Plan Name
South Country Health Alliance (CBP)
Reporting Year
2006
General Info
Disclaimers
Submission #
Plan ID
1
34
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 1:22:28 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
South Country Health Alliance (CBP)
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:22 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
196
61.25%
195
60.94%
282
88.13%
206
64.38%
175
54.69%
269
84.06%
185
57.81%
127
39.69%
115
35.94%
196
61.25%
189
59.06%
282
88.13%
206
64.38%
175
54.69%
269
84.06%
185
57.81%
127
39.69%
115
35.94%
196
88
88.75%
85.13%
92.37%
189
111
93.75%
90.94%
96.56%
282
19
94.06%
91.32%
96.81%
206
94
93.75%
90.94%
96.56%
175
129
95.00%
92.46%
97.54%
269
16
89.06%
85.49%
92.64%
185
68
79.06%
74.45%
83.68%
127
132
80.94%
76.48%
85.40%
115
115
71.88%
66.79%
76.96%
320
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 2007 (Reporting Year 2006)
MMR
320
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
320
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
320
Page 4
Effectiveness of Care
South Country Health Alliance (CBP)
Adolescent Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Adolescent Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Combo 2
105
61.05%
41
23.84%
44
25.58%
15
8.72%
104
60.47%
41
23.84%
43
25.00%
15
8.72%
104
41
84.80%
79.12%
90.47%
41
79
70.18%
63.03%
77.32%
43
59
59.65%
52.00%
67.29%
15
74
52.05%
44.27%
59.83%
172
1
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record Review
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
HEDIS 2007 (Reporting Year 2006)
VZV
172
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
172
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
171
Page 6
Effectiveness of Care
South Country Health Alliance (CBP)
Appropriate Treatment for Children with Upper
Respiratory Infection
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Colorectal Cancer Screening
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Commercial
Medicare
Advantage
Measurement Year
MSHO
2006
Data collection methodology (administrative or hybrid)
H
Eligible population
563
Number of numerator events by administrative data in eligible
population (before exclusions)
120
Current year's administrative rate (before exclusions)
NR
NR
21.31%
Minimum required sample size (MRSS) or other sample size
411
Oversampling rate
0.05
Final sample size (FSS)
432
Number of numerator events by administrative data in FSS
93
Administrative rate on FSS
NR
NR
21.53%
Number of original sample records excluded because of valid data
errors
0
Number of administrative data records excluded
0
Number of medical record data records excluded
0
Number of employee/dependent medical records excluded
0
Records added from the oversample list
0
Denominator
432
Numerator events by administrative data
93
Numerator events by medical records
56
Reported rate
NR
NR
34.49%
Lower 95% confidence interval
NR
NR
29.89%
Upper 95% confidence interval
NR
NR
39.09%
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
y Health Alliance (CBP)
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:22 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
y Health Alliance (CBP)
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:22 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
NR
NR
NR
Ages 52-69
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 10
Effectiveness of Care
y Health Alliance (CBP)
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:22 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
61
30
49.18%
35.81%
62.55%
61
30
49.18%
35.81%
62.55%
2006
A
Page 11
Effectiveness of Care
y Health Alliance (CBP)
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:22 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
123
47
38.21%
29.22%
47.21%
53
23
43.40%
29.11%
57.68%
176
70
39.77%
32.26%
47.29%
2006
A
Page 12
Effectiveness of Care
South Country Health Alliance (CBP)
Cervical Cancer Screening
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Commercial
Measurement Year
Data Collection Methodology
Eligible Member Population
Medicaid
2006
A
1070
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
