Medica Health Plans
Plan Name
2005
Reporting Year
Submission #
Title
General Info
Plan ID
Last Refreshed:
10/7/2009 11:34:30 AM
Page
Disclaimers
Effectiveness of
Care Measures
1
18
2
Measure
Page
Use of Services
Measures
Page
Measure
Childhood Immunization Status
3
Well-Child Visits In The First 15 Months of Life
28
Adolescent Immunization Status
5
Well-Child Visits In The Third, Fourth, Fifth And Sixth Year of Life
30
Appropriate Treatment of Children w/ Upper Respiratory Infection
7
Adolescent Well-Care Visits
31
Colorectal Cancer Screening
9
Frequency of Selected Procedures
32
Breast Cancer Screening
10
Inpatient Utilization - General Hospital/Acute Care
34
Cervical Cancer Screening
11
Ambulatory Care
37
Chlamydia Screening in Women
12
Inpatient Utilization - Nonacute Care
39
Controlling High Blood Pressure
13
Mental Health Utilization - Inpatient Discharges and Average Length of Stay
42
Beta Blocker Treatment after a Heart Attack
14
Mental Health Utilization - % of Members Receiving Inpatient and Ambulatory Services
45
Persistence of Beta Blocker Treatment after a Heart Attack
14
Chemical Dependency Utilization - Inpatient Discharges and Average Length of Stay
49
Cholesterol Management for Patients with Cardiovascular Conditions
15
Identification of Alcohol and Other Drug Services
52
Comprehensive Diabetes Care
16
Outpatient Drug Utilization
56
Use of Appropriate Medications for People with Asthma
20
Antidepressant Medication Management
26
Osteoporosis Management in Women who had a Fracture
27
Glaucoma Screening in Older Adults
27
Access /
Availability of
Care
Measure
Measure
Page
Practitioner Turnover
69
Years in Business / Total Membership
70
Page
Adults' Access to Preventive/Ambulatory Health Services
58
Children's Access to Primary Care Practitioners
62
Prenatal and Postpartum Care
64
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
66
HEDIS 2006 (Reporting Year 2005)
Health Plan
Stability
Health Plan
Descriptive
Information
Measure
Enrollment by Product Line (Age & Sex)
Page
71
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 2006 (Reporting Year 2005)
Page 2
Effectiveness of Care
Medica Health Plans
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Combo 3
1262
75.16%
1332
79.33%
1531
91.19%
1339
79.75%
1297
77.25%
1440
85.77%
805
47.95%
1071
63.79%
665
39.61%
328
75.93%
349
80.79%
395
91.44%
350
81.02%
334
77.31%
366
84.72%
200
46.30%
273
63.19%
167
38.66%
316
58
91.00%
88.11%
93.89%
335
58
95.62%
93.52%
97.72%
378
14
95.38%
93.23%
97.53%
335
52
94.16%
91.77%
96.55%
321
65
93.92%
91.48%
96.35%
349
22
90.27%
87.28%
93.25%
189
26
52.31%
47.36%
57.26%
262
85
84.43%
80.80%
88.06%
160
40
48.66%
43.71%
53.62%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
1
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
1
HEDIS 2006 (Reporting Year 2005)
MMR
411
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
IPV
2005
HO
S
1679
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
Pneumococcal
Combo 2
Conjugate
DTaP/DT
411
Page 3
Effectiveness of Care
Medica Health Plans
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Combo 3
1937
62.97%
2102
68.34%
2673
86.90%
2014
65.47%
1954
63.52%
2512
81.66%
1206
39.21%
1392
45.25%
797
25.91%
264
61.11%
305
70.60%
385
89.12%
283
65.51%
280
64.81%
374
86.57%
187
43.29%
198
45.83%
124
28.70%
316
25
82.97%
79.21%
86.72%
335
52
94.16%
91.77%
96.55%
378
4
92.94%
90.35%
95.54%
335
35
90.02%
87.01%
93.04%
321
50
90.27%
87.28%
93.25%
349
25
91.00%
88.11%
93.89%
189
40
55.72%
50.79%
60.64%
262
52
76.40%
72.17%
80.63%
160
45
49.88%
44.92%
54.83%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
HEDIS 2006 (Reporting Year 2005)
MMR
411
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
IPV
2005
HO
S
3076
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
Pneumococcal
Combo 2
Conjugate
DTaP/DT
411
Page 4
Effectiveness of Care
Medica Health Plans
Adolescent Immunization Status
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Combo 2
964
54.16%
374
21.01%
236
13.26%
71
3.99%
229
53.01%
91
21.06%
