First Plan of Minnesota
Plan Name
2007
Reporting Year
Submission #
General Info
Disclaimers
Code
CIS
Plan ID
1
Last Refreshed:
Page
Childhood Immunization Status
10/7/2009 1:30:01 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
2
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
First Plan of Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
MMR
HiB
Hepatitis B
VZV
Pneumococcal
Conjugate
Combo 2
Combo 3
8
61.54%
10
76.92%
12
92.31%
11
84.62%
9
69.23%
12
92.31%
10
76.92%
7
53.85%
7
53.85%
12
92.31%
13
100.00%
13
100.00%
13
100.00%
13
100.00%
13
100.00%
13
100.00%
12
92.31%
12
92.31%
0
12
NA
NA
NA
0
13
NA
NA
NA
0
13
NA
NA
NA
0
13
NA
NA
NA
0
13
NA
NA
NA
0
13
NA
NA
NA
0
13
NA
NA
NA
0
12
NA
NA
NA
0
12
NA
NA
NA
13
0.00%
13
Number of Records Excluded Because of
Valid Data Errors
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
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
13
HEDIS 2008 (Reporting Year 2007)
IPV
2007
H
13
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
Page 3
Effectiveness of Care
First Plan of Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:30 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
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
137
80.59%
74.35%
86.83%
0
151
88.82%
83.79%
93.85%
0
149
87.65%
82.41%
92.89%
0
149
87.65%
82.41%
92.89%
0
148
87.06%
81.72%
92.40%
0
141
82.94%
76.99%
88.89%
0
134
78.82%
72.39%
85.26%
0
128
75.29%
68.52%
82.07%
0
119
70.00%
62.82%
77.18%
170
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
170
0.00%
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
170
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
170
Page 4
Effectiveness of Care
First Plan of Minnesota
Appropriate Treatment for Children with Upper
Respiratory Infection
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Commercial
Data Elements
Commercial
Medicaid
2007
2007
Data Collection Methodology
A
A
Eligible Member Population
14
218
Numerator Events by Admin Data
2
41
Reported Rate
NA
81.19%
Lower 95% Confidence Interval
NA
75.78%
Upper 95% Confidence Interval
NA
86.61%
Measurement Year
HEDIS 2008 (Reporting Year 2007)
Page 5
Effectiveness of Care
First Plan of Minnesota
Colorectal Cancer Screening
Data Elements
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Commercial
Medicare
Advantage
MSHO
2007
2007
A
A
293
241
Number of numerator events by administrative data in eligible
population (before exclusions)
Current year's administrative rate (before exclusions)
NR
NR
NR
NR
NR
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid data
errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
184
93
Numerator events by medical records
Reported rate
62.80%
NR
38.59%
Lower 95% confidence interval
57.09%
NR
32.24%
Upper 95% confidence interval
68.50%
NR
44.94%
HEDIS 2008 (Reporting Year 2007)
Page 6
Effectiveness of Care
First Plan of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:30 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
126
113
89.68%
83.97%
95.39%
99
77
77.78%
69.08%
86.47%
225
190
84.44%
79.49%
89.40%
2007
A
Page 7
Effectiveness of Care
First Plan of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:30 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
53
28
52.83%
38.45%
67.21%
53
28
52.83%
38.45%
67.21%
2007
A
Page 9
Effectiveness of Care
First Plan of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:30 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
219
129
58.90%
52.16%
65.65%
175
112
64.00%
56.60%
71.40%
394
241
61.17%
56.23%
66.11%
2007
A
Page 10
Effectiveness of Care
First Plan of Minnesota
Cervical Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Commercial
Medicaid
2007
A
298
2007
A
1330
NR
NR
NR
NR
230
980
77.18%
72.25%
82.11%
73.68%
71.28%
76.09%
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
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 11
Effectiveness of Care
First Plan of Minnesota
Chlamydia Screening in Women
Data Last Refreshed:
Oct 7, 2009 1:30 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
26
24
NA
NA
NA
12
11
NA
NA
NA
38
35
92.11%
82.22%
100.00%
128
72
56.25%
47.27%
65.23%
216
102
47.22%
40.33%
54.11%
344
174
50.58%
45.15%
56.01%
Page 12
Effectiveness of Care
First Plan of Minnesota
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Osteoporosis Management in Women Who had a Fracture
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interva
HEDIS 2008 (Reporting Year 2007)
Medicare
Advantage
NR
NR
NR
MSHO
2007
A
50
17
34.00%
19.87%
48.13%
Page 13
Effectiveness of Care
First Plan of Minnesota
Controlling High Blood Pressure
Data Last Refreshed:
Oct 7, 2009 1:30 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
H
H
113
94
0
0
0.00%
NR
0.00%
113
94
0.00%
0.00%
113
94
0
0
0.00%
NR
0.00%
Records Excluded because of Valid Data
Errors
0
0
Number of administrative data records
excluded
0
0
Number of medical record data records
excluded
0
0
Number of employee/dependent medical
records excluded
0
0
Records Added from the OverSample List
0
0
113
94
0