NR
66.54%
NR
NR
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
712
NR
NR
NR
66.54%
63.67%
69.42%
Page 13
Effectiveness of Care
ealth Alliance (CBP)
Chlamydia Screening in Women
Data Last Refreshed:
Oct 7, 2009 1:22 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
186
58
31.18%
24.26%
38.11%
266
106
39.85%
33.78%
45.92%
452
164
36.28%
31.74%
40.83%
Page 14
Effectiveness of Care
South Country Health Alliance (CBP)
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 1:22 PM
Medicare
Advantage
NR
NR
NR
MSHO
2006
A
84
8
9.52%
2.65%
16.40%
Page 15
try Health Alliance (CBP)
Effectiveness of Care
Controlling High Blood Pressure
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Beta Blocker Treatment after Heart Attack
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Commercial
Medicare Advantage
Measurement Year
MSHO
2006
Data Collection Methodology
H
Eligible Member Population
19
Numerator Events by Admin Data on
Eligible Population
7
Current Year's Admin Rate
NR
NR
Minimum Required Sample Size
36.84%
15
Oversampling Rate
5.00%
Final Sample Size (FSS)
15
Numerator events by admin data in FSS
7
Admin rate on FSS
NR
NR
46.67%
Records Excluded because of Valid Data
Errors
1
Number of administrative data records
excluded
0
Number of medical record data records
excluded
0
Number of employee/dependent medical
records excluded
0
Records Added from the Oversample List
0
Denominator
14
Numerator Events by Admin Data
7
Numerator Events by Medical Record
2
Reported Rate
NR
NR
NA
Lower 95% Confidence Interval
NR
NR
NA
Upper 95% Confidence Interval
NR
NR
NA
HEDIS 2007 (Reporting Year 2006)
Page 17
Effectiveness of Care
South Country Health Alliance (CBP)
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Commercial
Medicare Advantage
MSHO
Reported Rate
NR
NR
NR
Lower 95% Confidence Interval
NR
NR
NR
Upper 95% Confidence Interval
NR
NR
NR
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population
HEDIS 2007 (Reporting Year 2006)
Page 18
Effectiveness of Care
South Country Health Alliance (CBP)
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:22 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 2007 (Reporting Year 2006)
Page 20
Effectiveness of Care
South Country Health Alliance (CBP)
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:22 PM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
0
35.29%
0.00%
10
0
29.41%
0.00%
10
14
0
16
75.00%
58.43%
91.57%
50.00%
31.11%
68.89%
34
5.00%
34
2
Number of administrative data records excluded
0
Number of medical record data records excluded
0
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
0
32
HEDIS 2007 (Reporting Year 2006)
12
34
Records Excluded because of Valid Data Errors
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
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
Page 21
Effectiveness of Care
South Country Health Alliance (CBP)
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:22 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
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 23
Effectiveness of Care
South Country Health Alliance (CBP)
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:22 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
129
2006
H
129
2006
H
129
2006
H
129
2006
H
129
2006
H
129
2006
H
129
2006
H
129
2006
H
129
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
55
42.64%
129
5%
129
55
42.64%
129
100.00%
129
5%
129
129
100.00%
0
0.00%
129
5%
129
0
0.00%
4
3.10%
129
5%
129
4
3.10%
45
34.88%
129
5%
129
45
34.88%
0
0.00%
129
5%
129
0
0.00%
108
83.72%
129
5%
129
108
83.72%
0
0.00%
129
5%
129
0
0.00%
0
0.00%
129
5%
129
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
129
55
56
86.05%
79.68%
92.41%
0
129
30
4
26.36%
18.37%
34.35%
0
129
0
62
48.06%
39.05%
57.07%
0
129
20
47
51.94%
42.93%
60.95%
0
129
45
51
74.42%
66.50%
82.34%
0
129
0
61
47.29%
38.28%
56.29%
0
129
108
8
89.92%
84.34%
95.50%
0
129
0
96
74.42%
66.50%
82.34%
0
129
0
66
51.16%
42.15%
60.18%
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
South Country Health Alliance (CBP)
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:22 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
