 1,000
Member
Months
720.49
275.58
208.60
404.61
519.11
516.01
422.91
262.16
350.00
Emergency Room Visits
Visits
6397
13536
7020
19323
4526
391
177
95
0
51465
Visits/ 1,000
Member
Months
111.64
49.72
30.14
73.88
47.26
43.63
37.48
23.95
54.90
Ambulatory
Surgery/Procedures
Procedures
239
1090
604
2627
2062
249
90
34
0
6995
Procedures/
1,000 Member
Months
4.17
4.00
2.59
10.04
21.53
27.79
19.06
8.57
7.46
Observation Room Stays
Resulting in Discharge
Stays
98
151
258
1110
146
30
11
4
0
1808
Stays/ 1,000
Member
Months
1.71
0.55
1.11
4.24
1.52
3.35
2.33
1.01
1.93
Page 54
Use of Services
UCare of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Age
Member
Months
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
NR
Discharges
Discharges /
1,000 Member
Months
Days
Days / 1,000
Member
Months
Average Length
of Stay
<1
NR
NR
NR
1-9
NR
NR
NR
10-19
NR
NR
NR
20-44
NR
NR
NR
45-64
NR
NR
NR
65-74
NR
NR
NR
75-84
NR
NR
NR
85+
NR
NR
NR
NR
NR
NR
Unknown
Total
NR
HEDIS 2008 (Reporting Year 2007)
NR
NR
Page 55
Use of Services
UCare of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare Advantage
Age
Member
Months
<1
0
1-9
0
10-19
0
20-44
549
45-64
10822
65-74
202970
75-84
150144
85+
72606
Unknown
0
437091
Total
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
Days
Days / 1,000
Member
Months
Average Length
of Stay
NA
0
NA
NA
0
NA
0
NA
NA
10-19
0
NA
0
NA
NA
20-44
0
0.00
0
0.00
NA
45-64
50
4.62
788
72.81
15.76
65-74
508
2.50
7720
38.04
15.20
75-84
1378
9.18
22663
150.94
16.45
85+
1683
23.18
29191
402.05
17.34
Unknown
0
3619
8.28
0
60362
138.10
NA
16.68
Age
Total
HEDIS 2008 (Reporting Year 2007)
Page 56
Use of Services
UCare of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
MSHO
Age
Member
Months
<1
0
1-9
0
10-19
0
20-44
0
45-64
16
65-74
33516
75-84
32803
85+
31435
Unknown
0
97770
Total
Discharges
Discharges /
1,000 Member
Months
Days
Days / 1,000
Member
Months
Average Length
of Stay
<1
0
NA
0
NA
NA
1-9
0
NA
0
NA
NA
10-19
0
NA
0
NA
NA
20-44
0
NA
0
NA
NA
45-64
0
0.00
0
0.00
NA
65-74
329
9.82
8152
243.23
24.78
75-84
662
20.18
17818
543.18
26.92
85+
897
28.54
29072
924.83
32.41
Unknown
0
1888
19.31
0
55042
562.97
NA
29.15
Age
Total
HEDIS 2008 (Reporting Year 2007)
Page 57
Use of Services
UCare of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
Age
Member
Months
<1
57300
1-9
272226
10-19
232906
20-44
261560
45-64
95774
65-74
8961
75-84
4722
85+
3967
Unknown
Total
0
937416
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
Days
Days / 1,000
Member
Months
Average Length
of Stay
0.00
0
0.00
NA
0
0.00
0
0.00
NA
10-19
2
0.01
7
0.03
3.50
20-44
4
0.02
47
0.18
11.75
45-64
7
0.07
120
1.25
17.14
65-74
47
5.24
1435
160.14
30.53
75-84
83
17.58
2378
503.60
28.65
85+
98
24.70
3561
897.66
36.34
Unknown
0
241
0.26
0
7548
8.05
NA
31.32
Age
Total
HEDIS 2008 (Reporting Year 2007)
Page 58
Use of Services
UCare of Minnesota
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Member Months
(Any)
Age
Male
Female
0-12
13-17
18-64
65+
Unknown
Total
NR
NR
Member Months
(Inpatient)
Total
Sex
M
F
Total
M
F
NR
13-17
Total
M
F
NR
18-64
Total
M
F
NR
65+
Total
M
F
NR
Unknown
Total
NR
NR
NR
NR
Age
Total
M
F
Total
Number
HEDIS 2008 (Reporting Year 2007)
Female
Total
Member Months
(Outpatient/ED)
Male
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
Any Services
0-12
Male
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
NR
NR
Inpatient
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
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
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 59
Use of Services
UCare of Minnesota
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare Advantage
Member Months
(Inpatient)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
Total
Male
Female
Total
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5018
165986
0
171004
6353
259734
0
266087
11371
425720
0
437091
5018
165986
0
171004
6353
259734
0
266087
11371
425720
0
437091
5018
165986
0
171004
6353
259734
0
266087
Any Services
Age
0-12
Sex
M
F
Total
13-17
M
F
Total
18-64
M
F
Total
65+
M
F
Unknown
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
Total
M
F
Total
