First Plan of Minnesota
Plan Name
2006
Reporting Year
General Info
Disclaimers
Submission #
Plan ID
1
2
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 1:13:14 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
First Plan of Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
MMR
HiB
Hepatitis B
VZV
Pneumococcal
Conjugate
Combo 2
Combo 3
5
71.43%
5
71.43%
6
85.71%
4
57.14%
5
71.43%
6
85.71%
4
57.14%
3
42.86%
2
28.57%
5
71.43%
5
71.43%
6
85.71%
4
57.14%
5
71.43%
6
85.71%
4
57.14%
3
42.86%
2
28.57%
5
1
NA
NA
NA
5
1
NA
NA
NA
6
1
NA
NA
NA
4
1
NA
NA
NA
5
1
NA
NA
NA
6
1
NA
NA
NA
4
1
NA
NA
NA
3
2
NA
NA
NA
2
2
NA
NA
NA
7
0.00%
7
Number of Records Excluded Because of
Valid Data Errors
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
7
HEDIS 2007 (Reporting Year 2006)
IPV
2006
H
7
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
DTaP/DT
Page 3
Effectiveness of Care
First Plan of Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:13 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
66
45.52%
72
49.66%
108
74.48%
60
41.38%
73
50.34%
108
74.48%
56
38.62%
46
31.72%
35
24.14%
66
45.52%
72
49.66%
108
74.48%
60
41.38%
73
50.34%
108
74.48%
56
38.62%
46
31.72%
35
24.14%
66
54
82.76%
76.27%
89.25%
72
41
77.93%
70.84%
85.03%
108
22
89.66%
84.35%
94.96%
60
61
83.45%
77.05%
89.84%
73
43
80.00%
73.14%
86.86%
108
18
86.90%
81.06%
92.73%
56
30
59.31%
50.97%
67.65%
46
50
66.21%
58.16%
74.25%
35
6
28.28%
20.60%
35.95%
145
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
145
0.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
IPV
2006
H
145
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
145
Page 4
Effectiveness of Care
First Plan of Minnesota
Adolescent Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Combo 2
10
62.50%
7
43.75%
4
25.00%
2
12.50%
10
62.50%
7
43.75%
4
25.00%
2
12.50%
10
4
NA
NA
NA
7
4
NA
NA
NA
4
0
NA
NA
NA
2
0
NA
NA
NA
16
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)
VZV
16
0.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Hepatitis B
2006
H
16
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
16
Page 5
Effectiveness of Care
First Plan of Minnesota
Adolescent Immunization Status
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
Combo 2
36
35.29%
6
5.88%
15
14.71%
2
1.96%
36
35.29%
6
5.88%
15
14.71%
2
1.96%
36
49
83.33%
75.61%
91.06%
6
63
67.65%
58.08%
77.22%
15
26
40.20%
30.19%
50.20%
2
32
33.33%
23.69%
42.97%
102
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)
VZV
102
0.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Hepatitis B
2006
H
102
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
102
Page 6
Effectiveness of Care
First Plan of Minnesota
Appropriate Treatment for Children with Upper
Respiratory Infection
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Data Elements
Measurement Year
General
Measure
Data
2006
Data Collection Methodology
A
Eligible Member Population
17
Numerator Events by Admin Data
2
Reported Rate
NA
Lower 95% Confidence Interval
NA
Upper 95% Confidence Interval
NA
HEDIS 2007 (Reporting Year 2006)
Page 7
Effectiveness of Care
First Plan of Minnesota
Colorectal Cancer Screening
Data Elements
Measurement Year
Data collection methodology (administrative or hybrid)
Eligible population
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Medicare
Advantage
MSHO
2006
2006
A
A
284
196
Number of numerator events by administrative data in eligible
population (before exclusions)
Current year's administrative rate (before exclusions)
NR
NR
NR
NR
NR
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of valid data
errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records excluded
Records added from the oversample list
Denominator
Numerator events by administrative data
170
66
Numerator events by medical records
Reported rate
59.86%
NR
33.67%
Lower 95% confidence interval
53.98%
NR
26.80%
Upper 95% confidence interval
65.74%
NR
40.54%
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
First Plan of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:13 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 42-51
Ages 52-69
Total
121
84
69.42%
60.80%
78.04%
119
93
78.15%
70.31%
86.00%
240
177
73.75%
67.97%
79.53%
2006
A
Page 9
Effectiveness of Care
First Plan of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:13 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
39
22
56.41%
39.57%
73.26%
39
22
56.41%
39.57%
73.26%
2006
A
Page 11
Effectiveness of Care
First Plan of Minnesota
Breast Cancer Screening
Data Last Refreshed:
Oct 7, 2009 1:13 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
270
161
59.63%
53.59%
65.67%
205
131
63.90%
57.08%
70.72%
475
292
61.47%
56.99%
65.96%
2006
A
Page 12
Effectiveness of Care
First Plan of Minnesota
Cervical Cancer Screening
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Medicaid
2006
A
312
2006
A
1387
78.85%
71.52%
NR
NR
246
992
78.85%
74.15%
83.54%
71.52%
69.11%
73.93%
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
Number of administrative data records excluded
Number of medical record data records excluded
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
Page 13
Effectiveness of Care
st Plan of Minnesota
Chlamydia Screening in Women
Data Last Refreshed:
Oct 7, 2009 1:13 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
2006
A
General
Measure Ages 16-20 Ages 21-25
Data
Total
2006
A
20
9
NA
NA
NA
16
8
NA
NA
NA
36
17
47.22%
29.53%
64.92%
147
74
50.34%
41.92%
58.76%
207
76
36.71%
29.91%
43.52%
354
150
42.37%
37.08%
47.66%
Page 14
Effectiveness of Care