126
2006
H
126
2006
H
126
2006
H
126
2006
H
126
2006
H
126
2006
H
126
2006
H
126
2006
H
126
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
94
74.60%
126
5%
126
94
74.60%
126
100.00%
126
5%
126
126
100.00%
0
0.00%
126
5%
126
0
0.00%
63
50.00%
126
5%
126
63
50.00%
77
61.11%
126
5%
126
77
61.11%
0
0.00%
126
5%
126
0
0.00%
88
69.84%
126
5%
126
88
69.84%
0
0.00%
126
5%
126
0
0.00%
0
0.00%
126
5%
126
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
1
1
1
1
1
1
1
1
1
0
0
0
0
0
0
0
0
0
0
125
94
7
80.80%
73.50%
88.10%
0
125
37
17
43.20%
34.12%
52.28%
0
125
0
37
29.60%
21.20%
38.00%
0
125
63
15
62.40%
53.51%
71.29%
0
125
77
10
69.60%
61.14%
78.06%
0
125
0
43
34.40%
25.67%
43.13%
0
125
88
9
77.60%
69.89%
85.31%
0
125
0
81
64.80%
56.03%
73.57%
0
125
0
58
46.40%
37.26%
55.54%
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
South Country Health Alliance (CBP)
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:22 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
17
16
NA
NA
NA
23
22
NA
NA
NA
29
29
NA
NA
NA
69
67
97.10%
92.42%
100.00%
2006
A
Page 27
Effectiveness of Care
South Country Health Alliance (CBP)
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:22 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 29
Effectiveness of Care
South Country Health Alliance (CBP)
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:22 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
2
NA
NA
NA
21
NA
NA
NA
19
NA
NA
NA
2006
A
28
Page 30
Effectiveness of Care
South Country Health Alliance (CBP)
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:22 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
14
17.28%
8.43%
26.14%
43
53.09%
41.60%
64.57%
25
30.86%
20.19%
41.54%
2006
A
81
Page 31
Effectiveness of Care
South Country Health Alliance (CBP)
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 7, 2009 1:22 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
115
0
21
18.26%
10.76%
25.76%
70
0
12
17.14%
7.60%
26.69%
2006
A
NR
NR
NR
NR
NR
NR
Page 32
Effectiveness of Care
South Country Health Alliance (CBP)
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interva
HEDIS 2007 (Reporting Year 2006)
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Medicare
Advantage
NR
NR
NR
MSHO
2006
A
1241
551
44.40%
41.60%
47.20%
Page 33
Effectiveness of Care
South Country Health Alliance (CBP)
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Medicare Advantage
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 35
Effectiveness of Care
South Country Health Alliance (CBP)
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:22 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
536
111
254
47.39%
43.07%
51.71%
98
33
46
46.94%
36.55%
57.33%
695
139
304
43.74%
39.98%
47.50%
85
29
37
43.53%
32.40%
54.66%
1414
312
641
45.33%
42.70%
47.96%
2006
A
Page 36
Effectiveness of Care
South Country Health Alliance (CBP)
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:22 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
99
4
77
77.78%
69.08%
86.47%
4
0
3
NA
NA
NA
85
4
66
77.65%
68.20%
87.09%
26
6
16
NA
NA
NA
214
14
162
75.70%
69.72%
81.68%
2006
A
Page 37
Effectiveness of Care
South Country Health Alliance (CBP)
Drugs to Be Avoided in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:22 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
1 or More
Prescriptions
NR
NR
NR
MSHO
2 or More
Prescriptions
NR
NR
NR
General
Measure
Data
2006
A
1625
1 or More
Prescriptions
2 or More
Prescriptions
400
24.62%
22.49%
26.74%
69
4.25%
3.23%
5.26%
Page 38
Effectiveness of Care
South Country Health Alliance (CBP)
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:22 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
Page 39
Effectiveness of Care
South Country Health Alliance (CBP)
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:22 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
47
16
34.04%
19.43%
48.65%
406
74
18.23%
14.35%
22.11%
60
9
15.00%
5.13%
24.87%
513
99
19.30%
15.79%
22.81%
Page 40
Use of Services
South Country Health Alliance (CBP)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:22 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 2007 (Reporting Year 2006)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