M
F
Total
Male
Female
Total
0
0
0
0
0
0
0
0
11371
425720
0
437091
5018
165986
0
171004
6353
259734
0
266087
11371
425720
0
437091
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
73
131
204
299
682
981
0
0
0
372
813
1185
NA
NA
NA
NA
NA
NA
17.46%
24.74%
21.53%
2.16%
3.15%
2.77%
NA
NA
NA
2.61%
3.67%
3.25%
0
0
0
0
0
0
8
17
25
60
106
166
0
0
0
68
123
191
NA
NA
NA
NA
NA
NA
1.91%
3.21%
2.64%
0.43%
0.49%
0.47%
NA
NA
NA
0.48%
0.55%
0.52%
0
0
0
0
0
0
0
2
2
2
6
8
0
0
0
2
8
10
NA
NA
NA
NA
NA
NA
0.00%
0.38%
0.21%
0.01%
0.03%
0.02%
NA
NA
NA
0.01%
0.04%
0.03%
0
0
0
0
0
0
73
126
199
254
609
863
0
0
0
327
735
1062
NA
NA
NA
NA
NA
NA
17.46%
23.80%
21.00%
1.84%
2.81%
2.43%
NA
NA
NA
2.29%
3.31%
2.92%
HEDIS 2008 (Reporting Year 2007)
Page 60
Use of Services
UCare of Minnesota
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:38 PM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Male
Female
Total
Male
Female
Total
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
26695
0
26703
8
71059
0
71067
16
97754
0
97770
8
26695
0
26703
8
71059
0
71067
16
97754
0
97770
8
26695
0
26703
8
71059
0
71067
Any Services
Age
0-12
Sex
M
F
Total
13-17
M
F
Total
18-64
M
F
Total
65+
M
F
Total
Unknown
M
F
Total
M
F
Total
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
Male
Female
Total
0
0
0
0
0
0
0
0
16
97754
0
97770
8
26695
0
26703
8
71059
0
71067
16
97754
0
97770
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
1
0
1
186
550
736
0
0
0
187
550
737
NA
NA
NA
NA
NA
NA
150.00%
0.00%
75.00%
8.36%
9.29%
9.03%
NA
NA
NA
8.40%
9.29%
9.05%
0
0
0
0
0
0
0
0
0
26
100
126
0
0
0
26
100
126
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
1.17%
1.69%
1.55%
NA
NA
NA
1.17%
1.69%
1.55%
0
0
0
0
0
0
0
0
0
4
11
15
0
0
0
4
11
15
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.18%
0.19%
0.18%
NA
NA
NA
0.18%
0.19%
0.18%
0
0
0
0
0
0
1
0
1
163
479
642
0
0
0
164
479
643
NA
NA
NA
NA
NA
NA
150.00%
0.00%
75.00%
7.33%
8.09%
7.88%
NA
NA
NA
7.37%
8.09%
7.89%
HEDIS 2008 (Reporting Year 2007)
Page 61
Use of Services
UCare of Minnesota
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Male
Female
Total
Male
Female
Total
203460
61629
197943
61230
401403
122859
203460
61629
197943
61230
401403
122859
203460
61629
197943
61230
145234
6172
0
416495
250270
11478
0
520921
395504
17650
0
937416
145234
6172
0
416495
250270
11478
0
520921
395504
17650
0
937416
145234
6172
0
416495
250270
11478
0
520921
Any Services
Age
0-12
Sex
M
F
Total
13-17
M
F
Total
18-64
M
F
Total
65+
M
F
Total
Unknown
M
F
Total
M
F
Total
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
Male
Female
Total
401403
122859
203460
61629
197943
61230
401403
122859
395504
17650
0
937416
145234
6172
0
416495
250270
11478
0
520921
395504
17650
0
937416
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
1422
906
2328
688
749
1437
2520
4780
7300
54
127
181
0
0
0
4684
6562
11246
8.39%
5.49%
6.96%
13.40%
14.68%
14.04%
20.82%
22.92%
22.15%
10.50%
13.28%
12.31%
NA
NA
NA
13.50%
15.12%
14.40%
31
14
45
26
64
90
250
286
536
5
12
17
0
0
0
312
376
688
0.18%
0.08%
0.13%
0.51%
1.25%
0.88%
2.07%
1.37%
1.63%
0.97%
1.25%
1.16%
NA
NA
NA
0.90%
0.87%
0.88%
56
34
90
32
44
76
146
252
398
2
6
8
0
0
0
236
336
572
0.33%
0.21%
0.27%
0.62%
0.86%
0.74%
1.21%
1.21%
1.21%
0.39%
0.63%
0.54%
NA
NA
NA
0.68%
0.77%
0.73%
1411
895
2306
674
725
1399
2403
4669
7072
47
114
161
0
0
0
4535
6403
10938
8.32%
5.43%
6.89%
13.12%
14.21%
13.66%
19.85%
22.39%
21.46%
9.14%
11.92%
10.95%
NA
NA
NA
13.07%
14.75%
14.00%
HEDIS 2008 (Reporting Year 2007)
Page 62
UCare of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
Female
NR
NR
Member Months
(Inpatient)
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 2008 (Reporting Year 2007)
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
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
NR
NR
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 63
UCare of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare Advantage
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
24
4994
165986
0
171004
Female
0
0
0
72
6281
259734
0
266087
Member Months
(Inpatient)
Total
0
0
0
96
11275
425720
0
437091
