South Country Health Alliance (CBP)
Plan Name
2007
Reporting Year
Submission #
General Info
Disclaimers
Code
CIS
Plan ID
1
Last Refreshed:
Page
Childhood Immunization Status
10/7/2009 1:37:52 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
34
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.
2. Due to an error, the Medicaid data for South Country Health Alliance was not initially displayed in this
report. This error was fixed on Aug 18, 2009. The data now displayed has not changed from what
was originally submitted.
HEDIS 2008 (Reporting Year 2007)
Page 2
Effectiveness of Care
South Country Health Alliance (CBP)
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:37 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
159
41.19%
190
49.22%
273
70.73%
164
42.49%
154
39.90%
265
68.65%
149
38.60%
105
27.20%
89
23.06%
257
66.58%
285
73.83%
327
84.72%
270
69.95%
245
63.47%
315
81.61%
253
65.54%
182
47.15%
163
42.23%
257
68
84.42%
80.66%
88.17%
285
68
91.69%
88.80%
94.58%
327
24
91.17%
88.20%
94.13%
270
76
89.87%
86.73%
93.01%
245
111
92.47%
89.70%
95.23%
315
27
88.83%
85.55%
92.11%
253
60
81.30%
77.27%
85.32%
182
126
80.00%
75.87%
84.13%
163
126
75.06%
70.61%
79.52%
386
1
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 2008 (Reporting Year 2007)
MMR
386
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
386
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
385
Page 4
Effectiveness of Care
South Country Health Alliance (CBP)
Appropriate Treatment for Children with Upper
Respiratory Infection
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Commercial
Data Elements
Commercial
Measurement Year
Medicaid
2007
Data Collection Methodology
A
Eligible Member Population
859
Numerator Events by Admin Data
180
Reported Rate
NR
79.05%
Lower 95% Confidence Interval
NR
76.27%
Upper 95% Confidence Interval
NR
81.83%
HEDIS 2008 (Reporting Year 2007)
Page 5
Effectiveness of Care
South Country Health Alliance (CBP)
Colorectal Cancer Screening
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Commercial
Medicare
Advantage
MSHO
2007
Measurement Year
H
Data collection methodology (administrative or hybrid)
Eligible population
583
Number of numerator events by administrative data in eligible
population (before exclusions)
126
Current year's administrative rate (before exclusions)
NR
NR
21.61%
Minimum required sample size (MRSS) or other sample size
411
Oversampling rate
0.05
Final sample size (FSS)
432
93
Number of numerator events by administrative data in FSS
Administrative rate on FSS
NR
NR
21.53%
Number of original sample records excluded because of valid data
errors
0
Number of administrative data records excluded
0
Number of medical record data records excluded
2
Number of employee/dependent medical records excluded
0
Records added from the oversample list
0
430
Denominator
Numerator events by administrative data
93
Numerator events by medical records
76
Reported rate
NR
NR
39.30%
Lower 95% confidence interval
NR
NR
34.57%
Upper 95% confidence interval
NR
NR
44.04%
HEDIS 2008 (Reporting Year 2007)
Page 6
Effectiveness of Care
South Country Health Alliance (CBP)
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:37 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
NR
NR
NR
Ages 52-69
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 8
Effectiveness of Care
South Country Health Alliance (CBP)
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:37 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
67
47
70.15%
58.45%
81.85%
67
47
70.15%
58.45%
81.85%
2007
A
Page 9
Effectiveness of Care
South Country Health Alliance (CBP)
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:37 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
118
55
46.61%
37.19%
56.03%
49
26
53.06%
38.07%
68.06%
167
81
48.50%
40.62%
56.38%
2007
A
Page 10
Effectiveness of Care
South Country Health Alliance (CBP)
Cervical Cancer Screening
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2007
H
1615
Numerator Events by Admin Data on Eligible
Population (before exclusions)
982
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
60.80%
411
5.00%
432
275
63.66%
0
Number of administrative data records excluded
0
Number of medical record data records excluded
10
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
422
275
44
75.59%
71.38%
79.81%
Page 11
Effectiveness of Care
South Country Health Alliance (CBP)
Chlamydia Screening in Women