24
5.41%
19
4.28%
17
3.83%
33
7.43%
60
13.51%
87
19.59%
204
45.95%
24
5.56%
18
4.17%
17
3.94%
33
7.64%
59
13.66%
86
19.91%
195
45.14%
10
0
2.31%
0.78%
3.85%
1
4
1.16%
0.03%
2.28%
3
3
1.39%
0.17%
2.61%
8
2
2.31%
0.78%
3.85%
23
14
8.56%
5.81%
11.32%
43
29
16.67%
13.04%
20.30%
195
97
67.59%
63.06%
72.12%
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
444
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
432
Page 42
Use of Services
South Country Health Alliance (CBP)
Well Child Visits in the 3rd, 4th,
5th and 6th Years of Life
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2006
H
942
Numerator events by admin data in eligible
population
413
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
190
NR
43.98%
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
432
190
69
59.95%
55.22%
64.69%
Page 43
Use of Services
South Country Health Alliance (CBP)
Adolescent Well-Care Visits
Data Elements
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Eligible Member Population
2006
H
1260
Numerator events by admin data in eligible
population
249
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
84
NR
19.44%
1
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
431
84
51
31.32%
26.83%
35.82%
Page 44
Use of Services
South Country Health Alliance (CBP)
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:22 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 2007 (Reporting Year 2006)
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 46
Use of Services
South Country Health Alliance (CBP)
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:22 PM
MSHO
Age
< 65
65-74
75-84
85+
Member Months
Male
Female
0
0
2293
3341
2104
5636
1859
8092
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
0
0
0
0
2
0
0
0
2
5
0
0
0
0
0
0
2
3
3
0
0
0
0
0
3
1
0
0
0
0
0
0
1
1
0
0
2
1
0
0
2
1
5
Procedures /
1,000 Member
Months
NA
0.00
0.00
0.00
NA
0.87
0.00
0.00
NA
0.87
2.38
0.00
NA
0.00
0.00
0.00
NA
0.87
1.43
1.61
NA
0.00
0.00
0.00
NA
1.31
0.48
0.00
NA
0.00
0.00
0.00
NA
0.44
0.48
0.00
NA
0.87
0.48
0.00
NA
0.87
0.48
2.69
Female
Number of
Procedures
0
2
0
0
0
1
2
3
0
4
2
1
0
0
0
0
0
1
5
11
0
0
1
0
0
2
2
0
0
0
0
0
0
0
0
0
0
2
1
2
0
9
12
1
0
0
0
0
0
1
1
0
0
2
0
1
0
0
0
0
Procedures /
1,000 Member
Months
NA
0.60
0.00
0.00
NA
0.30
0.35
0.37
NA
1.20
0.35
0.12
NA
0.00
0.00
0.00
NA
0.30
0.89
1.36
NA
0.00
0.18
0.00
NA
0.60
0.35
0.00
NA
0.00
0.00
0.00
NA
0.00
0.00
0.00
NA
0.60
0.18
0.25
NA
2.69
2.13
0.12
NA
0.00
0.00
0.00
NA
0.30
0.18
0.00
NA
0.60
0.00
0.12
NA
0.00
0.00
0.00
Page 47
Use of Services
lth Alliance (CBP
Inpatient Utilization - General Hospital/Acute Care
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:22 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
lth Alliance (CBP
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 7, 2009 1:22 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 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 49
Use of Services
lth Alliance (CBP
Inpatient Utilization - General Hospital/Acute Care
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Member Months
0
0
0
0
0
5634
7740
9951
0
23325
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
189
273
278
0
740
NA
NA
NA
NA
NA
33.55
35.27
27.94
0
0
0
0
0
183
265
274
0
722
NA
NA
NA
NA
NA
32.48
34.24
27.53
0
0
0
0
0
5
7
3
0
15
NA
NA
NA
NA
NA
0.89
0.90
0.30
0
0
0
0
0
HEDIS 2007 (Reporting Year 2006)
31.73
30.95
0.64
NA
NA
NA
NA
Days
Days / 1,000
Member
Months
0
0
0
0
0
684
866
752
0
2302
NA
NA
NA
NA
NA
121.41
111.89
75.57
0
0
0
0
0
632
832
734
0
2198
NA
NA
NA
NA
NA
112.18
107.49
73.76
0
0
0
0
0
42
26
14
0
82
NA
NA
NA
NA
NA
7.45
3.36
1.41
0
0
0
0
0
98.69
94.23
3.52
NA
NA
NA
NA
Average
Length of Stay
NA
NA
NA
NA
NA
3.62
3.17
2.71
NA
3.11
NA
NA
NA
NA
NA
3.45
3.14
2.68
NA
3.04
NA
NA
NA
NA
NA
8.40
3.71
4.67
NA
5.47
NA
NA
NA
NA
NA
Page 50
Use of Services
lth Alliance (CBP)
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:22 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
lth Alliance (CBP)
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:22 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 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 52
