Plan Name
Preferred One Community Health Plan
2007
Reporting Year
Submission #
General Info
Disclaimers
Code
CIS
Plan ID
1
Last Refreshed:
Page
Childhood Immunization Status
10/7/2009 1:34:49 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
23
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
Preferred One Community Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Pneumococcal
Conjugate
Combo 2
Combo 3
330
73.17%
345
76.50%
406
90.02%
347
76.94%
339
75.17%
396
87.80%
338
74.94%
278
61.64%
273
60.53%
317
73.55%
333
77.26%
390
90.49%
333
77.26%
328
76.10%
380
88.17%
325
75.41%
268
62.18%
263
61.02%
301
67
89.54%
86.46%
92.62%
315
77
95.38%
93.23%
97.53%
372
14
93.92%
91.48%
96.35%
317
67
93.43%
90.91%
95.95%
312
80
95.38%
93.23%
97.53%
363
18
92.70%
90.06%
95.34%
312
56
89.54%
86.46%
92.62%
255
88
83.45%
79.74%
87.17%
252
83
81.51%
77.63%
85.38%
431
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
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
451
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 3
Effectiveness of Care
Preferred One Community Health Plan
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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 4
Effectiveness of Care
Preferred One Community Health Plan
Appropriate Treatment for Children with Upper
Respiratory Infection
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Commercial
Medicaid
2007
A
Eligible Member Population
811
Numerator Events by Admin Data
116
Reported Rate
85.70%
NR
Lower 95% Confidence Interval
83.23%
NR
Upper 95% Confidence Interval
88.17%
NR
HEDIS 2008 (Reporting Year 2007)
Page 5
Effectiveness of Care
Preferred One Community Health Plan
Colorectal Cancer Screening
Data Elements
Measurement Year
Data collection methodology (administrative or hybrid)
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
NR
NR
NR
NR
H
5535
Number of numerator events by administrative data in eligible
population (before exclusions)
1959
35.39%
Minimum required sample size (MRSS) or other sample size
411
Oversampling rate
0.05
Final sample size (FSS)
432
Number of numerator events by administrative data in FSS
143
Administrative rate on FSS
MSHO
2007
Eligible population
Current year's administrative rate (before exclusions)
Medicare
Advantage
33.10%
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
0
Number of employee/dependent medical records excluded
0
Records added from the oversample list
0
Denominator
411
Numerator events by administrative data
139
Numerator events by medical records
71
Reported rate
51.09%
NR
NR
Lower 95% confidence interval
46.14%
NR
NR
Upper 95% confidence interval
56.05%
NR
NR
HEDIS 2008 (Reporting Year 2007)
Page 6
Effectiveness of Care
Preferred One Community Health Plan
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:34 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 42-51
Ages 52-69
Total
2605
1695
65.07%
63.22%
66.92%
2457
1800
73.26%
71.49%
75.03%
5062
3495
69.04%
67.76%
70.33%
2007
A
Page 7
Effectiveness of Care
Preferred One Community Health Plan
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:34 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
NR
NR
NR
Ages 52-69
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 9
Effectiveness of Care
Preferred One Community Health Plan
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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 10
Effectiveness of Care
Preferred One Community Health Plan
Cervical Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Medicaid
2007
A
5121
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
NR
NR
NR
NR
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)
3906
76.27%
75.10%
77.45%
NR
NR
NR
Page 11
Effectiveness of Care
Preferred One Community Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Oct 7, 2009 1:34 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
602
224
37.21%
33.26%
41.15%
765
320
41.83%
38.27%
45.39%
1367
544
39.80%
37.16%
42.43%
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 12
Effectiveness of Care
Preferred One Community Health Plan
Data Last Refreshed:
Oct 7, 2009 1:34 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
NR
NR
NR
NR
NR
NR
Page 13
Effectiveness of Care
Preferred One Community Health Plan
Controlling High Blood Pressure
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Commercial
NR
NR
NR
2063
0
0.00%
411
15.00%
465
0
0.00%
Number of administrative data records
excluded
0
Number of medical record data records
excluded
0
Number of employee/dependent medical
records excluded
0
Records Added from the OverSample List
8
Numerator Events by Medical Record
NR
H
8