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
25
32
57
204
156
360
0
0
0
229
188
417
HEDIS 2008 (Reporting Year 2007)
Male
0
0
0
24
4994
165986
0
171004
Female
0
0
0
72
6281
259734
0
266087
Total
0
0
0
96
11275
425720
0
437091
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
6.01%
6.11%
6.07%
1.47%
0.72%
1.01%
NA
NA
NA
1.61%
0.85%
1.14%
Number
0
0
0
0
0
0
0
0
0
0
0
0
11
19
30
122
112
234
0
0
0
133
131
264
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
2.64%
3.63%
3.19%
0.88%
0.52%
0.66%
NA
NA
NA
0.93%
0.59%
0.72%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
0
0
0
0
0
0
0
24
72
96
4994
6281
11275
165986
259734
425720
0
0
0
171004
266087
437091
Member Months
(Outpatient/ED)
Male
0
0
0
24
4994
165986
0
171004
Female
0
0
0
72
6281
259734
0
266087
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
18
21
39
102
58
160
0
0
0
120
79
199
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Total
0
0
0
96
11275
425720
0
437091
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
4.33%
4.01%
4.15%
0.74%
0.27%
0.45%
NA
NA
NA
0.84%
0.36%
0.55%
Page 64
UCare of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:38 PM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
0
8
26695
0
26703
Female
0
0
0
0
8
71059
0
71067
Member Months
(Inpatient)
Total
0
0
0
0
16
97754
0
97770
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
76
69
145
0
0
0
76
69
145
HEDIS 2008 (Reporting Year 2007)
Male
0
0
0
0
8
26695
0
26703
Female
0
0
0
0
8
71059
0
71067
Total
0
0
0
0
16
97754
0
97770
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.42%
1.17%
1.78%
NA
NA
NA
3.42%
1.17%
1.78%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
37
45
82
0
0
0
37
45
82
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
1.66%
0.76%
1.01%
NA
NA
NA
1.66%
0.76%
1.01%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
0
0
0
0
0
0
0
0
0
0
8
8
16
26695
71059
97754
0
0
0
26703
71067
97770
Member Months
(Outpatient/ED)
Male
0
0
0
0
8
26695
0
26703
Female
0
0
0
0
8
71059
0
71067
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
53
33
86
0
0
0
53
33
86
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Total
0
0
0
0
16
97754
0
97770
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
2.38%
0.56%
1.06%
NA
NA
NA
2.38%
0.56%
1.06%
Page 65
UCare of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
203460
61629
37199
31989
76046
6172
0
416495
Female
197943
61230
73288
75248
101734
11478
0
520921
Member Months
(Inpatient)
Total
401403
122859
110487
107237
177780
17650
0
937416
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
5
7
12
173
121
294
294
345
639
452
535
987
1220
831
2051
27
10
37
0
0
0
2171
1849
4020
HEDIS 2008 (Reporting Year 2007)
Male
203460
61629
37199
31989
76046
6172
0
416495
Female
197943
61230
73288
75248
101734
11478
0
520921
Total
401403
122859
110487
107237
177780
17650
0
937416
Inpatient
Percent
0.03%
0.04%
0.04%
3.37%
2.37%
2.87%
9.48%
5.65%
6.94%
16.96%
8.53%
11.04%
19.25%
9.80%
13.84%
5.25%
1.05%
2.52%
NA
NA
NA
6.26%
4.26%
5.15%
Number
0
0
0
26
30
56
63
86
149
95
140
235
325
229
554
14
3
17
0
0
0
523
488
1011
Percent
0.00%
0.00%
0.00%
0.51%
0.59%
0.55%
2.03%
1.41%
1.62%
3.56%
2.23%
2.63%
5.13%
2.70%
3.74%
2.72%
0.31%
1.16%
NA
NA
NA
1.51%
1.12%
1.29%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
203460
61629
37199
31989
76046
6172
0
416495
197943
61230
73288
75248
101734
11478
0
520921
401403
122859
110487
107237
177780
17650
0
937416
Member Months
(Outpatient/ED)
Male
203460
61629
37199
31989
76046
6172
0
416495
Female
197943
61230
73288
75248
101734
11478
0
520921
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
2
6
8
4
10
14
2
5
7
9
8
17
0
0
0
0
0
0
17
29
46
Number
5
7
12
164
105
269
266
289
555
412
467
879
1096
746
1842
17
8
25
0
0
0
1960
1622
3582
Percent
0.00%
0.00%
0.00%
0.04%
0.12%
0.08%
0.13%
0.16%
0.15%
0.08%
0.08%
0.08%
0.14%
0.09%
0.11%
0.00%
0.00%
0.00%
NA
NA
NA
0.05%
0.07%
0.06%
Total
401403
122859
110487
107237
177780
17650
0
937416
Percent
0.03%
0.04%
0.04%
3.19%
2.06%
2.63%
8.58%
4.73%
6.03%
15.46%
7.45%
9.84%
17.29%
8.80%
12.43%
3.31%
0.84%
1.70%
NA
NA
NA
5.65%
3.74%
4.59%
Page 66
