UCare of Minnesota
Plan Name
2006
Reporting Year
General Info
Disclaimers
Submission #
Plan ID
1
17
Last Refreshed:
23
Use of Services Measures
Well Child Visits in the First 15 Months of Life
24
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
43
44
Page
2
10/7/2009 1:23:22 PM
Page
41
Page
25
Adolescent Well-Care Visits
Childhood Immunization Status
3
26
Frequency of Selected Procedures
45
Adolescent Immunization Status
5
27
Inpatient Utilization - General Hospital/Acute Care
48
Appropriate Treatment for Children with Upper Respiratory Infection
7
28
Ambulatory Care
51
Colorectal Cancer Screening
8
29
Inpatient Utilization - Nonacute Care
54
Breast Cancer Screening
9
30
13
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
57
Cervical Cancer Screening
Chlamydia Screening in Women
14
31
15
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory Services
60
Osteoporosis Management in Women Who had a Fracture
Controlling High Blood Pressure
16
32
17
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
64
Beta Blocker Treatment after Heart Attack
33
Identification of Alcohol and Other Drug Services
67
34
Outpatient Drug Utilization
71
35
Adult's Access to Preventive/Ambulatory Health Services
75
36
Children's and Adolescents' Access to Primary Care Practitioners
79
37
Prenatal and Postpartum Care
81
38
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
83
Health Plan Stability Measures
Years in Business / Total Membership
Page
39
Health Plan Descriptive Information Measures
Enrollment by Product Line (Age & Sex)
Page
40
Effectiveness of Care Measures
Persistence of Beta Blocker Treatment After Hearth Attack
18
Cholesterol Management for Patients with Cardiovascular Conditions
19
Comprehensive Diabetes Care
22
Use of Appropriate Medications for People with Asthma
26
Antidepressant Medication Management
28
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
32
Glaucoma Screening in Older Adults
33
Annual Monitoring for Patients on Persistent Medications
34
Drugs to Be Avoided in the Elderly
38
Potentially Harmful Drug-Disease Interactions in the Elderly
39
HEDIS 2007 (Reporting Year 2006)
Access / Availability of Care Measures
Page
87
91
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 2007 (Reporting Year 2006)
Page 2
Effectiveness of Care
UCare of Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Data Elements
General
Measure
Data
DTaP/DT
IPV
MMR
HiB
Hepatitis B
VZV
Pneumococcal
Conjugate
Combo 2
Combo 3
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of Records Excluded because of
Contraindications by Admin Data
Number of Records Excluded because of
Contraindications by Medical Record
Review
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
Page 3
Effectiveness of Care
UCare of Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:23 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
1151
65.88%
1264
72.35%
1525
87.29%
1215
69.55%
1155
66.11%
1466
83.92%
1052
60.22%
868
49.69%
763
43.67%
298
68.98%
319
73.84%
386
89.35%
308
71.30%
284
65.74%
358
82.87%
270
62.50%
215
49.77%
189
43.75%
290
52
83.21%
79.48%
86.95%
310
63
90.75%
87.83%
93.68%
369
16
93.67%
91.20%
96.15%
299
61
87.59%
84.28%
90.90%
276
96
90.51%
87.56%
93.47%
345
26
90.27%
87.28%
93.25%
265
41
74.45%
70.11%
78.79%
209
102
75.67%
71.40%
79.94%
185
84
65.45%
60.73%
70.17%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
2
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 2007 (Reporting Year 2006)
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
2006
H
1747
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
DTaP/DT
411
Page 4
Effectiveness of Care
UCare of Minnesota
Adolescent Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Data Elements
General
Measure
Data
MMR
Hepatitis B
VZV
Combo 2
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of Records Excluded because of
Contraindications by Admin Data
Number of Records Excluded because of
Contraindications by Medical Record Review
Number of employee/dependent records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
Page 5
Effectiveness of Care
UCare of Minnesota
Adolescent Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Combo 2
836
58.18%
175
12.18%
464
32.29%
77
5.36%
245
56.71%
56
12.96%
132
30.56%
21
4.86%
234
115
84.91%
81.33%
88.50%
55
212
64.96%
60.23%
69.70%
124
103
55.23%
50.30%
60.16%
21
154
42.58%
37.68%
47.48%
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 2007 (Reporting Year 2006)
VZV
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
Hepatitis B
2006
H
1437
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
Admin rate on FSS
MMR
411
Page 6
Effectiveness of Care
UCare of Minnesota
Appropriate Treatment for Children with Upper
Respiratory Infection
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Data Elements
General
Measure
Data
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
NR
Lower 95% Confidence Interval
NR
Upper 95% Confidence Interval
NR
HEDIS 2007 (Reporting Year 2006)
Page 7
Effectiveness of Care
UCare of Minnesota
Colorectal Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare
Advantage
MSHO
2006
2006
H
H
Eligible population
14690
2776
Number of numerator events by administrative data in eligible
population (before exclusions)
5951
706
40.51%
25.43%
Minimum required sample size (MRSS) or other sample size
411
411
Oversampling rate
0.05
0.05
Final sample size (FSS)
432
432
Number of numerator events by administrative data in FSS
181
112
Data Elements
Commercial
Measurement Year
Data collection methodology (administrative or hybrid)
Current year's administrative rate (before exclusions)
NR
41.90%
25.93%
Number of original sample records excluded because of valid data
errors
0
0
Number of administrative data records excluded
50
16
Number of medical record data records excluded
0
0
Number of employee/dependent medical records excluded
0
0
Records added from the oversample list
0
0
Denominator
411
411
Numerator events by administrative data
172
107
Numerator events by medical records
37
33
Administrative rate on FSS
NR
Reported rate
NR
50.85%
34.06%
Lower 95% confidence interval
NR
45.90%
29.36%
Upper 95% confidence interval
NR
55.81%
38.77%
Data Elements with an Asterisk(*) are OPTIONAL and are not used in any calculation or total
HEDIS 2007 (Reporting Year 2006)
Page 8
Effectiveness of Care
UCare of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Data Elements
General Measure
Data
Ages 42-51
Ages 52-69
Total
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
NR
NR
NR
Page 9
Effectiveness of Care
UCare of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
General Measure
Data
Ages 42-51
Ages 52-69
Total
35
25
71.43%
55.03%
87.82%
2127
1635
76.87%
75.05%
78.68%
2162
1660
76.78%
74.98%
78.58%
2006
A
Page 10
Effectiveness of Care
UCare of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
General Measure
Data
Ages 42-51
Ages 52-69
Total
0
0
NA
NA
NA
396
220
55.56%
50.54%
60.58%
396
220
55.56%
50.54%
60.58%
2006
A
Page 11
Effectiveness of Care
UCare of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
General Measure
Data
Ages 42-51
Ages 52-69
Total
1504
774
51.46%
48.90%
54.02%
1150
633
55.04%
52.12%
57.96%
2654
1407
53.01%
51.10%
54.93%
2006
A
Page 12
Effectiveness of Care
UCare of Minnesota
Cervical Cancer Screening
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2006
H
8906
Numerator Events by Admin Data on Eligible
Population (before exclusions)
6139
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
NR
NR
68.93%
411
5.00%
432
305
70.60%
0
Number of administrative data records excluded
49
Number of medical record data records excluded
2
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
NR
NR
NR
2
411
292
7
72.75%
68.32%
77.18%
Page 13
Effectiveness of Care
UCare of Minnesota
Chlamydia Screening in Women
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
General
Measure Ages 16-20 Ages 21-25
Data
Medicaid
Total
General
Measure Ages 16-20 Ages 21-25
Data
Total
2006
A
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
1390
682
49.06%
46.40%
51.73%
1633
809
49.54%
47.09%
52.00%
3023
1491
49.32%
47.52%
51.12%
Page 14
Effectiveness of Care
UCare of Minnesota
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 2007 (Reporting Year 2006)
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare
Advantage
MSHO
2006
A
548
131
23.91%
20.24%
27.57%
2006
A
214
34
15.89%
10.76%
21.02%
Page 15
Effectiveness of Care
UCare of Minnesota
Controlling High Blood Pressure
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Data Elements
General Measure
Data
Ages 18-45
Ages 46-85
Total
Measurement Year
Data Collection Methodology (Hybrid)
Eligible Member Population
NR
Numerator Events by Admin Data on
Eligible Population (before exclusions)
NR
Current Year's Admin Rate
NR
NR
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
NR
NR
NR
NR
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
NR
Numerator Events by Admin Data
NR
Numerator Events by Medical Record
NR
Reported Rate
NR
NR
#VALUE!