Data Last Refreshed:
Oct 7, 2009 1:37 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
254
94
37.01%
30.87%
43.14%
387
165
42.64%
37.58%
47.69%
641
259
40.41%
36.53%
44.28%
Page 12
Effectiveness of Care
South Country Health Alliance (CBP)
Data Last Refreshed:
Oct 7, 2009 1:37 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
NR
NR
NR
MSHO
2007
A
54
6
11.11%
1.80%
20.42%
Page 13
Effectiveness of Care
South Country Health Alliance (CBP)
Controlling High Blood Pressure
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Commercial
Data Elements
Commercial
Medicare Advantage
Measurement Year
2007
Data Collection Methodology (Hybrid)
H
Eligible Member Population
318
Numerator Events by Admin Data on
Eligible Population (before exclusions)
Current Year's Admin Rate
0
NR
NR
Minimum Required Sample Size
0.00%
246
Oversampling Rate
5.00%
Final Sample Size (FSS)
246
Numerator events by admin data in FSS
Admin rate on FSS
MSHO
0
NR
NR
0.00%
Records Excluded because of Valid Data
Errors
0
Number of administrative data records
excluded
0
Number of medical record data records
excluded
1
Number of employee/dependent medical
records excluded
0
Records Added from the OverSample List
0
Denominator
244
Numerator Events by Admin Data
0
Numerator Events by Medical Record
142
Reported Rate
NR
NR
58.20%
Lower 95% Confidence Interval
NR
NR
51.80%
Upper 95% Confidence Interval
NR
NR
64.59%
HEDIS 2008 (Reporting Year 2007)
Page 14
Effectiveness of Care
South Country Health Alliance (CBP)
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Commercial
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicare Advantage
MSHO
Medicaid
2007
2007
Data Collection Methodology
A
A
Eligible Member Population
15
3
Numerator Events by Admin Data on
Eligible Population
11
3
Measurement Year
Reported Rate
NR
NR
NA
NA
Lower 95% Confidence Interval
NR
NR
NA
NA
Upper 95% Confidence Interval
NR
NR
NA
NA
HEDIS 2008 (Reporting Year 2007)
Page 15
Effectiveness of Care
South Country Health Alliance (CBP)
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicare Advantage
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 17
Effectiveness of Care
South Country Health Alliance (CBP)
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:37 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)
13
0
38.24%
0.00%
13
0
38.24%
0.00%
13
12
0
20
73.53%
57.23%
89.83%
58.82%
40.81%
76.84%
34
5.00%
34
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
34
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
34
Page 18
Effectiveness of Care
South Country Health Alliance (CBP)
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:37 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)
7
0
87.50%
0.00%
7
0
87.50%
0.00%
7
1
0
2
NA
NA
NA
NA
NA
NA
8
5.00%
8
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
8
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
8
Page 19
Effectiveness of Care
South Country Health Alliance (CBP)
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicare Advantage
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
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
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
NR
NR
NR
Page 21
Effectiveness of Care
South Country Health Alliance (CBP)
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:37 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
151
2007
H
151
2007
H
151
2007
H
151
2007
H
151
2007
H
151
2007
H
151
2007
H
151
2007
H
151
64
42.38%
150
99.34%
1
0.66%
51
34.44%
53
35.10%
0
0.00%
129
84.11%
0
0.00%
0
0.00%
Number of Records Excluded Because of
Valid Data Errors
2
2
2
2
2
2
2
2
2
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
149
64
67
87.92%
82.35%
93.49%
0
149
29
6
23.49%
16.35%
30.63%
0
149
1
90
61.07%
52.91%
69.24%
0
149
52
48
67.11%
59.23%
74.99%
0
149
53
57
73.83%
66.43%
81.22%
0
149
0
78
52.35%
43.99%
60.70%
0
149
127
10
91.95%
87.24%
96.65%
0
149
0
94
63.09%
55.00%
71.17%
0
149
0
67
44.97%
36.64%
53.29%
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
South Country Health Alliance (CBP)
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:37 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
206
2007
H
206
2007
H
206
2007
H
206
2007
H
206
2007
H
206
2007
H
206
2007
H
206
2007
H
206
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
143
69.42%
198
5%
198
140
70.71%
206
100.00%
198
5%
198
198
100.00%
0
0.00%
198
5%
198
0
0.00%
89