First Plan 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 1:13 PM
Medicare
Advantage
NR
NR
NR
MSHO
2006
A
50
16
32.00%
18.07%
45.93%
Page 15
Effectiveness of Care
First Plan of Minnesota
Controlling High Blood Pressure
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Data Elements
General Measure
Data
Ages 18-45
Ages 46-85
Total
Eligible Member Population
8
68
76
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
0
0
0.00%
0.00%
0.00%
0
0
0
0.00%
0.00%
0.00%
Denominator
8
68
76
Numerator Events by Admin Data
0
0
0
Numerator Events by Medical Record
2
43
45
Reported Rate
NA
63.24%
59.21%
Lower 95% Confidence Interval
NA
51.04%
47.50%
Upper 95% Confidence Interval
NA
75.43%
70.92%
Measurement Year
Data Collection Methodology (Hybrid)
2006
H
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
76
0.00%
76
Numerator events by admin data in FSS
Admin rate on FSS
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
HEDIS 2007 (Reporting Year 2006)
Page 16
Effectiveness of Care
First Plan of Minnesota
Beta Blocker Treatment after Heart Attack
Data Elements
Measurement Year
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Medicare Advantage
MSHO
2006
2006
Data Collection Methodology
H
H
Eligible Member Population
1
4
Numerator Events by Admin Data on
Eligible Population
1
1
Current Year's Admin Rate
Minimum Required Sample Size
100.00%
NR
25.00%
1
4
0.00%
0.00%
Final Sample Size (FSS)
1
4
Numerator events by admin data in FSS
1
1
Oversampling Rate
Admin rate on FSS
100.00%
NR
25.00%
Records Excluded because of Valid Data
Errors
0
0
Number of administrative data records
excluded
0
0
Number of medical record data records
excluded
0
0
Number of employee/dependent medical
records excluded
0
0
Records Added from the Oversample List
0
0
Denominator
1
4
Numerator Events by Admin Data
1
1
Numerator Events by Medical Record
0
0
Reported Rate
NA
NR
NA
Lower 95% Confidence Interval
NA
NR
NA
Upper 95% Confidence Interval
NA
NR
NA
HEDIS 2007 (Reporting Year 2006)
Page 17
Effectiveness of Care
First Plan of Minnesota
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Measurement Year
Commercial
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Medicare Advantage
MSHO
2006
Data Collection Methodology
A
Eligible Member Population
0
Numerator Events by Admin Data on
Eligible Population
0
Reported Rate
NR
NR
NR
Lower 95% Confidence Interval
NR
NR
NR
Upper 95% Confidence Interval
NR
NR
NR
HEDIS 2007 (Reporting Year 2006)
Page 18
Effectiveness of Care
First Plan of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
0
Number of administrative data records excluded
0
Number of medical record data records excluded
0
Number of employee/dependent medical records
excluded
0
HEDIS 2007 (Reporting Year 2006)
3
0
100.00%
0.00%
3
0
100.00%
0.00%
3
0
0
0
NA
NA
NA
NA
NA
NA
3
0.00%
3
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
3
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
3
Page 19
Effectiveness of Care
First Plan of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Cholesterol Management for Patients with Cardiovascular
Conditions
Data Last Refreshed:
Oct 7, 2009 1:13 PM
MSHO
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
0
66.67%
0.00%
4
0
66.67%
0.00%
4
0
0
0
NA
NA
NA
NA
NA
NA
6
0.00%
6
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
Denominator
0
6
HEDIS 2007 (Reporting Year 2006)
4
6
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
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
HbA1c
Testing
Poor HbA1c Good HbA1c
Control
Control
Eye Exam
LDL-C
Screening
LDL-C Level
<100 mg/dL
Blood
Monitoring
Pressure
for Diabetic
<140/90 mm
Nephropathy
Hg
Blood
Pressure
<130/80 mm
Hg
2006
H
56
2006
H
56
2006
H
56
2006
H
56
2006
H
56
2006
H
56
2006
H
56
2006
H
56
2006
H
56
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
56
100.00%
56
0%
56
56
100.00%
0
0.00%
56
0%
56
0
0.00%
0
0.00%
56
0%
56
0
0.00%
34
60.71%
56
0%
56
34
60.71%
44
78.57%
56
0%
56
44
78.57%
0
0.00%
56
0%
56
0
0.00%
49
87.50%
56
0%
56
49
87.50%
0
0.00%
56
0%
56
0
0.00%
0
0.00%
56
0%
56
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
56
56
0
100.00%
99.11%
100.00%
0
56
0
19
33.93%
20.63%
47.22%
0
56
0
23
41.07%
27.29%
54.85%
0
56
34
0
60.71%
47.03%
74.40%
0
56
44
5
87.50%
77.95%
97.05%
0
56
0
32
57.14%
43.29%
71.00%
0
56
49
1
89.29%
80.29%
98.28%
0
56
0
35
62.50%
48.93%
76.07%
0
56
0
14
25.00%
12.77%
37.23%
Numerator events by admin data in eligible
population
Number of medical record data records
excluded
Number of employee/dependent medical
records excluded
Additional Records Added from the
Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
Page 22
Effectiveness of Care
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:13 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
66
2006
H
66
2006
H
66
2006
H
66
2006
H
66
2006
H
66
2006
H
66
2006
H
66
2006
H
66
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
59
89.39%
66
0%
66
59
89.39%
0
0.00%
66
0%
66
0
0.00%
0
0.00%
66
0%
66
0
0.00%
39
59.09%
66
0%
66
39
59.09%
45
68.18%
66
0%
66
45
68.18%
0
0.00%
66
0%
66
0
0.00%
57
86.36%
66
0%
66
57
86.36%
0
0.00%
66
0%
66
0
0.00%
0
0.00%
66
0%
66
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
66
59
0
89.39%
81.21%
97.58%
0
66
0
16
24.24%
13.15%
35.34%
0
66
0
34
51.52%
38.70%
64.33%
0
66
39
0
59.09%
46.47%
71.71%
0
66
45
8
80.30%
69.95%
90.66%
0
66
0
35
53.03%
40.23%
65.83%
0
66
57
0
86.36%
77.33%
95.40%
0
66
0
40
60.61%
48.06%
73.15%
0
66
0
17
25.76%
14.45%
37.07%
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