Lower 95% Confidence Interval
NR
NR
#VALUE!
Upper 95% Confidence Interval
NR
NR
#VALUE!
HEDIS 2007 (Reporting Year 2006)
Page 16
Effectiveness of Care
UCare of Minnesota
Beta Blocker Treatment after Heart Attack
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Medicare Advantage
MSHO
2006
2006
H
H
Eligible Member Population
205
42
Numerator Events by Admin Data on
Eligible Population
160
34
78.05%
80.95%
186
37
0.00%
0.00%
Final Sample Size (FSS)
186
37
Numerator events by admin data in FSS
160
34
Measurement Year
Data Collection Methodology
Current Year's Admin Rate
NR
Minimum Required Sample Size
Oversampling Rate
Admin rate on FSS
86.02%
91.89%
Records Excluded because of Valid Data
Errors
NR
0
0
Number of administrative data records
excluded
22
8
Number of medical record data records
excluded
3
0
Number of employee/dependent medical
records excluded
0
0
Records Added from the Oversample List
0
0
Denominator
183
37
Numerator Events by Admin Data
160
34
8
2
Numerator Events by Medical Record
Reported Rate
NR
91.80%
97.30%
Lower 95% Confidence Interval
NR
87.56%
90.72%
Upper 95% Confidence Interval
NR
96.05%
100.00%
HEDIS 2007 (Reporting Year 2006)
Page 17
Effectiveness of Care
UCare of Minnesota
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Commercial
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare Advantage
MSHO
2006
2006
A
A
Eligible Member Population
170
170
Numerator Events by Admin Data on
Eligible Population
124
124
Measurement Year
Data Collection Methodology
Reported Rate
NR
72.94%
72.94%
Lower 95% Confidence Interval
NR
65.97%
65.97%
Upper 95% Confidence Interval
NR
79.91%
79.91%
HEDIS 2007 (Reporting Year 2006)
Page 18
Effectiveness of Care
UCare of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Data Elements
General
Measure
Data
LDL-C
screening
LDL-C Level of
<100 mg/dL
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
Page 19
Effectiveness of Care
UCare of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:23 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
16
Number of employee/dependent medical records
excluded
0
HEDIS 2007 (Reporting Year 2006)
682
0
86.77%
0.00%
411
5.00%
432
Records Excluded because of Valid Data Errors
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
LDL-C Level of
<100 mg/dL
2006
H
786
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
382
0
88.43%
0.00%
364
8
0
242
90.51%
87.56%
93.47%
58.88%
54.00%
63.76%
16
411
Page 20
Effectiveness of Care
UCare of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:23 PM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Number of administrative data records excluded
0
Number of medical record data records excluded
9
Number of employee/dependent medical records
excluded
0
HEDIS 2007 (Reporting Year 2006)
0
78.65%
0.00%
140
0
78.65%
0.00%
134
3
0
81
81.07%
74.86%
87.27%
47.93%
40.10%
55.76%
178
0.00%
178
0
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
140
178
Records Excluded because of Valid Data Errors
Records Added from the Oversample List
Denominator
LDL-C Level of
<100 mg/dL
2006
H
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
169
Page 21
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Data Elements
HbA1c
Testing
Poor HbA1c Good HbA1c
Control
Control
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Number of Records Excluded Because of
Valid Data Errors
Number of administrative data records
excluded
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
Page 22
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare Advantage
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
2006
H
2304
2006
H
2304
2006
H
2304
2006
H
2304
2006
H
2304
2006
H
2304
2006
H
2304
2006
H
2304
2006
H
2304
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
2112
91.67%
411
5%
432
399
92.36%
2304
100.00%
411
5%
432
432
100.00%
0
0.00%
411
5%
432
0
0.00%
1742
75.61%
411
5%
432
329
76.16%
1983
86.07%
411
5%
432
370
85.65%
0
0.00%
411
5%
432
0
0.00%
2005
87.02%
411
5%
432
368
85.19%
0
0.00%
411
5%
432
0
0.00%
0
0.00%
411
5%
432
0
0.00%
Number of Records Excluded Because of
Valid Data Errors
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
0
0
0
0
0
0
0
0
0
4
4
4
4
4
4
4
4
4
0
0
0
0
0
0
0
0
0
4
411
379
3
92.94%
90.35%
95.54%
4
411
27
70
23.60%
19.37%
27.83%
4
411
0
223
54.26%
49.32%
59.20%
4
411
313
14
79.56%
75.54%
83.58%
4
411
350
7
86.86%
83.47%
90.25%
4
411
0
209
50.85%
45.90%
55.81%
4
411
352
15
89.29%
86.18%
92.41%
4
411
0
293
71.29%
66.79%
75.79%
4
411
0
185
45.01%
40.08%
49.94%
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 2007 (Reporting Year 2006)
Page 23
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:23 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
2006
H
784
2006
H
784
2006
H
784
2006
H
784
2006
H
784
2006
H
784
2006
H
784
2006
H
784
2006
H
784
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
699
89.16%
411
5%
432
389
90.05%
782
99.74%
411
5%
432
432
100.00%
0
0.00%
411
5%
432
0
0.00%
505
64.41%
411
5%
432
272
62.96%
596
76.02%
411
5%
432
334
77.31%
0
0.00%
411
5%
432
0
0.00%
670
85.46%
411
5%
432
373
86.34%
0
0.00%
411
5%
432
0
0.00%
0
0.00%
411
5%
432
0
0.00%
Number of Records Excluded Because of
Valid Data Errors
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
2
2
2
2
2
2
2
2
2
1
1
1
1
1
1
1
1
1
0
0
0
0
0
0
0
0
0
1
411
372
7
92.21%
89.50%
94.93%
1
411
33
118
36.74%
31.96%
41.52%
1
411
0
170
41.36%
36.48%
46.25%
1
411
263
14
67.40%
62.74%
72.05%
1
411
320
10
80.29%
76.32%
84.26%
1
411
0
191
46.47%
41.53%
51.42%
1
411
356
13
89.78%
86.73%
92.83%
1
411
0
277
67.40%
62.74%
72.05%
1
411
0
192
46.72%
41.77%
51.66%
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 2007 (Reporting Year 2006)
Page 24
Effectiveness of Care
UCare of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:23 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
2006
H
1238
2006
H
1238
2006
H
1238
2006
H
1238
2006
H
1238
2006
H
1238
2006
H
1238
2006
H
1238
2006
H
1238
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
1019
82.31%
411
5%
432
363
84.03%
1208
97.58%
411
5%
432
432
100.00%
0
0.00%
411
5%
432
0
0.00%
641
51.78%
411
5%
432
244
56.48%
875
70.68%
411
5%
432
310
71.76%
0
0.00%
411
5%
432
0
0.00%
950
76.74%
411
5%
432
345
79.86%
0
0.00%
411
5%
432
0
0.00%
0
0.00%
411
5%
432
0
0.00%
Number of Records Excluded Because of
Valid Data Errors
0
0
0
0
0
0
0
0
0
Number of administrative data records
excluded
30
30
30
30
30
30
30
30
30
16
16
16
16
16
16
16
16
16
0
0
0
0
0
0
0
0
0
16
411
350
13
88.32%
85.09%
91.55%
16
411
28
141
41.12%
36.24%
46.00%
16
411
0
142
34.55%
29.83%
39.27%
16
411
237
21
62.77%
57.98%
67.57%
16
411
298
20
