Plan Name
HealthPartners and Group Health
Reporting Year
2007
Submission #
General Info
Disclaimers
Code
CIS
Plan ID
1
Last Refreshed:
Page
Childhood Immunization Status
10/7/2009 1:31:07 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
37
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
HealthPartners and Group Health
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:31 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
3891
79.51%
4179
85.39%
4510
92.15%
4095
83.67%
4081
83.39%
4379
89.48%
3889
79.46%
3483
71.17%
3381
69.08%
343
79.40%
371
85.88%
405
93.75%
369
85.42%
363
84.03%
395
91.44%
347
80.32%
318
73.61%
310
71.76%
326
43
89.78%
86.73%
92.83%
352
43
96.11%
94.12%
98.10%
387
10
96.59%
94.72%
98.47%
352
41
95.62%
93.52%
97.72%
344
47
95.13%
92.93%
97.34%
377
8
93.67%
91.20%
96.15%
330
38
89.54%
86.46%
92.62%
301
49
85.16%
81.60%
88.72%
293
48
82.97%
79.21%
86.72%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
1
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
4894
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
HealthPartners and Group Health
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:31 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
717
79.58%
798
88.57%
829
92.01%
764
84.79%
791
87.79%
815
90.46%
713
79.13%
666
73.92%
645
71.59%
346
80.09%
387
89.58%
400
92.59%
371
85.88%
383
88.66%
395
91.44%
340
78.70%
320
74.07%
305
70.60%
330
21
85.40%
81.87%
88.94%
369
23
95.38%
93.23%
97.53%
383
9
95.38%
93.23%
97.53%
355
27
92.94%
90.35%
95.54%
365
30
96.11%
94.12%
98.10%
378
10
94.40%
92.06%
96.75%
324
20
83.70%
80.01%
87.39%
306
36
83.21%
79.48%
86.95%
292
35
79.56%
75.54%
83.58%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
HEDIS 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
901
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
DTaP/DT
411
Page 4
Effectiveness of Care
HealthPartners and Group Health
Appropriate Treatment for Children with Upper
Respiratory Infection
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Commercial
Data Elements
Commercial
Medicaid
2007
2007
A
A
Eligible Member Population
7342
1845
Numerator Events by Admin Data
856
100
Reported Rate
88.34%
94.58%
Lower 95% Confidence Interval
87.60%
93.52%
Upper 95% Confidence Interval
89.08%
95.64%
Measurement Year
Data Collection Methodology
HEDIS 2008 (Reporting Year 2007)
Page 5
Effectiveness of Care
HealthPartners and Group Health
Colorectal Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Commercial
Medicare
Advantage
MSHO
2007
2007
2007
H
H
H
Eligible population
94680
937
1184
Number of numerator events by administrative data in eligible
population (before exclusions)
57038
567
448
60.24%
60.51%
37.84%
Minimum required sample size (MRSS) or other sample size
388
384
411
Oversampling rate
0.05
0.05
0.05
Final sample size (FSS)
408
404
432
Number of numerator events by administrative data in FSS
265
254
180
64.95%
62.87%
41.67%
Number of original sample records excluded because of valid data
errors
0
0
0
Number of administrative data records excluded
0
0
0
Number of medical record data records excluded
2
0
5
Number of employee/dependent medical records excluded
0
0
0
Records added from the oversample list
2
0
5
Denominator
388
384
411
Numerator events by administrative data
252
240
175
Numerator events by medical records
15
11
23
Reported rate
68.81%
65.36%
48.18%
Lower 95% confidence interval
64.08%
60.48%
43.22%
Upper 95% confidence interval
73.55%
70.25%
53.13%
Data Elements
Measurement Year
Data collection methodology (administrative or hybrid)
Current year's administrative rate (before exclusions)
Administrative rate on FSS
HEDIS 2008 (Reporting Year 2007)
Page 6
Effectiveness of Care
HealthPartners and Group Health
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:31 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
36662
26269
71.65%
71.19%
72.11%
43836
34931
79.69%
79.31%
80.06%
80498
61200
76.03%
75.73%
76.32%
2007
A
Page 7
Effectiveness of Care
HealthPartners and Group Health
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2008 (Reporting Year 2007)
General Measure
Data
Ages 42-51
Ages 52-69
Total
13
12
NA
NA
NA
91
65
71.43%
61.60%
81.26%
104
77
74.04%
65.13%
82.95%
2007
A
Page 8
Effectiveness of Care
HealthPartners and Group Health
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:31 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
197
123
62.44%
55.42%
69.45%
197
123
62.44%
55.42%
69.45%
2007
A
Page 9
Effectiveness of Care
HealthPartners and Group Health
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:31 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
779
395
50.71%
47.13%
54.28%
766
479
62.53%
59.04%
66.03%
1545
874
56.57%
54.07%
59.07%
2007
A
Page 10
Effectiveness of Care HealthPartners and Group Health
Cervical Cancer Screening
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2007
H
99064
2007
H
5281
Numerator Events by Admin Data on Eligible
Population (before exclusions)
76537
3772
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
77.26%
219
10.00%
241
206
85.48%
0
71.43%
260
10.00%
286
215
75.17%
0
Number of administrative data records excluded
0
0
Number of medical record data records excluded
4
9
Number of employee/dependent medical records
excluded
0
0
4
219
189
2
87.21%
82.56%
91.87%
9
260
201
13
82.31%
77.48%
87.14%
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
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 11
Effectiveness of Care
HealthPartners and Group Health
Chlamydia Screening in Women
Data Last Refreshed:
Oct 7, 2009 1:31 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
2007
A
General
Measure Ages 16-20 Ages 21-25
Data
Total
2007
A
8121
3372
41.52%
40.44%
42.60%
7834
3960
50.55%
49.44%
51.66%
15955
7332
45.95%
45.18%
46.73%
837
538
64.28%
60.97%
67.58%
983
647
65.82%
62.80%
68.83%
1820
1185
65.11%
62.89%
67.33%
Page 12
Effectiveness of Care
HealthPartners and Group Health
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Osteoporosis Management in Women Who had a Fracture
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interva
HEDIS 2008 (Reporting Year 2007)
Medicare
Advantage
MSHO
2007
A
85
9
10.59%
3.46%
17.72%
2007
A
86
13
15.12%
6.96%
23.27%
Page 13
Effectiveness of Care
HealthPartners and Group Health
Controlling High Blood Pressure
Data Last Refreshed:
Oct 7, 2009 1:31 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
Medicare Advantage
MSHO
2007
2007
2007
H
H
H
29256
575
668
0
0
0
0.00%
0.00%
0.00%
366
342
360
10.00%
10.00%
10.00%
403
377
396
0
0
0
0.00%
0.00%
0.00%
Records Excluded because of Valid Data
Errors
0
0
0
Number of administrative data records
excluded
0
0
0
Number of medical record data records
excluded
2
17
12
Number of employee/dependent medical
records excluded
0
0
0
Records Added from the OverSample List
2
17
12
366
342
360
0
0
0
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
261
257
264
Reported Rate
71.31%
75.15%
73.33%
Lower 95% Confidence Interval
66.54%
70.42%
68.63%
Upper 95% Confidence Interval
76.08%
79.87%
78.04%
HEDIS 2008 (Reporting Year 2007)
Page 14
Effectiveness of Care
HealthPartners and Group Health