43.20%
198
5%
198
89
44.95%
117
56.80%
198
5%
198
116
58.59%
1
0.49%
198
5%
198
1
0.51%
136
66.02%
198
5%
198
132
66.67%
0
0.00%
198
5%
198
0
0.00%
0
0.00%
198
5%
198
0
0.00%
Number of Records Excluded Because of
Valid Data Errors
2
2
2
2
2
2
2
2
2
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
1
1
1
1
1
1
1
1
1
0
0
0
0
0
0
0
0
0
0
195
140
29
86.67%
81.64%
91.69%
0
195
48
33
41.54%
34.37%
48.71%
0
195
0
73
37.44%
30.39%
44.49%
0
195
88
34
62.56%
55.51%
69.61%
0
195
116
30
74.87%
68.53%
81.22%
0
195
1
63
32.82%
25.97%
39.67%
0
195
132
23
79.49%
73.56%
85.41%
0
195
0
136
69.74%
63.04%
76.45%
0
195
0
86
44.10%
36.88%
51.33%
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
South Country Health Alliance (CBP)
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:37 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
24
21
NA
NA
NA
21
21
NA
NA
NA
43
39
90.70%
80.85%
100.00%
88
81
92.05%
85.82%
98.27%
2007
A
Page 25
Effectiveness of Care
South Country Health Alliance (CBP)
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:37 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 27
Effectiveness of Care
South Country Health Alliance (CBP)
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:37 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
1
NA
NA
NA
14
NA
NA
NA
14
NA
NA
NA
2007
A
25
Page 28
Effectiveness of Care
South Country Health Alliance (CBP)
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:37 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
14
13.33%
6.35%
20.31%
52
49.52%
39.48%
59.56%
32
30.48%
21.20%
39.76%
2007
A
105
Page 29
Effectiveness of Care
South Country Health Alliance (CBP)
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 7, 2009 1:37 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
68
12
17.65%
7.85%
27.44%
18
4
NA
NA
NA
2007
A
NR
NR
NR
NR
NR
NR
Page 30
Effectiveness of Care
South Country Health Alliance (CBP)
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 1:37 PM
Medicare
Advantage
NR
NR
NR
MSHO
2007
A
1231
512
41.59%
38.80%
44.39%
Page 31
Effectiveness of Care
South Country Health Alliance (CBP)
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:37 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 33
Effectiveness of Care
South Country Health Alliance (CBP)
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:37 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
446
268
60.09%
55.43%
64.75%
76
51
67.11%
55.88%
78.33%
539
341
63.27%
59.10%
67.43%
58
37
63.79%
50.56%
77.02%
1119
697
62.29%
59.40%
65.17%
2007
A
Page 34
Effectiveness of Care
South Country Health Alliance (CBP)
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:37 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
126
101
80.16%
72.80%
87.52%
2
1
NA
NA
NA
105
79
75.24%
66.51%
83.97%
28
18
NA
NA
NA
261
199
76.25%
70.89%
81.60%
2007
A
Page 35
Effectiveness of Care
South Country Health Alliance (CBP)
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:37 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
1 or More
Prescriptions
NR
NR
NR
MSHO
2 or More
Prescriptions
NR
NR
NR
General
Measure
Data
2007
A
1731
1 or More
Prescriptions
2 or More
Prescriptions
426
24.61%
22.55%
26.67%
80
4.62%
3.60%
5.64%
Page 36
Effectiveness of Care
South Country Health Alliance (CBP)
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:37 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
Page 37
Effectiveness of Care
South Country Health Alliance (CBP)
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:37 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
42
11
26.19%
11.70%
40.68%
439
115
26.20%
21.97%
30.42%
20
0
NA
NA
NA
501
126
25.15%
21.25%
29.05%
Page 38
Use of Services
South Country Health Alliance (CBP)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
1
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
29
6.79%
23
5.39%
32
7.49%
31
7.26%
52
12.18%
76
17.80%
184
43.09%
29
6.79%
23
5.39%
32
7.49%
31
7.26%
52
12.18%
76
17.80%
184
43.09%
13
0
3.05%
1.30%
4.80%
1
2
0.70%
0.00%
1.62%
11
4
3.52%
1.65%
5.39%
18
8
6.10%
3.71%
8.49%
27
9
8.45%
5.69%
11.21%
41
25
15.49%
11.94%
19.05%
190
77
62.68%
57.97%
67.39%
411
5.00%
427
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
427
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
426
Page 40
Use of Services
South Country Health Alliance (CBP)
Well Child Visits in the 3rd, 4th,
5th and 6th Years of Life