Numerator Events by Admin Data
MSHO
2007
Records Excluded because of Valid Data
Errors
Denominator
Medicare Advantage
411
0
271
Reported Rate
65.94%
NR
NR
Lower 95% Confidence Interval
61.23%
NR
NR
Upper 95% Confidence Interval
70.64%
NR
NR
HEDIS 2008 (Reporting Year 2007)
Page 14
Effectiveness of Care
Preferred One Community Health Plan
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Measurement Year
Commercial
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicare Advantage
MSHO
Medicaid
2007
Data Collection Methodology
A
Eligible Member Population
44
Numerator Events by Admin Data on
Eligible Population
39
Reported Rate
88.64%
NR
NR
NR
Lower 95% Confidence Interval
78.12%
NR
NR
NR
Upper 95% Confidence Interval
99.15%
NR
NR
NR
HEDIS 2008 (Reporting Year 2007)
Page 15
Effectiveness of Care
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
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)
159
0
86.41%
0.00%
159
0
86.41%
0.00%
159
6
0
118
89.67%
85.01%
94.34%
64.13%
56.93%
71.33%
411
5.00%
184
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
184
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
184
Page 16
Effectiveness of Care
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:34 PM
MSHO
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 18
Effectiveness of Care
Preferred One Community Health Plan
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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 19
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
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
1027
2007
H
1027
2007
H
1027
2007
H
1027
2007
H
1027
2007
H
1027
2007
H
1027
2007
H
1027
2007
H
1027
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
911
88.70%
411
5%
432
382
88.43%
1025
99.81%
411
5%
432
432
100.00%
2
0.19%
411
5%
432
0
0.00%
520
50.63%
411
5%
432
196
45.37%
835
81.30%
411
5%
432
345
79.86%
3
0.29%
411
5%
432
1
0.23%
831
80.92%
411
5%
432
354
81.94%
0
0.00%
411
5%
432
0
0.00%
0
0.00%
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
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
411
368
6
91.00%
88.11%
93.89%
0
411
38
89
30.90%
26.31%
35.49%
0
411
0
176
42.82%
37.92%
47.73%
0
411
188
48
57.42%
52.52%
62.32%
0
411
334
5
82.48%
78.69%
86.28%
0
411
1
169
41.36%
36.48%
46.25%
0
411
338
8
84.18%
80.54%
87.83%
0
411
0
282
68.61%
64.00%
73.22%
0
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 20
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:34 PM
MSHO
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
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
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 22
Effectiveness of Care
Preferred One Community Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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 23
Effectiveness of Care
Preferred One Community Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:34 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
Ages 10-17
Ages 18-56
Total
43
42
97.67%
92.01%
100.00%
81
79
97.53%
93.53%
100.00%
271
245
90.41%
86.71%
94.10%
395
366
92.66%
89.96%
95.36%
2007
A
Page 24
Effectiveness of Care
Preferred One Community Health Plan
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:34 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
NR
NR
NR
Ages 10-17
NR
NR
NR
Ages 18-56
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 25
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:34 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
57
19.66%
14.91%
24.40%
188
64.83%
59.16%
70.50%
142
48.97%
43.04%
54.89%
2007
A
290
Page 26
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:34 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 28
Effectiveness of Care
Preferred One Community Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
Data Elements
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
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)
Page 29
Effectiveness of Care
Preferred One Community Health Plan
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 7, 2009 1:34 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
Medicaid
Initiation
Phase
Continuation
and
Maintenance
Phase
97
42
43.30%
32.92%
53.68%
31
14
45.16%
26.03%
64.29%
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
NR
NR
NR
NR
NR
NR
2007
A
Page 30
Effectiveness of Care
Preferred One Community Health Plan
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interva
HEDIS 2008 (Reporting Year 2007)
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicare
Advantage
MSHO
NR
NR
NR
NR
NR
NR
Page 31
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:34 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