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 1:13 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
170
2006
H
170
2006
H
170
2006
H
170
2006
H
170
2006
H
170
2006
H
170
2006
H
170
2006
H
170
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
161
94.71%
170
0%
170
161
94.71%
0
0.00%
170
0%
170
0
0.00%
0
0.00%
170
0%
170
0
0.00%
86
50.59%
170
0%
170
86
50.59%
125
73.53%
170
0%
170
125
73.53%
0
0.00%
170
0%
170
0
0.00%
152
89.41%
170
0%
170
152
89.41%
0
0.00%
170
0%
170
0
0.00%
0
0.00%
170
0%
170
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
170
161
5
97.65%
95.07%
100.00%
0
170
0
59
34.71%
27.26%
42.16%
0
170
0
71
41.76%
34.06%
49.47%
0
170
86
0
50.59%
42.78%
58.40%
0
170
125
20
85.29%
79.68%
90.91%
0
170
0
76
44.71%
36.94%
52.47%
0
170
152
0
89.41%
84.49%
94.33%
0
170
0
117
68.82%
61.57%
76.08%
0
170
0
66
38.82%
31.20%
46.44%
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
First Plan of Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:13 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
Ages 10-17
Ages 18-56
Total
4
3
NA
NA
NA
5
5
NA
NA
NA
33
26
78.79%
63.32%
94.25%
42
34
80.95%
67.89%
94.02%
2006
A
Page 26
Effectiveness of Care
First Plan of Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 1:13 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
27
24
NA
NA
NA
46
32
69.57%
55.18%
83.95%
127
81
63.78%
55.03%
72.53%
200
137
68.50%
61.81%
75.19%
2006
A
Page 27
Effectiveness of Care
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:13 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
0
NA
NA
NA
2
NA
NA
NA
1
NA
NA
NA
2006
A
2
Page 28
Effectiveness of Care
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:13 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
0
NA
NA
NA
2
NA
NA
NA
1
NA
NA
NA
2006
A
2
Page 30
Effectiveness of Care
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 1:13 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
4
NA
NA
NA
9
NA
NA
NA
7
NA
NA
NA
2006
A
20
Page 31
Effectiveness of Care
First Plan of Minnesota
Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
Data Last Refreshed:
Oct 7, 2009 1:13 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
2006
A
General
Measure
Data
Initiation
Phase
Continuation
and
Maintenance
Phase
24
0
8
NA
NA
NA
3
0
2
NA
NA
NA
2006
A
1
0
1
NA
NA
NA
1
0
1
NA
NA
NA
Page 32
Effectiveness of Care
First Plan of Minnesota
Glaucoma Screening in Older Adults
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interva
HEDIS 2007 (Reporting Year 2006)
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Medicare
Advantage
NR
NR
NR
MSHO
2006
A
391
325
83.12%
79.28%
86.96%
Page 33
Effectiveness of Care
First Plan of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:13 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 Interval
HEDIS 2007 (Reporting Year 2006)
General
Measure
Data
Annual Monitoring for Members on
ACE Inhibitors
or ARBs
Digoxin
Diuretics
Anticonvulsants
Total
88
0
71
80.68%
71.86%
89.50%
1
0
1
NA
NA
NA
67
0
51
76.12%
65.16%
87.07%
3
0
2
NA
NA
NA
159
0
125
78.62%
71.93%
85.30%
2006
A
Page 34
Effectiveness of Care
First Plan of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:13 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
265
0
229
86.42%
82.10%
90.73%
56
0
51
91.07%
82.71%
99.43%
285
0
244
85.61%
81.36%
89.86%
46
0
32
69.57%
55.18%
83.95%
652
0
556
85.28%
82.48%
88.07%
2006
A
Page 36
Effectiveness of Care
First Plan of Minnesota
Annual Monitoring for Patients on Persisten
Medications
Data Last Refreshed:
Oct 7, 2009 1:13 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
199
0
155
77.89%
71.87%
83.91%
7
0
6
NA
NA
NA
153
0
124
81.05%
74.51%
87.58%
20
0
14
NA
NA
NA
379
0
299
78.89%
74.65%
83.13%
2006
A
Page 37
Effectiveness of Care
First Plan of Minnesota
Drugs to Be Avoided in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:13 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
661
1 or More
Prescriptions
2 or More
Prescriptions
185
27.99%
24.49%
31.49%
74
11.20%
8.72%
13.67%
Page 38
Effectiveness of Care
First Plan of Minnesota
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Potentially Harmful Drug-Disease Interactions in the Elderly
Data Last Refreshed:
Oct 7, 2009 1:13 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
14
1
NA
NA
NA
137
33
24.09%
16.56%
31.61%
4
0
NA
NA
NA
155
34
21.94%
15.10%
28.77%
Page 40
Use of Services
First Plan of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
General
Measure
Data
0
Number of records excluded because of
contraindications identified through
administrative data
0
Number of records excluded because of
contraindications identified through medical
record review
0
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Oversample List
0
HEDIS 2007 (Reporting Year 2006)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
0
0.00%
1
6.25%
1
6.25%
0
0.00%
0
0.00%
3
18.75%
10
62.50%
0
0.00%
1
6.25%
1
6.25%
0
0.00%
0
0.00%
3
18.75%
10
62.50%
0
0
NA
NA
NA
1
0
NA
NA
NA
1
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
3
0
NA
NA
NA
10
0
NA
NA
NA
16
0.00%
16
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
16
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
16
Page 41
Use of Services
First Plan of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 1:13 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
5
2.69%
8
4.30%
1
0.54%
7
3.76%
9
4.84%
37
19.89%
119
63.98%
5
2.69%
8
4.30%
1
0.54%
7
3.76%
9
4.84%
37
19.89%
119
63.98%
5
0
2.69%
0.09%
5.28%
8
0
4.30%
1.12%
7.49%
1
0
0.54%
0.00%
1.86%
7
0
3.76%
0.76%
6.77%
9
0
4.84%