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2007
H
1412
Numerator events by admin data in eligible
population
769
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
54.46%
411
5.00%
432
237
NR
54.86%
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
432
237
15
58.33%
53.57%
63.10%
Page 41
Use of Services
South Country Health Alliance (CBP)
Adolescent Well-Care Visits
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2007
H
1946
Numerator events by admin data in eligible
population
465
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
23.90%
411
5.00%
432
118
NR
27.31%
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
432
118
26
33.33%
28.77%
37.89%
Page 42
Use of Services
South Country Health Alliance (CBP)
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicare Advantage
Age
< 65
65-74
75-84
85+
Member Months
Male
Female
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
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
Female
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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 44
Use of Services
South Country Health Alliance (CBP)
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:37 PM
MSHO
Age
< 65
65-74
75-84
85+
Member Months
Male
Female
0
0
2294
3495
2211
5818
1937
8387
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
0
0
0
0
0
1
0
0
1
2
0
0
0
0
0
0
3
3
7
0
0
0
1
0
5
0
0
0
0
1
0
0
1
0
0
0
0
0
0
0
2
0
0
Procedures /
1,000 Member
Months
NA
0.00
0.00
0.00
NA
0.00
0.45
0.00
NA
0.44
0.90
0.00
NA
0.00
0.00
0.00
NA
1.31
1.36
3.61
NA
0.00
0.00
0.52
NA
2.18
0.00
0.00
NA
0.00
0.45
0.00
NA
0.44
0.00
0.00
NA
0.00
0.00
0.00
NA
0.87
0.00
0.00
Female
Number of
Procedures
0
1
1
0
0
1
3
1
0
9
8
0
0
0
0
0
0
1
5
12
0
3
1
0
0
5
3
0
0
3
4
1
0
0
2
1
0
0
1
0
0
3
1
0
0
1
2
0
0
0
0
0
0
0
3
0
0
0
4
2
Procedures /
1,000 Member
Months
NA
0.29
0.17
0.00
NA
0.29
0.52
0.12
NA
2.58
1.38
0.00
NA
0.00
0.00
0.00
NA
0.29
0.86
1.43
NA
0.86
0.17
0.00
NA
1.43
0.52
0.00
NA
0.86
0.69
0.12
NA
0.00
0.34
0.12
NA
0.00
0.17
0.00
NA
0.86
0.17
0.00
NA
0.29
0.34
0.00
NA
0.00
0.00
0.00
NA
0.00
0.52
0.00
NA
0.00
0.69
0.24
Page 45
Use of Services
South Country Health Alliance (CBP)
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicaid
Member Months
Total
64521
104460
97341
57402
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
356
79
139
33
Procedures /
1,000 Member
Months
5.52
0.81
1.33
0.57
Member Months
Male
Female
67942
19389
53826
18277
7327
8096
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
1
0.05
5
22
11
Number of
Procedures
7
1
14
4
24
5
Procedures /
1,000 Member
Months
0.10
0.12
0.21
0.49
0.35
0.62
3
0
0.04
0.00
68
7
24
11
1
1
14
2
1.00
0.86
0.45
1.36
0.01
0.12
0.21
0.25
0.27
1.13
1.50
Page 46
Use of Services
South Country Health Alliance (CBP)
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 1:37 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
South Country Health Alliance (CBP)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicare Advantage
Age
Member Months
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
NR
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
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 48
Use of Services
South Country Health Alliance (CBP)
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 1:37 PM
Member Months
0
0
0
0
0
5789
8029
10324
0
24142
Discharges
0
0
0
0
0
289
419
397
0
1105
0
0
0
0
0
287
411
387
0
1085
Discharges /
1,000 Member
Months
NA
NA
NA
NA
NA
49.92
52.19
38.45
45.77
NA
NA
NA
NA
NA
49.58
51.19
37.49
44.94
0
0
0
0
0
0
0
0
0
0
NA
NA
NA
NA
NA
0.00
0.00
0.00
0
0
0
0
0
NA
NA
NA
HEDIS 2008 (Reporting Year 2007)
0.00
NA
Days
0
0
0
0
0
857
1401
1211
0
3469
0
0
0
0
0
851
1386
1187
0
3424
Days / 1,000
Member
Months
NA
NA
NA
NA
NA
148.04
174.49
117.30
143.69
NA
NA
NA
NA
NA
147.00
172.62
114.97
141.83
0
0
0
0
0
0
0
0
0
0
NA
NA
NA
NA
NA
0.00
0.00
0.00
0
0
0
0
0
NA
NA
NA
0.00
NA
Average
Length of Stay
NA
NA
NA
NA
NA
2.97
3.34
3.05
NA
3.14
NA
NA
NA
NA
NA
2.97
3.37
3.07
NA
3.16
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Page 49
Use of Services
South Country Health Alliance (CBP)
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 1:37 PM
Member Months
19782
84678
57402
73215
15423
3122
2810
2884
0
259316
Discharges
Discharges /
1,000 Member
Months
190
175
366
1794
214
75
70
79
0
2963
9.60
2.07
6.38
24.50
13.88
24.02
24.91
27.39
157
157
102
358
167
74
70
77
0
1162
7.94
1.85
1.78
4.89
10.83
23.70
24.91