2030
1571
77.39%
75.54%
79.23%
34
29
85.29%
71.92%
98.67%
1627
1243
76.40%
74.30%
78.49%
123
77
62.60%
53.64%
71.56%
3814
2920
76.56%
75.20%
77.92%
2007
A
Page 32
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:34 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 34
Effectiveness of Care
Preferred One Community Health Plan
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:34 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 35
Effectiveness of Care
Preferred One Community Health Plan
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:34 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
MSHO
1 or More
Prescriptions
2 or More
Prescriptions
NR
NR
NR
NR
NR
NR
General
Measure
Data
1 or More
Prescriptions
2 or More
Prescriptions
NR
NR
NR
NR
NR
NR
Page 36
Effectiveness of Care
Preferred One Community Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:34 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
Page 38
Use of Services
Preferred One Community Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
12
0
5
13
25
78
277
2.93%
1.17%
4.68%
0.00%
0.00%
0.12%
1.22%
0.04%
2.40%
3.17%
1.35%
4.99%
6.10%
3.66%
8.54%
19.02%
15.10%
22.95%
67.56%
62.91%
72.21%
2007
A
410
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
Preferred One Community Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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 40
Use of Services
Preferred One Community Health Plan
Well Child Visits in the 3rd, 4th,
5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Medicaid
2007
A
2206
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
NR
NR
NR
NR
Records Excluded - Contraindications/Admin Data
Records Excluded - Contraindications/Medical
Record Review
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)
1316
59.66%
57.59%
61.73%
NR
NR
NR
Page 41
Use of Services
Preferred One Community Health Plan
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Medicaid
2007
A
5754
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
NR
NR
NR
NR
Records Excluded because of Valid Data Errors
Records Excluded - Contraindications/Admin Data
Records Excluded - Contraindications/Medical
Record Review
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)
1710
29.72%
28.53%
30.91%
NR
NR
NR
Page 42
Use of Services
Preferred One Community Health Plan
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Member Months
Total
44407
90153
142459
96713
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
208
56
83
31
Procedures /
1,000 Member
Months
4.68
0.39
0.92
0.32
Member Months
Male
Female
147091
133904
122735
176585
93060
91710
3082
2689
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+
Back Surgery
20-44
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
1
0.01
0
29
0
34
49
1
112
16
80
3
25
2
16
4
0.00
0.16
0.00
0.25
0.53
0.32
1.20
5.19
0.86
0.97
0.27
0.65
0.17
1.30
Number of
Procedures
5
14
30
47
0
25
23
1
Procedures /
1,000 Member
Months
0.03
0.15
0.20
0.51
0.00
0.17
0.25
0.37
5
2
0
0.03
0.02
0.00
56
36
3
39
53
2
20
0
30
5
5
2
0.38
0.39
1.12
0.32
0.58
0.74
0.22
0.00
0.33
1.86
0.05
0.74
9
26
0
34
44
0
0.06
0.28
0.00
0.23
0.48
0.00
Page 43
Use of Services
Preferred One Community Health Plan
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:34 PM
MSHO
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 45
Use of Services
Preferred One Community Health Plan
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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
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
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)
Number of
Procedures
Female
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
Page 46
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Member Months
8706
81447
96713
256639
184770
5413
312
46
0
634046
Discharges
Discharges /
1,000 Member
Months
78
128
159
1463
1276
87
17
1
7
3216
8.96
1.57
1.64
5.70
6.91
16.07
54.49
21.74
63
91
86
311
627
42
10
1
4
1235
7.24
1.12
0.89
1.21
3.39
7.76
32.05
21.74
15
37
49
320
646
45
7
0
2
1121
1.72
0.45
0.51
1.25
3.50
8.31
22.44
0.00
24
831
2
1
858
0.25
3.24
0.01
HEDIS 2008 (Reporting Year 2007)
5.07
1.95
1.77
1.59
Days
Days / 1,000
Member
Months
377
362
439
3744
4619
323
53
1
21
9939
43.30
4.44
4.54
14.59
25.00
59.67
169.87
21.74
253
190
217
788
2294
179
30
1
16
3968
29.06
2.33
2.24
3.07
12.42
33.07
96.15
21.74
124
172
163
802
2319
144
23
0
3
3750
14.24
2.11
1.69
3.13
12.55
26.60
73.72
0.00
59
2153
5
2
2219
0.61
8.39
0.03
15.68
6.26
5.91
4.12
Average
Length of Stay
4.83
2.83
2.76
2.56
3.62
3.71
3.12
1.00
3.00
3.09
4.02
2.09
2.52
2.53
3.66
4.26
3.00
1.00
4.00
3.21
8.27
4.65