1.49%
8.19%
37
0
19.89%
13.89%
25.90%
119
0
63.98%
56.81%
71.15%
186
0.00%
186
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
186
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
186
Page 42
Use of Services
First Plan of Minnesota
Well Child Visits in the 3rd, 4th,
5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Medicaid
2006
A
39
2006
A
492
NR
NR
NR
NR
29
328
74.36%
59.37%
89.35%
66.67%
62.40%
70.93%
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
Records Excluded - Contraindications/Admin Data
Records Excluded - Contraindications/Medical
Record Review
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
Page 43
Use of Services
First Plan of Minnesota
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Eligible Member Population
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Medicaid
2006
A
159
2006
A
954
NR
NR
NR
NR
53
364
33.33%
25.69%
40.98%
38.16%
35.02%
41.29%
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
Records Excluded - Contraindications/Admin Data
Records Excluded - Contraindications/Medical
Record Review
Number of employee/dependent medical records
excluded
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2007 (Reporting Year 2006)
Page 44
Use of Services
First Plan of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Member Months
Total
825
1544
3105
2386
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
4
4
1
0
Procedures /
1,000 Member
Months
4.85
1.29
0.65
0.00
Member Months
Male
Female
3861
2383
3239
4859
3237
3225
72
62
Female
Male
Procedure
Dilation &
Curettage
Hysterectomy,
Abdominal
Age
15-44
45-64
15-44
45-64
65+
Hysterectomy,
15-44
Vaginal
45-64
65+
Cholecystectomy,
30-64
Open
15-44
45-64
65+
Cholecystectomy,
30-64
Closed
15-44
45-64
65+
Back Surgery
20-44
45-64
65+
Angioplasty (PTCA) 45-64
65+
45-64
Cardiac
Catheterization
65+
45-64
CABG
65+
Prostatectomy
45-64
65+
Mastectomy
15-44
45-64
65+
Lumpectomy
15-44
45-64
65+
HEDIS 2007 (Reporting Year 2006)
Number of
Procedures
Procedures /
1,000 Member
Months
0
0.00
0
3
0
2
2
0
7
0
8
0
0
0
1
0
0.00
0.62
0.00
0.84
0.62
0.00
2.16
0.00
2.47
0.00
0.00
0.00
0.31
0.00
Number of
Procedures
1
0
0
0
0
2
1
0
Procedures /
1,000 Member
Months
0.26
0.00
0.00
0.00
0.00
0.52
0.31
0.00
0
1
0
0.00
0.31
0.00
1
2
0
7
6
0
2
0
5
0
0
0
0.26
0.62
0.00
2.16
1.86
0.00
0.62
0.00
1.55
0.00
0.00
0.00
0
0
0
0
1
0
0.00
0.00
0.00
0.00
0.31
0.00
Page 45
Use of Services
First Plan of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 1:13 PM
MSHO
Age
< 65
65-74
75-84
85+
Member Months
Male
Female
6
4
941
1617
735
2493
613
3635
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
3
0
0
0
0
0
0
0
1
1
0
0
1
0
0
0
0
0
0
0
2
0
0
2
0
0
0
1
1
1
0
0
0
0
Procedures /
1,000 Member
Months
0.00
0.00
0.00
0.00
0.00
2.13
0.00
0.00
0.00
2.13
4.08
0.00
0.00
0.00
0.00
0.00
0.00
0.00
1.36
1.63
0.00
0.00
1.36
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2.72
0.00
0.00
2.13
0.00
0.00
0.00
1.06
1.36
1.63
0.00
0.00
0.00
0.00
Female
Number of
Procedures
0
0
0
0
0
0
2
0
0
4
3
0
0
0
0
0
0
1
2
10
0
1
0
1
0
4
2
1
0
0
0
1
0
0
0
1
0
1
1
0
0
5
4
11
0
0
0
1
0
0
0
0
0
1
1
1
0
0
3
3
Procedures /
1,000 Member
Months
0.00
0.00
0.00
0.00
0.00
0.00
0.80
0.00
0.00
2.47
1.20
0.00
0.00
0.00
0.00
0.00
0.00
0.62
0.80
2.75
0.00
0.62
0.00
0.28
0.00
2.47
0.80
0.28
0.00
0.00
0.00
0.28
0.00
0.00
0.00
0.28
0.00
0.62
0.40
0.00
0.00
3.09
1.60
3.03
0.00
0.00
0.00
0.28
0.00
0.00
0.00
0.00
0.00
0.62
0.40
0.28
0.00
0.00
1.20
0.83
Page 47
Use of Services
Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Member Months
165
1379
2386
5622
6462
125
9
0
0
16148
Discharges
Discharges /
1,000 Member
Months
5
3
5
63
45
3
0
0
0
124
30.30
2.18
2.10
11.21
6.96
24.00
0.00
NA
2
1
3
15
14
1
0
0
0
36
12.12
0.73
1.26
2.67
2.17
8.00
0.00
NA
1
2
1
23
27
1
0
0
0
55
6.06
1.45
0.42
4.09
4.18
8.00
0.00
NA
0
21
0
0
21
0.00
3.74
0.00
HEDIS 2007 (Reporting Year 2006)
7.68
2.23
3.41
1.45
Days
Days / 1,000
Member
Months
15
5
13
196
151
10
0
0
0
390
90.91
3.63
5.45
34.86
23.37
80.00
0.00
NA
4
1
4
44
48
3
0
0
0
104
24.24
0.73
1.68
7.83
7.43
24.00
0.00
NA
3
3
1
117
112
3
0
0
0
239
18.18
2.18
0.42
20.81
17.33
24.00
0.00
NA
0
44
0
0
44
0.00
7.83
0.00
24.15
6.44
14.80
3.04
Average
Length of Stay
3.00
1.67
2.60
3.11
3.36
3.33
NA
NA
NA
3.15
2.00
1.00
1.33
2.93
3.43
3.00
NA
NA
NA
2.89
3.00
1.50
1.00
5.09
4.15
3.00
NA
NA
NA
4.35
NA
2.10
NA
NA
2.10
Page 48
Use of Services
Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 7, 2009 1:13 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
Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
MSHO
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Member Months
0
0
0
0
10
2558
3228
4248
0
10044
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
161
281
479
0
921
NA
NA
NA
NA
0.00
62.94
87.05
112.76
0
0
0
0
0
125
237
444
0
806
NA
NA
NA
NA
0.00
48.87
73.42
104.52
0
0
0
0
0
36
44
35
0
115
NA
NA
NA
NA
0.00
14.07
13.63
8.24
0
0
0
0
0
HEDIS 2007 (Reporting Year 2006)
91.70
80.25
11.45
NA
NA
0.00
0.00
Days
Days / 1,000
Member
Months
0
0
0
0
0
1477
2823
5670
0
9970
NA
NA
NA
NA
0.00
577.40
874.54
1334.75
0
0
0
0
0
1183
2545
5426
0
9154
NA
NA
NA
NA
0.00
462.47
788.41
1277.31
0
0
0
0
0
294
278
244
0
816
NA
NA
NA
NA
0.00
114.93
86.12
57.44
0
0
0
0
0
NA
NA
0.00
992.63
911.39
81.24
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
9.17
10.05
11.84
NA
10.83
NA
NA
NA
NA
NA
9.46
10.74
12.22
NA
11.36
NA
NA
NA
NA
NA
8.17
6.32
6.97
NA
7.10
NA
NA
NA
NA
NA
Page 50
Use of Services
Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
165
1379
2386
5622
6462
125
9
0
0
16148