26.70
10
18
13
79
47
0
0
0
0
167
0.51
0.21
0.23
1.08
3.05
0.00
0.00
0.00
251
1353
0
0
1604
HEDIS 2008 (Reporting Year 2007)
11.43
4.48
0.64
4.37
18.48
0.00
10.98
Days
Days / 1,000
Member
Months
965
470
806
3695
802
247
207
253
0
7445
48.78
5.55
14.04
50.47
52.00
79.12
73.67
87.73
660
384
252
814
507
237
207
250
0
3311
33.36
4.53
4.39
11.12
32.87
75.91
73.67
86.69
28.71
12.77
47
86
32
215
295
0
0
0
0
675
2.38
1.02
0.56
2.94
19.13
0.00
0.00
0.00
522
2657
0
0
3179
9.09
36.29
0.00
2.60
21.77
Average
Length of Stay
5.08
2.69
2.20
2.06
3.75
3.29
2.96
3.20
NA
2.51
4.20
2.45
2.47
2.27
3.04
3.20
2.96
3.25
NA
2.85
4.70
4.78
2.46
2.72
6.28
NA
NA
NA
NA
4.04
2.08
1.96
NA
NA
1.98
Page 50
Use of Services
South Country Health Alliance (CBP)
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicare Advantage
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Member
Months
NR
Total
Outpatient Visits
(Excludes MH/CD)
Age
Visits
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits/ 1,000
Member
Months
NR
NR
Emergency Room Visits
Visits
NR
NR
NR
NR
NR
NR
NR
HEDIS 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 52
Use of Services
South Country Health Alliance (CBP)
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:37 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
0
5789
8029
10324
0
24142
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
0
4403
5671
4465
0
14539
HEDIS 2008 (Reporting Year 2007)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
760.58
706.31
432.49
602.23
Emergency Room Visits
Visits
0
0
0
0
0
321
377
318
0
1016
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
55.45
46.95
30.80
42.08
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
0
150
198
147
0
495
Procedures/
1,000 Member
Months
NA
NA
NA
NA
NA
25.91
24.66
14.24
20.50
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
2
5
12
0
19
Stays/ 1,000
Member
Months
NA
NA
NA
NA
NA
0.35
0.62
1.16
0.79
Page 53
Use of Services
South Country Health Alliance (CBP)
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicaid
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
19782
84678
57402
73215
15423
3122
2810
2884
0
259316
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
Visits
15627
30050
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
16905
42000
9135
1692
1218
1004
0
117631
HEDIS 2008 (Reporting Year 2007)
Visits/ 1,000
Member
Months
789.96
354.87
294.50
573.65
592.30
541.96
433.45
348.13
453.62
Emergency Room Visits
Visits
1848
4414
2216
5945
807
140
131
100
0
15601
Visits/ 1,000
Member
Months
93.42
52.13
38.60
81.20
52.32
44.84
46.62
34.67
60.16
Ambulatory
Surgery/Procedures
Procedures
83
439
156
884
381
51
57
38
0
2089
Procedures/
1,000 Member
Months
4.20
5.18
2.72
12.07
24.70
16.34
20.28
13.18
8.06
Observation Room Stays
Resulting in Discharge
Stays
57
65
215
1007
24
2
1
2
0
1373
Stays/ 1,000
Member
Months
2.88
0.77
3.75
13.75
1.56
0.64
0.36
0.69
5.29
Page 54
Use of Services
South Country Health Alliance (CBP)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicare Advantage
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 56
Use of Services
South Country Health Alliance (CBP)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:37 PM
MSHO
Age
Member
Months
<1
0
1-9
0
10-19
0
20-44
0
45-64
0
65-74
5789
75-84
8029
85+
10324
Unknown
0
24142
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
NA
0
NA
NA
65-74
98
16.93
2407
415.79
24.56
75-84
279
34.75
7450
927.89
26.70
85+
427
41.36
10798
1045.91
25.29
Unknown
0
804
33.30
0
20655
855.56
NA
25.69
Age
Total
HEDIS 2008 (Reporting Year 2007)
Page 57
Use of Services
South Country Health Alliance (CBP)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicaid
Age
Member
Months
<1
19782
1-9
84678
10-19
57402
20-44
73215
45-64
15423
65-74
3122
75-84
2810
85+
2884
Unknown
Total
0
259316
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
0
0.00
0
0.00
NA
20-44
2
0.03
14
0.19
7.00
45-64
5
0.32
127
8.23
25.40
65-74
13
4.16
305
97.69
23.46
75-84
24
8.54
1018
362.28
42.42
85+
31
10.75
844
292.65
27.23
Unknown
0
75
0.29
0
2308
8.90
NA
30.77
Age
Total
HEDIS 2008 (Reporting Year 2007)
Page 58
Use of Services
Health Alliance (CBP)
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:37 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
Health Alliance (CBP)
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicare Advantage
Member Months
(Inpatient)
Member Months
(Any)
Male
Age
Female