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
Commercial
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Member Months
NR
Total Cost of
Prescriptions
0-9
10-19
20-44
45-64
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
HEDIS 2008 (Reporting Year 2007)
NR
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 67
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
Medicare Advantage
Age
Member Months
0-9
0
10-19
0
20-44
455
45-64
9220
65-74
162824
75-84
128178
85+
65363
Unknown
0
Total
366040
Age
Total Cost of
Prescriptions
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
$0.00
$0.00
$101,466.71
$2,401,426.43
$19,801,197.87
$18,145,963.59
$9,732,555.86
$0.00
$50,182,610.46
HEDIS 2008 (Reporting Year 2007)
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
$223.00
$260.46
$121.61
$141.57
$148.90
$137.10
Total Number of
Prescriptions
0
0
1010
31919
311066
343093
229222
0
916310
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
26.64
41.54
22.93
32.12
42.08
30.04
Page 68
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
MSHO
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Member Months
0
0
0
16
33516
32803
31435
0
97770
Total Cost of
Prescriptions
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
$0.00
$0.00
$0.00
$2,197.26
$10,461,170.99
$10,678,567.06
$9,212,889.26
$0.00
$30,354,824.57
HEDIS 2008 (Reporting Year 2007)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
NA
$137.33
$312.12
$325.54
$293.08
$310.47
Total Number of
Prescriptions
0
0
0
36
197417
234728
252434
0
684615
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
NA
27.00
70.68
85.87
96.36
84.03
Page 69
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
Medicaid
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Member Months
329526
232906
248888
77471
8846
4718
3967
0
906322
Total Cost of
Prescriptions
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:38 PM
$4,141,071.73
$5,559,555.47
$18,123,124.99
$11,252,542.09
$344,796.66
$116,366.29
$62,126.22
$0.00
$39,599,583.45
HEDIS 2008 (Reporting Year 2007)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$12.57
$23.87
$72.82
$145.25
$38.98
$24.66
$15.66
$43.69
Total Number of
Prescriptions
116724
86238
295131
183076
11119
6152
6028
0
704468
Avg. Num. Of
Prescriptions /
Per Member Per
Year
4.25
4.44
14.23
28.36
15.08
15.65
18.23
9.33
Page 70
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data collection methodology (Administrativ
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 2008 (Reporting Year 2007)
Page 71
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare Advantage
Data Elements
General Measure
Data
Measurement Year
Data collection methodology (Administrativ
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 2008 (Reporting Year 2007)
Ages 20-44
Ages 45-64
Ages 65+
36
747
33054
2007
A
32
721
31829
88.89%
77.23%
100.00%
96.52%
95.14%
97.90%
96.29%
96.09%
96.50%
Page 72
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:38 PM
MSHO
Data Elements
General Measure
Data
Measurement Year
Data collection methodology (Administrativ
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 2008 (Reporting Year 2007)
Ages 20-44
Ages 45-64
Ages 65+
0
0
7070
2007
A
0
0
6889
NA
NA
NA
NA
NA
NA
97.44%
97.06%
97.82%
Page 73
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
Data Elements
General Measure
Data
Measurement Year
Data collection methodology (Administrativ
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 2008 (Reporting Year 2007)
Ages 20-44
Ages 45-64
Ages 65+
9764
4717
837
2007
A
8529
4222
776
87.35%
86.69%
88.02%
89.51%
88.62%
90.39%
92.71%
90.89%
94.53%
Page 74
Access/Availability of Care
UCare of Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Data Elements
General Measure
Data
12-24 months
25 months 6 yrs.
7-11 yrs.
12-19 yrs.
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data collection methodology (Administrativ
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 2008 (Reporting Year 2007)
Page 75
Access/Availability of Care
UCare of Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
Data Elements
Measurement Year
Data collection methodology (Administrativ