Use of Services
lth Alliance (CBP)
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:22 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
5634
7740
9951
0
23325
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
3663
4448
3488
0
11599
HEDIS 2007 (Reporting Year 2006)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
650.16
574.68
350.52
497.28
Emergency Room Visits
Visits
0
0
0
0
0
244
290
295
0
829
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
43.31
37.47
29.65
35.54
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
0
139
142
108
0
389
Procedures/
1,000 Member
Months
NA
NA
NA
NA
NA
24.67
18.35
10.85
16.68
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
5
8
4
0
17
Stays/ 1,000
Member
Months
NA
NA
NA
NA
NA
0.89
1.03
0.40
0.73
Page 53
Use of Services
South Country Health Alliance (CBP)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:22 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 2007 (Reporting Year 2006)
NR
NR
Page 55
Use of Services
South Country Health Alliance (CBP)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:22 PM
MSHO
Age
Member
Months
<1
0
1-9
0
10-19
0
20-44
0
45-64
0
65-74
5634
75-84
7740
85+
9951
Unknown
0
23325
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
60
10.65
1081
191.87
18.02
75-84
168
21.71
4067
525.45
24.21
85+
220
22.11
5368
539.44
24.40
Unknown
0
448
19.21
0
10516
450.85
NA
23.47
Age
Total
HEDIS 2007 (Reporting Year 2006)
Page 56
Use of Services
South Country Health Alliance (CBP)
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Medicare Advantage
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
Gender
M
F
Total
13-17
M
F
Total
18-64
65+
Unknown
Total
M
F
Total
M
F
Total
M
F
Total
M
F
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 58
Use of Services
South Country Health Alliance (CBP)
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Oct 7, 2009 1:22 PM
MSHO
Member Months
Age
Male
Female
Total
0-12
13-17
18-64
65+
Unknown
Total
0
0
0
6256
0
6256
0
0
0
17069
0
17069
0
0
0
23325
0
23325
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
26
43
69
4.16
2.52
2.96
370
795
1165
14.23
18.49
16.88
0
0
0
NA
NA
NA
370
795
1165
14.23
18.49
16.88
65+
Unknown
Total
HEDIS 2007 (Reporting Year 2006)
0
0
0
26
43
69
4.16
2.52
2.96
Page 59
Use of Services
Health Alliance (CBP)
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory
Data Last Refreshed:
Oct 7, 2009 1:22 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
Health Alliance (CBP)
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Medicare Advantage
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
Female
NR
Member Months (Inpatient)
Total
Age
Sex
M
F
Total
Number
NR
13-17
M
F
Total
NR
18-64
M
F
Total
NR
65+
M
F
Total
NR
Unknown
M
F
Total
M
F
Total
NR
NR
NR
NR
Total
HEDIS 2007 (Reporting Year 2006)
Female
Total
Member Months (Day/Night)
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
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
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
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 61
Use of Services
Health Alliance (CBP)
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory
Data Last Refreshed:
Oct 7, 2009 1:22 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
6256
0
6256
0
17069
0
17069
0
23325
0
23325
0
6256
0
6256
0
17069
0
17069
0
23325
0
23325
0
6256
0
6256
0
17069
0
17069
0
23325
0
23325
0
6256
0
6256
0
17069
0
17069
0
23325
0
23325
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
45
117
162
0
0
0
45
117
162
NA
NA
NA
NA
NA
NA
NA
NA
NA
8.63%
8.23%
8.33%
NA
NA
NA
8.63%
8.23%
8.33%
0
0
0
0
0
0
0
0
0
14
33
47
0
0
0
14
33
47
NA
NA
NA
NA
NA
NA
NA
NA
NA
2.69%
2.32%
2.42%
NA
NA
NA
2.69%
2.32%
2.42%
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
35
94
129
0
0
0
35
94
129
HEDIS 2007 (Reporting Year 2006)
NA
NA
NA
NA
NA
NA
NA
NA
NA
6.71%
6.61%
6.64%
NA
NA
NA
6.71%
6.61%
6.64%
Page 62
Use of Services
Health Alliance (CBP)
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory
Data Last Refreshed:
Oct 7, 2009 1:22 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