77.37%
73.21%
81.54%
16
411
0
114
27.74%
23.29%
32.19%
16
411
334
21
86.37%
82.94%
89.81%
16
411
0
293
71.29%
66.79%
75.79%
16
411
0
176
42.82%
37.92%
47.73%
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 2007 (Reporting Year 2006)
Page 25
Effectiveness of Care
UCare of Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
General
Measure Data
Ages 5-9
NR
NR
NR
Ages 10-17
NR
NR
NR
Ages 18-56
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 26
Effectiveness of Care
UCare of Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
Total
154
148
96.10%
92.72%
99.48%
224
211
94.20%
90.91%
97.48%
342
287
83.92%
79.88%
87.96%
720
646
89.72%
87.43%
92.01%
2006
A
Page 27
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 28
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
12
5.38%
2.20%
8.57%
123
55.16%
48.41%
61.91%
94
42.15%
35.45%
48.86%
2006
A
223
Page 29
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
8
10.96%
3.11%
18.81%
53
72.60%
61.69%
83.52%
42
57.53%
45.51%
69.56%
2006
A
73
Page 30
Effectiveness of Care
UCare of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
144
25.58%
21.88%
29.27%
254
45.12%
40.92%
49.31%
172
30.55%
26.66%
34.44%
2006
A
563
Page 31
Effectiveness of Care
UCare of Minnesota
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Total Exclusions
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interva
HEDIS 2007 (Reporting Year 2006)
General
Measure
Data
Initiation
Phase
Medicaid
Continuation
and
Maintenance
Phase
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
394
0
175
44.42%
39.38%
49.45%
103
0
48
46.60%
36.48%
56.72%
2006
A
NR
NR
NR
NR
NR
NR
Page 32
Effectiveness of Care
UCare of Minnesota
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interva
HEDIS 2007 (Reporting Year 2006)
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare
Advantage
MSHO
2006
A
22893
18332
80.08%
79.56%
80.60%
2006
A
4956
3497
70.56%
69.28%
71.84%
Page 33
Effectiveness of Care
UCare of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Data Elements
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
Measurement Year
Data Collection Methodology
Eligible Member Population
Total Exclusions
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
Page 34
Effectiveness of Care
UCare of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare Advantage
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Total Exclusions
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
8468
158
7505
88.63%
87.95%
89.31%
779
25
706
90.63%
88.52%
92.74%
9296
163
8347
89.79%
89.17%
90.41%
366
0
299
81.69%
77.60%
85.79%
18909
346
16857
89.15%
88.70%
89.59%
2006
A
Page 35
Effectiveness of Care
UCare of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:23 PM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Total Exclusions
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
2244
99
2060
91.80%
90.64%
92.96%
336
10
311
92.56%
89.60%
95.51%
2539
110
2348
92.48%
91.43%
93.52%
353
0
301
85.27%
81.43%
89.11%
5472
219
5020
91.74%
91.00%
92.48%
2006
A
Page 36
Effectiveness of Care
UCare of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Total Exclusions
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
1072
18
846
78.92%
76.43%
81.41%
24
0
16
NA
NA
NA
883
12
720
81.54%
78.92%
84.16%
159
0
119
74.84%
67.78%
81.90%
2138
30
1701
79.56%
77.83%
81.29%
2006
A
Page 37
Effectiveness of Care
UCare of Minnesota
Drugs to Be Avoided in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
General
Measure
Data
2006
A
26197
MSHO
1 or More
Prescriptions
2 or More
Prescriptions
4496
17.16%
16.70%
17.62%
764
2.92%
2.71%
3.12%
General
Measure
Data
2006
A
6575
1 or More
Prescriptions
2 or More
Prescriptions
1655
25.17%
24.11%
26.23%
338
5.14%
4.60%
5.68%
Page 38
Effectiveness of Care
UCare of Minnesota
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
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
2006
A
1191
140
11.75%
9.88%
13.63%
1816
372
20.48%
18.60%
22.37%
180
8
4.44%
1.16%
7.73%
3187
520
16.32%
15.02%
17.61%
Page 39
Effectiveness of Care
UCare of Minnesota
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
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
2006
A
369
77
20.87%
16.59%
25.15%
1515
405
26.73%
24.47%
28.99%
68
5
7.35%
0.41%
14.29%
1952
487
24.95%
23.00%
26.89%
Page 40
Use of Services
UCare of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Data Elements
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of records excluded because of
contraindications identified through
administrative data
Number of records excluded because of
contraindications identified through medical
record review
Number of employee/dependent medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
Page 41
Use of Services
UCare of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:23 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
1
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Oversample List
1
HEDIS 2007 (Reporting Year 2006)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
37
1.58%
56
2.39%
99
4.22%
150
6.39%
332
14.15%
591
25.18%
1077
45.89%
6
1.39%
6
1.39%
13
3.01%
29
6.71%
58
13.43%
92
21.30%
228
52.78%
3
0
0.73%
0.00%
1.67%
4
0
0.97%
0.00%
2.04%
10
2
2.92%
1.17%
4.67%
11
7
4.38%
2.28%
6.48%
37
10
11.44%
8.24%
14.63%
64
15
19.22%
15.29%
23.15%
198
50
60.34%
55.49%
65.19%
411
5.00%
432
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
1 visit
2006
H
2347
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Zero Visits
411
Page 42
Use of Services
UCare of Minnesota
Well Child Visits in the 3rd, 4th,
5th and 6th Years of Life
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2006
H
5915
Numerator events by admin data in eligible
population
3678
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
NR
NR
411
5.00%
432
257
NR
59.49%
0
Records Excluded - Contraindications/Admin Data
0
Records Excluded - Contraindications/Medical
Record Review
0
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
NR
NR
NR
0
411
240
19
63.02%
58.23%
67.81%
Page 43
Use of Services
UCare of Minnesota
Adolescent Well-Care Visits
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2006
H
11218
Numerator events by admin data in eligible
population
3769
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
NR
NR
411
5.00%
432
163
NR
37.73%
0
Records Excluded because of Valid Data Errors
Records Excluded - Contraindications/Admin Data
0
Records Excluded - Contraindications/Medical
Record Review
0
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
NR
NR
NR
0
411
150
25
42.58%
37.68%
47.48%
Page 44
Use of Services
UCare of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Member Months