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
Visits
141
397
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
482
1424
2051
36
7
0
0
4538
HEDIS 2007 (Reporting Year 2006)
Visits/ 1,000
Member
Months
854.55
287.89
202.01
253.29
317.39
288.00
777.78
NA
281.03
Emergency Room Visits
Visits
9
35
46
165
138
3
1
0
0
397
Visits/ 1,000
Member
Months
54.55
25.38
19.28
29.35
21.36
24.00
111.11
NA
24.59
Ambulatory
Surgery/Procedures
Procedures
0
0
0
1
1
0
0
0
0
2
Procedures/
1,000 Member
Months
0.00
0.00
0.00
0.18
0.15
0.00
0.00
NA
0.12
Observation Room Stays
Resulting in Discharge
Stays
0
0
4
9
6
0
0
0
0
19
Stays/ 1,000
Member
Months
0.00
0.00
1.68
1.60
0.93
0.00
0.00
NA
1.18
Page 51
Use of Services
Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:13 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
Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 1:13 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
10
2558
3228
4248
0
10044
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
13
1599
1534
1374
0
4520
HEDIS 2007 (Reporting Year 2006)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
1300.00
625.10
475.22
323.45
450.02
Emergency Room Visits
Visits
0
0
0
0
4
143
224
266
0
637
Visits/ 1,000
Member
Months
NA
NA
NA
NA
400.00
55.90
69.39
62.62
63.42
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
0
3
0
0
0
3
Procedures/
1,000 Member
Months
NA
NA
NA
NA
0.00
1.17
0.00
0.00
0.30
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
15
17
18
0
50
Stays/ 1,000
Member
Months
NA
NA
NA
NA
0.00
5.86
5.27
4.24
4.98
Page 53
Use of Services
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Age
Member
Months
<1
165
1-9
1379
10-19
2386
20-44
5622
45-64
6462
65-74
125
75-84
9
85+
0
Unknown
Total
0
16148
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
Days
Days / 1,000
Member
Months
Average Length
of Stay
0.00
0
0.00
NA
0
0.00
0
0.00
NA
10-19
0
0.00
0
0.00
NA
20-44
1
0.18
4
0.71
4.00
45-64
0
0.00
0
0.00
NA
65-74
0
0.00
0
0.00
NA
75-84
0
0.00
0
0.00
NA
85+
0
NA
0
NA
NA
Unknown
0
1
0.06
0
4
0.25
NA
4.00
Age
Total
HEDIS 2007 (Reporting Year 2006)
Page 54
Use of Services
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 1:13 PM
MSHO
Age
Member
Months
<1
0
1-9
0
10-19
0
20-44
0
45-64
10
65-74
2558
75-84
3228
85+
4248
Unknown
0
10044
Total
Discharges
Discharges /
1,000 Member
Months
Days
Days / 1,000
Member
Months
Average Length
of Stay
<1
0
NA
0
NA
NA
1-9
0
NA
0
NA
NA
10-19
0
NA
0
NA
NA
20-44
0
NA
0
NA
NA
45-64
0
0.00
0
0.00
NA
65-74
113
44.18
1767
690.77
15.64
75-84
182
56.38
2735
847.27
15.03
85+
274
64.50
4341
1021.89
15.84
Unknown
0
569
56.65
0
8843
880.43
NA
15.54
Age
Total
HEDIS 2007 (Reporting Year 2006)
Page 56
Use of Services
First Plan of Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Member Months
Age
Male
Female
Total
0-12
13-17
18-64
65+
Unknown
Total
1260
875
2135
729
5856
72
0
7917
541
6753
62
0
8231
1270
12609
134
0
16148
Discharges
Discharges /
1,000 Member
Months
Days*
Average Length
of Stay
Age
0-12
Gender
M
F
Total
0
0
0
0.00
0.00
0.00
0
0
0
NA
NA
NA
13-17
M
F
Total
1
0
1
1.37
0.00
0.79
2
0
2
2.00
NA
2.00
18-64
M
F
Total
M
F
Total
M
F
Total
M
F
TOTAL
3
1
4
0.51
0.15
0.32
7
2
9
2.33
2.00
2.25
1
0
1
13.89
0.00
7.46
2
0
2
2.00
NA
2.00
0
0
0
NA
NA
NA
11
2
13
2.20
2.00
2.17
65+
Unknown
Total
HEDIS 2007 (Reporting Year 2006)
0
0
0
5
1
6
0.63
0.12
0.37
Page 57
Use of Services
First Plan of Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Oct 7, 2009 1:13 PM
MSHO
Member Months
Age
Male
Female
Total
0-12
13-17
18-64
65+
Unknown
Total
0
0
6
2289
0
2295
0
0
4
7745
0
7749
0
0
10
10034
0
10044
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
0.00
0.00
0.00
0
0
0
NA
NA
NA
13
70
83
5.68
9.04
8.27
166
1417
1583
12.77
20.24
19.07
0
0
0
NA
NA
NA
166
1417
1583
12.77
20.24
19.07
65+
Unknown
Total
HEDIS 2007 (Reporting Year 2006)
0
0
0
13
70
83
5.66
9.03
8.26
Page 59
Use of Services
rst Plan of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
13-17
18-64
65+
Unknown
Total
Member Months (Day/Night)
Member Months (Ambulatory)
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
1260
729
875
541
2135
1270
1260
729
875
541
2135
1270
1260
729
875
541
2135
1270
1260
729
875
541
2135
1270
5856
72
0
7917
6753
62
0
8231
12609
134
0
16148
5856
72
0
7917
6753
62
0
8231
12609
134
0
16148
5856
72
0
7917
6753
62
0
8231
12609
134
0
16148
5856
72
0
7917
6753
62
0
8231
12609
134
0
16148
Any Mental Health Services
0-12
Member Months (Inpatient)
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
Inpatient Mental Health Services
Number
Percent
Number
Percent
Day/Night Mental Health Services
Percent
Number
10
4
14
13
7
20
38
96
134
1
0
1
0
0
0
62
107
169
9.52%
5.49%
7.87%
21.40%
15.53%
18.90%
7.79%
17.06%
12.75%
16.67%
0.00%
8.96%
NA
NA
NA
9.40%
15.60%
12.56%
0
0
0
0
1
1
3
3
6
0
0
0
0
0
0
3
4
7
0.00%
0.00%
0.00%
0.00%
2.22%
0.94%
0.61%
0.53%
0.57%
0.00%
0.00%
0.00%
NA
NA
NA
0.45%
0.58%
0.52%
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
10
4
14
13
7
20
37
95
132
1
0
1
0
0
0
61
106
167
9.52%
5.49%
7.87%
21.40%
15.53%
18.90%
7.58%
16.88%
12.56%
16.67%
0.00%
8.96%
NA
NA
NA
9.25%
15.45%
12.41%
Page 60
Use of Services
rst Plan of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory
Data Last Refreshed:
Oct 7, 2009 1:13 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
rst Plan of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory
Data Last Refreshed:
Oct 7, 2009 1:13 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
6
2289
0
2295
4
7745
0
7749
10
10034
0
10044
6
2289
0
2295
4
7745