36370
7879
34834
8216
71204
16095
36370
7879
34834
8216
71204
16095
36370
7879
34834
8216
71204
16095
36370
7879
34834
8216
71204
16095
15322
1152
0
60723
38255
2745
0
84050
53577
3897
0
144773
15322
1152
0
60723
38255
2745
0
84050
53577
3897
0
144773
15322
1152
0
60723
38255
2745
0
84050
53577
3897
0
144773
15322
1152
0
60723
38255
2745
0
84050
53577
3897
0
144773
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
276
171
447
124
123
247
298
810
1108
3
13
16
0
0
0
701
1117
1818
9.11%
5.89%
7.53%
18.89%
17.96%
18.42%
23.34%
25.41%
24.82%
3.13%
5.68%
4.93%
NA
NA
NA
13.85%
15.95%
15.07%
1
5
6
3
11
14
28
41
69
1
1
2
0
0
0
33
58
91
0.03%
0.17%
0.10%
0.46%
1.61%
1.04%
2.19%
1.29%
1.55%
1.04%
0.44%
0.62%
NA
NA
NA
0.65%
0.83%
0.75%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
HEDIS 2007 (Reporting Year 2006)
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%
Ambulatory Mental Health Services
Percent
Number
275
171
446
124
120
244
292
807
1099
2
12
14
0
0
0
693
1110
1803
9.07%
5.89%
7.52%
18.89%
17.53%
18.19%
22.87%
25.31%
24.62%
2.08%
5.25%
4.31%
NA
NA
NA
13.69%
15.85%
14.94%
Page 63
Use of Services
South Country Health Alliance (CBP)
Chemical Dependency Utilization Inpatient Discharges and Average Length of
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Chemical Dependency Utilization Inpatient Discharges and Average Length of
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Medicare Advantage
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
13-17
18-64
65+
Unknown
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
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 65
Use of Services
South Country Health Alliance (CBP)
Chemical Dependency Utilization Inpatient Discharges and Average Length of
Data Last Refreshed:
Oct 7, 2009 1:22 PM
MSHO
Member Months
Age
Male
Female
Total
0-12
13-17
18-64
65+
Unknown
Total
0
0
0
6256
0
6256
0
0
0
17069
0
17069
0
0
0
23325
0
23325
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
2
2
4
0.32
0.12
0.17
24
111
135
12.00
55.50
33.75
0
0
0
NA
NA
NA
24
111
135
12.00
55.50
33.75
Age
0-12
65+
Unknown
Total
HEDIS 2007 (Reporting Year 2006)
0
0
0
2
2
4
0.32
0.12
0.17
Page 66
ealth Alliance (CBP)
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:22 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
ealth Alliance (CBP)
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Medicare Advantage
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
Inpatient Chemical Dependency
Services
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 (Day/Night)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Day/Night Chemical Dependency
Services
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 (Ambulatory)
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Ambulatory Chemical Dependency
Services
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
Page 68
ealth Alliance (CBP)
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:22 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
6256
0
6256
Female
0
0
0
0
0
17069
0
17069
Total
0
0
0
0
0
23325
0
23325
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
17
17
34
0
0
0
17
17
34
HEDIS 2007 (Reporting Year 2006)
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
NA
NA
NA
3.26%
1.20%
1.75%
NA
NA
NA
3.26%
1.20%
1.75%
Member Months (Inpatient)
Male
0
0
0
0
0
6256
0
6256
Female
0
0
0
0
0
17069
0
17069
Total
0
0
0
0
0
23325
0
23325
Member Months (Day/Night)
Male
0
0
0
0
0
6256
0
6256
Female
0
0
0
0
0
17069
0
17069
Total
0
0
0
0
0
23325
0
23325
Member Months (Ambulatory)
Male
0
0
0
0
0
6256
0
6256
Female
0
0
0
0
0
17069
0
17069
Total
0
0
0
0
0
23325
0
23325
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
11
8
19
0
0
0
11
8
19
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
9
18
0
0
0
9
9
18
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
NA
NA
NA
2.11%
0.56%
0.98%
NA
NA
NA
2.11%
0.56%
0.98%
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
1.73%
0.63%
0.93%
NA
NA
NA
1.73%
0.63%
0.93%
Page 69
ealth Alliance (CBP)
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Medicaid
Member Months (Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