0
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
56
59
Reported Rate
49.56%
NR
62.77%
Lower 95% Confidence Interval
39.90%
NR
52.46%
Upper 95% Confidence Interval
59.22%
NR
73.07%
HEDIS 2008 (Reporting Year 2007)
Page 14
Effectiveness of Care
First Plan of Minnesota
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
MSHO
Medicaid
2007
2007
2007
Data Collection Methodology
A
A
A
Eligible Member Population
1
3
5
Numerator Events by Admin Data on
Eligible Population
0
0
1
Measurement Year
Commercial
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Medicare Advantage
Reported Rate
NA
NR
NA
NA
Lower 95% Confidence Interval
NA
NR
NA
NA
Upper 95% Confidence Interval
NA
NR
NA
NA
HEDIS 2008 (Reporting Year 2007)
Page 15
Effectiveness of Care
First Plan of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:30 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)
4
0
100.00%
0.00%
4
0
100.00%
0.00%
4
0
0
2
NA
NA
NA
NA
NA
NA
4
0.00%
4
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
4
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
4
Page 16
Effectiveness of Care
First Plan of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:30 PM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
0
Number of administrative data records excluded
0
Number of medical record data records excluded
0
Number of employee/dependent medical records
excluded
0
HEDIS 2008 (Reporting Year 2007)
0
0
0.00%
0.00%
0
0
0.00%
0.00%
0
6
0
6
NA
NA
NA
NA
NA
NA
8
0.00%
8
Records Excluded because of Valid Data Errors
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
LDL-C Level of
<100 mg/dL
2007
H
8
Numerator Events by Admin Data on Eligible
Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
LDL-C
screening
0
8
Page 18
Effectiveness of Care
First Plan of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:30 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)
0
0
0.00%
0.00%
0
0
0.00%
0.00%
0
4
0
1
NA
NA
NA
NA
NA
NA
4
0.00%
4
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
4
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
4
Page 19
Effectiveness of Care
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:30 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
74
2007
H
74
2007
H
74
2007
H
74
2007
H
74
2007
H
74
2007
H
74
2007
H
74
2007
H
74
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
65
87.84%
74
0%
74
65
87.84%
14
18.92%
74
0%
74
14
18.92%
0
0.00%
74
0%
74
0
0.00%
0
0.00%
74
0%
74
0
0.00%
0
0.00%
74
0%
74
0
0.00%
0
0.00%
74
0%
74
0
0.00%
0
0.00%
74
0%
74
0
0.00%
0
0.00%
74
0%
74
0
0.00%
0
0.00%
74
0%
74
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
74
0
65
87.84%
79.72%
95.96%
0
74
0
14
18.92%
9.32%
28.52%
0
74
0
39
52.70%
40.65%
64.75%
0
74
0
47
63.51%
51.87%
75.16%
0
74
0
62
83.78%
74.71%
92.86%
0
74
0
38
51.35%
39.29%
63.42%
0
74
0
64
86.49%
78.02%
94.95%
0
74
0
52
70.27%
59.18%
81.36%
0
74
0
30
40.54%
28.68%
52.40%
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
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:30 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
73
2007
H
73
2007
H
73
2007
H
73
2007
H
73
2007
H
73
2007
H
73
2007
H
73
2007
H
73
0
0.00%
17
23.29%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
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
73
0
62
84.93%
76.04%
93.82%
0
73
17
0
23.29%
12.91%
33.67%
0
73
0
47
64.38%
52.71%
76.05%
0
73
0
51
69.86%
58.65%
81.07%
0
73
0
53
72.60%
61.69%
83.52%
0
73
0
30
41.10%
29.12%
53.07%
0
73
0
66
90.41%
82.97%
97.85%
0
73
0
47
64.38%
52.71%
76.05%
0
73
0
23
31.51%
20.17%
42.85%
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
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:30 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
143
2007
H
143
2007
H
143
2007
H
143
2007
H
143
2007
H
143
2007
H
143
2007
H
143
2007
H
143
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
124
86.71%
143
0%
143
124
86.71%
45
31.47%
143
0%
143
45
31.47%
0
0.00%
143
0%
143
0
0.00%
0
0.00%
143
0%
143
0
0.00%
0
0.00%
143
0%
143
0
0.00%
0
0.00%
143
0%
143
0
0.00%
0
0.00%
143
0%
143
0
0.00%
0
0.00%
143
0%
143
0
0.00%
0
0.00%
143
0%
143
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
143
124
0
86.71%
80.80%
92.63%
0
143
45
0
31.47%
23.51%
39.43%
0
143
0
63
44.06%
35.57%
52.54%
0
143
0
86
60.14%
51.77%
68.51%
0
143
0
112
78.32%
71.22%
85.43%
0
143
0
65
45.45%
36.94%
53.97%
0
143
0
126
88.11%
82.46%
93.77%
0
143
0
96
67.13%
59.08%
75.18%
0
143
0
57
39.86%
31.49%
48.23%
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
First Plan of Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:30 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
3
3
NA
NA
NA
6
4
NA
NA
NA
26
20
NA
NA
NA
35
27
77.14%
61.80%
92.48%
2007
A
Page 24
Effectiveness of Care
First Plan of Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2008 (Reporting Year 2007)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
Total
24
20
NA
NA
NA
46
29
63.04%
48.01%
78.08%
98
62
63.27%
53.21%
73.32%
168
111
66.07%
58.61%
73.53%
2007
A
Page 25