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Commercial
Medicare Advantage
MSHO
Medicaid
2007
2007
2007
2007
A
A
A
A
Eligible Member Population
317
14
5
12
Numerator Events by Admin Data on
Eligible Population
264
14
3
9
Reported Rate
83.28%
NA
NA
NA
Lower 95% Confidence Interval
79.02%
NA
NA
NA
Upper 95% Confidence Interval
87.55%
NA
NA
NA
Measurement Year
Data Collection Methodology
HEDIS 2008 (Reporting Year 2007)
Page 15
Effectiveness of Care
HealthPartners and Group Health
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:31 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)
3219
1163
86.18%
31.14%
334
129
85.64%
33.08%
303
22
120
148
91.81%
88.81%
94.81%
75.71%
71.10%
80.31%
354
10.00%
390
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
3735
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
354
Page 16
Effectiveness of Care
HealthPartners and Group Health
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
0
Number of administrative data records excluded
0
Number of medical record data records excluded
0
Number of employee/dependent medical records
excluded
0
HEDIS 2008 (Reporting Year 2007)
38
32
79.17%
66.67%
38
32
79.17%
66.67%
38
0
32
1
79.17%
66.64%
91.70%
68.75%
54.60%
82.90%
48
0.00%
48
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
48
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
48
Page 17
Effectiveness of Care
HealthPartners and Group Health
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:31 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
1
Number of employee/dependent medical records
excluded
0
HEDIS 2008 (Reporting Year 2007)
76
47
81.72%
50.54%
76
47
81.72%
50.54%
76
1
47
12
83.70%
75.60%
91.79%
64.13%
53.79%
74.47%
93
0.00%
93
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
93
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
92
Page 18
Effectiveness of Care
HealthPartners and Group Health
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:31 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)
63
27
78.75%
33.75%
63
27
78.75%
33.75%
60
9
26
23
86.25%
78.08%
94.42%
61.25%
49.95%
72.55%
80
0.00%
80
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
80
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
80
Page 19
Effectiveness of Care
HealthPartners and Group Health
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:31 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
16355
2007
H
16355
2007
H
16355
2007
H
16355
2007
H
16355
2007
H
16355
2007
H
16355
2007
H
16355
2007
H
16355
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
14554
88.99%
411
10%
453
399
88.08%
11930
72.94%
411
10%
453
326
71.96%
2660
16.26%
411
10%
453
81
17.88%
9117
55.74%
411
10%
453
259
57.17%
13521
82.67%
411
10%
453
366
80.79%
3340
20.42%
411
10%
453
94
20.75%
13578
83.02%
411
10%
453
377
83.22%
4754
29.07%
411
10%
453
146
32.23%
3353
20.50%
411
10%
453
99
21.85%
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
15
15
15
15
15
15
15
15
15
0
0
0
0
0
0
0
0
0
15
411
371
15
93.92%
91.48%
96.35%
15
411
84
3
21.17%
17.10%
25.24%
15
411
74
135
50.85%
45.90%
55.81%
15
411
238
34
66.18%
61.48%
70.88%
15
411
336
22
87.10%
83.74%
90.47%
15
411
87
107
47.20%
42.25%
52.15%
15
411
345
19
88.56%
85.37%
91.76%
15
411
132
193
79.08%
75.02%
83.13%
15
411
89
131
53.53%
48.58%
58.47%
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
HealthPartners and Group Health
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2008 (Reporting Year 2007)
HbA1c
Testing
Poor HbA1c Good HbA1c
Control
Control
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
2007
H
138
2007
H
138
2007
H
138
2007
H
138
2007
H
138
2007
H
138
2007
H
138
2007
H
138
2007
H
138
127
92.03%
138
0%
138
127
92.70%
87.98%
97.42%
27
19.57%
138
0%
138
27
14.60%
8.32%
20.88%
71
51.45%
138
0%
138
71
54.74%
46.04%
63.44%
90
65.22%
138
0%
138
90
70.80%
62.82%
78.78%
111
80.43%
138
0%
138
111
80.29%
73.27%
87.32%
76
55.07%
138
0%
138
76
58.39%
49.78%
67.01%
123
89.13%
138
0%
138
123
89.05%
83.46%
94.64%
93
67.39%
138
0%
138
93
75.18%
67.58%
82.78%
72
52.17%
138
0%
138
72
56.20%
47.53%
64.88%
Page 21
Effectiveness of Care
HealthPartners and Group Health
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:31 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
377
2007
H
377
2007
H
377
2007
H
377
2007
H
377
2007
H
377
2007
H
377
2007
H
377
2007
H
377
338
89.66%
228
60.48%
101
26.79%
271
71.88%
302
80.11%
113
29.97%
328
87.00%
163
43.24%
119
31.56%
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
9
9
9
9
9
9
9
9
9
0
0
0
0
0
0
0
0
0
0
368
334
11
93.75%
91.14%
96.36%
0
368
68
0
18.48%
14.38%
22.58%
0
368
98
91
51.36%
46.12%
56.60%
0
368
267
27
79.89%
75.66%
84.12%
0
368
298
10
83.70%
79.79%
87.61%
0
368
111
103
58.15%
52.98%
63.33%
0
368
325
11
91.30%
88.29%
94.32%
0
368
156
128
77.17%
72.75%
81.60%
0
368
117
83
54.35%
49.12%
59.57%
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
HealthPartners and Group Health
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:31 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
899
2007
H
899
2007
H
899
2007
H
899
2007
H
899
2007
H
899
2007
H
899
2007
H
899
2007
H
899
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
742
82.54%
411
10%
453
377
83.22%
567
63.07%
411
10%
453
285
62.91%
190
21.13%
411
10%
453
93
20.53%
495
55.06%
411
10%
453
240
52.98%
640
71.19%
411
10%
453
322
71.08%
225
25.03%
411
10%
453
114
25.17%
686
76.31%
411
10%
453
341
75.28%
402
44.72%
411
10%
453
200
44.15%
280
31.15%
411
10%
453
144
31.79%
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
9
9
9
9
9
9
9
9
9
0
0
0
0
0
0
0
0
0
9
411
350
15
88.81%
85.64%
91.98%
9
411
120
4
30.17%
25.61%
34.73%
9
411
87
77
39.90%
35.05%
44.76%
9
411
225
46
65.94%
61.23%
70.64%
9
411
298
16
76.40%
72.17%
80.63%
9
411
106
76
44.28%
39.36%
49.21%
9
411
317
29
84.18%
80.54%
87.83%
9
411
181
119
72.99%
68.58%
77.41%
9
411
131
79
51.09%
46.14%
56.05%
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
HealthPartners and Group Health
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:31 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
552
538
97.46%
96.06%
98.87%
778
741
95.24%
93.68%
96.80%
3554
3249
91.42%
90.48%
92.35%
4884
4528
92.71%
91.97%
93.45%
2007
A
Page 24
Effectiveness of Care
HealthPartners and Group Health
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:31 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
83
78
93.98%
88.25%
99.70%
115
104
90.43%
84.62%
96.25%
195
166
85.13%
79.88%
90.38%
393
348
88.55%
85.27%
91.83%
2007
A
Page 25
Effectiveness of Care
HealthPartners and Group Health
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:31 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
631
15.72%
14.58%
16.85%
2936
73.13%
71.74%
74.51%
2320
57.78%
56.24%
59.32%
2007
A
4015
Page 26
Effectiveness of Care
HealthPartners and Group Health
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:31 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
2
5.71%
0.00%
14.83%
23
65.71%
48.56%
82.87%
19
54.29%
36.35%
72.22%
2007
A
35
Page 27
Effectiveness of Care
HealthPartners and Group Health