3.33
2.51
3.59
3.20
3.29
NA
1.50
3.35
2.46
2.59
2.50
2.00
2.59
Page 47
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Inpatient Utilization - General Hospital/Acute Care
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:34 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 49
Use of Services
Preferred One Community Health Plan
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 1:34 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 50
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
8706
81447
96713
256639
184770
5413
312
46
0
634046
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
Visits
7363
23848
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
20320
59776
58307
2725
215
19
0
172573
HEDIS 2008 (Reporting Year 2007)
Visits/ 1,000
Member
Months
845.74
292.80
210.11
232.92
315.57
503.42
689.10
413.04
272.18
Emergency Room Visits
Visits
284
1301
1078
3138
2080
102
20
2
0
8005
Visits/ 1,000
Member
Months
32.62
15.97
11.15
12.23
11.26
18.84
64.10
43.48
12.63
Ambulatory
Surgery/Procedures
Procedures
56
458
341
1663
3607
144
13
0
0
6282
Procedures/
1,000 Member
Months
6.43
5.62
3.53
6.48
19.52
26.60
41.67
0.00
9.91
Observation Room Stays
Resulting in Discharge
Stays
16
27
20
276
112
8
0
0
0
459
Stays/ 1,000
Member
Months
1.84
0.33
0.21
1.08
0.61
1.48
0.00
0.00
0.72
Page 51
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:34 PM
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
NR
Outpatient Visits
(Excludes MH/CD)
Age
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 53
Use of Services
Preferred One Community Health Plan
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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 54
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Age
Member
Months
<1
8706
1-9
81447
10-19
96713
20-44
256639
45-64
184770
65-74
5413
75-84
312
85+
46
Unknown
Total
0
634046
Discharges
Discharges /
1,000 Member
Months
<1
1
1-9
Days
Days / 1,000
Member
Months
Average Length
of Stay
0.11
1
0.11
1.00
0
0.00
0
0.00
NA
10-19
0
0.00
0
0.00
NA
20-44
5
0.02
23
0.09
4.60
45-64
42
0.23
505
2.73
12.02
65-74
4
0.74
14
2.59
3.50
75-84
3
9.62
3
9.62
1.00
85+
0
0.00
0
0.00
NA
Unknown
0
55
0.09
0
546
0.86
NA
9.93
Age
Total
HEDIS 2008 (Reporting Year 2007)
Page 55
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:34 PM
MSHO
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 57
Use of Services
Preferred One Community Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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 58
Use of Services
mmunity Health Plan
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Male
Female
Total
Male
Female
Total
Male
Female
Total
58554
25344
118406
50743
59852
25399
58554
25344
118406
50743
59852
25399
58554
25344
118406
50743
59852
25399
58554
25344
118406
50743
235857
3082
0
324190
223269
2689
0
309856
459126
5771
0
634046
235857
3082
0
324190
223269
2689
0
309856
459126
5771
0
634046
235857
3082
0
324190
223269
2689
0
309856
459126
5771
0
634046
235857
3082
0
324190
223269
2689
0
309856
459126
5771
0
634046
0-12
Sex
M
F
13-17
Total
M
F
18-64
Total
M
F
65+
Total
M
F
Unknown
Total
M
F
Total
Total
Member Months
(Outpatient/ED)
59852
25399
Any Services
Age
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
M
F
Total
Inpatient
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
302
173
475
265
306
571
1187
1984
3171
9
11
20
0
0
0
1763
2474
4237
6.05%
3.55%
4.81%
12.52%
14.49%
13.50%
6.04%
10.66%
8.29%
3.50%
4.91%
4.16%
NA
NA
NA
6.53%
9.58%
8.02%
9
4
13
14
28
42
59
97
156
0
1
1
0
0
0
82
130
212
0.18%
0.08%
0.13%
0.66%
1.33%
0.99%
0.30%
0.52%
0.41%
0.00%
0.45%
0.21%
NA
NA
NA
0.30%
0.50%
0.40%
19
11
30
24
32
56
55
124
179
1
2
3
0
0
0
99
169
268
0.38%
0.23%
0.30%
1.13%
1.52%
1.32%
0.28%
0.67%
0.47%
0.39%
0.89%
0.62%
NA
NA
NA
0.37%
0.65%
0.51%
274
158
432
227
246
473
1073
1763
2836
8
8
16
0
0
0
1582
2175
3757
5.49%
3.24%
4.38%
10.72%
11.65%
11.19%
5.46%
9.48%
7.41%
3.11%
3.57%
3.33%
NA
NA
NA
5.86%
8.42%
7.11%
HEDIS 2008 (Reporting Year 2007)
Page 59
Use of Services
mmunity Health Plan
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:34 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
mmunity Health Plan
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:34 PM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
Female
NR
Member Months
(Inpatient)
Total
Age
Sex
M
F
Total
Number
NR
13-17
M
F
Total
NR
18-64
M
F
Total
NR
65+
M
F
Total
NR
Unknown
M
F
Total
M
F
Total
NR
NR
NR
NR
Total
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
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 61
Use of Services
mmunity Health Plan