0
7749
10
10034
0
10044
6
2289
0
2295
4
7745
0
7749
10
10034
0
10044
6
2289
0
2295
4
7745
0
7749
10
10034
0
10044
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
30
107
137
0
0
0
30
107
137
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
15.73%
16.58%
16.38%
NA
NA
NA
15.69%
16.57%
16.37%
0
0
0
0
0
0
0
0
0
8
24
32
0
0
0
8
24
32
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
4.19%
3.72%
3.83%
NA
NA
NA
4.18%
3.72%
3.82%
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
0
0
0
0
0
0
0
0
0
25
96
121
0
0
0
25
96
121
HEDIS 2007 (Reporting Year 2006)
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
13.11%
14.87%
14.47%
NA
NA
NA
13.07%
14.87%
14.46%
Page 62
Use of Services
rst Plan of Minnesota
Mental Health Utilization % of Members Receiving Inpatient, Day/Night and Ambulatory
Data Last Refreshed:
Oct 7, 2009 1:13 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
15858
5002
15964
5556
31822
10558
15858
5002
15964
5556
31822
10558
15858
5002
15964
5556
31822
10558
15858
5002
15964
5556
31822
10558
21750
603
0
43213
33797
1564
0
56881
55547
2167
0
100094
21750
603
0
43213
33797
1564
0
56881
55547
2167
0
100094
21750
603
0
43213
33797
1564
0
56881
55547
2167
0
100094
21750
603
0
43213
33797
1564
0
56881
55547
2167
0
100094
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
164
116
280
149
141
290
514
879
1393
6
21
27
0
0
0
833
1157
1990
12.41%
8.72%
10.56%
35.75%
30.45%
32.96%
28.36%
31.21%
30.09%
11.94%
16.11%
14.95%
NA
NA
NA
23.13%
24.41%
23.86%
2
1
3
7
10
17
42
44
86
2
6
8
0
0
0
53
61
114
0.15%
0.08%
0.11%
1.68%
2.16%
1.93%
2.32%
1.56%
1.86%
3.98%
4.60%
4.43%
NA
NA
NA
1.47%
1.29%
1.37%
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
1
1
HEDIS 2007 (Reporting Year 2006)
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.04%
0.02%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.02%
0.01%
Ambulatory Mental Health Services
Percent
Number
164
116
280
148
140
288
511
877
1388
6
16
22
0
0
0
829
1149
1978
12.41%
8.72%
10.56%
35.51%
30.24%
32.73%
28.19%
31.14%
29.99%
11.94%
12.28%
12.18%
NA
NA
NA
23.02%
24.24%
23.71%
Page 63
Use of Services
First Plan of Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Member Months
Age
Male
Female
Total
0-12
13-17
18-64
65+
Unknown
Total
1260
729
5856
72
0
7917
875
541
6753
62
0
8231
2135
1270
12609
134
0
16148
Discharges
Discharges /
1,000 Member
Months
Days
Average Length
of Stay
M
F
Total
0
0
0
0.00
0.00
0.00
0
0
0
NA
NA
NA
13-17
M
F
Total
1
0
1
1.37
0.00
0.79
2
0
2
2.00
NA
2.00
18-64
M
F
Total
M
F
Total
M
F
Total
M
F
TOTAL
0
0
0
0.00
0.00
0.00
0
0
0
NA
NA
NA
0
0
0
0.00
0.00
0.00
0
0
0
NA
NA
NA
0
0
0
NA
NA
NA
2
0
2
2.00
NA
2.00
Age
0-12
65+
Unknown
Total
HEDIS 2007 (Reporting Year 2006)
0
0
0
1
0
1
0.13
0.00
0.06
Page 64
Use of Services
First Plan of Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of
Data Last Refreshed:
Oct 7, 2009 1:13 PM
MSHO
Member Months
Age
Male
Female
Total
0-12
13-17
18-64
65+
Unknown
Total
0
0
6
2289
0
2295
0
0
4
7745
0
7749
0
0
10
10034
0
10044
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
0.00
0.00
0.00
0
0
0
NA
NA
NA
8
0
8
3.49
0.00
0.80
14
0
14
1.75
NA
1.75
0
0
0
NA
NA
NA
14
0
14
1.75
NA
1.75
Age
0-12
65+
Unknown
Total
HEDIS 2007 (Reporting Year 2006)
0
0
0
8
0
8
3.49
0.00
0.80
Page 66
st Plan of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Member Months (Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
1260
729
571
944
4341
72
0
7917
Female
875
541
748
1281
4724
62
0
8231
Total
2135
1270
1319
2225
9065
134
0
16148
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
3
3
6
2
1
3
4
3
7
1
0
1
0
0
0
10
7
17
HEDIS 2007 (Reporting Year 2006)
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NR
NR
NA
1.90%
1.37%
1.69%
1.11%
0.76%
0.93%
16.67%
0.00%
8.96%
NA
NA
NA
1.52%
1.02%
1.26%
Member Months (Inpatient)
Male
1260
729
571
944
4341
72
0
7917
Female
875
541
748
1281
4724
62
0
8231
Total
2135
1270
1319
2225
9065
134
0
16148
Member Months (Day/Night)
Male
1260
729
571
944
4341
72
0
7917
Female
875
541
748
1281
4724
62
0
8231
Total
2135
1270
1319
2225
9065
134
0
16148
Member Months (Ambulatory)
Male
1260
729
571
944
4341
72
0
7917
Female
875
541
748
1281
4724
62
0
8231
Total
2135
1270
1319
2225
9065
134
0
16148
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
0
0
0
0
0
0
1
1
2
0
0
0
1
0
1
0
0
0
0
0
0
2
1
3
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
2
2
4
1
1
2
2
2
4
1
0
1
0
0
0
6
5
11
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NR
NR
NA
0.00%
0.00%
0.00%
0.28%
0.00%
0.13%
0.00%
0.00%
0.00%
NA
NA
NA
0.30%
0.15%
0.22%
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NR
NR
NA
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%
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NR
NR
NA
0.95%
1.37%
1.12%
0.55%
0.51%
0.53%
16.67%
0.00%
8.96%
NA
NA
NA
0.91%
0.73%
0.82%
Page 67
st Plan of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:13 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
st Plan of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:13 PM
MSHO
Member Months (Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
0
6
2289
0
2295
Female
0
0
0
0
4
7745
0
7749
Total
0
0
0
0
10
10034
0
10044
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
5
8
13
0
0
0
5
8
13
HEDIS 2007 (Reporting Year 2006)
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
0.00%
0.00%
0.00%
2.62%
1.24%
1.55%
NA
NA
NA
2.61%
1.24%
1.55%
Member Months (Inpatient)
Male
0
0
0
0
6
2289
0
2295
Female
0
0
0
0
4
7745
0
7749
Total
0
0
0
0
10
10034
0
10044
Member Months (Day/Night)
Male