50
11.57%
19
4.40%
221
142
88.32%
85.09%
91.55%
85
206
70.80%
66.29%
75.32%
50
181
56.20%
51.29%
61.12%
19
178
47.93%
42.98%
52.88%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record Review
1
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
1
HEDIS 2006 (Reporting Year 2005)
VZV
411
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Hepatitis B
2005
HO
S
1780
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
MMR
411
Page 5
Effectiveness of Care
Medica Health Plans
Adolescent Immunization Status
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Combo 2
1321
63.36%
366
17.55%
497
23.84%
100
4.80%
264
61.11%
63
14.58%
102
23.61%
19
4.40%
221
134
86.37%
82.94%
89.81%
85
190
66.91%
62.24%
71.58%
50
192
58.88%
54.00%
63.76%
19
179
48.18%
43.22%
53.13%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
1
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
1
HEDIS 2006 (Reporting Year 2005)
VZV
411
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Hepatitis B
2005
HO
S
2085
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
MMR
411
Page 6
Effectiveness of Care
Medica Health Plans
Appropriate Treatment for Children with Upper
Respiratory Infection
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
General
Measure
Data
2005
A
Eligible Member Population
3875
Numerator Events by Admin Data
487
Reported Rate
87.43%
Lower 95% Confidence Interval
86.38%
Upper 95% Confidence Interval
88.49%
HEDIS 2006 (Reporting Year 2005)
Page 7
Effectiveness of Care
Medica Health Plans
Colorectal Cancer Screening
Data Elements
Measurement Year
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Medicare
Advantage
MSHO
2005
2005
HO
HO
S
S
Eligible population
20143
584
Number of numerator events by administrative data in eligible
population (before exclusions)
8185
143
Data collection methodology (administrative or hybrid)
Sampling method used (see User's Guide for entry descriptions)
Current year's administrative rate (before exclusions)
40.63%
NR
24.49%
Minimum required sample size (MRSS) or other sample size
410
395
Oversampling rate
0.05
0.05
Final sample size (FSS)
431
415
Number of numerator events by administrative data in FSS
168
94
Administrative rate on FSS
Number of original sample records excluded because of valid data
errors
Records Excluded because of contraindications through Admin
Data
Records Excluded because of contraindications through Medical
Record Review
38.98%
NR
22.65%
0
0
0
0
0
1
Number of employee/dependent medical records excluded
0
0
Records added from the oversample list
0
1
Denominator
410
395
Numerator events by administrative data
168
94
FOBT by administrative data*
26
10
DCBE by administrative data*
2
0
Numerator events by medical records
50
33
Flexible sigmoidoscopy by medical records*
17
8
DCBE by medical records*
2
1
Colonoscopy by medical records*
32
22
Reported rate
53.17%
NR
32.15%
Lower 95% confidence interval
48.22%
NR
27.42%
Upper 95% confidence interval
58.12%
NR
36.88%
Data Elements with an Asterisk(*) are OPTIONAL and are not used in any calculation or total
HEDIS 2006 (Reporting Year 2005)
Page 8
Effectiveness of Care
Medica Health Plans
Breast Cancer Screening
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 2006 (Reporting Year 2005)
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
2005
A
9367
7074
75.52%
74.64%
76.40%
Medicare
Advantage
NR
NR
NR
Medicaid
2005
A
1794
1030
57.41%
55.10%
59.73%
Page 9
Effectiveness of Care
Medica Health Plans
Cervical Cancer Screening
Data Elements
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Sampling Method Used
2005
A
2004
A
Eligible Member Population
26083
17209
80.17%
73.41%
NR
NR
20912
12633
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
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
Records Excluded because of contraindications
through Admin Data
Records Excluded because of contraindications
through 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 2006 (Reporting Year 2005)
Page 10
Effectiveness of Care
Medica Health Plans