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
Female
NR
Member Months
(Inpatient)
Total
Age
Sex
M
F
Total
Number
NR
13-17
M
F
Total
NR
18-64
M
F
Total
NR
65+
M
F
Total
NR
Unknown
M
F
Total
M
F
Total
NR
NR
NR
NR
Total
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
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 62
ommunity Health Plan
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
59852
25399
30609
53824
151424
3082
0
324190
Female
58554
25344
28773
47746
146750
2689
0
309856
Member Months
(Inpatient)
Total
118406
50743
59382
101570
298174
5771
0
634046
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
2
4
6
2
0
2
6
3
9
30
13
43
0
0
0
0
0
0
40
20
60
HEDIS 2008 (Reporting Year 2007)
Male
59852
25399
30609
53824
151424
3082
0
324190
Female
58554
25344
28773
47746
146750
2689
0
309856
Total
118406
50743
59382
101570
298174
5771
0
634046
Inpatient
Percent
0.00%
0.00%
0.00%
0.09%
0.19%
0.14%
0.08%
0.00%
0.04%
0.13%
0.08%
0.11%
0.24%
0.11%
0.17%
0.00%
0.00%
0.00%
NA
NA
NA
0.15%
0.08%
0.11%
Number
0
0
0
2
4
6
2
0
2
6
3
9
30
13
43
0
0
0
0
0
0
40
20
60
Percent
0.00%
0.00%
0.00%
0.09%
0.19%
0.14%
0.08%
0.00%
0.04%
0.13%
0.08%
0.11%
0.24%
0.11%
0.17%
0.00%
0.00%
0.00%
NA
NA
NA
0.15%
0.08%
0.11%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
59852
58554
118406
25399
25344
50743
30609
28773
59382
53824
47746
101570
151424
146750
298174
3082
2689
5771
0
0
0
324190
309856
634046
Member Months
(Outpatient/ED)
Male
59852
25399
30609
53824
151424
3082
0
324190
Female
58554
25344
28773
47746
146750
2689
0
309856
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
0
0
0
0
0
0
0
0
0
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
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
118406
50743
59382
101570
298174
5771
0
634046
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
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%
Page 63
ommunity Health Plan
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:34 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
ommunity Health Plan
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:34 PM
MSHO
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 65
ommunity Health Plan
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
NR
Member Months
(Inpatient)
Female
Total
NR
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
NR
Female
Total
NR
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)
Total
Male
Female
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Member Months
(Outpatient/ED)
Male
NR
Female
Total
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
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
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 66
Use of Services
Preferred One Community Health Plan
Outpatient Drug Utilization
Commercial
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Member Months
90153
96713
256639
184770
5413
312
46
0
634046
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 1:34 PM
$1,141,174.00
$2,772,123.00
$9,421,194.00
$16,555,958.00
$829,442.00
$66,168.00
$8,306.00
$0.00
$30,794,365.00
HEDIS 2008 (Reporting Year 2007)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$12.66
$28.66
$36.71
$89.60
$153.23
$212.08
$180.57
$48.57
Total Number of
Prescriptions
22043
35360
171210
302128
16996
1476
229
0
549442
Avg. Num. Of
Prescriptions /
Per Member Per
Year
2.93
4.39
8.01
19.62
37.68
56.77
59.74
10.40
Page 67
Use of Services
Preferred One Community Health Plan
Outpatient Drug Utilization
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Outpatient Drug Utilization
MSHO
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Member Months
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 69
Use of Services
Preferred One Community Health Plan
Outpatient Drug Utilization
Medicaid
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Member Months
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 70
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
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+
5299
5702
235
4933
5454
232
93.09%
92.40%
93.79%
95.65%
95.11%
96.19%
98.72%
97.08%
100.00%
2007
A
Page 71
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:34 PM
MSHO
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data collection methodology (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 73
Access/Availability of Care
Preferred One Community Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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 74
Access/Availability of Care
Preferred One Community Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
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.