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:31 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
6
17.65%
3.36%
31.93%
19
55.88%
37.72%
74.04%
17
50.00%
31.72%
68.28%
2007
A
34
Page 28
Effectiveness of Care
HealthPartners and Group Health
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:31 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
75
21.68%
17.19%
26.16%
162
46.82%
41.42%
52.22%
104
30.06%
25.08%
35.03%
2007
A
346
Page 29
Effectiveness of Care
HealthPartners and Group Health
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 7, 2009 1:31 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
2007
A
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
155
57
36.77%
28.86%
44.69%
36
15
41.67%
24.17%
59.16%
2007
A
730
235
32.19%
28.73%
35.65%
246
95
38.62%
32.33%
44.91%
Page 30
Effectiveness of Care HealthPartners and Group Health
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 1:31 PM
Medicare
Advantage
MSHO
2007
A
1789
1440
80.49%
78.63%
82.36%
2007
A
1774
1330
74.97%
72.93%
77.02%
Page 31
Effectiveness of Care
HealthPartners and Group Health
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:31 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
25415
20069
78.97%
78.46%
79.47%
542
447
82.47%
79.18%
85.77%
22768
18023
79.16%
78.63%
79.69%
1629
1121
68.82%
66.53%
71.10%
50354
39660
78.76%
78.40%
79.12%
2007
A
Page 32
Effectiveness of Care
HealthPartners and Group Health
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:31 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
685
627
91.53%
89.38%
93.69%
77
74
96.10%
91.13%
100.00%
842
780
92.64%
90.81%
94.46%
67
54
80.60%
70.38%
90.81%
1671
1535
91.86%
90.52%
93.20%
2007
A
Page 33
Effectiveness of Care
HealthPartners and Group Health
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:31 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
772
709
91.84%
89.84%
93.84%
89
87
97.75%
94.11%
100.00%
834
786
94.24%
92.60%
95.89%
125
109
87.20%
80.94%
93.46%
1820
1691
92.91%
91.71%
94.12%
2007
A
Page 34
Effectiveness of Care
HealthPartners and Group Health
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:31 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
602
516
85.71%
82.84%
88.59%
21
18
NA
NA
NA
561
481
85.74%
82.76%
88.72%
109
84
77.06%
68.71%
85.42%
1293
1099
85.00%
83.01%
86.98%
2007
A
Page 35
Effectiveness of Care
HealthPartners and Group Health
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2008 (Reporting Year 2007)
General
Measure
Data
2007
A
1909
MSHO
1 or More
Prescriptions
2 or More
Prescriptions
262
13.72%
12.15%
15.29%
27
1.41%
0.86%
1.97%
General
Measure
Data
2007
A
2308
1 or More
Prescriptions
2 or More
Prescriptions
444
19.24%
17.61%
20.87%
71
3.08%
2.35%
3.80%
Page 36
Effectiveness of Care
HealthPartners and Group Health
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
Drug-Disease Interactions
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2008 (Reporting Year 2007)
General
Measure
Data
History of Falls +
Dementia +
Chronic Renal
Tricyclic
Tricyclic
Failure +
Antidepressants, Antidepressants or Nonaspirin NSAIDs
Antipsychotics or
Anticholinergic or Cox-2 Selective
Sleep Agents
Agents
NSAIDs
Total
2007
A
183
23
12.57%
7.49%
17.64%
370
55
14.86%
11.10%
18.62%
33
3
9.09%
0.00%
20.41%
586
81
13.82%
10.94%
16.70%
Page 37
Effectiveness of Care
HealthPartners and Group Health
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:31 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
143
31
21.68%
14.57%
28.78%
538
117
21.75%
18.17%
25.33%
45
1
2.22%
0.00%
7.64%
726
149
20.52%
17.52%
23.53%
Page 38
Use of Services
HealthPartners and Group Health
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
0
Number of records excluded because of
contraindications identified through
administrative data
0
Number of records excluded because of
contraindications identified through medical
record review
0
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Oversample List
0
HEDIS 2008 (Reporting Year 2007)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
26
0.57%
25
0.54%
31
0.67%
79
1.72%
184
4.00%
686
14.92%
3566
77.57%
5
1.83%
0
0.00%
3
1.10%
3
1.10%
11
4.03%
37
13.55%
214
78.39%
0
1
0.38%
0.00%
1.33%
0
0
0.00%
0.00%
0.19%
0
1
0.38%
0.00%
1.33%
0
0
0.00%
0.00%
0.19%
0
9
3.46%
1.05%
5.88%
0
29
11.15%
7.14%
15.17%
203
17
84.62%
80.04%
89.19%
260
5.00%
273
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
4597
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
260
Page 39
Use of Services
HealthPartners and Group Health
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
0
Number of records excluded because of
contraindications identified through
administrative data
0
Number of records excluded because of
contraindications identified through medical
record review
0
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Oversample List
0
HEDIS 2008 (Reporting Year 2007)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
25
1.83%
34
2.48%
38
2.78%
71
5.19%
141
10.30%
265
19.36%
795
58.07%
7
1.91%
8
2.19%
12
3.28%
26
7.10%
38
10.38%
67
18.31%
208
56.83%
0
2
0.57%
0.00%
1.51%
0
3
0.86%
0.00%
1.98%
0
3
0.86%
0.00%
1.98%
0
12
3.45%
1.39%
5.51%
0
26
7.47%
4.57%
10.38%
0
48
13.79%
10.03%
17.56%
205
49
72.99%
68.18%
77.80%
348
5.00%
366
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
1369
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
348
Page 40
Use of Services
HealthPartners and Group Health
Well Child Visits in the 3rd, 4th,
5th and 6th Years of Life
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2007
H
22855
2007
H
2846
Numerator events by admin data in eligible
population
14547
1948
63.65%
388
5.00%
408
268
68.45%
342
5.00%
360
252
65.69%
0
70.00%
0
Records Excluded - Contraindications/Admin Data
0
0
Records Excluded - Contraindications/Medical
Record Review
0
0
Number of employee/dependent medical records
excluded
0
0
0
388
258
15
70.36%
65.69%
75.03%
0
342
237
12
72.81%
67.94%
77.67%
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
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 41
Use of Services
HealthPartners and Group Health
Adolescent Well-Care Visits
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2007
H
64324
2007
H
5447
Numerator events by admin data in eligible
population
21829
2032
33.94%
411
5.00%
432
139
37.30%
411
5.00%
432
163
32.18%
0
37.73%
0
Records Excluded - Contraindications/Admin Data
0
0
Records Excluded - Contraindications/Medical
Record Review
0
0
Number of employee/dependent medical records
excluded
0
0
0
411
134
32
40.39%
35.52%
45.25%
0
411
159
45
49.64%
44.68%
54.59%
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
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 42
Use of Services
HealthPartners and Group Health
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Commercial
Member Months
Total
388482
788398
1296311
896395
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
2110
496
691
319
Procedures /
1,000 Member
Months
5.43
0.38
0.88
0.36
Member Months
Male
Female
1316637
952205
1089204
1573540
928253
1027039
68623
64296
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
51
0.03
6
313
23
214
434
45
544
69
580
106
130
34
294
68
0.09