0-12
13-17
18-64
65+
Unknown
Total
NR
NR
Total
Age
Sex
M
F
Total
Number
NR
13-17
M
F
Total
NR
18-64
M
F
Total
NR
65+
M
F
Unknown
Total
Total
M
F
NR
Total
M
F
Total
NR
NR
NR
NR
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)
Male
Female
Total
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
Intensive Outpatient/Partial
Hospitalization
Inpatient
Percent
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 60
Use of Services
Health Alliance (CBP)
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:37 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
0
6442
0
6442
0
17700
0
17700
0
24142
0
24142
0
6442
0
6442
0
17700
0
17700
0
24142
0
24142
0
6442
0
6442
0
17700
0
17700
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
0
24142
0
24142
0
6442
0
6442
0
17700
0
17700
0
24142
0
24142
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
0
0
0
54
136
190
0
0
0
54
136
190
NA
NA
NA
NA
NA
NA
NA
NA
NA
10.06%
9.22%
9.44%
NA
NA
NA
10.06%
9.22%
9.44%
0
0
0
0
0
0
0
0
0
17
54
71
0
0
0
17
54
71
NA
NA
NA
NA
NA
NA
NA
NA
NA
3.17%
3.66%
3.53%
NA
NA
NA
3.17%
3.66%
3.53%
0
0
0
0
0
0
0
0
0
0
2
2
0
0
0
0
2
2
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.14%
0.10%
NA
NA
NA
0.00%
0.14%
0.10%
0
0
0
0
0
0
0
0
0
43
89
132
0
0
0
43
89
132
NA
NA
NA
NA
NA
NA
NA
NA
NA
8.01%
6.03%
6.56%
NA
NA
NA
8.01%
6.03%
6.56%
HEDIS 2008 (Reporting Year 2007)
Page 61
Use of Services
Health Alliance (CBP)
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicaid
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Age
Female
Total
Female
Total
Male
Female
Total
63565
14462
60557
14815
124122
29277
63565
14462
60557
14815
124122
29277
63565
14462
60557
14815
124122
29277
63565
14462
60557
14815
124122
29277
29956
2722
0
110705
67145
6093
0
148610
97101
8815
0
259315
29956
2722
0
110705
67145
6093
0
148610
97101
8815
0
259315
29956
2722
0
110705
67145
6093
0
148610
97101
8815
0
259315
29956
2722
0
110705
67145
6093
0
148610
97101
8815
0
259315
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
Male
Member Months
(Outpatient/ED)
Male
Any Services
0-12
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
Intensive Outpatient/Partial
Hospitalization
Inpatient
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
676
459
1135
318
358
676
591
1541
2132
21
49
70
0
0
0
1606
2407
4013
12.76%
9.10%
10.97%
26.39%
29.00%
27.71%
23.67%
27.54%
26.35%
9.26%
9.65%
9.53%
NA
NA
NA
17.41%
19.44%
18.57%
11
4
15
13
27
40
46
93
139
8
5
13
0
0
0
78
129
207
0.21%
0.08%
0.15%
1.08%
2.19%
1.64%
1.84%
1.66%
1.72%
3.53%
0.98%
1.77%
NA
NA
NA
0.85%
1.04%
0.96%
10
4
14
3
3
6
10
14
24
0
0
0
0
0
0
23
21
44
0.19%
0.08%
0.14%
0.25%
0.24%
0.25%
0.40%
0.25%
0.30%
0.00%
0.00%
0.00%
NA
NA
NA
0.25%
0.17%
0.20%
673
459
1132
318
355
673
584
1520
2104
16
47
63
0
0
0
1591
2381
3972
12.71%
9.10%
10.94%
26.39%
28.75%
27.58%
23.39%
27.17%
26.00%
7.05%
9.26%
8.58%
NA
NA
NA
17.25%
19.23%
18.38%
HEDIS 2008 (Reporting Year 2007)
Page 62
Health Alliance (CBP)
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:37 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
Health Alliance (CBP)
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicare Advantage
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 64
Health Alliance (CBP)
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:37 PM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
0
0
6442
0
6442
Female
0
0
0
0
0
17700
0
17700
Member Months
(Inpatient)
Total
0
0
0
0
0
24142
0
24142
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
19
15
34
0
0
0
19
15
34
HEDIS 2008 (Reporting Year 2007)
Male
0
0
0
0
0
6442
0
6442
Female
0
0
0
0
0
17700
0
17700
Total
0
0
0
0
0
24142
0
24142
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
3.54%
1.02%
1.69%
NA
NA
NA
3.54%
1.02%
1.69%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
10
22
0
0
0
12
10
22
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
2.24%
0.68%
1.09%
NA
NA
NA
2.24%
0.68%
1.09%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6442
17700
24142
0
0
0
6442
17700
24142
Member Months
(Outpatient/ED)
Male
0
0
0
0
0
6442
0
6442
Female
0
0
0
0
0
17700
0
17700
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
9
6
15
0
0
0
9
6
15
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Total
0
0
0
0
0
24142
0
24142
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
1.68%
0.41%
0.75%
NA
NA
NA
1.68%
0.41%
0.75%
Page 65
Health Alliance (CBP)