Effectiveness of Care
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:30 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
3
NA
NA
NA
3
NA
NA
NA
0
NA
NA
NA
2007
A
3
Page 26
Effectiveness of Care
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:30 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
0
NA
NA
NA
0
NA
NA
NA
0
NA
NA
NA
2007
A
2
Page 28
Effectiveness of Care
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:30 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
4
NA
NA
NA
13
NA
NA
NA
10
NA
NA
NA
2007
A
27
Page 29
Effectiveness of Care
First Plan of Minnesota
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 7, 2009 1:30 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
21
8
NA
NA
NA
3
0
NA
NA
NA
2007
A
1
0
NA
NA
NA
0
0
NA
NA
NA
Page 30
Effectiveness of Care
First Plan of Minnesota
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interva
HEDIS 2008 (Reporting Year 2007)
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Medicare
Advantage
NR
NR
NR
MSHO
2007
A
477
416
87.21%
84.11%
90.31%
Page 31
Effectiveness of Care
First Plan of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:30 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
126
100
79.37%
71.90%
86.83%
0
0
NA
NA
NA
99
78
78.79%
70.23%
87.35%
5
2
NA
NA
NA
230
180
78.26%
72.71%
83.81%
2007
A
Page 32
Effectiveness of Care
First Plan of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:30 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
306
275
89.87%
86.33%
93.41%
58
52
89.66%
80.96%
98.35%
331
298
90.03%
86.65%
93.41%
45
33
73.33%
59.30%
87.37%
740
658
88.92%
86.59%
91.25%
2007
A
Page 34
Effectiveness of Care
First Plan of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:30 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
193
158
81.87%
76.17%
87.56%
5
4
NA
NA
NA
150
119
79.33%
72.52%
86.15%
27
16
NA
NA
NA
375
297
79.20%
74.96%
83.44%
2007
A
Page 35
Effectiveness of Care
First Plan of Minnesota
Use of High Risk Medications in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2008 (Reporting Year 2007)
General
Measure
Data
1 or More
Prescriptions
NR
NR
NR
MSHO
2 or More
Prescriptions
NR
NR
NR
General
Measure
Data
2007
A
778
1 or More
Prescriptions
2 or More
Prescriptions
213
27.38%
24.18%
30.58%
83
10.67%
8.43%
12.90%
Page 36
Effectiveness of Care
First Plan of Minnesota
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:30 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
20
3
NA
NA
NA
183
48
26.23%
19.58%
32.88%
7
2
NA
NA
NA
210
53
25.24%
19.12%
31.35%
Page 38
Use of Services
First Plan of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:30 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
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
1
NA
NA
NA
0
1
NA
NA
NA
0
7
NA
NA
NA
9
0.00%
9
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
9
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
9
Page 39
Use of Services
First Plan of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:30 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
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
0
7
3.40%
0.68%
6.11%
0
0
0.00%
0.00%
0.24%
0
5
2.43%
0.08%
4.77%
0
11
5.34%
2.03%
8.65%
0
16
7.77%
3.87%
11.66%
0
40
19.42%
13.77%
25.06%
0
127
61.65%
54.77%
68.53%
206
0.00%
206
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
206
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
206
Page 40
Use of Services
First Plan of Minnesota
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 1:30 PM
Commercial
Medicaid
2007
A
54
2007
A
488
NR
NR
NR
NR
35
321
64.81%
51.15%
78.48%
65.78%
61.47%
70.09%
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
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)
Page 41
Use of Services
First Plan of Minnesota
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Commercial
Medicaid
2007
A
200
2007
A
952
NR
NR
NR
NR
72
347
36.00%
29.10%
42.90%
36.45%
33.34%
39.56%
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
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)
Page 42
Use of Services
First Plan of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Commercial
Member Months
Total
1021
2028
3793
2786
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
1
1
3
1
Procedures /
1,000 Member
Months
0.98
0.26
1.48
0.36
Member Months
Male
Female
4981
2993
4292
5698
3814
4371
114
123
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
0.18
0
1
0
0
2
0
5
0
6
0
0
0
0
0
0.00
0.18
0.00
0.00
0.52
0.00
1.31
0.00
1.57
0.00
0.00
0.00
0.00
0.00
Number of
Procedures
1
1
1
0
0
1
2
0
Procedures /
1,000 Member
Months
0.20
0.23
0.20
0.00
0.00
0.20
0.46
0.00
0
0
0
0.00
0.00
0.00
0
4
0
1
1
0
1
0
2
0
0
0
0.00
0.92
0.00
0.23
0.23
0.00
0.23
0.00
0.46
0.00
0.00
0.00
0
0
0
3
4
0
0.00
0.00
0.00
0.60
0.92
0.00
Page 43
Use of Services
First Plan of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:30 PM
MSHO
Age
< 65
65-74
75-84
85+
Member Months
Male
Female
5
7
1039
2023
803
2595
663
4213
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