0
0
0
0
6
2289
0
2295
Female
0
0
0
0
4
7745
0
7749
Total
0
0
0
0
10
10034
0
10044
Member Months (Ambulatory)
Male
0
0
0
0
6
2289
0
2295
Female
0
0
0
0
4
7745
0
7749
Total
0
0
0
0
10
10034
0
10044
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
3
0
3
0
0
0
3
0
3
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
3
7
10
0
0
0
3
7
10
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
0.00%
0.00%
0.00%
1.57%
0.00%
0.36%
NA
NA
NA
1.57%
0.00%
0.36%
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%
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
0.00%
0.00%
0.00%
1.57%
1.08%
1.20%
NA
NA
NA
1.57%
1.08%
1.19%
Page 69
st Plan of Minnesota
Use of Services
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Medicaid
Member Months (Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
15858
5002
4744
5117
11889
603
0
43213
Female
15964
5556
8974
9092
15731
1564
0
56881
Total
31822
10558
13718
14209
27620
2167
0
100094
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
1
1
9
9
18
38
54
92
74
57
131
142
88
230
2
0
2
0
0
0
265
209
474
HEDIS 2007 (Reporting Year 2006)
Percent
0.00%
0.08%
0.04%
2.16%
1.94%
2.05%
NR
NR
NA
5.60%
4.28%
4.94%
14.33%
6.71%
9.99%
3.98%
0.00%
1.11%
NA
NA
NA
7.36%
4.41%
5.68%
Member Months (Inpatient)
Male
15858
5002
4744
5117
11889
603
0
43213
Female
15964
5556
8974
9092
15731
1564
0
56881
Total
31822
10558
13718
14209
27620
2167
0
100094
Member Months (Day/Night)
Male
15858
5002
4744
5117
11889
603
0
43213
Female
15964
5556
8974
9092
15731
1564
0
56881
Total
31822
10558
13718
14209
27620
2167
0
100094
Member Months (Ambulatory)
Male
15858
5002
4744
5117
11889
603
0
43213
Female
15964
5556
8974
9092
15731
1564
0
56881
Total
31822
10558
13718
14209
27620
2167
0
100094
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
0
0
0
5
4
9
10
14
24
17
13
30
41
21
62
1
0
1
0
0
0
74
52
126
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
1
1
6
7
13
29
39
68
50
48
98
110
75
185
1
0
1
0
0
0
196
170
366
Percent
0.00%
0.00%
0.00%
1.20%
0.86%
1.02%
NR
NR
NA
1.29%
0.98%
1.13%
4.14%
1.60%
2.69%
1.99%
0.00%
0.55%
NA
NA
NA
2.05%
1.10%
1.51%
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NR
NR
NA
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%
Percent
0.00%
0.08%
0.04%
1.44%
1.51%
1.48%
NR
NR
NA
3.78%
3.61%
3.70%
11.10%
5.72%
8.04%
1.99%
0.00%
0.55%
NA
NA
NA
5.44%
3.59%
4.39%
Page 70
Use of Services
First Plan of Minnesota
Outpatient Drug Utilization
Commercial
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Member Months
1544
2386
5622
6462
125
9
0
0
16148
Total Cost of
Prescriptions
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
$22,233.07
$50,885.71
$359,884.67
$758,343.89
$25,475.76
$3,875.30
$0.00
$0.00
$1,220,698.40
HEDIS 2007 (Reporting Year 2006)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$14.40
$21.33
$64.01
$117.35
$203.81
$430.59
NA
$75.59
Total Number of
Prescriptions
376
912
4881
12556
386
93
0
0
19204
Avg. Num. Of
Prescriptions /
Per Member Per
Year
2.92
4.59
10.42
23.32
37.06
124.00
NA
14.27
Page 71
Use of Services
First Plan of Minnesota
Outpatient Drug Utilization
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Outpatient Drug Utilization
MSHO
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Member Months
0
0
0
10
2558
3228
4248
0
10044
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
$4,138.64
$712,580.75
$878,475.37
$1,010,187.38
$0.00
$2,605,382.14
HEDIS 2007 (Reporting Year 2006)
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
NA
$413.86
$278.57
$272.14
$237.80
$259.40
Total Number of
Prescriptions
0
0
0
102
18183
27879
40082
0
86246
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
NA
122.40
85.30
103.64
113.23
103.04
Page 73
Use of Services
First Plan of Minnesota
Outpatient Drug Utilization
Medicaid
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Member Months
25764
20469
35995
15699
873
564
730
0
100094
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 1:13 PM
$309,046.63
$608,684.31
$2,813,276.56
$2,339,272.71
$42,384.35
$23,225.26
$9,694.98
$0.00
$6,145,584.80
HEDIS 2007 (Reporting Year 2006)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$12.00
$29.74
$78.16
$149.01
$48.55
$41.18
$13.28
$61.40
Total Number of
Prescriptions
7272
10746
50610
41886
1296
1128
1170
0
114108
Avg. Num. Of
Prescriptions /
Per Member Per
Year
3.39
6.30
16.87
32.02
17.81
24.00
19.23
13.68
Page 74
Access/Availability of Care
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Data Elements
General Measure
Data
Measurement Year
Data collection methodology (Administrativ
only)
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2007 (Reporting Year 2006)
Ages 20-44
Ages 45-64
Ages 65+
224
390
9
215
367
9
95.98%
93.19%
98.78%
94.10%
91.64%
96.57%
NA
NA
NA
2006
A
Page 75
Access/Availability of Care
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:13 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
661
2006
A
0
0
647
NA
NA
NA
NA
NA
NA
97.88%
96.71%
99.06%
Page 77
Access/Availability of Care
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 1:13 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+
1456
860
117
2006
A
1257
729
107
86.33%
84.53%
88.13%
84.77%
82.31%
87.23%
91.45%
85.96%
96.95%
Page 78
Access/Availability of Care
First Plan of Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Data Elements
Measurement Year
Data collection methodology (Administrativ
only)
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2007 (Reporting Year 2006)
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
12-19 yrs.