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicaid
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
63565
14462
7394
8024
14538
2722
0
110705
Female
60557
14815
21658
24068
21419
6093
0
148610
Member Months
(Inpatient)
Total
124122
29277
29052
32092
35957
8815
0
259315
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
4
2
6
57
51
108
84
122
206
104
183
287
242
188
430
9
3
12
0
0
0
500
549
1049
HEDIS 2008 (Reporting Year 2007)
Male
63565
14462
7394
8024
14538
2722
0
110705
Female
60557
14815
21658
24068
21419
6093
0
148610
Total
124122
29277
29052
32092
35957
8815
0
259315
Inpatient
Percent
0.08%
0.04%
0.06%
4.73%
4.13%
4.43%
13.63%
6.76%
8.51%
15.55%
9.12%
10.73%
19.98%
10.53%
14.35%
3.97%
0.59%
1.63%
NA
NA
NA
5.42%
4.43%
4.85%
Number
2
0
2
18
15
33
22
29
51
14
54
68
83
62
145
4
2
6
0
0
0
143
162
305
Percent
0.04%
0.00%
0.02%
1.49%
1.21%
1.35%
3.57%
1.61%
2.11%
2.09%
2.69%
2.54%
6.85%
3.47%
4.84%
1.76%
0.39%
0.82%
NA
NA
NA
1.55%
1.31%
1.41%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
63565
14462
7394
8024
14538
2722
0
110705
60557
14815
21658
24068
21419
6093
0
148610
124122
29277
29052
32092
35957
8815
0
259315
Member Months
(Outpatient/ED)
Male
63565
14462
7394
8024
14538
2722
0
110705
Female
60557
14815
21658
24068
21419
6093
0
148610
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
0
2
2
0
1
1
1
1
2
0
0
0
0
0
0
1
4
5
Number
2
2
4
51
47
98
78
109
187
99
163
262
211
172
383
6
1
7
0
0
0
447
494
941
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.11%
0.08%
0.00%
0.05%
0.04%
0.08%
0.06%
0.07%
0.00%
0.00%
0.00%
NA
NA
NA
0.01%
0.03%
0.02%
Total
124122
29277
29052
32092
35957
8815
0
259315
Percent
0.04%
0.04%
0.04%
4.23%
3.81%
4.02%
12.66%
6.04%
7.72%
14.81%
8.13%
9.80%
17.42%
9.64%
12.78%
2.65%
0.20%
0.95%
NA
NA
NA
4.85%
3.99%
4.35%
Page 66
Use of Services
South Country Health Alliance (CBP)
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 1:37 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
South Country Health Alliance (CBP)
Outpatient Drug Utilization
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicare Advantage
Age
Member Months
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
NR
Age
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 68
Use of Services
South Country Health Alliance (CBP)
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 1:37 PM
Member Months
0
0
0
0
5789
8029
10324
0
24142
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
$13,370.00
$2,027,945.00
$2,709,437.00
$2,707,314.00
$0.00
$7,458,066.00
HEDIS 2008 (Reporting Year 2007)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
NA
NA
$350.31
$337.46
$262.23
$308.92
Total Number of
Prescriptions
0
0
0
244
43742
71727
92215
0
207928
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
NA
NA
90.67
107.20
107.19
103.35
Page 69
Use of Services
South Country Health Alliance (CBP)
Outpatient Drug Utilization
Medicaid
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Member Months
104460
57402
73215
15423
3122
2810
2884
0
259316
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 1:37 PM
$1,934,587.00
$2,124,265.00
$6,098,331.00
$2,673,025.00
$1,918.00
$1,917.00
$6,710.00
$0.00
$12,840,753.00
HEDIS 2008 (Reporting Year 2007)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$18.52
$37.01
$83.29
$173.31
$0.61
$0.68
$2.33
$49.52
Total Number of
Prescriptions
42178
34227
120287
50799
37
66
257
0
247851
Avg. Num. Of
Prescriptions /
Per Member Per
Year
4.85
7.16
19.72
39.52
0.14
0.28
1.07
11.47
Page 70
Access/Availability of Care
South Country Health Alliance (CBP)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:37 PM
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 (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 72
Access/Availability of Care
South Country Health Alliance (CBP)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:37 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
1731
2007
A
0
0
1699
NA
NA
NA
NA
NA
NA
98.15%
97.49%
98.81%
Page 73
Access/Availability of Care
South Country Health Alliance (CBP)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:37 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+
2056
500
414
2007
A
1891
451
383
91.97%
90.78%
93.17%
90.20%
87.49%
92.91%
92.51%
89.86%
95.17%
Page 74
Access/Availability of Care
South Country Health Alliance (CBP)
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:37 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.