0
1
0
0
3
3
0
0
0
0
0
0
0
2
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
Procedures /
1,000 Member
Months
0.00
1.92
0.00
0.00
0.00
0.00
1.25
0.00
0.00
2.89
3.74
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2.49
1.51
0.00
0.00
0.00
0.00
0.00
0.96
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
1.25
1.51
0.00
0.00
0.00
0.00
Female
Number of
Procedures
0
1
0
0
0
4
0
4
0
7
3
10
0
0
0
0
0
1
8
9
0
1
3
1
0
3
0
1
0
1
3
0
0
0
2
0
0
2
1
0
0
0
1
0
0
0
0
0
0
0
1
0
0
1
0
0
0
1
0
1
Procedures /
1,000 Member
Months
0.00
0.49
0.00
0.00
0.00
1.98
0.00
0.95
0.00
3.46
1.16
2.37
0.00
0.00
0.00
0.00
0.00
0.49
3.08
2.14
0.00
0.49
1.16
0.24
0.00
1.48
0.00
0.24
0.00
0.49
1.16
0.00
0.00
0.00
0.77
0.00
0.00
0.99
0.39
0.00
0.00
0.00
0.39
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.39
0.00
0.00
0.49
0.00
0.00
0.00
0.49
0.00
0.24
Page 45
Use of Services
First Plan of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Medicaid
Member Months
Total
16697
27177
29902
19422
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
33
19
21
12
Procedures /
1,000 Member
Months
1.98
0.64
0.77
0.62
Member Months
Male
Female
27946
12167
22495
13679
7067
7905
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
0
0.00
3
6
5
Number of
Procedures
10
5
4
5
7
4
Procedures /
1,000 Member
Months
0.36
0.63
0.14
0.63
0.25
0.51
1
0
0.04
0.00
20
3
12
2
0
0
10
8
0.72
0.38
0.53
0.25
0.00
0.00
0.36
1.01
0.22
0.49
0.71
Page 46
Use of Services
First Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Member Months
286
1742
2786
7285
8185
216
21
0
0
20521
Discharges
Discharges /
1,000 Member
Months
23
5
2
49
52
2
0
0
0
133
80.42
2.87
0.72
6.73
6.35
9.26
0.00
NA
23
1
1
12
14
2
0
0
0
53
80.42
0.57
0.36
1.65
1.71
9.26
0.00
NA
0
4
1
11
38
0
0
0
0
54
0.00
2.30
0.36
1.51
4.64
0.00
0.00
NA
0
26
0
0
26
0.00
3.57
0.00
HEDIS 2008 (Reporting Year 2007)
6.48
2.58
2.63
1.42
Days
Days / 1,000
Member
Months
59
10
8
125
164
3
0
0
0
369
206.29
5.74
2.87
17.16
20.04
13.89
0.00
NA
59
1
3
29
20
3
0
0
0
115
206.29
0.57
1.08
3.98
2.44
13.89
0.00
NA
0
9
5
28
144
0
0
0
0
186
0.00
5.17
1.79
3.84
17.59
0.00
0.00
NA
0
68
0
0
68
0.00
9.33
0.00
17.98
5.60
9.06
3.72
Average
Length of Stay
2.57
2.00
4.00
2.55
3.15
1.50
NA
NA
NA
2.77
2.57
1.00
3.00
2.42
1.43
1.50
NA
NA
NA
2.17
NA
2.25
5.00
2.55
3.79
NA
NA
NA
NA
3.44
NA
2.62
NA
NA
2.62
Page 47
Use of Services
First Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Member Months
0
0
0
0
12
3062
3398
4876
0
11348
Discharges
0
0
0
0
0
225
330
481
0
1036
Discharges /
1,000 Member
Months
NA
NA
NA
NA
0.00
73.48
97.12
98.65
91.29
0
0
0
0
0
181
290
444
0
915
NA
NA
NA
NA
0.00
59.11
85.34
91.06
0
0
0
0
0
44
40
37
0
121
NA
NA
NA
NA
0.00
14.37
11.77
7.59
0
0
0
0
0
HEDIS 2008 (Reporting Year 2007)
80.63
10.66
NA
NA
0.00
0.00
Days
Days / 1,000
Member
Months
0
0
0
0
0
1691
3242
5207
0
10140
NA
NA
NA
NA
0.00
552.25
954.09
1067.88
0
0
0
0
0
1372
3015
5000
0
9387
NA
NA
NA
NA
0.00
448.07
887.29
1025.43
0
0
0
0
0
319
227
207
0
753
NA
NA
NA
NA
0.00
104.18
66.80
42.45
0
0
0
0
0
NA
NA
0.00
893.55
827.19
66.36
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
7.52
9.82
10.83
NA
9.79
NA
NA
NA
NA
NA
7.58
10.40
11.26
NA
10.26
NA
NA
NA
NA
NA
7.25
5.68
5.59
NA
6.22
NA
NA
NA
NA
NA
Page 49
Use of Services
First Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Medicaid
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Member Months
5072
22105
19422
34662
14972
21
0
0
0
96254
Discharges
321
98
78
622
206
1
0
0
0
1326
Discharges /
1,000 Member
Months
63.29
4.43
4.02
17.94
13.76
47.62
NA
NA
13.78
306
76
27
125
111
1
0
0
0
646
60.33
3.44
1.39
3.61
7.41
47.62
NA
NA
15
22
17
152
94
0
0
0
0
300
2.96
1.00
0.88
4.39
6.28
0.00
NA
NA
34
345
1
0
380
1.75
9.95
0.07
HEDIS 2008 (Reporting Year 2007)
6.71
3.12
5.50
Days
Days / 1,000
Member
Months
1219
221
198
1776
718
3
0
0
0
4135
240.34
10.00
10.19
51.24
47.96
142.86
NA
NA
967
141
51
426
295
3
0
0
0
1883
190.65
6.38
2.63
12.29
19.70
142.86
NA
NA
252
80
56
499
420
0
0
0
0
1307
49.68
3.62
2.88
14.40
28.05
0.00
NA
NA
91
851
3
0
945
42.96
19.56
13.58
4.69
24.55
0.20
13.68
Average
Length of Stay
3.80
2.26
2.54
2.86
3.49
3.00
NA
NA
NA
3.12
3.16
1.86
1.89
3.41
2.66
3.00
NA
NA
NA
2.91
16.80
3.64
3.29
3.28
4.47
NA
NA
NA
NA
4.36
2.68
2.47
3.00
NA
2.49
Page 50
Use of Services
First Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
286
1742
2786
7285
8185
216
21
0
0
20521
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
Visits
194
457
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
573
1863
2651
81
10
0
0
5829
HEDIS 2008 (Reporting Year 2007)
Visits/ 1,000
Member
Months
678.32
262.34
205.67
255.73
323.89
375.00
476.19
NA
284.05
Emergency Room Visits
Visits
9
31
52
176
137
0
0
0
0
405
Visits/ 1,000
Member
Months
31.47
17.80
18.66
24.16
16.74
0.00
0.00
NA
19.74
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
2
0
0
0
0
2
Procedures/
1,000 Member
Months
0.00
0.00
0.00
0.00
0.24
0.00
0.00
NA
0.10
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
16
4
0
0
0
0
20
Stays/ 1,000
Member
Months