Total
Age
0-4
0-9
5-19
10-19
Total
Procedure
Myringotomy
Tonsillectomy
Age
15-44
20-44
30-64
45-64
65+
Age
0-4
5-19
0-9
10-19
Number of
Procedures
Procedures /
1,000 Member
Months
NR
NR
NR
NR
Member Months
Male
Female
Female
Male
Procedure
Dilation &
Curettage
Hysterectomy,
Abdominal
Age
15-44
45-64
15-44
45-64
65+
Hysterectomy,
15-44
Vaginal
45-64
65+
Cholecystectomy,
30-64
Open
15-44
45-64
65+
Cholecystectomy,
30-64
Closed
15-44
45-64
65+
20-44
Back Surgery
45-64
65+
Angioplasty (PTCA) 45-64
65+
45-64
Cardiac
Catheterization
65+
45-64
CABG
65+
Prostatectomy
45-64
65+
Mastectomy
15-44
45-64
65+
Lumpectomy
15-44
45-64
65+
HEDIS 2007 (Reporting Year 2006)
Number of
Procedures
Procedures /
1,000 Member
Months
Number of
Procedures
Procedures /
1,000 Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 45
Use of Services
UCare of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare Advantage
Age
< 65
65-74
75-84
85+
Member Months
Male
Female
4332
5705
73180
98925
53820
89608
19313
49757
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 2007 (Reporting Year 2006)
Number of
Procedures
2
32
33
4
5
98
119
15
7
133
109
18
0
20
20
1
0
7
22
25
1
29
31
5
3
69
59
5
0
18
28
10
0
8
4
5
1
29
19
6
16
228
204
52
Procedures /
1,000 Member
Months
0.46
0.44
0.61
0.21
1.15
1.34
2.21
0.78
1.62
1.82
2.03
0.93
0.00
0.27
0.37
0.05
0.00
0.10
0.41
1.29
0.23
0.40
0.58
0.26
0.69
0.94
1.10
0.26
0.00
0.25
0.52
0.52
0.00
0.11
0.07
0.26
0.23
0.40
0.35
0.31
3.69
3.12
3.79
2.69
Female
Number of
Procedures
1
12
16
3
9
59
91
27
5
94
137
31
2
15
17
3
4
28
78
109
5
53
58
24
8
104
112
22
3
25
32
13
0
12
8
3
1
39
39
14
41
311
422
183
2
24
8
2
3
19
6
1
1
25
17
3
1
39
49
13
Procedures /
1,000 Member
Months
0.18
0.12
0.18
0.06
1.58
0.60
1.02
0.54
0.88
0.95
1.53
0.62
0.35
0.15
0.19
0.06
0.70
0.28
0.87
2.19
0.88
0.54
0.65
0.48
1.40
1.05
1.25
0.44
0.53
0.25
0.36
0.26
0.00
0.12
0.09
0.06
0.18
0.39
0.44
0.28
7.19
3.14
4.71
3.68
0.35
0.24
0.09
0.04
0.53
0.19
0.07
0.02
0.18
0.25
0.19
0.06
0.18
0.39
0.55
0.26
Page 46
Use of Services
UCare of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:23 PM
MSHO
Age
< 65
65-74
75-84
85+
Member Months
Male
Female
0
0
10885
19993
8877
22135
4873
24793
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 2007 (Reporting Year 2006)
Number of
Procedures
0
1
3
0
0
17
11
0
0
13
14
5
0
2
0
0
0
5
8
3
0
1
3
0
0
3
5
0
0
4
6
2
0
0
1
0
0
4
3
2
0
21
24
1
Procedures /
1,000 Member
Months
NA
0.09
0.34
0.00
NA
1.56
1.24
0.00
NA
1.19
1.58
1.03
NA
0.18
0.00
0.00
NA
0.46
0.90
0.62
NA
0.09
0.34
0.00
NA
0.28
0.56
0.00
NA
0.37
0.68
0.41
NA
0.00
0.11
0.00
NA
0.37
0.34
0.41
NA
1.93
2.70
0.21
Female
Number of
Procedures
0
3
2
0
0
13
20
3
0
30
21
4
0
2
2
0
0
6
37
52
0
15
6
4
0
25
15
6
0
8
7
5
0
3
5
1
0
16
3
8
0
91
55
30
0
4
0
1
0
1
2
0
0
4
1
1
0
7
2
6
Procedures /
1,000 Member
Months
NA
0.15
0.09
0.00
NA
0.65
0.90
0.12
NA
1.50
0.95
0.16
NA
0.10
0.09
0.00
NA
0.30
1.67
2.10
NA
0.75
0.27
0.16
NA
1.25
0.68
0.24
NA
0.40
0.32
0.20
NA
0.15
0.23
0.04
NA
0.80
0.14
0.32
NA
4.55
2.48
1.21
NA
0.20
0.00
0.04
NA
0.05
0.09
0.00
NA
0.20
0.05
0.04
NA
0.35
0.09
0.24
Page 47
Use of Services
Care 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 1:23 PM
Member Months
NR
Discharges
Discharges /
1,000 Member
Months
Days
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2007 (Reporting Year 2006)
NR
NR
NR
NR
NR
NR
NR
NR
NR
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
Care of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare Advantage
Age
Member Months
<1
0
1-9
0
10-19
0
20-44
540
45-64
9497
65-74
172105
75-84
143428
85+
69070
Unknown
0
394640
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Discharges
0
0
0
12
282
2813
4222
2711
0
10040
Discharges /
1,000 Member
Months
NA
NA
NA
22.22
29.69
16.34
29.44
39.25
25.44
0
0
0
9
161
1484
2692
2046
0
6392
NA
NA
NA
16.67
16.95
8.62
18.77
29.62
0
0
0
3
119
1328
1530
664
0
3644
NA
NA
NA
5.56
12.53
7.72
10.67
9.61
0
0
1
0
1
NA
0.00
0.11
HEDIS 2007 (Reporting Year 2006)
16.20
9.23
0.10
Days
0
0
0
36
1262
11718
19148
12131
0
44295
Days / 1,000
Member
Months
NA
NA
NA
66.67
132.88
68.09
133.50
175.63
112.24
0
0
0
32
570
5159
9919
7876
0
23556
NA
NA
NA
59.26
60.02
29.98
69.16
114.03
0
0
0
4
648
6530
9229
4248
0
20659
NA
NA
NA
7.41
68.23
37.94
64.35
61.50
0
0
5
0
5
NA
0.00
0.53
59.69
52.35
0.50
Average
Length of Stay
NA
NA
NA
3.00
4.48
4.17
4.54
4.47
NA
4.41
NA
NA
NA
3.56
3.54
3.48
3.68
3.85
NA
3.69
NA
NA
NA
1.33
5.45
4.92
6.03
6.40
NA
5.67
NA
NA
5.00
NA
5.00
Page 49
Use of Services
Care 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 1:23 PM
Member Months
0
0
0
0
0
30878
31012
29666
0
91556
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
1110
1219
1045
0
3374
NA
NA
NA
NA
NA
35.95
39.31
35.23
0
0
0
0
0
785
920
843
0
2548
NA
NA
NA
NA
NA
25.42
29.67
28.42
36.85
27.83
0
0
0
0
0
322
299
202
0
823
NA
NA
NA
NA
NA
10.43
9.64
6.81
0
0
0
0
0
NA
NA
NA
HEDIS 2007 (Reporting Year 2006)
8.99
NA
Days
0
0
0
0
0
5352
5600
4919
0
15871
0
0
0
0
0
3000
3554
3594
0
10148
Days / 1,000
Member
Months
NA
NA
NA
NA
NA
173.33
180.58
165.81
173.35
NA
NA
NA
NA
NA
97.16
114.60
121.15
110.84
0
0
0
0
0
2157
2046
1325
0
5528
NA
NA
NA
NA
NA
69.86
65.97
44.66
0
0
0
0
0
NA
NA
NA
60.38
NA
Average
Length of Stay
NA
NA
NA
NA
NA
4.82
4.59
4.71
NA
4.70
NA
NA
NA
NA
NA
3.82
3.86
4.26
NA
3.98
NA
NA
NA
NA
NA
6.70
6.84
6.56
NA
6.72
NA
NA
NA
NA
NA
Page 50
Use of Services
Care of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
NR
Outpatient Visits
(Excludes MH/CD)
Age
Visits
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits/ 1,000
Member
Months
NR
NR
Emergency Room Visits
Visits
NR
NR
NR
NR
NR
NR
NR
HEDIS 2007 (Reporting Year 2006)
NR
Visits/ 1,000
Member
Months
NR
NR
Ambulatory
Surgery/Procedures
Procedures
NR
NR
NR
NR
NR
NR
NR
NR
Procedures/
1,000 Member
Months
NR
NR
Observation Room Stays
Resulting in Discharge
Stays
NR
NR
NR
NR
NR
NR
NR
NR
Stays/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 51
Use of Services
Care of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:23 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
540
9497
172105
143428
69070
0
394640
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
0
311
6910
91524
96865
41658
0
237268
HEDIS 2007 (Reporting Year 2006)
Visits/ 1,000
Member
Months
NA
NA
NA
575.93
727.60
531.79
675.36
603.13
601.23
Emergency Room Visits
Visits
0
0
0
31
253
2270
2823
1686
0
7063
Visits/ 1,000
Member
Months
NA
NA
NA
57.41
26.64
13.19
19.68
24.41
17.90
Ambulatory
Surgery/Procedures
Procedures
0
0
0
11
346
5373
5015
1397
0
12142
Procedures/
1,000 Member
Months
NA
NA
NA
20.37
36.43
31.22
34.97
20.23
30.77