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 2008 (Reporting Year 2007)
General Measure
Data
12-24 months
25 months 6 yrs.
7-11 yrs.
12-19 yrs.
2694
6848
4522
6921
2007
A
2634
6072
3899
6016
97.77%
97.20%
98.35%
88.67%
87.91%
89.43%
86.22%
85.21%
87.24%
86.92%
86.12%
87.73%
Page 76
Access/Availability of Care
UCare of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Data Elements
Timeliness of
Prenatal Care
Postpartum
Care
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data collection methodology (Administrative or Hybrid)
Eligible member population (i.e. members who meet all
denominator criteria)
Number of numerator events by administrative data in
eligible population (before exclusions)
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of
valid data errors
Number of administrative data records excluded
Number of medical records 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 record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 77
Access/Availability of Care
UCare of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
Timeliness of
Prenatal Care
Postpartum
Care
Data collection methodology (Administrative or Hybrid)
H
H
Eligible member population (i.e. members who meet all
denominator criteria)
3306
3306
Number of numerator events by administrative data in
eligible population (before exclusions)
1638
1756
Current year's administrative rate (before exclusions)
49.55%
53.12%
Minimum required sample size (MRSS) or other sample size
411
411
Oversampling rate
Final sample size (FSS)
5%
432
5%
432
Number of numerator events by administrative data in FSS
223
230
51.62%
53.24%
Number of original sample records excluded because of
valid data errors
0
0
Number of administrative data records excluded
0
0
Number of medical records data records excluded
1
1
Number of employee/dependent medical records excluded
0
0
1
411
216
57
1
411
220
33
66.42%
61.74%
71.11%
61.56%
56.73%
66.38%
Data Elements
Administrative rate on FSS
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 2008 (Reporting Year 2007)
Page 78
Access/Availability of Care
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Overall Rate
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members who
meet all denominator criteria)
NR
Numerator events by administrative data
NR
NR
Reported rate
NR
NR
NR
NR
NR
NR
Lower 95% confidence interval
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 79
Access/Availability of Care
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare Advantage
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
General
Measure
Data
Initiation of
AOD
Treatment
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Overall Rate
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
2007
A
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Engagement
of AOD
Treatment
18+ Year Olds
0
314
314
0
0
205
15
205
15
Reported rate
NA
NA
65.29%
4.78%
65.29%
4.78%
Lower 95% confidence interval
NA
NA
NA
NA
59.86%
70.71%
2.26%
7.30%
59.86%
70.71%
2.26%
7.30%
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 80
Access/Availability of Care
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:38 PM
MSHO
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
General
Measure
Data
Initiation of
AOD
Treatment
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Overall Rate
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
2007
A
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Engagement
of AOD
Treatment
18+ Year Olds
0
92
92
0
0
48
4
48
4
Reported rate
NA
NA
52.17%
4.35%
52.17%
4.35%
Lower 95% confidence interval
NA
NA
NA
NA
41.42%
62.92%
0.00%
9.06%
41.42%
62.92%
0.00%
9.06%
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 81
Access/Availability of Care
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
General
Measure
Data
Initiation of
AOD
Treatment
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Overall Rate
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
2007
A
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Engagement
of AOD
Treatment
18+ Year Olds
155
1570
1725
62
32
633
203
695
235
Reported rate