0.00
0.00
0.00
2.20
0.49
0.00
0.00
NA
0.97
Page 51
Use of Services
First Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:30 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
12
3062
3398
4876
0
11348
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
6
2019
1616
1727
0
5368
HEDIS 2008 (Reporting Year 2007)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
500.00
659.37
475.57
354.18
473.03
Emergency Room Visits
Visits
0
0
0
0
1
240
268
362
0
871
Visits/ 1,000
Member
Months
NA
NA
NA
NA
83.33
78.38
78.87
74.24
76.75
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
0
5
2
0
0
7
Procedures/
1,000 Member
Months
NA
NA
NA
NA
0.00
1.63
0.59
0.00
0.62
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
26
14
20
0
60
Stays/ 1,000
Member
Months
NA
NA
NA
NA
0.00
8.49
4.12
4.10
5.29
Page 53
Use of Services
First Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Medicaid
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
5072
22105
19422
34662
14972
21
0
0
0
96254
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
Visits
3463
6325
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
4817
13289
6678
5
0
0
0
34577
HEDIS 2008 (Reporting Year 2007)
Visits/ 1,000
Member
Months
682.77
286.13
248.02
383.39
446.03
238.10
NA
NA
359.23
Emergency Room Visits
Visits
488
1065
830
2830
605
0
0
0
0
5818
Visits/ 1,000
Member
Months
96.21
48.18
42.74
81.65
40.41
0.00
NA
NA
60.44
Ambulatory
Surgery/Procedures
Procedures
0
1
0
5
10
0
0
0
0
16
Procedures/
1,000 Member
Months
0.00
0.05
0.00
0.14
0.67
0.00
NA
NA
0.17
Observation Room Stays
Resulting in Discharge
Stays
21
10
54
281
35
0
0
0
0
401
Stays/ 1,000
Member
Months
4.14
0.45
2.78
8.11
2.34
0.00
NA
NA
4.17
Page 54
Use of Services
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Commercial
Age
Member
Months
<1
286
1-9
1742
10-19
2786
20-44
7285
45-64
8185
65-74
216
75-84
21
85+
0
Unknown
Total
0
20521
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
Days
Days / 1,000
Member
Months
Average Length
of Stay
0.00
0
0.00
NA
0
0.00
0
0.00
NA
10-19
0
0.00
0
0.00
NA
20-44
1
0.14
4
0.55
4.00
45-64
3
0.37
31
3.79
10.33
65-74
0
0.00
0
0.00
NA
75-84
0
0.00
0
0.00
NA
85+
0
NA
0
NA
NA
Unknown
0
4
0.19
0
35
1.71
NA
8.75
Age
Total
HEDIS 2008 (Reporting Year 2007)
Page 55
Use of Services
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:30 PM
MSHO
Age
Member
Months
<1
0
1-9
0
10-19
0
20-44
0
45-64
12
65-74
3062
75-84
3398
85+
4876
Unknown
0
11348
Total
Discharges
Discharges /
1,000 Member
Months
Days
Days / 1,000
Member
Months
Average Length
of Stay
<1
0
NA
0
NA
NA
1-9
0
NA
0
NA
NA
10-19
0
NA
0
NA
NA
20-44
0
NA
0
NA
NA
45-64
0
0.00
0
0.00
NA
65-74
168
54.87
2410
787.07
14.35
75-84
385
113.30
5710
1680.40
14.83
85+
629
129.00
8724
1789.17
13.87
Unknown
0
1182
104.16
0
16844
1484.31
NA
14.25
Age
Total
HEDIS 2008 (Reporting Year 2007)
Page 57
Use of Services
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Medicaid
Age
Member
Months
<1
5072
1-9
22105
10-19
19422
20-44
34662
45-64
14972
65-74
21
75-84
0
85+
0
Unknown
Total
0
96254
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
Days
Days / 1,000
Member
Months
Average Length
of Stay
0.00
0
0.00
NA
0
0.00
0
0.00
NA
10-19
0
0.00
0
0.00
NA
20-44
9
0.26
151
4.36
16.78
45-64
2
0.13
35
2.34
17.50
65-74
0
0.00
0
0.00
NA
75-84
0
NA
0
NA
NA
85+
0
NA
0
NA
NA
0.11
0
186
1.93
NA
16.91
Age
Unknown
Total
0
11
HEDIS 2008 (Reporting Year 2007)
Page 58
Use of Services
st Plan of Minnesota
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Commercial
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
Male
Female
Total
1533
800
1201
666
2734
1466
1533
800
1201
666
2734
1466
1533
800
1201
666
2734
1466
1533
800
1201
666
2734
1466
7120
114
0
9567
8964
123
0
10954
16084
237
0
20521
7120
114
0
9567
8964
237
0
11068
16084
351
0
20635
7120
114
0
9567
8964
237
0
11068
16084
351
0
20635
7120
114
0
9567
8964
237
0
11068
16084
351
0
20635
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
Any Services
0-12
Sex
M
F
13-17
Total
M
F
18-64
Total
M
F
65+
Total
M
F
Unknown
Total
M
F
Age
Total
Total
M
F
Total
Inpatient
Member Months
(Outpatient/ED)
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
11
6
17
16
7
23
52
129
181
0
1
1
0
0
0
79
143
222
8.61%
6.00%
7.46%
24.00%
12.61%
18.83%
8.76%
17.27%
13.50%
0.00%
9.76%
5.06%
NA
NA
NA
9.91%
15.67%
12.98%
0
0
0
0
0
0
1
2
3
0
0
0
0
0
0
1
2
3
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.17%
0.27%
0.22%
0.00%
0.00%
0.00%
NA
NA
NA
0.13%
0.22%
0.17%
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
1
0
1
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.17%
0.00%
0.07%
0.00%
0.00%
0.00%
NA
NA
NA
0.13%
0.00%
0.06%
11
6
17
16
7
23
52
129
181
0
1
1
0
0
0
79
143
222
8.61%
6.00%
7.46%
24.00%
12.61%
18.83%
8.76%
17.27%
13.50%
0.00%
5.06%
3.42%
NA
NA
NA
9.91%
15.50%
12.91%
HEDIS 2008 (Reporting Year 2007)
Page 59
Use of Services
st Plan of Minnesota
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:30 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
st Plan of Minnesota