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
5
119
187
106
0
417
Stays/ 1,000
Member
Months
NA
NA
NA
0.00
0.53
0.69
1.30
1.53
1.06
Page 52
Use of Services
Care of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:23 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
30878
31012
29666
0
91556
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
19881
16371
8565
0
44817
HEDIS 2007 (Reporting Year 2006)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
643.86
527.89
288.71
489.50
Emergency Room Visits
Visits
0
0
0
0
0
1118
898
730
0
2746
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
36.21
28.96
24.61
29.99
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
0
874
718
341
0
1933
Procedures/
1,000 Member
Months
NA
NA
NA
NA
NA
28.30
23.15
11.49
21.11
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
40
56
36
0
132
Stays/ 1,000
Member
Months
NA
NA
NA
NA
NA
1.30
1.81
1.21
1.44
Page 53
Use of Services
UCare of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Age
Member
Months
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
NR
Discharges
Discharges /
1,000 Member
Months
Days
Days / 1,000
Member
Months
Average Length
of Stay
<1
NR
NR
NR
1-9
NR
NR
NR
10-19
NR
NR
NR
20-44
NR
NR
NR
45-64
NR
NR
NR
65-74
NR
NR
NR
75-84
NR
NR
NR
85+
NR
NR
NR
NR
NR
NR
Unknown
Total
NR
HEDIS 2007 (Reporting Year 2006)
NR
NR
Page 54
Use of Services
UCare of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare Advantage
Age
Member
Months
<1
0
1-9
0
10-19
0
20-44
540
45-64
9497
65-74
172105
75-84
143428
85+
69070
Unknown
0
394640
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
48
5.05
716
75.39
14.92
65-74
414
2.41
6365
36.98
15.37
75-84
1266
8.83
20479
142.78
16.18
85+
1331
19.27
23317
337.59
17.52
Unknown
0
3059
7.75
0
50877
128.92
NA
16.63
Age
Total
HEDIS 2007 (Reporting Year 2006)
Page 55
Use of Services
UCare of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:23 PM
MSHO
Age
Member
Months
<1
0
1-9
0
10-19
0
20-44
0
45-64
0
65-74
30878
75-84
31012
85+
29666
Unknown
0
91556
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
291
9.42
6115
198.04
21.01
75-84
560
18.06
14117
455.21
25.21
85+
669
22.55
17121
577.13
25.59
Unknown
0
1520
16.60
0
37353
407.98
NA
24.57
Age
Total
HEDIS 2007 (Reporting Year 2006)
Page 56
Use of Services
UCare of Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Member Months
Age
Male
0-12
13-17
18-64
65+
Unknown
Total
Female
NR
NR
NR
Discharges
Age
0-12
Gender
M
F
Total
13-17
M
F
Total
18-64
M
F
Total
M
F
Total
M
F
Total
M
F
TOTAL
65+
Unknown
Total
Total
HEDIS 2007 (Reporting Year 2006)
NR
NR
NR
NR
NR
Discharges /
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
Days*
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
Page 57
Use of Services
UCare of Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare Advantage
Member Months
Male
Female
Total
0
0
4332
146313
0
150645
0
0
5705
238290
0
243995
0
0
10037
384603
0
394640
Discharges
Discharges /
1,000 Member
Months
Days*
Average Length
of Stay
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Gender
M
F
Total
0
0
0
NA
NA
NA
0
0
0
NA
NA
NA
13-17
M
F
Total
0
0
0
NA
NA
NA
0
0
0
NA
NA
NA
18-64
M
F
Total
M
F
Total
M
F
Total
M
F
TOTAL
10
24
34
2.31
4.21
3.39
113
289
402
11.30
12.04
11.82
61
134
195
0.42
0.56
0.51
575
1517
2092
9.43
11.32
10.73
0
0
0
NA
NA
NA
688
1806
2494
9.69
11.43
10.89
65+
Unknown
Total
HEDIS 2007 (Reporting Year 2006)
0
0
0
71
158
229
0.47
0.65
0.58
Page 58
Use of Services
UCare of Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Oct 7, 2009 1:23 PM
MSHO
Member Months
Age
Male
Female
Total
0-12
13-17
18-64
65+
Unknown
Total
0
0
0
24635
0
24635
0
0
0
66921
0
66921
0
0
0
91556
0
91556
Discharges
Discharges /
1,000 Member
Months
Days*
Average Length
of Stay
Age
0-12
Gender
M
F
Total
0
0
0
NA
NA
NA
0
0
0
NA
NA
NA
13-17
M
F
Total
0
0
0
NA
NA
NA
0
0
0
NA
NA
NA
18-64
M
F
Total
M
F
Total
M
F
Total
M
F
TOTAL
0
0
0
NA
NA
NA
0
0
0
NA
NA
NA
39
94
133
1.58
1.40
1.45
606
1637
2243
15.54
17.41
16.86
0
0
0
NA
NA
NA
606
1637
2243
15.54
17.41
16.86
65+
Unknown
Total
HEDIS 2007 (Reporting Year 2006)
0
0
0
39
94
133
1.58
1.40
1.45
Page 59
Use of Services
UCare of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
Female
NR
Member Months (Inpatient)
Total
Age
13-17
18-64
65+
Unknown
Total
Sex
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
HEDIS 2007 (Reporting Year 2006)
Female
Total
Male
Female
Total
Member Months (Ambulatory)
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 Mental Health Services
0-12
Male
Member Months (Day/Night)
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Inpatient Mental Health Services
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
Day/Night Mental Health Services
Percent
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Ambulatory Mental Health Services
Percent
Number
NR
NR
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 60
Use of Services
UCare of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare Advantage
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months (Inpatient)
Age
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4332
146313
0
150645
5705
238290
0
243995
10037
384603
0
394640
4332
146313
0
150645
5705
238290
0
243995
10037
384603
0
394640
4332
146313
0
150645
5705
238290
0
243995
10037
384603
0
394640
4332
146313
0
150645
5705
238290
0
243995
10037
384603
0
394640
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 (Ambulatory)
Female
Any Mental Health Services
0-12
Member Months (Day/Night)
Male
Inpatient Mental Health Services
Day/Night Mental Health Services
Number
Percent
Number
Percent
Number
Percent
Ambulatory Mental Health Services
Percent
Number
0
0
0
0
0
0
63
108
171
253
633
886
0
0
0
316
741
1057
NA
NA
NA
NA
NA
NA
17.45%
22.72%
20.44%
2.08%
3.19%
2.76%
NA
NA
NA
2.52%
3.64%
3.21%
0
0
0
0
0
0
8
15
23
52
106
158
0
0
0
60
121
181
NA
NA
NA
NA
NA
NA
2.22%
3.16%
2.75%
0.43%
0.53%
0.49%
NA
NA
NA
0.48%
0.60%
0.55%
0
0
0
0
0
0
1
2
3
1
0
1
0
0
0
2
2
4
NA
NA
NA
NA
NA
NA
0.28%
0.42%
0.36%
0.01%
0.00%
0.00%
NA
NA
NA
0.02%
0.01%
0.01%
0
0
0
0
0
0
60
107
167
211
556
767
0
0
0
271
663
934
HEDIS 2007 (Reporting Year 2006)
NA
NA
NA
NA
NA
NA
16.62%
22.51%
19.97%
1.73%
2.80%
2.39%
NA
NA
NA
2.16%
3.26%
2.84%
Page 61
Use of Services
UCare of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory
Data Last Refreshed:
Oct 7, 2009 1:23 PM
MSHO
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months (Inpatient)
Age
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
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
24635
0
24635
0
66921
0
66921
0
91556
0
91556
0
24635
0
24635
0
66921
0
66921
0
91556
0
91556
0