0.20
0.34
0.22
0.47
0.66
0.59
1.01
0.62
1.54
0.14
0.50
0.32
0.99
Number of
Procedures
74
106
287
426
7
188
260
11
Procedures /
1,000 Member
Months
0.06
0.10
0.22
0.41
0.11
0.14
0.25
0.17
24
34
5
0.02
0.03
0.08
494
489
23
204
386
35
152
24
363
48
30
4
0.38
0.48
0.36
0.19
0.38
0.54
0.15
0.37
0.35
0.75
0.03
0.06
43
150
13
225
457
21
0.03
0.15
0.20
0.17
0.44
0.33
Page 43
Use of Services
HealthPartners and Group Health
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
Age
< 65
65-74
75-84
85+
Member Months
Male
Female
633
808
1783
3835
3664
8226
2031
5417
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
1
2
3
0
4
5
1
1
1
6
1
0
1
3
0
0
1
0
2
1
0
2
0
0
2
3
0
0
0
2
1
0
0
1
1
0
0
0
0
1
3
3
0
Procedures /
1,000 Member
Months
0.00
0.56
0.55
1.48
0.00
2.24
1.36
0.49
1.58
0.56
1.64
0.49
0.00
0.56
0.82
0.00
0.00
0.56
0.00
0.98
1.58
0.00
0.55
0.00
0.00
1.12
0.82
0.00
0.00
0.00
0.55
0.49
0.00
0.00
0.27
0.49
0.00
0.00
0.00
0.00
1.58
1.68
0.82
0.00
Female
Number of
Procedures
0
0
1
0
0
3
9
6
4
5
9
3
0
0
6
0
0
1
8
10
0
5
9
1
1
7
7
2
0
2
3
3
1
0
0
0
0
1
5
4
2
1
7
2
0
0
2
0
0
1
0
0
0
0
4
1
0
0
4
1
Procedures /
1,000 Member
Months
0.00
0.00
0.12
0.00
0.00
0.78
1.09
1.11
4.95
1.30
1.09
0.55
0.00
0.00
0.73
0.00
0.00
0.26
0.97
1.85
0.00
1.30
1.09
0.18
1.24
1.83
0.85
0.37
0.00
0.52
0.36
0.55
1.24
0.00
0.00
0.00
0.00
0.26
0.61
0.74
2.48
0.26
0.85
0.37
0.00
0.00
0.24
0.00
0.00
0.26
0.00
0.00
0.00
0.00
0.49
0.18
0.00
0.00
0.49
0.18
Page 44
Use of Services
HealthPartners and Group Health
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:31 PM
MSHO
Age
< 65
65-74
75-84
85+
Member Months
Male
Female
0
0
4317
7997
2828
7578
1346
6623
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
2
0
0
0
2
5
0
0
8
8
0
0
1
1
0
0
0
2
0
0
1
0
1
0
1
0
0
0
1
1
0
0
1
0
0
0
4
0
0
0
3
2
0
Procedures /
1,000 Member
Months
NA
0.46
0.00
0.00
NA
0.46
1.77
0.00
NA
1.85
2.83
0.00
NA
0.23
0.35
0.00
NA
0.00
0.71
0.00
NA
0.23
0.00
0.74
NA
0.23
0.00
0.00
NA
0.23
0.35
0.00
NA
0.23
0.00
0.00
NA
0.93
0.00
0.00
NA
0.69
0.71
0.00
Female
Number of
Procedures
0
0
1
0
0
6
2
3
0
7
6
0
0
1
0
1
0
0
3
13
0
1
2
1
0
9
1
0
0
3
3
3
0
3
1
0
0
3
2
2
0
4
1
0
0
1
0
0
0
1
2
0
0
1
1
11
0
3
1
0
Procedures /
1,000 Member
Months
NA
0.00
0.13
0.00
NA
0.75
0.26
0.45
NA
0.88
0.79
0.00
NA
0.13
0.00
0.15
NA
0.00
0.40
1.96
NA
0.13
0.26
0.15
NA
1.13
0.13
0.00
NA
0.38
0.40
0.45
NA
0.38
0.13
0.00
NA
0.38
0.26
0.30
NA
0.50
0.13
0.00
NA
0.13
0.00
0.00
NA
0.13
0.26
0.00
NA
0.13
0.13
1.66
NA
0.38
0.13
0.00
Page 45
Use of Services
HealthPartners and Group Health
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicaid
Member Months
Total
109664
185599
206318
130383
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
270
108
97
52
Procedures /
1,000 Member
Months
2.46
0.52
0.52
0.40
Member Months
Male
Female
153434
60572
120173
64035
29367
32746
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
4
0.06
11
24
36
Number of
Procedures
7
1
25
16
19
6
Procedures /
1,000 Member
Months
0.05
0.03
0.16
0.49
0.12
0.18
3
4
0.02
0.12
91
22
40
20
1
5
26
10
0.59
0.67
0.33
0.61
0.01
0.15
0.17
0.31
0.17
0.40
1.23
Page 46
Use of Services
HealthPartners and Group Health
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 1:31 PM
Member Months
75671
712727
896395
2041409
1955292
95868
29910
7141
0
5814413
Discharges
Discharges /
1,000 Member
Months
525
1099
1516
12254
13408
1346
720
235
0
31103
6.94
1.54
1.69
6.00
6.86
14.04
24.07
32.91
412
821
754
2548
6168
702
451
183
0
12039
5.44
1.15
0.84
1.25
3.15
7.32
15.08
25.63
113
278
550
2731
7220
643
269
52
0
11856
1.49
0.39
0.61
1.34
3.69
6.71
8.99
7.28
210
6972
19
0
7201
HEDIS 2008 (Reporting Year 2007)
5.35
2.07
2.04
0.23
3.42
0.01
1.47
Days
Days / 1,000
Member
Months
2093
3140
4651
34069
46899
5218
3042
925
0
100037
27.66
4.41
5.19
16.69
23.99
54.43
101.71
129.53
1279
1973
2256
7719
21025
2561
1678
629
0
39120
16.90
2.77
2.52
3.78
10.75
26.71
56.10
88.08
814
1167
1840
7941
25810
2655
1364
296
0
41887
10.76
1.64
2.05
3.89
13.20
27.69
45.60
41.45
526
18403
62
0
18991
0.59
9.01
0.03
17.21
6.73
7.20
3.88
Average
Length of Stay
3.99
2.86
3.07
2.78
3.50
3.88
4.23
3.94
NA
3.22
3.10
2.40
2.99
3.03
3.41
3.65
3.72
3.44
NA
3.25
7.20
4.20
3.35
2.91
3.57
4.13
5.07
5.69
NA
3.53
2.50
2.64
3.26
NA
2.64
Page 47
Use of Services
HealthPartners and Group Health
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
Age
Member Months
<1
0
1-9
0
10-19
0
20-44
232
45-64
1209
65-74
5618
75-84
11890
85+
7448
Unknown
0
26397
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
0
0
0
14
39
152
458
304
0
967
NA
NA
NA
60.34
32.26
27.06
38.52
40.82
0
0
0
12
27
99
314
216
0
668
NA
NA
NA
51.72
22.33
17.62
26.41
29.00
0
0
0
2
12
53
144
88
0
299
NA
NA
NA
8.62
9.93
9.43
12.11
11.82
0
0
0
0
0
NA
0.00
0.00
HEDIS 2008 (Reporting Year 2007)
36.63
25.31
11.33
0.00
Days
Days / 1,000
Member
Months
0
0
0
72
145
610
2195
1587
0
4609
NA
NA
NA
310.34
119.93
108.58
184.61
213.08
0
0
0
55
92
372
1357
990
0
2866
NA
NA
NA
237.07
76.10
66.22
114.13
132.92
0
0
0
17
53
238
838
597
0
1743
NA
NA
NA
73.28
43.84
42.36
70.48
80.16
0
0
0
0
0
174.60
108.57
66.03
NA
0.00
0.00
0.00
Average
Length of Stay
NA
NA
NA
5.14
3.72
4.01
4.79
5.22
NA
4.77
NA
NA
NA
4.58
3.41
3.76
4.32
4.58
NA
4.29
NA
NA
NA
8.50
4.42
4.49
5.82
6.78
NA
5.83
NA
NA
NA
NA
NA
Page 48
Use of Services
HealthPartners and Group Health
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 1:31 PM
Member Months
0
0
0
0
0
12314
10406
7969
0
30689
Discharges
0
0
0
0
0
435
447
308
0
1190
Discharges /
1,000 Member
Months
NA
NA
NA
NA
NA
35.33
42.96
38.65
38.78
0
0
0
0
0
341
364
252
0
957
NA
NA
NA
NA
NA
27.69
34.98
31.62
0
0
0
0
0
94
83
56
0
233
NA
NA
NA
NA
NA
7.63
7.98
7.03
0
0
0
0
0
HEDIS 2008 (Reporting Year 2007)
31.18
7.59
NA
NA
NA
NA
Days
0
0
0
0
0
1921
2206
1474
0
5601
Days / 1,000
Member
Months
NA
NA
NA
NA
NA
156.00
211.99
184.97
182.51
0
0
0
0
0
1352
1696
1021
0
4069
NA
NA
NA
NA
NA
109.79
162.98
128.12
0
0
0
0
0
569
510
453
0
1532
NA
NA
NA
NA
NA
46.21
49.01
56.85
0
0
0
0
0
132.59
49.92
NA
NA
NA
NA
Average
Length of Stay
NA
NA
NA
NA
NA
4.42
4.94
4.79
NA
4.71
NA
NA
NA
NA
NA
3.96
4.66
4.05
NA
4.25
NA
NA
NA
NA
NA
6.05
6.14
8.09
NA
6.58
NA
NA
NA
NA
NA
Page 49
Use of Services
HealthPartners and Group Health
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 1:31 PM
Member Months
33446
152153
130383
180745
62113
11895
6756
3876
0
581367
Discharges
Discharges /
1,000 Member
Months
324
369
572
3424
986
288
202
105
0
6270
9.69
2.43
4.39
18.94
15.87
24.21
29.90
27.09
286
305
131
773
618
229
164
89
0
2595
8.55
2.00
1.00
4.28
9.95
19.25
24.27
22.96
38
64
76
386
363
59
38
16
0
1040
1.14
0.42
0.58
2.14
5.84
4.96
5.62
4.13
365
2265
5
0
2635
HEDIS 2008 (Reporting Year 2007)
10.78
4.46
1.79
2.80
12.53
0.08
7.06
Days
Days / 1,000
Member
Months
1522
1141
1634
9401
3643
1308
991
469
0
20109
45.51
7.50
12.53
52.01
58.65
109.96
146.68
121.00
1078
888
530
2422
1980
958
713
400
0
8969
32.23
5.84
4.06
13.40
31.88
80.54
105.54
103.20
444
253
212
1370
1650
350
278
69
0
4626
13.28
1.66
1.63
7.58
26.56
29.42
41.15
17.80
892
5609
13
0
6514
6.84
31.03
0.21
34.59
15.43
7.96
17.45
Average
Length of Stay
4.70
3.09
2.86
2.75
3.69
4.54
4.91
4.47
NA
3.21
3.77
2.91
4.05
3.13