12
45
47
126
12
43
38
111
NA
NA
NA
95.56%
88.42%
100.00%
80.85%
68.54%
93.16%
88.10%
82.04%
94.15%
2006
A
Page 79
Access/Availability of Care
First Plan of Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 1:13 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.
242
599
352
642
2006
A
236
526
314
581
97.52%
95.35%
99.69%
87.81%
85.11%
90.52%
89.20%
85.82%
92.59%
90.50%
88.15%
92.84%
Page 80
Access/Availability of Care
First Plan of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
General
Measure Data
Data collection methodology (Administrative or Hybrid)
A
Eligible member population (i.e. members who meet all
denominator criteria)
14
Timeliness of
Prenatal Care
Postpartum
Care
57.14%
78.57%
NR
NR
8
11
NR
NR
NR
NR
NR
NR
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
First Plan of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Medicaid
General
Measure Data
Data collection methodology (Administrative or Hybrid)
A
Eligible member population (i.e. members who meet all
denominator criteria)
290
Number of numerator events by administrative data in
eligible population (before exclusions)
Current year's administrative rate (before exclusions)
Timeliness of
Prenatal Care
Postpartum
Care
NR
73.79%
NR
NR
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of
valid data errors
Number of administrative data records excluded
Number of medical 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)
214
NR
NR
NR
NR
NR
NR
Page 82
Access/Availability of Care
First Plan of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
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
Overall Rate
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
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
0
7
1
5
0
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
13
0
0
4
0
1
0
2
0
0
0
7
0
Reported rate
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Lower 95% confidence interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Upper 95% confidence interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
HEDIS 2007 (Reporting Year 2006)
Page 83
Access/Availability of Care
First Plan of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:13 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
Overall Rate
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
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Engagement
of AOD
Treatment
0
0
0
0
8
8
2006
A
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
18-25 Year Olds
0
0
0
0
0
0
0
0
3
2
3
2
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
First Plan of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 1:13 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
9
40
54
113
2
218
5
1
28
6
29
11
63
20
2
1
127
39
Reported rate
NA
NA
70.00%
15.00%
53.70%
20.37%
55.75%
17.70%
NA
NA
58.26%
17.89%
Lower 95% confidence interval
NA
NA
54.55%
2.68%
39.48%
8.70%
46.15%
10.22%
NA
NA
51.48%
12.57%
Upper 95% confidence interval
NA
NA
85.45%
27.32%
67.93%
32.04%
65.35%
25.18%
NA
NA
65.03%
23.21%
HEDIS 2007 (Reporting Year 2006)
Page 86
Health Plan Stability
First Plan of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
Product/Product Line
Years in Business
Members*
11.00
63.00
2.00
7228
1304
832
63.00
9364
NR
NR
NR
NR
9364
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
First Plan of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:13 PM
MSHO
Product/Product Line
Years in Business
Members*
11.00
63.00
2.00
7228
1304
832
63.00
9364
NR
NR
NR
NR
9364
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
First Plan of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Medicaid
Product/Product Line
Years in Business
Members*
11.00
63.00
2.00
7228
1304
832
63.00
9364
NR
NR
NR
NR
9364
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
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:13 PM
Commercial
<1
1-4
5-9
10-14
15-17
18-19
Male
96
396
432
612
456
240
Member Months
Female
72
264
288
456
336
288
Total
168
660
720
1068
792
528
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
2232
28.10%
336
432
516
468
636
1704
20.70%
456
588
696
684
816
3936
24.33%
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
2388
30.06%
936
1068
768
480
3240
39.36%
1032
984
816
396
5628
34.79%
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
3252
40.94%
72
0
0
0
0
0
3228
39.21%
48
0
0
12
0
0
6480
40.06%
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
72
0.91%
0
60
0.73%
0
132
0.82%
7944
8232
HEDIS 2007 (Reporting Year 2006)
792
1020
1212
1152
1452
1968
2052
1584
876
120
0
0
12
0
0
0
16176
Page 91
Health Plan Descriptive Information
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:13 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
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:13 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
12
0
0.00%
0
0
0
0
0
0.00%
12
0.52%
576
360
348
384
396
216
0
0.00%
1032
588
1008
1488
1716
1920
12
0.12%
2280
99.48%
0
7752
100.00%
0
10032
99.88%
2292
7752
HEDIS 2007 (Reporting Year 2006)
0
0
0
0
0
0
0
0
12
1608
948
1356
1872
2112
2136
0
10044
Page 93
Health Plan Descriptive Information
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 1:13 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
2361
5548
4961
5085
2905
1586
Member Months
Female
2204
5576
5114
5279
3347
2267
Total
4565
11124
10075
10364
6252
3853
22446
51.94%
3158
2904
2213
2178
2777
23787
41.82%
6707
5370
3722
3222
3744
46233
46.19%
13230
30.62%
2664
2179
1370
721
22765
40.02%
3446
2159
1735
1425
35995
35.96%
6934
16.05%
228
105
62
67
103
38
8765
15.41%
337
203
213
222
304
285
15699
15.68%
603
1.40%
0
1564
2.75%
0
2167
2.16%
43213
56881
HEDIS 2007 (Reporting Year 2006)
9865
8274
5935
5400
6521
6110
4338
3105
2146
565
308
275
289
407
323
0
100094
Page 94