766
1810
643
776
2007
A
743
1549
550
630
97.00%
95.72%
98.27%
85.58%
83.93%
87.23%
85.54%
82.74%
88.33%
81.19%
78.37%
84.00%
Page 76
Access/Availability of Care
South Country Health Alliance (CBP)
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:37 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)
661
661
Number of numerator events by administrative data in
eligible population (before exclusions)
357
264
Current year's administrative rate (before exclusions)
54.01%
39.94%
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
244
171
56.48%
39.58%
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
0
0
Number of employee/dependent medical records excluded
0
0
0
432
244
141
0
432
171
122
89.12%
86.07%
92.17%
67.82%
63.30%
72.35%
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
South Country Health Alliance (CBP)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:37 PM
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
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 80
Access/Availability of Care
South Country Health Alliance (CBP)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:37 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
25
25
0
0
14
1
14
1
Reported rate
NA
NA
NA
NA
NA
NA
Lower 95% confidence interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 81
Access/Availability of Care
South Country Health Alliance (CBP)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:37 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
44
353
397
23
6
187
74
210
80
Reported rate
52.27%
13.64%
52.97%
20.96%
52.90%
20.15%
Lower 95% confidence interval
36.38%
68.17%
2.36%
24.91%
47.63%
58.32%
16.58%
25.35%
47.86%
57.93%
16.08%
24.22%
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 82
Health Plan Stability
South Country Health Alliance (CBP)
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicare Advantage
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 84
Health Plan Stability
South Country Health Alliance (CBP)
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:37 PM
MSHO
Product/Product Line
Years in Business
Members*
2.33
0.00
0.00
0.00
0.00
2.33
2040
0
0
0
0
2040
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
2040
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
South Country Health Alliance (CBP)
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:37 PM
Medicaid
Product/Product Line
Years in Business
Members*
6.16
0.00
0.00
0.00
0.00
6.16
23169
0
0
0
0
23169
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
23169
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
South Country Health Alliance (CBP)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:37 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
South Country Health Alliance (CBP)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:37 PM
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 2008 (Reporting Year 2007)
Page 88
Health Plan Descriptive Information
South Country Health Alliance (CBP)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:37 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
0
0
0.00%
0
0
0
0
0
0.00%
0
0.00%
1044
1236
1236
972
1068
864
0
0.00%
1512
1980
2352
3456
3984
4392
0
0.00%
6420
100.00%
0
17676
100.00%
0
24096
100.00%
6420
17676
HEDIS 2008 (Reporting Year 2007)
0
0
0
0
0
0
0
0
0
2556
3216
3588
4428
5052
5256
0
24096
Page 89
Health Plan Descriptive Information
South Country Health Alliance (CBP)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:37 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
10124
23122
20306
16340
8135
3240
Member Months
Female
9658
21617
19633
15571
8893
5223
Total
19782
44739
39939
31911
17028
8463
81267
73.41%
4154
4285
3739
3732
3479
80595
54.23%
16435
14146
9922
7769
5554
161862
62.42%
19389
17.51%
3281
2189
1264
593
53826
36.22%
4108
2017
1297
674
73215
28.23%
7327
6.62%
847
360
471
451
350
243
8096
5.45%
1177
738
747
1141
1079
1211
15423
5.95%
2722
2.46%
0
6093
4.10%
0
8815
3.40%
110705
148610
HEDIS 2008 (Reporting Year 2007)
20589
18431
13661
11501
9033
7389
4206
2561
1267
2024
1098
1218
1592
1429
1454
0
259315
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