3.20
4.18
4.35
4.49
NA
3.46
11.68
3.95
2.79
3.55
4.55
5.93
7.32
4.31
NA
4.45
2.44
2.48
2.60
NA
2.47
Page 50
Use of Services
HealthPartners and Group Health
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
75671
712727
896395
2041409
1955292
95868
29910
7141
0
5814413
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
Visits
67406
220953
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
201404
540268
701363
50260
19805
4131
0
1805590
HEDIS 2008 (Reporting Year 2007)
Visits/ 1,000
Member
Months
890.78
310.01
224.68
264.65
358.70
524.26
662.15
578.49
310.54
Emergency Room Visits
Visits
2247
11104
10290
23578
18559
1273
586
186
0
67823
Visits/ 1,000
Member
Months
29.69
15.58
11.48
11.55
9.49
13.28
19.59
26.05
11.66
Ambulatory
Surgery/Procedures
Procedures
610
3568
3062
16871
40064
3091
1047
179
0
68492
Procedures/
1,000 Member
Months
8.06
5.01
3.42
8.26
20.49
32.24
35.01
25.07
11.78
Observation Room Stays
Resulting in Discharge
Stays
37
37
81
1161
95
8
2
0
0
1421
Stays/ 1,000
Member
Months
0.49
0.05
0.09
0.57
0.05
0.08
0.07
0.00
0.24
Page 51
Use of Services
HealthPartners and Group Health
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
0
232
1209
5618
11890
7448
0
26397
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
115
781
3176
7276
3674
0
15022
HEDIS 2008 (Reporting Year 2007)
Visits/ 1,000
Member
Months
NA
NA
NA
495.69
645.99
565.33
611.94
493.29
569.08
Emergency Room Visits
Visits
0
0
0
18
37
108
288
187
0
638
Visits/ 1,000
Member
Months
NA
NA
NA
77.59
30.60
19.22
24.22
25.11
24.17
Ambulatory
Surgery/Procedures
Procedures
0
0
0
8
26
166
382
106
0
688
Procedures/
1,000 Member
Months
NA
NA
NA
34.48
21.51
29.55
32.13
14.23
26.06
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
1
0
1
0
2
Stays/ 1,000
Member
Months
NA
NA
NA
0.00
0.00
0.18
0.00
0.13
0.08
Page 52
Use of Services
HealthPartners and Group Health
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:31 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
12314
10406
7969
0
30689
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
7659
5370
2235
0
15264
HEDIS 2008 (Reporting Year 2007)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
621.97
516.05
280.46
497.38
Emergency Room Visits
Visits
0
0
0
0
0
380
367
185
0
932
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
30.86
35.27
23.21
30.37
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
0
405
226
69
0
700
Procedures/
1,000 Member
Months
NA
NA
NA
NA
NA
32.89
21.72
8.66
22.81
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
1
0
2
0
3
Stays/ 1,000
Member
Months
NA
NA
NA
NA
NA
0.08
0.00
0.25
0.10
Page 53
Use of Services
HealthPartners and Group Health
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicaid
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
33446
152153
130383
180745
62113
11895
6756
3876
0
581367
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
Visits
23538
44517
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
30204
73070
31026
6485
3199
1025
0
213064
HEDIS 2008 (Reporting Year 2007)
Visits/ 1,000
Member
Months
703.76
292.58
231.66
404.27
499.51
545.19
473.51
264.45
366.49
Emergency Room Visits
Visits
2987
6468
3569
11163
2747
350
187
98
0
27569
Visits/ 1,000
Member
Months
89.31
42.51
27.37
61.76
44.23
29.42
27.68
25.28
47.42
Ambulatory
Surgery/Procedures
Procedures
162
572
514
2765
1507
282
155
21
0
5978
Procedures/
1,000 Member
Months
4.84
3.76
3.94
15.30
24.26
23.71
22.94
5.42
10.28
Observation Room Stays
Resulting in Discharge
Stays
10
6
146
751
13
2
0
2
0
930
Stays/ 1,000
Member
Months
0.30
0.04
1.12
4.16
0.21
0.17
0.00
0.52
1.60
Page 54
Use of Services
HealthPartners and Group Health
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Commercial
Age
Member
Months
<1
75671
1-9
712727
10-19
896395
20-44
2041409
45-64
1955292
65-74
95868
75-84
29910
85+
7141
Unknown
Total
0
5814413
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
2
0.00
74
0.10
37.00
10-19
10
0.01
231
0.26
23.10
20-44
79
0.04
1340
0.66
16.96
45-64
721
0.37
10210
5.22
14.16
65-74
103
1.07
1717
17.91
16.67
75-84
122
4.08
2957
98.86
24.24
85+
58
8.12
1622
227.14
27.97
0.19
0
18151
3.12
NA
16.58
Age
Unknown
Total
0
1095
HEDIS 2008 (Reporting Year 2007)
Page 55
Use of Services
HealthPartners and Group Health
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
Age
Member
Months
<1
0
1-9
0
10-19
0
20-44
232
45-64
1209
65-74
5618
75-84
11890
85+
7448
Unknown
0
26397
Total
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
Days
Days / 1,000
Member
Months
Average Length
of Stay
NA
0
NA
NA
0
NA
0
NA
NA
10-19
0
NA
0
NA
NA
20-44
0
0.00
0
0.00
NA
45-64
9
7.44
115
95.12
12.78
65-74
38
6.76
522
92.92
13.74
75-84
207
17.41
3838
322.79
18.54
85+
173
23.23
3739
502.01
21.61
Unknown
0
427
16.18
0
8214
311.17
NA
19.24
Age
Total
HEDIS 2008 (Reporting Year 2007)
Page 56
Use of Services
HealthPartners and Group Health
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:31 PM
MSHO
Age
Member
Months
<1
0
1-9
0
10-19
0
20-44
0
45-64
0
65-74
12314
75-84
10406
85+
7969
Unknown
0
30689
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
132
10.72
3968
322.23
30.06
75-84
217
20.85
7172
689.22
33.05
85+
197
24.72
7328
919.56
37.20
Unknown
0
546
17.79
0
18468
601.78
NA
33.82
Age
Total
HEDIS 2008 (Reporting Year 2007)
Page 57
Use of Services
HealthPartners and Group Health
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicaid
Age
Member
Months
<1
33446
1-9
152153
10-19
130383
20-44
180745
45-64
62113
65-74
11895
75-84
6756
85+
3876
Unknown
Total
0
581367
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
1
0.01
7
0.05
7.00
10-19
0
0.00
0
0.00
NA
20-44
10
0.06
110
0.61
11.00
45-64
10
0.16
111
1.79
11.10
65-74
50
4.20
994
83.56
19.88
75-84
76
11.25
1499
221.88
19.72
85+
78
20.12
1886
486.58
24.18
Unknown
0
225
0.39
0
4607
7.92
NA
20.48
Age
Total
HEDIS 2008 (Reporting Year 2007)
Page 58
Use of Services
ers and Group Health
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:31 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
507472
229240
1041656
468936
534184
239696
507472
229240
1041656
468936
534184
239696
507472
229240
1041656
468936
534184
239696
507472
229240
1041656
468936
1968539
68623
0
2811042
2202363
64296
0
3003371
4170902
132919
0
5814413
1968539
68623
0
2811042
2202363
64296
0
3003371
4170902
132919
0
5814413
1968539
68623
0
2811042
2202363
64296
0
3003371
4170902
132919
0
5814413
1968539
68623
0
2811042
2202363
64296
0
3003371
4170902
132919
0
5814413
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)
534184
239696
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
2827
1518
4345
2467
2639
5106
10928
20793
31721
175
252
427
0
0
0
16397
25202
41599
6.35%
3.59%
5.01%
12.35%
13.81%
13.07%
6.66%
11.33%
9.13%
3.06%
4.70%
3.85%
NA
NA
NA
7.00%
10.07%
8.59%
37
21
58
122
187
309
337
540
877
5
9
14
0
0
0
501
757
1258
0.08%
0.05%
0.07%
0.61%
0.98%
0.79%
0.21%
0.29%
0.25%
0.09%
0.17%
0.13%
NA
NA
NA
0.21%
0.30%
0.26%
160
85
245
232
239
471
442
782
1224
3
5
8
0
0
0
837
1111
1948
0.36%
0.20%
0.28%
1.16%
1.25%
1.21%
0.27%
0.43%
0.35%
0.05%
0.09%
0.07%
NA
NA
NA
0.36%
0.44%
0.40%
2747
1464
4211
2371
2564
4935
10642
20392
31034
172
243
415
0