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:30 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
5
2505
0
2510
7
8831
0
8838
12
11336
0
11348
5
2505
0
2510
7
8831
0
8838
12
11336
0
11348
5
2505
0
2510
7
8831
0
8838
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
12
11336
0
11348
5
2505
0
2510
7
8831
0
8838
12
11336
0
11348
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
0
0
0
0
0
0
1
0
1
34
125
159
0
0
0
35
125
160
NA
NA
NA
NA
NA
NA
240.00%
0.00%
100.00%
16.29%
16.99%
16.83%
NA
NA
NA
16.73%
16.97%
16.92%
0
0
0
0
0
0
0
0
0
8
16
24
0
0
0
8
16
24
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.83%
2.17%
2.54%
NA
NA
NA
3.82%
2.17%
2.54%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
0
0
0
0
0
0
0
0
0
29
116
145
0
0
0
29
116
145
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
13.89%
15.76%
15.35%
NA
NA
NA
13.86%
15.75%
15.33%
HEDIS 2008 (Reporting Year 2007)
Page 61
Use of Services
st Plan of Minnesota
Mental Health Utilization
% of Members Receiving Inpatient, Day/Night and Ambulato
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Medicaid
Male
Female
Total
Male
Female
Total
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
16090
4872
16638
5275
32728
10147
16090
4872
16638
5275
32728
10147
16090
4872
16638
5275
32728
10147
16090
4872
16638
5275
32728
10147
20732
3
0
41697
32626
18
0
54557
53358
21
0
96254
20732
3
0
41697
32626
18
0
54557
53358
21
0
96254
20732
3
0
41697
32626
18
0
54557
53358
21
0
96254
20732
3
0
41697
32626
18
0
54557
53358
21
0
96254
Member Months
(Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months
(Inpatient)
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
Intensive Outpatient/Partial
Hospitalization
Inpatient
Member Months
(Outpatient/ED)
Male
Female
Total
Outpatient/ED
Number
Percent
Number
Percent
Number
Percent
Number
Percent
187
127
314
133
148
281
557
970
1527
0
0
0
0
0
0
877
1245
2122
13.95%
9.16%
11.51%
32.76%
33.67%
33.23%
32.24%
35.68%
34.34%
0.00%
0.00%
0.00%
NA
NA
NA
25.24%
27.38%
26.46%
0
1
1
7
15
22
45
51
96
0
0
0
0
0
0
52
67
119
0.00%
0.07%
0.04%
1.72%
3.41%
2.60%
2.60%
1.88%
2.16%
0.00%
0.00%
0.00%
NA
NA
NA
1.50%
1.47%
1.48%
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
1
0
1
0.00%
0.00%
0.00%
0.25%
0.00%
0.12%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.03%
0.00%
0.01%
187
127
314
132
146
278
553
967
1520
0
0
0
0
0
0
872
1240
2112
13.95%
9.16%
11.51%
32.51%
33.21%
32.88%
32.01%
35.57%
34.18%
0.00%
0.00%
0.00%
NA
NA
NA
25.10%
27.27%
26.33%
HEDIS 2008 (Reporting Year 2007)
Page 62
rst Plan of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Commercial
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
1533
800
820
1203
5097
114
0
9567
Female
1201
666
949
1767
6248
123
0
10954
Member Months
(Inpatient)
Total
2734
1466
1769
2970
11345
237
0
20521
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
1
0
1
0
2
2
2
3
5
6
6
12
1
0
1
0
0
0
10
11
21
HEDIS 2008 (Reporting Year 2007)
Male
1533
800
820
1203
5097
114
0
9567
Female
1201
666
949
1767
6248
123
0
10954
Total
2734
1466
1769
2970
11345
237
0
20521
Inpatient
Percent
0.00%
0.00%
0.00%
1.50%
0.00%
0.82%
0.00%
2.53%
1.36%
2.00%
2.04%
2.02%
1.41%
1.15%
1.27%
10.53%
0.00%
5.06%
NA
NA
NA
1.25%
1.21%
1.23%
Number
0
0
0
0
0
0
0
1
1
0
0
0
2
0
2
0
0
0
0
0
0
2
1
3
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
1.26%
0.68%
0.00%
0.00%
0.00%
0.47%
0.00%
0.21%
0.00%
0.00%
0.00%
NA
NA
NA
0.25%
0.11%
0.18%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
1533
1201
2734
800
666
1466
820
949
1769
1203
1767
2970
5097
6248
11345
114
123
237
0
0
0
9567
10954
20521
Member Months
(Outpatient/ED)
Male
1533
800
820
1203
5097
114
0
9567
Female
1201
666
949
1767
6248
123
0
10954
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
1
0
1
0
2
2
2
3
5
6
6
12
1
0
1
0
0
0
10
11
21
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
2734
1466
1769
2970
11345
237
0
20521
Percent
0.00%
0.00%
0.00%
1.50%
0.00%
0.82%
0.00%
2.53%
1.36%
2.00%
2.04%
2.02%
1.41%
1.15%
1.27%
10.53%
0.00%
5.06%
NA
NA
NA
1.25%
1.21%
1.23%
Page 63
rst Plan of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:30 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
rst Plan of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:30 PM
MSHO
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
0
5
2505
0
2510
Female
0
0
0
0
7
8831
0
8838
Member Months
(Inpatient)
Total
0
0
0
0
12
11336
0
11348
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
7
13
20
0
0
0
7
13
20
HEDIS 2008 (Reporting Year 2007)
Male
0
0
0
0
5
2505
0
2510
Female
0
0
0
0
7
8831
0
8838
Total
0
0
0
0
12
11336
0
11348
Inpatient
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
3.35%
1.77%
2.12%
NA
NA
NA
3.35%
1.77%
2.11%
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
9
14
0
0
0
5
9
14
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
2.40%
1.22%
1.48%
NA
NA
NA
2.39%
1.22%
1.48%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Male
Female
Total
0
0
0
0
0
0
0
0
0
0
0
0
5
7
12
2505
8831
11336