36370
7879
3807
4186
7329
1152
0
60723
Female
34834
8216
13059
13524
11672
2745
0
84050
Total
71204
16095
16866
17710
19001
3897
0
144773
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
13
14
27
22
24
46
42
71
113
61
95
156
108
94
202
2
0
2
0
0
0
248
298
546
HEDIS 2007 (Reporting Year 2006)
Percent
0.43%
0.48%
0.46%
3.35%
3.51%
3.43%
NR
NR
NA
2.01%
3.27%
2.63%
17.68%
9.66%
12.76%
2.08%
0.00%
0.62%
NA
NA
NA
4.90%
4.25%
4.53%
Member Months (Inpatient)
Male
36370
7879
3807
4186
7329
1152
0
60723
Female
34834
8216
13059
13524
11672
2745
0
84050
Total
71204
16095
16866
17710
19001
3897
0
144773
Member Months (Day/Night)
Male
36370
7879
3807
4186
7329
1152
0
60723
Female
34834
8216
13059
13524
11672
2745
0
84050
Total
71204
16095
16866
17710
19001
3897
0
144773
Member Months (Ambulatory)
Male
36370
7879
3807
4186
7329
1152
0
60723
Female
34834
8216
13059
13524
11672
2745
0
84050
Total
71204
16095
16866
17710
19001
3897
0
144773
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
0
0
0
5
11
16
9
15
24
14
27
41
33
25
58
1
0
1
0
0
0
62
78
140
Number
0
0
0
1
0
1
0
2
2
1
2
3
1
2
3
0
0
0
0
0
0
3
6
9
Number
13
14
27
19
21
40
38
60
98
56
86
142
91
83
174
1
0
1
0
0
0
218
264
482
Percent
0.00%
0.00%
0.00%
0.76%
1.61%
1.19%
NR
NR
NA
0.46%
0.93%
0.69%
5.40%
2.57%
3.66%
1.04%
0.00%
0.31%
NA
NA
NA
1.23%
1.11%
1.16%
Percent
0.00%
0.00%
0.00%
0.15%
0.00%
0.07%
NR
NR
NA
0.03%
0.07%
0.05%
0.16%
0.21%
0.19%
0.00%
0.00%
0.00%
NA
NA
NA
0.06%
0.09%
0.07%
Percent
0.43%
0.48%
0.46%
2.89%
3.07%
2.98%
NR
NR
NA
1.85%
2.96%
2.39%
14.90%
8.53%
10.99%
1.04%
0.00%
0.31%
NA
NA
NA
4.31%
3.77%
4.00%
Page 70
Use of Services
South Country Health Alliance (CBP)
Outpatient Drug Utilization
Commercial
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Outpatient Drug Utilization
Data Last Refreshed:
Oct 7, 2009 1:22 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 2007 (Reporting Year 2006)
NR
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 72
Use of Services
South Country Health Alliance (CBP)
Outpatient Drug Utilization
MSHO
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Member Months
0
0
0
0
5634
7740
9951
0
23325
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
$1,726,287.00
$2,416,380.00
$2,578,271.00
$0.00
$6,720,938.00
HEDIS 2007 (Reporting Year 2006)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
NA
NA
$306.41
$312.19
$259.10
$288.14
Total Number of
Prescriptions
0
0
0
0
39322
66204
86045
0
191571
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
NA
NA
83.75
102.64
103.76
98.56
Page 73
Use of Services
South Country Health Alliance (CBP)
Outpatient Drug Utilization
Medicaid
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Member Months
60573
31423
40714
8166
1257
1189
1451
0
144773
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 1:22 PM
$947,129.00
$972,154.00
$2,860,983.00
$1,284,486.00
$22,076.00
$22,159.00
$35,420.00
$0.00
$6,144,407.00
HEDIS 2007 (Reporting Year 2006)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$15.64
$30.94
$70.27
$157.30
$17.56
$18.64
$24.41
$42.44
Total Number of
Prescriptions
70171
30389
96220
42461
631
708
964
0
241544
Avg. Num. Of
Prescriptions /
Per Member Per
Year
13.90
11.61
28.36
62.40
6.02
7.15
7.97
20.02
Page 74
Access/Availability of Care
South Country Health Alliance (CBP)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:22 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 2007 (Reporting Year 2006)
Page 76
Access/Availability of Care
South Country Health Alliance (CBP)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:22 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
1625
2006
A
0
0
1568
NA
NA
NA
NA
NA
NA
96.49%
95.57%
97.42%
Page 77
Access/Availability of Care
South Country Health Alliance (CBP)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:22 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+
1343
376
162
2006
A
1219
325
122
90.77%
89.18%
92.35%
86.44%
82.84%
90.03%
75.31%
68.36%
82.26%
Page 78
Access/Availability of Care
South Country Health Alliance (CBP)
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:22 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.