549
2668
1841
3366
509
2264
1551
2859
92.71%
90.45%
94.98%
84.86%
83.48%
86.24%
84.25%
82.56%
85.94%
84.94%
83.71%
86.16%
2007
A
Page 75
Access/Availability of Care
Preferred One Community Health Plan
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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 76
Access/Availability of Care
Preferred One Community Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
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)
692
692
Number of numerator events by administrative data in
eligible population (before exclusions)
526
411
Current year's administrative rate (before exclusions)
76.01%
59.39%
Minimum required sample size (MRSS) or other sample size
411
411
Oversampling rate
Final sample size (FSS)
5%
425
5%
425
Number of numerator events by administrative data in FSS
332
251
Data Elements
Administrative rate on FSS
78.12%
59.06%
Number of original sample records excluded because of
valid data errors
7
7
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
7
411
322
63
7
411
243
83
93.67%
91.20%
96.15%
79.32%
75.28%
83.36%
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
Preferred One Community Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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 78
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
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
38
443
481
15
3
196
44
211
47
Reported rate
39.47%
7.89%
44.24%
9.93%
43.87%
9.77%
Lower 95% confidence interval
22.62%
56.33%
0.00%
17.78%
39.51%
48.98%
7.03%
12.83%
39.33%
48.41%
7.01%
12.53%
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 79
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:34 PM
MSHO
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
18+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
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 81
Access/Availability of Care
Preferred One Community Health Plan
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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 82
Health Plan Stability
Preferred One Community Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Product/Product Line
Years in Business
Members*
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
0.00
12.00
0.00
0.00
0.00
12.00
0
52106
0
0
0
52106
52106
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
Preferred One Community Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:34 PM
MSHO
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 85
Health Plan Stability
Preferred One Community Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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 86
Health Plan Descriptive Information
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Commercial
Member Months
Female
4380
18324
22140
23544
15540
8832
<1
1-4
5-9
10-14
15-17
18-19
Male
4332
17388
23616
24480
15468
8904
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
94188
29.04%
21720
28668
25164
27864
30516
92760
29.93%
19956
23904
23856
26244
28800
186948
29.47%
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
133932
41.30%
31512
27876
20880
12816
122760
39.61%
30768
26820
21240
12900
256692
40.47%
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
93084
28.70%
2232
636
132
72
24
24
91728
29.59%
2124
432
96
36
12
0
184812
29.14%
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
3120
0.96%
0
2700
0.87%
0
5820
0.92%
324324
309948
HEDIS 2008 (Reporting Year 2007)
Total
8712
35712
45756
48024
31008
17736
41676
52572
49020
54108
59316
62280
54696
42120
25716
4356
1068
228
108
36
24
0
634272
Page 87
Health Plan Descriptive Information
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:34 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
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:34 PM
MSHO
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
NR
NR
NR
NR
NR
NR
Age Unknown
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2008 (Reporting Year 2007)
Page 89
Health Plan Descriptive Information
Preferred One Community Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:34 PM
Medicaid
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 90