0
0
0
2510
8838
11348
Member Months
(Outpatient/ED)
Male
0
0
0
0
5
2505
0
2510
Female
0
0
0
0
7
8831
0
8838
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
4
6
10
0
0
0
4
6
10
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Total
0
0
0
0
12
11336
0
11348
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
1.92%
0.82%
1.06%
NA
NA
NA
1.91%
0.81%
1.06%
Page 65
rst Plan of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Medicaid
Member Months
(Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
16090
4872
4213
5125
11394
3
0
41697
Female
16638
5275
8865
9489
14272
18
0
54557
Member Months
(Inpatient)
Total
32728
10147
13078
14614
25666
21
0
96254
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
1
0
1
12
10
22
47
54
101
76
58
134
155
100
255
0
0
0
0
0
0
291
222
513
HEDIS 2008 (Reporting Year 2007)
Male
16090
4872
4213
5125
11394
3
0
41697
Female
16638
5275
8865
9489
14272
18
0
54557
Total
32728
10147
13078
14614
25666
21
0
96254
Inpatient
Percent
0.07%
0.00%
0.04%
2.96%
2.27%
2.60%
13.39%
7.31%
9.27%
17.80%
7.33%
11.00%
16.32%
8.41%
11.92%
0.00%
0.00%
0.00%
NA
NA
NA
8.37%
4.88%
6.40%
Number
0
0
0
2
5
7
13
21
34
25
17
42
64
49
113
0
0
0
0
0
0
104
92
196
Percent
0.00%
0.00%
0.00%
0.49%
1.14%
0.83%
3.70%
2.84%
3.12%
5.85%
2.15%
3.45%
6.74%
4.12%
5.28%
0.00%
0.00%
0.00%
NA
NA
NA
2.99%
2.02%
2.44%
Member Months
(Intensive Outpatient/Partial
Hospitalization)
Total
Male
Female
16090
4872
4213
5125
11394
3
0
41697
16638
5275
8865
9489
14272
18
0
54557
32728
10147
13078
14614
25666
21
0
96254
Member Months
(Outpatient/ED)
Male
16090
4872
4213
5125
11394
3
0
41697
Female
16638
5275
8865
9489
14272
18
0
54557
Intensive Outpatient/Partial
Hospitalization
Outpatient/ED
Number
0
0
0
0
0
0
1
0
1
1
0
1
4
3
7
0
0
0
0
0
0
6
3
9
Number
1
0
1
12
10
22
41
46
87
64
56
120
136
79
215
0
0
0
0
0
0
254
191
445
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.28%
0.00%
0.09%
0.23%
0.00%
0.08%
0.42%
0.25%
0.33%
0.00%
0.00%
0.00%
NA
NA
NA
0.17%
0.07%
0.11%
Total
32728
10147
13078
14614
25666
21
0
96254
Percent
0.07%
0.00%
0.04%
2.96%
2.27%
2.60%
11.68%
6.23%
7.98%
14.99%
7.08%
9.85%
14.32%
6.64%
10.05%
0.00%
0.00%
0.00%
NA
NA
NA
7.31%
4.20%
5.55%
Page 66
Use of Services
First Plan of Minnesota
Outpatient Drug Utilization
Commercial
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Member Months
2028
2786
7285
8185
216
21
0
0
20521
Total Cost of
Prescriptions
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
$35,170.94
$143,608.33
$409,981.66
$949,193.49
$20,185.95
$5,986.38
$0.00
$0.00
$1,564,126.75
HEDIS 2008 (Reporting Year 2007)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$17.34
$51.55
$56.28
$115.97
$93.45
$285.07
NA
$76.22
Total Number of
Prescriptions
494
1348
6577
17161
455
144
0
0
26179
Avg. Num. Of
Prescriptions /
Per Member Per
Year
2.92
5.81
10.83
25.16
25.28
82.29
NA
15.31
Page 67
Use of Services
First Plan of Minnesota
Outpatient Drug Utilization
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Outpatient Drug Utilization
MSHO
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Member Months
0
0
0
12
3062
3398
4876
0
11348
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
$464.35
$1,183,190.23
$1,071,738.71
$1,202,169.54
$0.00
$3,457,562.83
HEDIS 2008 (Reporting Year 2007)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
NA
$38.70
$386.41
$315.40
$246.55
$304.68
Total Number of
Prescriptions
0
0
0
10
26215
32277
45586
0
104088
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
NA
10.00
102.74
113.99
112.19
110.07
Page 69
Use of Services
First Plan of Minnesota
Outpatient Drug Utilization
Medicaid
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Member Months
27177
19422
34662
14972
21
0
0
0
96254
Total Cost of
Prescriptions
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
$354,629.00
$663,047.31
$2,922,150.34
$2,376,955.29
$1,817.64
$0.00
$0.00
$0.00
$6,318,599.58
HEDIS 2008 (Reporting Year 2007)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$13.05
$34.14
$84.30
$158.76
$86.55
NA
NA
$65.65
Total Number of
Prescriptions
7326
11450
52564
44330
26
0
0
0
115696
Avg. Num. Of
Prescriptions /
Per Member Per
Year
3.23
7.07
18.20
35.53
14.86
NA
NA
14.42
Page 70
Access/Availability of Care
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:30 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+
205
390
14
196
374
14
95.61%
92.56%
98.66%
95.90%
93.80%
97.99%
NA
NA
NA
2007
A
Page 71
Access/Availability of Care
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:30 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
778
2007
A
0
0
755
NA
NA
NA
NA
NA
NA
97.04%
95.79%
98.30%
Page 73
Access/Availability of Care
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:30 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+
1418
806
1
2007
A
1244
698
1
87.73%
85.99%
89.47%
86.60%
84.19%
89.01%
NA
NA
NA
Page 74
Access/Availability of Care
First Plan of Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:30 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.