24635
0
24635
0
66921
0
66921
0
91556
0
91556
0
24635
0
24635
0
66921
0
66921
0
91556
0
91556
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 (Ambulatory)
Female
Any Mental Health Services
0-12
Member Months (Day/Night)
Male
Inpatient Mental Health Services
Day/Night Mental Health Services
Number
Percent
Number
Percent
Number
Percent
Ambulatory Mental Health Services
Percent
Number
0
0
0
0
0
0
0
0
0
202
535
737
0
0
0
202
535
737
NA
NA
NA
NA
NA
NA
NA
NA
NA
9.84%
9.59%
9.66%
NA
NA
NA
9.84%
9.59%
9.66%
0
0
0
0
0
0
0
0
0
28
83
111
0
0
0
28
83
111
NA
NA
NA
NA
NA
NA
NA
NA
NA
1.36%
1.49%
1.45%
NA
NA
NA
1.36%
1.49%
1.45%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
0
0
0
0
0
0
0
0
0
181
479
660
0
0
0
181
479
660
HEDIS 2007 (Reporting Year 2006)
NA
NA
NA
NA
NA
NA
NA
NA
NA
8.82%
8.59%
8.65%
NA
NA
NA
8.82%
8.59%
8.65%
Page 62
Use of Services
UCare of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicaid
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
Member Months (Ambulatory)
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
209699
63897
204467
64380
414166
128277
209699
63897
204467
64380
414166
128277
209699
63897
204467
64380
414166
128277
209699
63897
204467
64380
414166
128277
151168
5191
0
429955
264521
9559
0
542927
415689
14750
0
972882
151168
5191
0
429955
264521
9559
0
542927
415689
14750
0
972882
151168
5191
0
429955
264521
9559
0
542927
415689
14750
0
972882
151168
5191
0
429955
264521
9559
0
542927
415689
14750
0
972882
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 (Day/Night)
Female
Any Mental Health Services
0-12
Member Months (Inpatient)
Male
Inpatient Mental Health Services
Number
Percent
Number
Percent
Day/Night Mental Health Services
Percent
Number
1455
917
2372
742
798
1540
2431
4872
7303
50
105
155
0
0
0
4678
6692
11370
8.33%
5.38%
6.87%
13.93%
14.87%
14.41%
19.30%
22.10%
21.08%
11.56%
13.18%
12.61%
NA
NA
NA
13.06%
14.79%
14.02%
21
12
33
43
72
115
241
286
527
2
6
8
0
0
0
307
376
683
0.12%
0.07%
0.10%
0.81%
1.34%
1.08%
1.91%
1.30%
1.52%
0.46%
0.75%
0.65%
NA
NA
NA
0.86%
0.83%
0.84%
1
0
1
8
10
18
2
18
20
0
0
0
0
0
0
11
28
39
HEDIS 2007 (Reporting Year 2006)
0.01%
0.00%
0.00%
0.15%
0.19%
0.17%
0.02%
0.08%
0.06%
0.00%
0.00%
0.00%
NA
NA
NA
0.03%
0.06%
0.05%
Ambulatory Mental Health Services
Percent
Number
1453
915
2368
733
781
1514
2349
4813
7162
49
103
152
0
0
0
4584
6612
11196
8.31%
5.37%
6.86%
13.77%
14.56%
14.16%
18.65%
21.83%
20.68%
11.33%
12.93%
12.37%
NA
NA
NA
12.79%
14.61%
13.81%
Page 63
Use of Services
UCare of Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Member Months
Age
Male
0-12
13-17
18-64
65+
Unknown
Total
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
Discharges
Age
0-12
M
F
Total
13-17
M
F
Total
18-64
M
F
Total
M
F
Total
M
F
Total
M
F
TOTAL
65+
Unknown
Total
HEDIS 2007 (Reporting Year 2006)
Discharges /
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
Days
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
Page 64
Use of Services
UCare of Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare Advantage
Member Months
Male
Female
Total
0
0
4332
146313
0
150645
0
0
5705
238290
0
243995
0
0
10037
384603
0
394640
Discharges
Discharges /
1,000 Member
Months
Days
Average Length
of Stay
M
F
Total
0
0
0
NA
NA
NA
0
0
0
NA
NA
NA
13-17
M
F
Total
0
0
0
NA
NA
NA
0
0
0
NA
NA
NA
18-64
M
F
Total
5
1
6
1.15
0.18
0.60
27
1
28
5.40
1.00
4.67
65+
M
F
Total
M
F
Total
M
F
TOTAL
32
27
59
0.22
0.11
0.15
255
191
446
7.97
7.07
7.56
0
0
0
NA
NA
NA
282
192
474
7.62
6.86
7.29
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Unknown
Total
HEDIS 2007 (Reporting Year 2006)
0
0
0
37
28
65
0.25
0.11
0.16
Page 65
Use of Services
UCare of Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of
Data Last Refreshed:
Oct 7, 2009 1:23 PM
MSHO
Member Months
Age
Male
Female
Total
0-12
13-17
18-64
65+
Unknown
Total
0
0
0
24635
0
24635
0
0
0
66921
0
66921
0
0
0
91556
0
91556
Discharges
Discharges /
1,000 Member
Months
Days
Average Length
of Stay
M
F
Total
0
0
0
NA
NA
NA
0
0
0
NA
NA
NA
13-17
M
F
Total
0
0
0
NA
NA
NA
0
0
0
NA
NA
NA
18-64
M
F
Total
M
F
Total
M
F
Total
M
F
TOTAL
0
0
0
NA
NA
NA
0
0
0
NA
NA
NA
9
6
15
0.37
0.09
0.16
63
306
369
7.00
51.00
24.60
0
0
0
NA
NA
NA
63
306
369
7.00
51.00
24.60
Age
0-12
65+
Unknown
Total
HEDIS 2007 (Reporting Year 2006)
0
0
0
9
6
15
0.37
0.09
0.16
Page 66
UCare of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Member Months (Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Any Chemical Dependency 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 2007 (Reporting Year 2006)
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 (Inpatient)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Member Months (Day/Night)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Member Months (Ambulatory)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
Number
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 67
UCare of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare Advantage
Member Months (Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
37
4295
146313
0
150645
Female
0
0
0
55
5650
238290
0
243995
Total
0
0
0
92
9945
384603
0
394640
Any Chemical Dependency 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
36
24
60
213
177
390
0
0
0
249
201
450
HEDIS 2007 (Reporting Year 2006)
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
10.06%
5.10%
7.24%
1.75%
0.89%
1.22%
NA
NA
NA
1.98%
0.99%
1.37%
Member Months (Inpatient)
Male
0
0
0
37
4295
146313
0
150645
Female
0
0
0
55
5650
238290
0
243995
Total
0
0
0
92
9945
384603
0
394640
Inpatient Chemical Dependency
Services
Number
0
0
0
0
0
0
0
0
0
0
0
0
17
13
30
117
104
221
0
0
0
134
117
251
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
4.75%
2.76%
3.62%
0.96%
0.52%
0.69%
NA
NA
NA
1.07%
0.58%
0.76%
Member Months (Day/Night)
Male
0
0
0
37
4295
146313
0
150645
Female
0
0
0
55
5650
238290
0
243995
Total
0
0
0
92
9945
384603
0
394640
Day/Night Chemical Dependency
Services
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Percent
NA
NA
NA
NA
NA
NA
NR
NR
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%
Member Months (Ambulatory)
Male
0
0
0
37
4295
146313
0
150645
Female
0
0
0
55
5650
238290
0
243995
Total
0
0
0
92
9945
384603
0
394640
Ambulatory Chemical Dependency
Services
Number
0
0
0
0
0
0
0
0
0
0
0
0
28
17
45
123
89
212
0
0
0
151
106
257
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
7.82%
3.61%
5.43%
1.01%
0.45%
0.66%
NA
NA
NA
1.20%
0.52%
0.78%
Page 68
UCare of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:23 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
24635
0
24635
Female
0
0
0
0
0
66921
0
66921
Total
0
0
0