0
0
15932
24663
40595
6.17%
3.46%
4.85%
11.87%
13.42%
12.63%
6.49%
11.11%
8.93%
3.01%
4.54%
3.75%
NA
NA
NA
6.80%
9.85%
8.38%
HEDIS 2008 (Reporting Year 2007)
Page 59
Use of Services
ers and Group Health
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
Member Months
(Inpatient)
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
Total
Male
Female
Total
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
633
7478
0
8111
808
17478
0
18286
1441
24956
0
26397
633
7478
0
8111
808
17478
0
18286
1441
24956
0
26397
633
7478
0
8111
808
17478
0
18286
Any Services
Age
0-12
Sex
M
F
Total
13-17
M
F
Total
18-64
M
F
Total
65+
M
F
Unknown
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
Total
M
F
Total
M
F
Total
Male
Female
Total
0
0
0
0
0
0
0
0
1441
24956
0
26397
633
7478
0
8111
808
17478
0
18286
1441
24956
0
26397
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
21
32
53
28
77
105
0
0
0
49
109
158
NA
NA
NA
NA
NA
NA
39.81%
47.52%
44.14%
4.49%
5.29%
5.05%
NA
NA
NA
7.25%
7.15%
7.18%
0
0
0
0
0
0
0
2
2
6
12
18
0
0
0
6
14
20
NA
NA
NA
NA
NA
NA
0.00%
2.97%
1.67%
0.96%
0.82%
0.87%
NA
NA
NA
0.89%
0.92%
0.91%
0
0
0
0
0
0
1
1
2
0
0
0
0
0
0
1
1
2
NA
NA
NA
NA
NA
NA
1.90%
1.49%
1.67%
0.00%
0.00%
0.00%
NA
NA
NA
0.15%
0.07%
0.09%
0
0
0
0
0
0
20
32
52
22
67
89
0
0
0
42
99
141
NA
NA
NA
NA
NA
NA
37.91%
47.52%
43.30%
3.53%
4.60%
4.28%
NA
NA
NA
6.21%
6.50%
6.41%
HEDIS 2008 (Reporting Year 2007)
Page 60
Use of Services
ers and Group Health
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:31 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
8491
0
8491
0
22198
0
22198
0
30689
0
30689
0
8491
0
8491
0
22198
0
22198
0
30689
0
30689
0
8491
0
8491
0
22198
0
22198
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
30689
0
30689
0
8491
0
8491
0
22198
0
22198
0
30689
0
30689
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
97
240
337
0
0
0
97
240
337
NA
NA
NA
NA
NA
NA
NA
NA
NA
13.71%
12.97%
13.18%
NA
NA
NA
13.71%
12.97%
13.18%
0
0
0
0
0
0
0
0
0
25
42
67
0
0
0
25
42
67
NA
NA
NA
NA
NA
NA
NA
NA
NA
3.53%
2.27%
2.62%
NA
NA
NA
3.53%
2.27%
2.62%
0
0
0
0
0
0
0
0
0
5
4
9
0
0
0
5
4
9
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.71%
0.22%
0.35%
NA
NA
NA
0.71%
0.22%
0.35%
0
0
0
0
0
0
0
0
0
79
208
287
0
0
0
79
208
287
NA
NA
NA
NA
NA
NA
NA
NA
NA
11.16%
11.24%
11.22%
NA
NA
NA
11.16%
11.24%
11.22%
HEDIS 2008 (Reporting Year 2007)
Page 61
Use of Services
ers and Group Health
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicaid
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Male
Female
Total
Male
Female
Total
115534
33513
110657
33907
226191
67420
115534
33513
110657
33907
226191
67420
115534
33513
110657
33907
99327
7632
0
256006
165902
14895
0
325361
265229
22527
0
581367
99327
7632
0
256006
165902
14895
0
325361
265229
22527
0
581367
99327
7632
0
256006
165902
14895
0
325361
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
226191
67420
115534
33513
110657
33907
226191
67420
265229
22527
0
581367
99327
7632
0
256006
165902
14895
0
325361
265229
22527
0
581367
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
802
470
1272
405
453
858
1726
3122
4848
66
130
196
0
0
0
2999
4175
7174
8.33%
5.10%
6.75%
14.50%
16.03%
15.27%
20.85%
22.58%
21.93%
10.38%
10.47%
10.44%
NA
NA
NA
14.06%
15.40%
14.81%
12
4
16
14
37
51
122
182
304
10
21
31
0
0
0
158
244
402
0.12%
0.04%
0.08%
0.50%
1.31%
0.91%
1.47%
1.32%
1.38%
1.57%
1.69%
1.65%
NA
NA
NA
0.74%
0.90%
0.83%
55
32
87
40
55
95
178
291
469
3
6
9
0
0
0
276
384
660
0.57%
0.35%
0.46%
1.43%
1.95%
1.69%
2.15%
2.10%
2.12%
0.47%
0.48%
0.48%
NA
NA
NA
1.29%
1.42%
1.36%
779
453
1232
387
425
812
1602
2963
4565
57
109
166
0
0
0
2825
3950
6775
8.09%
4.91%
6.54%
13.86%
15.04%
14.45%
19.35%
21.43%
20.65%
8.96%
8.78%
8.84%
NA
NA
NA
13.24%
14.57%
13.98%
HEDIS 2008 (Reporting Year 2007)
Page 62
ers and Group Health
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
534184
239696
239614
336818
1392107
68623
0
2811042
Female
507472
229240
261738
405788
1534837
64296
0
3003371
Member Months
(Inpatient)
Total
1041656
468936
501352
742606
2926944
132919
0
5814413
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
10
10
20
568
354
922
790
461
1251
715
417
1132
2697
1598
4295
97
46
143
0
0
0
4877
2886
7763
HEDIS 2008 (Reporting Year 2007)
Male
534184
239696
239614
336818
1392107
68623
0
2811042
Female
507472
229240
261738
405788
1534837
64296
0
3003371
Total
1041656
468936
501352
742606
2926944
132919
0
5814413
Inpatient
Percent
0.02%
0.02%
0.02%
2.84%
1.85%
2.36%
3.96%
2.11%
2.99%
2.55%
1.23%
1.83%
2.32%
1.25%
1.76%
1.70%
0.86%
1.29%
NA
NA
NA
2.08%
1.15%
1.60%
Number
5
7
12
106
99
205
130
95
225
120
94
214
716
434
1150
46
25
71
0
0
0
1123
754
1877
Percent
0.01%
0.02%
0.01%
0.53%
0.52%
0.52%
0.65%
0.44%
0.54%
0.43%
0.28%
0.35%
0.62%
0.34%
0.47%
0.80%
0.47%
0.64%
NA
NA
NA
0.48%
0.30%
0.39%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
534184
507472
1041656
239696
229240
468936
239614
261738
501352
336818
405788
742606
1392107
1534837
2926944
68623
64296
132919
0
0
0
2811042
3003371
5814413
Member Months
(Outpatient/ED)
Male
534184
239696
239614
336818
1392107
68623
0
2811042
Female
507472
229240
261738
405788
1534837
64296
0
3003371
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
162
78
240
98
35
133
95
43
138
271
130
401
4
0
4
0
0
0
630
286
916
Number
5
4
9
517
300
817
687
392
1079
637
364
1001
2229
1329
3558
56
25
81
0
0
0
4131
2414
6545
Percent
0.00%
0.00%
0.00%
0.81%
0.41%
0.61%
0.49%
0.16%
0.32%
0.34%
0.13%
0.22%
0.23%
0.10%
0.16%
0.07%
0.00%
0.04%
NA
NA
NA
0.27%
0.11%
0.19%
Total
1041656
468936
501352
742606
2926944
132919
0
5814413
Percent
0.01%
0.01%
0.01%
2.59%
1.57%
2.09%
3.44%
1.80%
2.58%
2.27%
1.08%
1.62%
1.92%
1.04%
1.46%
0.98%
0.47%
0.73%
NA
NA
NA
1.76%
0.96%
1.35%
Page 63
ers and Group Health
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
3
10
620
7478
0
8111
Female
0
0
0
20
788
17478
0
18286
Member Months
(Inpatient)
Total
0
0
3
30
1408
24956
0
26397
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
5
7
12
17
20
37
0
0
0
22
27
49
HEDIS 2008 (Reporting Year 2007)
Male
0
0
3
10
620
7478
0
8111
Female
0
0
0
20
788
17478
0
18286
Total
0
0
3
30
1408
24956
0
26397
Inpatient
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
0.00%
0.00%
0.00%
9.68%
10.66%
10.23%
2.73%
1.37%
1.78%
NA
NA
NA
3.25%
1.77%
2.23%
Number
0
0
0
0
0
0
0
0
0
0
0
0
1
4
5
9
17
26
0
0
0
10
21
31
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
0.00%
0.00%
0.00%
1.94%
6.09%
4.26%
1.44%
1.17%
1.25%
NA
NA
NA
1.48%
1.38%
1.41%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
0
0
0
0
3
0
3
10
20
30
620
788
1408
7478
17478
24956
0
0
0
8111
18286
26397
Member Months
(Outpatient/ED)
Male
0
0
3
10
620
7478
0
8111
Female
0
0
0
20
788
17478
0
18286
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
4
4
8
9
3
12
0
0
0
13
7
20
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
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
0
0
3
30
1408
24956
0
26397
Percent
NA
NA
NA
NA
NA
NA
0.00%
NA
0.00%
0.00%
0.00%
0.00%
7.74%
6.09%
6.82%
1.44%
0.21%
0.58%
NA
NA
NA
1.92%
0.46%
0.91%
Page 64
ers and Group Health
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:31 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