493
1192
601
770
2006
A
448
954
501
657
90.87%
88.23%
93.52%
80.03%
77.72%
82.34%
83.36%
80.30%
86.42%
85.32%
82.76%
87.89%
Page 80
Access/Availability of Care
South Country Health Alliance (CBP)
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Medicaid
General
Measure Data
Data collection methodology (Administrative or Hybrid)
H
Eligible member population (i.e. members who meet all
denominator criteria)
661
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
0
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
357
264
54.01%
39.94%
244
171
56.48%
39.58%
244
141
171
122
89.12%
86.07%
92.17%
67.82%
63.30%
72.35%
0
432
Page 82
Access/Availability of Care
South Country Health Alliance (CBP)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Medicare Advantage
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
NR
NR
Reported rate
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Lower 95% confidence interval
Upper 95% confidence interval
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Numerator events by administrative data
HEDIS 2007 (Reporting Year 2006)
Page 84
Access/Availability of Care
South Country Health Alliance (CBP)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:22 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
26
26
0
0
0
0
0
0
0
0
15
1
15
1
Reported rate
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Lower 95% confidence interval
Upper 95% confidence interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
HEDIS 2007 (Reporting Year 2006)
Page 85
Access/Availability of Care
South Country Health Alliance (CBP)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Medicaid
13-17 Year Olds
Data Elements
Measurement Year
Data collection methodology
(Administrative only)
General
Measure
Data
Initiation of
AOD
Treatment
26-34 Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
2
8
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
16
25
3
54
0
0
4
0
7
0
9
0
2
1
22
1
Reported rate
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
40.74%
1.85%
Lower 95% confidence interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
26.71%
0.00%
Upper 95% confidence interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
54.77%
6.37%
HEDIS 2007 (Reporting Year 2006)
Page 86
Health Plan Stability
South Country Health Alliance (CBP)
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:22 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
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
South Country Health Alliance (CBP)
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:22 PM
MSHO
Product/Product Line
Years in Business
Members*
0.00
0.00
1.33
0.00
0.00
1.33
0
0
2007
0
0
2007
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
2007
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
South Country Health Alliance (CBP)
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:22 PM
Medicaid
Product/Product Line
Years in Business
Members*
5.16
0.00
0.00
0.00
0.00
5.16
11882
0
0
0
0
11882
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
11882
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
South Country Health Alliance (CBP)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:22 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
South Country Health Alliance (CBP)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:22 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 2007 (Reporting Year 2006)
Page 92
Health Plan Descriptive Information
South Country Health Alliance (CBP)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:22 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%
1140
1152
1176
924
1140
708
0
0.00%
1500
1824
2460
3168
3816
4260
0
0.00%
6240
100.00%
0
17028
100.00%
0
23268
100.00%
6240
17028
HEDIS 2007 (Reporting Year 2006)
0
0
0
0
0
0
0
0
0
2640
2976
3636
4092
4956
4968
0
23268
Page 93
Health Plan Descriptive Information
South Country Health Alliance (CBP)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:22 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
5668
13309
11848
8984
4440
1545
Member Months
Female
5396
13174
11178
8720
4582
3152
Total
11064
26483
23026
17704
9022
4697
45794
75.41%
2262
2234
1952
1818
1808
46202
54.97%
9907
7781
5743
4094
3115
91996
63.54%
10074
16.59%
1543
1150
575
435
30640
36.45%
2221
1036
874
332
40714
28.12%
3703
6.10%
300
145
219
159
143
186
4463
5.31%
536
276
350
461
511
611
8166
5.64%
1152
1.90%
0
2745
3.27%
0
3897
2.69%
60723
84050
HEDIS 2007 (Reporting Year 2006)
12169
10015
7695
5912
4923
3764
2186
1449
767
836
421
569
620
654
797
0
144773
Page 94