0
0
91556
0
91556
Any Chemical Dependency 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
90
71
161
0
0
0
90
71
161
HEDIS 2007 (Reporting Year 2006)
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
NA
NA
NA
4.38%
1.27%
2.11%
NA
NA
NA
4.38%
1.27%
2.11%
Member Months (Inpatient)
Male
0
0
0
0
0
24635
0
24635
Female
0
0
0
0
0
66921
0
66921
Total
0
0
0
0
0
91556
0
91556
Member Months (Day/Night)
Male
0
0
0
0
0
24635
0
24635
Female
0
0
0
0
0
66921
0
66921
Total
0
0
0
0
0
91556
0
91556
Member Months (Ambulatory)
Male
0
0
0
0
0
24635
0
24635
Female
0
0
0
0
0
66921
0
66921
Total
0
0
0
0
0
91556
0
91556
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
47
40
87
0
0
0
47
40
87
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
60
39
99
0
0
0
60
39
99
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
NA
NA
NA
2.29%
0.72%
1.14%
NA
NA
NA
2.29%
0.72%
1.14%
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
NA
NA
NA
2.92%
0.70%
1.30%
NA
NA
NA
2.92%
0.70%
1.30%
Page 69
UCare of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicaid
Member Months (Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
209699
63897
39041
34160
77967
5191
0
429955
Female
204467
64380
79992
78402
106127
9559
0
542927
Total
414166
128277
119033
112562
184094
14750
0
972882
Any Chemical Dependency 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
7
17
199
158
357
289
372
661
441
522
963
1219
850
2069
16
7
23
0
0
0
2174
1916
4090
HEDIS 2007 (Reporting Year 2006)
Percent
0.06%
0.04%
0.05%
3.74%
2.95%
3.34%
NR
NR
NA
2.52%
3.06%
2.79%
18.76%
9.61%
13.49%
3.70%
0.88%
1.87%
NA
NA
NA
6.07%
4.23%
5.04%
Member Months (Inpatient)
Male
209699
63897
39041
34160
77967
5191
0
429955
Female
204467
64380
79992
78402
106127
9559
0
542927
Total
414166
128277
119033
112562
184094
14750
0
972882
Member Months (Day/Night)
Male
209699
63897
39041
34160
77967
5191
0
429955
Female
204467
64380
79992
78402
106127
9559
0
542927
Total
414166
128277
119033
112562
184094
14750
0
972882
Member Months (Ambulatory)
Male
209699
63897
39041
34160
77967
5191
0
429955
Female
204467
64380
79992
78402
106127
9559
0
542927
Total
414166
128277
119033
112562
184094
14750
0
972882
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
2
2
4
29
37
66
66
92
158
96
139
235
353
217
570
7
3
10
0
0
0
553
490
1043
Number
0
0
0
1
5
6
1
1
2
1
2
3
1
2
3
0
0
0
0
0
0
4
10
14
Number
8
5
13
187
138
325
257
318
575
404
464
868
1094
779
1873
11
5
16
0
0
0
1961
1709
3670
Percent
0.01%
0.01%
0.01%
0.54%
0.69%
0.62%
NR
NR
NA
0.55%
0.82%
0.68%
5.43%
2.45%
3.72%
1.62%
0.38%
0.81%
NA
NA
NA
1.54%
1.08%
1.29%
Percent
0.00%
0.00%
0.00%
0.02%
0.09%
0.06%
NR
NR
NA
0.01%
0.01%
0.01%
0.02%
0.02%
0.02%
0.00%
0.00%
0.00%
NA
NA
NA
0.01%
0.02%
0.02%
Percent
0.05%
0.03%
0.04%
3.51%
2.57%
3.04%
NR
NR
NA
2.31%
2.72%
2.51%
16.84%
8.81%
12.21%
2.54%
0.63%
1.30%
NA
NA
NA
5.47%
3.78%
4.53%
Page 70
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
Commercial
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Member Months
NR
Total Cost of
Prescriptions
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Avg. Cost of
Prescriptions /
Per Member Per
Month
Total Number of
Prescriptions
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2007 (Reporting Year 2006)
NR
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 71
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
Medicare Advantage
Age
Member Months
0-9
0
10-19
0
20-44
506
45-64
8895
65-74
158693
75-84
134029
85+
65287
Unknown
0
Total
367410
Age
Total Cost of
Prescriptions
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
$0.00
$0.00
$84,359.96
$2,080,412.83
$19,459,378.37
$18,828,424.95
$9,228,356.61
$0.00
$49,680,932.72
HEDIS 2007 (Reporting Year 2006)
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
$166.72
$233.89
$122.62
$140.48
$141.35
$135.22
Total Number of
Prescriptions
0
0
1085
29353
311784
360546
224573
0
927341
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
25.73
39.60
23.58
32.28
41.28
30.29
Page 72
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
MSHO
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Member Months
0
0
0
0
30878
31012
29666
0
91556
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
$9,465,377.60
$9,507,514.21
$8,360,305.17
$0.00
$27,333,196.98
HEDIS 2007 (Reporting Year 2006)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
NA
NA
$306.54
$306.58
$281.81
$298.54
Total Number of
Prescriptions
0
0
0
0
180851
211595
231752
0
624198
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
NA
NA
70.28
81.88
93.74
81.81
Page 73
Use of Services
UCare of Minnesota
Outpatient Drug Utilization
Medicaid
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Member Months
337780
244710
280245
95397
7601
4060
3089
0
972882
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 1:23 PM
$4,008,868.92
$5,265,666.56
$18,421,150.03
$13,068,435.39
$395,474.86
$191,414.57
$91,016.44
$0.00
$41,442,026.77
HEDIS 2007 (Reporting Year 2006)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$11.87
$21.52
$65.73
$136.99
$52.03
$47.15
$29.46
$42.60
Total Number of
Prescriptions
115766
88569
313290
222696
10562
6393
5387
0
762663
Avg. Num. Of
Prescriptions /
Per Member Per
Year
4.11
4.34
13.41
28.01
16.67
18.90
20.93
9.41
Page 74
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data collection methodology (Administrativ
only)
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2007 (Reporting Year 2006)
Page 75
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
Ages 20-44
Ages 45-64
Ages 65+
31
597
28646
2006
A
28
577
27583
90.32%
78.30%
100.00%
96.65%
95.12%
98.18%
96.29%
96.07%
96.51%
Page 76
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
Ages 20-44
Ages 45-64
Ages 65+
0
0
6575
2006
A
0
0
6418
NA
NA
NA
NA
NA
NA
97.61%
97.24%
97.99%
Page 77
Access/Availability of Care
UCare of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
Ages 20-44
Ages 45-64
Ages 65+
10809
4924
664
2006
A
9515
4383
619
88.03%
87.41%
88.65%
89.01%
88.13%
89.90%
93.22%
91.24%
95.21%
Page 78
Access/Availability of Care
UCare of Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Data Elements
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
12-19 yrs.
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Measurement Year
Data collection methodology (Administrativ
only)
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2007 (Reporting Year 2006)
Page 79
Access/Availability of Care
UCare of Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:23 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 2007 (Reporting Year 2006)
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
12-19 yrs.