8491
0
8491
Female
0
0
0
0
0
22198
0
22198
Member Months
(Inpatient)
Total
0
0
0
0
0
30689
0
30689
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
54
37
91
0
0
0
54
37
91
HEDIS 2008 (Reporting Year 2007)
Male
0
0
0
0
0
8491
0
8491
Female
0
0
0
0
0
22198
0
22198
Total
0
0
0
0
0
30689
0
30689
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
7.63%
2.00%
3.56%
NA
NA
NA
7.63%
2.00%
3.56%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
29
26
55
0
0
0
29
26
55
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
4.10%
1.41%
2.15%
NA
NA
NA
4.10%
1.41%
2.15%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8491
22198
30689
0
0
0
8491
22198
30689
Member Months
(Outpatient/ED)
Male
0
0
0
0
0
8491
0
8491
Female
0
0
0
0
0
22198
0
22198
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
1
0
1
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
30
15
45
0
0
0
30
15
45
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.14%
0.00%
0.04%
NA
NA
NA
0.14%
0.00%
0.04%
Total
0
0
0
0
0
30689
0
30689
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
4.24%
0.81%
1.76%
NA
NA
NA
4.24%
0.81%
1.76%
Page 65
ers and Group Health
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicaid
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
115534
33513
22227
24348
52752
7632
0
256006
Female
110657
33907
46284
52544
67074
14895
0
325361
Member Months
(Inpatient)
Total
226191
67420
68511
76892
119826
22527
0
581367
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
9
5
14
143
111
254
271
307
578
488
505
993
1202
823
2025
35
24
59
0
0
0
2148
1775
3923
HEDIS 2008 (Reporting Year 2007)
Male
115534
33513
22227
24348
52752
7632
0
256006
Female
110657
33907
46284
52544
67074
14895
0
325361
Total
226191
67420
68511
76892
119826
22527
0
581367
Inpatient
Percent
0.09%
0.05%
0.07%
5.12%
3.93%
4.52%
14.63%
7.96%
10.12%
24.05%
11.53%
15.50%
27.34%
14.72%
20.28%
5.50%
1.93%
3.14%
NA
NA
NA
10.07%
6.55%
8.10%
Number
6
4
10
26
27
53
56
90
146
95
118
213
295
162
457
26
14
40
0
0
0
504
415
919
Percent
0.06%
0.04%
0.05%
0.93%
0.96%
0.94%
3.02%
2.33%
2.56%
4.68%
2.69%
3.32%
6.71%
2.90%
4.58%
4.09%
1.13%
2.13%
NA
NA
NA
2.36%
1.53%
1.90%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
115534
33513
22227
24348
52752
7632
0
256006
110657
33907
46284
52544
67074
14895
0
325361
226191
67420
68511
76892
119826
22527
0
581367
Member Months
(Outpatient/ED)
Male
115534
33513
22227
24348
52752
7632
0
256006
Female
110657
33907
46284
52544
67074
14895
0
325361
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
39
27
66
24
28
52
63
54
117
120
81
201
1
0
1
0
0
0
247
190
437
Number
3
2
5
117
93
210
241
237
478
434
426
860
1068
750
1818
16
12
28
0
0
0
1879
1520
3399
Percent
0.00%
0.00%
0.00%
1.40%
0.96%
1.17%
1.30%
0.73%
0.91%
3.10%
1.23%
1.83%
2.73%
1.45%
2.01%
0.16%
0.00%
0.05%
NA
NA
NA
1.16%
0.70%
0.90%
Total
226191
67420
68511
76892
119826
22527
0
581367
Percent
0.03%
0.02%
0.03%
4.19%
3.29%
3.74%
13.01%
6.14%
8.37%
21.39%
9.73%
13.42%
24.29%
13.42%
18.21%
2.52%
0.97%
1.49%
NA
NA
NA
8.81%
5.61%
7.02%
Page 66
Use of Services
HealthPartners and Group Health
Outpatient Drug Utilization
Commercial
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Member Months
711959
809078
1865263
1775429
88227
27931
6689
0
5284576
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 1:31 PM
$9,958,578.82
$23,379,919.66
$80,631,296.10
$164,902,715.93
$12,410,391.97
$4,415,697.66
$1,033,198.95
$0.00
$296,731,799.09
HEDIS 2008 (Reporting Year 2007)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$13.99
$28.90
$43.23
$92.88
$140.66
$158.09
$154.46
$56.15
Total Number of
Prescriptions
192873
325353
1445745
3215013
292927
120998
30470
0
5623379
Avg. Num. Of
Prescriptions /
Per Member Per
Year
3.25
4.83
9.30
21.73
39.84
51.98
54.66
12.77
Page 67
Use of Services
HealthPartners and Group Health
Outpatient Drug Utilization
Medicare Advantage
Age
Member Months
0-9
0
10-19
0
20-44
232
45-64
1209
65-74
5618
75-84
11890
85+
7448
Unknown
0
Total
26397
Age
Total Cost of
Prescriptions
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
$0.00
$0.00
$162,528.42
$353,964.85
$858,162.16
$1,704,688.67
$989,585.25
$0.00
$4,068,929.35
HEDIS 2008 (Reporting Year 2007)
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
$700.55
$292.77
$152.75
$143.37
$132.87
$154.14
Total Number of
Prescriptions
0
0
993
6063
23326
51988
32203
0
114573
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
51.36
60.18
49.82
52.47
51.88
52.08
Page 68
Use of Services
HealthPartners and Group Health
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 1:31 PM
Member Months
0
0
0
0
12314
10406
7969
0
30689
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
$0.00
$3,339,525.77
$2,858,524.34
$1,968,017.81
$0.00
$8,166,067.92
HEDIS 2008 (Reporting Year 2007)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
NA
NA
$271.20
$274.70
$246.96
$266.09
Total Number of
Prescriptions
0
0
0
0
77652
73713
60762
0
212127
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
NA
NA
75.67
85.00
91.50
82.95
Page 69
Use of Services
HealthPartners and Group Health
Outpatient Drug Utilization
Medicaid
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Member Months
185599
130383
180745
62113
11895
6756
3876
0
581367
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 1:31 PM
$2,057,099.70
$2,827,602.50
$11,035,739.51
$6,768,119.30
$608,816.68
$202,282.40
$68,996.71
$0.00
$23,568,656.80
HEDIS 2008 (Reporting Year 2007)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$11.08
$21.69
$61.06
$108.96
$51.18
$29.94
$17.80
$40.54
Total Number of
Prescriptions
72405
52368
217570
144431
21873
11983
7209
0
527839
Avg. Num. Of
Prescriptions /
Per Member Per
Year
4.68
4.82
14.44
27.90
22.07
21.28
22.32
10.90
Page 70
Access/Availability of Care
HealthPartners and Group Health
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:31 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+
81568
114284
8803
78449
110939
8662
96.18%
96.04%
96.31%
97.07%
96.97%
97.17%
98.40%
98.13%
98.67%
2007
A
Page 71
Access/Availability of Care
HealthPartners and Group Health
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
Data Elements
General Measure
Data
Measurement Year
Data collection methodology (Administrativ
only)
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Ages 20-44
Ages 45-64
Ages 65+
19
89
1909
2007
A
18
84
1839
NA
NA
NA
94.38%
89.04%
99.73%
96.33%
95.46%
97.20%
Page 72
Access/Availability of Care
HealthPartners and Group Health
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:31 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
2311
2007
A
0
0
2258
NA
NA
NA
NA
NA
NA
97.71%
97.07%
98.34%
Page 73
Access/Availability of Care
HealthPartners and Group Health
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:31 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+
6346
2957
1301
2007
A
5548
2609
1189
87.43%
86.60%
88.25%
88.23%
87.05%
89.41%
91.39%
89.83%
92.95%
Page 74
Access/Availability of Care
HealthPartners and Group Health
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:31 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.