40.00%
20.65%
40.32%
12.93%
40.29%
13.62%
Lower 95% confidence interval
31.96%
48.04%
13.95%
27.34%
37.86%
42.78%
11.24%
14.62%
37.95%
42.63%
11.98%
15.27%
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 82
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Product/Product Line
Years in Business
Members*
NR
NR
NR
NR
NR
NR
NR
HMO
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total HMO:
PPO
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total PPO:
POS
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2007
HEDIS 2008 (Reporting Year 2007)
Page 83
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare Advantage
Product/Product Line
Years in Business
Members*
20.00
0.00
12.00
0.00
0.00
20.00
79422
0
46556
0
0
125978
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
125978
HMO
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total HMO:
PPO
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total PPO:
POS
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2007
HEDIS 2008 (Reporting Year 2007)
Page 84
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:38 PM
MSHO
Product/Product Line
Years in Business
Members*
20.00
0.00
12.00
0.00
0.00
20.00
79422
0
46556
0
0
125978
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
125978
HMO
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total HMO:
PPO
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total PPO:
POS
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2007
HEDIS 2008 (Reporting Year 2007)
Page 85
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
Product/Product Line
Years in Business
Members*
20.00
0.00
12.00
0.00
0.00
20.00
79422
0
46556
0
0
125978
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
125978
HMO
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total HMO:
PPO
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total PPO:
POS
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2007
HEDIS 2008 (Reporting Year 2007)
Page 86
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Commercial
Male
Member Months
Female
<1
1-4
5-9
10-14
15-17
18-19
Total
NR
NR
NR
NR
NR
NR
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
NR
NR
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
NR
NR
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
NR
NR
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
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
HEDIS 2008 (Reporting Year 2007)
NR
NR
NR
NR
NR
NR
NR
Page 87
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicare Advantage
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
0
0
24
36
180
0
0.00%
0
12
60
36
204
0
0.00%
240
0.14%
360
672
1248
2496
312
0.12%
492
840
1548
3156
552
0.13%
4776
2.79%
47400
40416
31572
26016
14148
6432
6036
2.27%
62976
52176
48180
44376
31476
20556
10812
2.47%
165984
97.07%
0
259740
97.61%
0
171000
266088
HEDIS 2008 (Reporting Year 2007)
0
12
84
72
384
852
1512
2796
5652
110376
92592
79752
70392
45624
26988
425724
97.40%
0
437088
Page 88
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:38 PM
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
12
0
0.00%
0
0
0
12
0
0.00%
12
0.04%
5772
6060
5352
4056
3384
2064
12
0.02%
9876
11820
11436
11964
12048
13932
24
0.02%
26688
99.96%
0
71076
99.98%
0
97764
99.98%
26700
71088
HEDIS 2008 (Reporting Year 2007)
0
0
0
0
0
0
0
0
24
15648
17880
16788
16020
15432
15996
0
97788
Page 89
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:38 PM
Medicaid
<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
29229
69918
68147
61147
36648
16730
Member Months
Female
28071
66802
67359
59851
37090
21440
Total
57300
136720
135506
120998
73738
38170
281819
67.66%
20469
17289
14700
15856
16884
280613
53.87%
51848
44558
30690
26614
22652
562432
60.00%
85198
20.46%
16537
12672
8974
5123
176362
33.86%
20083
14226
9875
8284
261560
27.90%
43306
10.40%
2453
1308
1019
607
443
342
52468
10.07%
3350
1850
1432
1664
1795
1387
95774
10.22%
6172
1.48%
0
11478
2.20%
0
17650
1.88%
416495
520921
HEDIS 2008 (Reporting Year 2007)
72317
61847
45390
42470
39536
36620
26898
18849
13407
5803
3158
2451
2271
2238
1729
0
937416
Page 90