2662
7357
4775
7444
2006
A
2600
6608
4228
6616
97.67%
97.08%
98.26%
89.82%
89.12%
90.52%
88.54%
87.63%
89.46%
88.88%
88.16%
89.60%
Page 80
Access/Availability of Care
UCare of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
General
Measure Data
Timeliness of
Prenatal Care
Postpartum
Care
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data collection methodology (Administrative or Hybrid)
Eligible member population (i.e. members who meet all
denominator criteria)
Number of numerator events by administrative data in
eligible population (before exclusions)
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of
valid data errors
Number of administrative data records excluded
Number of medical records data records excluded
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2007 (Reporting Year 2006)
Page 81
Access/Availability of Care
UCare of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicaid
General
Measure Data
Data collection methodology (Administrative or Hybrid)
H
Eligible member population (i.e. members who meet all
denominator criteria)
3465
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
411
Oversampling rate
Final sample size (FSS)
5%
432
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of
valid data errors
0
Number of administrative data records excluded
0
Number of medical records data records excluded
4
Number of employee/dependent medical records excluded
0
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 2007 (Reporting Year 2006)
Timeliness of
Prenatal Care
Postpartum
Care
1888
1903
54.49%
54.92%
219
251
50.69%
58.10%
209
91
240
29
72.99%
68.58%
77.41%
65.45%
60.73%
70.17%
4
411
Page 82
Access/Availability of Care
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
18-25 Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
26-34 Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
35-64 Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
65+ Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Overall Rate
Engagement Initiation of
of AOD
AOD
Treatment
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
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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2007 (Reporting Year 2006)
Page 83
Access/Availability of Care
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare Advantage
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
General
Measure
Data
Initiation of
AOD
Treatment
18-25 Year Olds
26-34 Year Olds
35-64 Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
0
0
0
65+ Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Overall Rate
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Engagement
of AOD
Treatment
2006
A
Eligible member population (i.e. members
who meet all denominator criteria)
36
307
343
0
0
0
0
0
0
13
2
130
8
143
10
Reported rate
NA
NA
NA
NA
NA
NA
36.11%
5.56%
42.35%
2.61%
41.69%
2.92%
Lower 95% confidence interval
Upper 95% confidence interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
19.03%
53.19%
0.00%
14.43%
36.66%
48.04%
0.66%
4.55%
36.33%
47.05%
0.99%
4.84%
Numerator events by administrative data
HEDIS 2007 (Reporting Year 2006)
Page 84
Access/Availability of Care
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:23 PM
MSHO
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
General
Measure
Data
Initiation of
AOD
Treatment
26-34 Year Olds
35-64 Year Olds
65+ Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
0
0
0
0
Overall Rate
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Engagement
of AOD
Treatment
2006
A
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
18-25 Year Olds
112
112
0
0
0
0
0
0
0
0
49
3
49
3
Reported rate
NA
NA
NA
NA
NA
NA
NA
NA
43.75%
2.68%
43.75%
2.68%
Lower 95% confidence interval
Upper 95% confidence interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
34.12%
53.38%
0.00%
6.12%
34.12%
53.38%
0.00%
6.12%
HEDIS 2007 (Reporting Year 2006)
Page 85
Access/Availability of Care
UCare of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicaid
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
General
Measure
Data
Initiation of
AOD
Treatment
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
26-34 Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
35-64 Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
65+ Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Overall Rate
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Engagement
of AOD
Treatment
2006
A
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
18-25 Year Olds
190
367
348
900
10
1815
67
36
138
50
122
47
305
104
3
0
635
237
Reported rate
35.26%
18.95%
37.60%
13.62%
35.06%
13.51%
33.89%
11.56%
NA
NA
34.99%
13.06%
Lower 95% confidence interval
28.21%
13.11%
32.51%
9.98%
29.90%
9.77%
30.74%
9.41%
NA
NA
32.76%
11.48%
Upper 95% confidence interval
42.32%
24.78%
42.69%
17.27%
40.21%
17.24%
37.04%
13.70%
NA
NA
37.21%
14.64%
HEDIS 2007 (Reporting Year 2006)
Page 86
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Product/Product Line
Years in Business
Members*
NR
NR
NR
NR
NR
NR
NR
HMO
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total HMO:
PPO
Commercial
Medicare (cost or risk)
Self-insured
Other
Total PPO:
POS
Commercial
Medicare (cost or risk)
Self-insured
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2006
HEDIS 2007 (Reporting Year 2006)
Page 87
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicare Advantage
Product/Product Line
Years in Business
Members*
19.00
0.00
8.00
0.00
11.00
19.00
79278
0
33826
0
7873
120977
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
120977
HMO
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total HMO:
PPO
Commercial
Medicare (cost or risk)
Self-insured
Other
Total PPO:
POS
Commercial
Medicare (cost or risk)
Self-insured
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2006
HEDIS 2007 (Reporting Year 2006)
Page 88
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:23 PM
MSHO
Product/Product Line
Years in Business
Members*
19.00
0.00
8.00
0.00
11.00
19.00
79278
0
33826
0
7873
120977
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
120977
HMO
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total HMO:
PPO
Commercial
Medicare (cost or risk)
Self-insured
Other
Total PPO:
POS
Commercial
Medicare (cost or risk)
Self-insured
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2006
HEDIS 2007 (Reporting Year 2006)
Page 89
Health Plan Stability
UCare of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Medicaid
Product/Product Line
Years in Business
Members*
19.00
0.00
8.00
0.00
11.00
19.00
79278
0
33826
0
7873
120977
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
120977
HMO
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
Total HMO:
PPO
Commercial
Medicare (cost or risk)
Self-insured
Other
Total PPO:
POS
Commercial
Medicare (cost or risk)
Self-insured
Other
Total POS:
Total:
* Total number of members in each category as of December 31, 2006
HEDIS 2007 (Reporting Year 2006)
Page 90
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:23 PM
Commercial
Male
Member Months
Female
<1
1-4
5-9
10-14
15-17
18-19
Total
NR
NR
NR
NR
NR
NR
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
NR
NR
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
NR
NR
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
NR
NR
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2007 (Reporting Year 2006)
NR
NR
NR
NR
NR
NR
NR
Page 91
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:23 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
36
48
168
0
0.00%
0
12
48
36
192
0
0.00%
252
0.17%
384
504
1308
1884
288
0.12%
492
792
1308
2832
540
0.14%
4080
2.71%
38796
34392
29064
24756
13128
6180
5424
2.22%
52440
46488
46344
43272
30660
19092
9504
2.41%
146316
97.12%
0
238296
97.66%
0
384612
97.45%
150648
244008
HEDIS 2007 (Reporting Year 2006)
0
12
84
84
360
876
1296
2616
4716
91236
80880
75408
68028
43788
25272
0
394656
Page 92
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:23 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%
5496
5388
4920
3948
2916
1968
0
0.00%
9000
10992
10884
11256
11172
13620
0
0.00%
24636
100.00%
0
66924
100.00%
0
91560
100.00%
24636
66924
HEDIS 2007 (Reporting Year 2006)
0
0
0
0
0
0
0
0
0
14496
16380
15804
15204
14088
15588
0
91560
Page 93
Health Plan Descriptive Information
UCare of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:23 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
28991
71465
70245
65138
37757
17307
Member Months
Female
27190
69210
70679
63419
38349
22740
Total
56181
140675
140924
128557
76106
40047
290903
67.66%
21734
18040
16120
16562
18436
291587
53.71%
57252
46087
32315
28481
25218
582490
59.87%
90892
21.14%
16579
12597
8911
4882
189353
34.88%
20529
14201
9665
8033
280245
28.81%
42969
9.99%
2029
1076
836
577
437
236
52428
9.66%
2901
1595
1279
1368
1243
1173
95397
9.81%
5191
1.21%
0
9559
1.76%
0
14750
1.52%
429955
542927
HEDIS 2007 (Reporting Year 2006)
78986
64127
48435
45043
43654
37108
26798
18576
12915
4930
2671
2115
1945
1680
1409
0
972882
Page 94