5684
27810
23389
43971
5550
24571
20633
38885
97.64%
97.24%
98.05%
88.35%
87.97%
88.73%
88.22%
87.80%
88.63%
88.43%
88.13%
88.73%
2007
A
Page 75
Access/Availability of Care
HealthPartners and Group Health
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:31 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.
1484
3560
2293
3306
2007
A
1408
3120
1998
2831
94.88%
93.72%
96.03%
87.64%
86.55%
88.74%
87.13%
85.74%
88.53%
85.63%
84.42%
86.84%
Page 76
Access/Availability of Care
HealthPartners and Group Health
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:31 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)
6356
6042
Number of numerator events by administrative data in
eligible population (before exclusions)
4427
3325
Current year's administrative rate (before exclusions)
69.65%
55.03%
Minimum required sample size (MRSS) or other sample size
207
229
Oversampling rate
Final sample size (FSS)
5%
218
5%
241
Number of numerator events by administrative data in FSS
156
126
Data Elements
Administrative rate on FSS
71.56%
52.28%
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
207
85
116
0
229
86
109
97.10%
94.57%
99.63%
85.15%
80.33%
89.98%
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
HealthPartners and Group Health
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:31 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)
1901
1901
Number of numerator events by administrative data in
eligible population (before exclusions)
1103
749
Current year's administrative rate (before exclusions)
58.02%
39.40%
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
251
168
58.10%
38.89%
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
411
105
270
0
411
105
181
91.24%
88.39%
94.10%
69.59%
65.02%
74.16%
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
HealthPartners and Group Health
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:31 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
492
4487
4979
210
123
1826
733
2036
856
Reported rate
42.68%
25.00%
40.70%
16.34%
40.89%
17.19%
Lower 95% confidence interval
38.21%
47.16%
21.07%
28.93%
39.25%
42.14%
15.24%
17.43%
39.52%
42.27%
16.13%
18.25%
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 79
Access/Availability of Care
HealthPartners and Group Health
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
General
Measure
Data
Initiation of
AOD
Treatment
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Overall Rate
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
2007
A
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Engagement
of AOD
Treatment
18+ Year Olds
0
33
33
0
0
22
1
22
1
Reported rate
NA
NA
66.67%
3.03%
66.67%
3.03%
Lower 95% confidence interval
NA
NA
NA
NA
49.07%
84.27%
0.00%
10.39%
49.07%
84.27%
0.00%
10.39%
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 80
Access/Availability of Care
HealthPartners and Group Health
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:31 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
40
40
0
0
24
2
24
2
Reported rate
NA
NA
60.00%
5.00%
60.00%
5.00%
Lower 95% confidence interval
NA
NA
NA
NA
43.57%
76.43%
0.00%
13.00%
43.57%
76.43%
0.00%
13.00%
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 81
Access/Availability of Care
HealthPartners and Group Health
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:31 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
123
1301
1424
44
26
552
194
596
220
Reported rate
35.77%
21.14%
42.43%
14.91%
41.85%
15.45%
Lower 95% confidence interval
26.89%
44.65%
13.52%
28.76%
39.70%
45.15%
12.94%
16.89%
39.26%
44.45%
13.54%
17.36%
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 82
Health Plan Stability
HealthPartners and Group Health
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Commercial
Product/Product Line
Years in Business
Members*
22.00
52.00
23.00
20.00
52.00
52.00
48581
23348
38312
52663
1131
164035
0.00
7.00
0.00
7.00
0.00
7.00
0
212814
0
101371
0
314185
0.00
24.00
0.00
7.00
0.00
24.00
0
16680
0
75577
0
92257
570477
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
HealthPartners and Group Health
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
Product/Product Line
Years in Business
Members*
22.00
52.00
23.00
20.00
52.00
52.00
48581
23348
38312
52663
1131
164035
0.00
7.00
0.00
7.00
0.00
7.00
0
212814
0
101371
0
314185
0.00
24.00
0.00
7.00
0.00
24.00
0
16680
0
75577
0
92257
570477
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
HealthPartners and Group Health
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:31 PM
MSHO
Product/Product Line
Years in Business
Members*
22.00
52.00
23.00
20.00
52.00
52.00
48581
23348
38312
52663
1131
164035
0.00
7.00
0.00
7.00
0.00
7.00
0
212814
0
101371
0
314185
0.00
24.00
0.00
7.00
0.00
24.00
0
16680
0
75577
0
92257
570477
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
HealthPartners and Group Health
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicaid
Product/Product Line
Years in Business
Members*
22.00
52.00
23.00
20.00
52.00
52.00
48581
23348
38312
52663
1131
164035
0.00
7.00
0.00
7.00
0.00
7.00
0
212814
0
101371
0
314185
0.00
24.00
0.00
7.00
0.00
24.00
0
16680
0
75577
0
92257
570477
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
HealthPartners and Group Health
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Commercial
Member Months
Female
36912
151716
195288
211488
141312
86124
<1
1-4
5-9
10-14
15-17
18-19
Male
38760
161100
204624
222252
147156
88080
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
861972
30.66%
151536
155388
181428
221148
242700
822840
27.40%
175620
198432
207360
240900
266904
1684812
28.98%
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
952200
33.87%
270408
259368
234684
163800
1089216
36.27%
305316
293892
256980
170844
2041416
35.11%
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
928260
33.02%
36096
15624
8460
5328
2544
564
1027032
34.20%
30432
13716
9192
6924
2940
1092
1955292
33.63%
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
68616
2.44%
0
64296
2.14%
0
132912
2.29%
2811048
3003384
HEDIS 2008 (Reporting Year 2007)
Total
75672
312816
399912
433740
288468
174204
327156
353820
388788
462048
509604
575724
553260
491664
334644
66528
29340
17652
12252
5484
1656
0
5814432
Page 87
Health Plan Descriptive Information
HealthPartners and Group Health
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:31 PM
Medicare Advantage
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
0
0
12
36
60
0
0.00%
0
0
12
36
60
0
0.00%
108
1.33%
72
108
192
132
108
0.59%
132
168
132
252
216
0.82%
504
6.22%
660
1128
1860
1812
1488
540
684
3.74%
1104
2736
3528
4704
3360
2052
1188
4.50%
7488
92.44%
0
17484
95.67%
0
24972
94.68%
8100
18276
HEDIS 2008 (Reporting Year 2007)
0
0
24
72
120
204
276
324
384
1764
3864
5388
6516
4848
2592
0
26376
Page 88
Health Plan Descriptive Information
HealthPartners and Group Health
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:31 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%
1980
2340
1704
1128
864
492
0
0.00%
3756
4236
3768
3816
3036
3588
0
0.00%
8508
100.00%
0
22200
100.00%
0
30708
100.00%
8508
22200
HEDIS 2008 (Reporting Year 2007)
0
0
0
0
0
0
0
0
0
5736
6576
5472
4944
3900
4080
0
30708
Page 89
Health Plan Descriptive Information
HealthPartners and Group Health
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:31 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
17258
39139
39062
33564
20024
9388
Member Months
Female
16188
37079
36873
34146
20278
12983
Total
33446
76218
75935
67710
40302
22371
158435
61.89%
12839
13065
11283
11402
11983
157547
48.42%
33301
32070
20474
18901
15427
315982
54.35%
60572
23.66%
11693
8962
5661
3051
120173
36.94%
12700
8845
6522
4679
180745
31.09%
29367
11.47%
2767
1807
1352
824
597
285
32746
10.06%
4285
3036
2374
2206
1580
1414
62113
10.68%
7632
2.98%
0
14895
4.58%
0
22527
3.87%
256006
325361
HEDIS 2008 (Reporting Year 2007)
46140
45135
31757
30303
27410
24393
17807
12183
7730
7052
4843
3726
3030
2177
1699
0
581367
Page 90