18
68
42
117
18
60
34
103
NA
NA
NA
88.24%
79.84%
96.63%
80.95%
67.89%
94.02%
88.03%
81.73%
94.34%
2007
A
Page 75
Access/Availability of Care
First Plan of Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:30 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.
293
635
343
600
2007
A
281
555
303
550
95.90%
93.46%
98.34%
87.40%
84.74%
90.06%
88.34%
84.80%
91.88%
91.67%
89.37%
93.96%
Page 76
Access/Availability of Care
First Plan of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
Data collection methodology (Administrative or Hybrid)
A
A
Eligible member population (i.e. members who meet all
denominator criteria)
29
29
37.93%
68.97%
NR
NR
11
20
NR
NR
NR
NR
NR
NR
Data Elements
Number of numerator events by administrative data in
eligible population (before exclusions)
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of
valid data errors
Number of administrative data records excluded
Number of medical records data records excluded
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 77
Access/Availability of Care
First Plan of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Medicaid
Timeliness of
Prenatal Care
Postpartum
Care
Data collection methodology (Administrative or Hybrid)
A
A
Eligible member population (i.e. members who meet all
denominator criteria)
347
347
33.72%
72.91%
NR
NR
117
253
NR
NR
NR
NR
NR
NR
Data Elements
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
First Plan of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:30 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
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
Overall Rate
18+ Year Olds
0
18
18
0
0
6
2
6
2
Reported rate
NA
NA
NA
NA
NA
NA
Lower 95% confidence interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 79
Access/Availability of Care
First Plan of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:30 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
22
22
0
0
7
0
7
0
Reported rate
NA
NA
NA
NA
NA
NA
Lower 95% confidence interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 81
Access/Availability of Care
First Plan of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:30 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
10
211
221
3
3
73
30
76
33
Reported rate
NA
NA
34.60%
14.22%
34.39%
14.93%
Lower 95% confidence interval
NA
NA
NA
NA
27.94%
41.25%
9.27%
19.17%
27.90%
40.88%
10.01%
19.86%
Upper 95% confidence interval
HEDIS 2008 (Reporting Year 2007)
Page 82
Health Plan Stability
First Plan of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Commercial
Product/Product Line
Years in Business
Members*
11.00
8576
2.00
956
11.00
9532
NR
NR
63.00
1747
63.00
1747
11279
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
First Plan of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:30 PM
MSHO
Product/Product Line
Years in Business
Members*
11.00
8576
2.00
956
11.00
9532
NR
NR
63.00
1747
63.00
1747
11279
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
First Plan of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Medicaid
Product/Product Line
Years in Business
Members*
11.00
8576
2.00
956
11.00
9532
NR
NR
63.00
1747
63.00
1747
11279
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
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:30 PM
Commercial
<1
1-4
5-9
10-14
15-17
18-19
Male
168
456
564
684
504
324
Member Months
Female
132
288
456
624
396
312
Total
300
744
1020
1308
900
636
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
2700
27.88%
516
612
612
552
744
2208
19.93%
660
876
912
876
1008
4908
23.64%
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
3036
31.35%
1056
1176
924
672
4332
39.11%
1368
1248
1140
636
7368
35.49%
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
3828
39.53%
96
24
0
0
0
0
4392
39.65%
96
24
12
12
0
0
8220
39.60%
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
120
1.24%
0
144
1.30%
0
264
1.27%
9684
11076
HEDIS 2008 (Reporting Year 2007)
1176
1488
1524
1428
1752
2424
2424
2064
1308
192
48
12
12
0
0
0
20760
Page 87
Health Plan Descriptive Information
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:30 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
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:30 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
12
0
0.00%
0
0.00%
624
420
384
420
396
276
12
0.14%
1188
828
960
1632
2040
2184
12
0.11%
2520
100.00%
0
8832
99.86%
0
11352
99.89%
2520
8844
HEDIS 2008 (Reporting Year 2007)
0
0
0
0
0
0
0
0
12
1812
1248
1344
2052
2436
2460
0
11364
Page 89
Health Plan Descriptive Information
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:30 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
2434
5849
5137
4590
2952
1498
Member Months
Female
2638
5776
5343
4931
3225
2226
Total
5072
11625
10480
9521
6177
3724
22460
53.86%
2715
2840
2285
2065
2262
24139
44.25%
6639
5639
3850
3229
3138
46599
48.41%
12167
29.18%
2598
2214
1478
777
22495
41.23%
3088
2138
1434
1245
34662
36.01%
7067
16.95%
3
0
0
0
0
0
7905
14.49%
18
0
0
0
0
0
14972
15.55%
3
0.01%
0
18
0.03%
0
21
0.02%
41697
54557
HEDIS 2008 (Reporting Year 2007)
9354
8479
6135
5294
5400
5686
4352
2912
2022
21
0
0
0
0
0
0
96254
Page 90