Chlamydia Screening in Women
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
General
Measure Ages 16-20 Ages 21-25
Data
Medicaid
Total
2005
A
General
Measure Ages 16-20 Ages 21-25
Data
Total
2005
A
1680
478
28.45%
26.27%
30.64%
2536
736
29.02%
27.24%
30.81%
4216
1214
28.80%
27.42%
30.17%
2172
828
38.12%
36.06%
40.19%
2812
1053
37.45%
35.64%
39.25%
4984
1881
37.74%
36.38%
39.10%
Page 11
Effectiveness of Care
Medica Health Plans
Controlling High Blood Pressure
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Data Elements
Measurement Year
Data Collection Methodology (Hybrid)
Sampling Method Used
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Commercial
2005
HO
S
4703
0
0.00%
20.00%
478
0
0.00%
0
Records Excluded because of
contraindications through Admin Data
1
Records Excluded because of
contraindications through Medical Record
Review
22
Number of employee/dependent medical
records excluded
0
Records Added from the OverSample List
23
Denominator
398
Numerator Events by Medical Record
NR
398
Records Excluded because of Valid Data
Errors
Numerator Events by Admin Data
Medicare Advantage
NR
0
282
Reported Rate
70.85%
NR
Lower 95% Confidence Interval
66.26%
NR
Upper 95% Confidence Interval
75.44%
NR
HEDIS 2006 (Reporting Year 2005)
Page 12
Effectiveness of Care
Medica Health Plans
Beta Blocker Treatment after Heart Attack
Data Elements
Measurement Year
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Medicare Advantage
MSHO
2005
2005
HO
HO
Sampling Method Used
N
S
Eligible Member Population
80
24
Numerator Events by Admin Data on
Eligible Population
67
15
Data Collection Methodology
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
83.75%
NR
62.50%
80
13
0.00%
0.00%
Final Sample Size (FSS)
80
13
Numerator events by admin data in FSS
67
13
Admin rate on FSS
83.75%
NR
100.00%
Records Excluded because of Valid Data
Errors
0
0
Records Excluded because of
contraindications through Admin Data
0
0
Records Excluded because of
contraindications through Medical Record
Review
2
0
Number of employee/dependent medical
records excluded
0
0
Records Added from the Oversample List
0
0
Denominator
78
13
Numerator Events by Admin Data
67
13
Numerator Events by Medical Record
10
0
Reported Rate
98.72%
NR
NA
Lower 95% Confidence Interval
95.58%
NR
NA
Upper 95% Confidence Interval
100.00%
NR
NA
HEDIS 2006 (Reporting Year 2005)
Page 13
Effectiveness of Care
Medica Health Plans
Persistence of Beta Blocker Treatment After Hearth Attack
Data Elements
Measurement Year
Commercial
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
MSHO
2005
Data Collection Methodology
A
Eligible Member Population
85
Numerator Events by Admin Data on
Eligible Population
59
Reported Rate
69.41%
NR
NR
Lower 95% Confidence Interval
59.03%
NR
NR
Upper 95% Confidence Interval
79.80%
NR
NR
HEDIS 2006 (Reporting Year 2005)
Page 14
Effectiveness of Care
Medica Health Plans
Cholesterol Management for
Patients with Cardiovascular
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
0
Records Excluded because of contraindications
through Admin Data
3
Records Excluded because of contraindications
through Medical Record Review
0
Number of employee/dependent medical
records excluded
0
HEDIS 2006 (Reporting Year 2005)
LDL-C
screening
LDL-C Level of LDL-C Level of
<100 mg/dL
<130 mg/dL
795
0
0
62.80%
0.00%
0.00%
271
0
0
62.73%
0.00%
0.00%
271
44
0
198
0
253
76.64%
72.43%
80.85%
48.18%
43.22%
53.13%
61.56%
56.73%
66.38%
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
411
5.00%
432
Records Excluded because of Valid Data Errors
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
General
LDL-C Level of LDL-C Level of
Measure
<100 mg/dL
<130 mg/dL
Data
2005
HO
S
1266
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
Medicare Advantage
3
411
Page 15
Effectiveness of Care
Medica Health Plans
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
HbA1c
Testing
Poor HbA1c
Control
Eye Exam
LDL-C
Screening
LDL-C Level
<130 mg/dL
LDL-C Level
<100 mg/dL
Monitoring for
Diabetic
Nephropathy
2005
HO
S
3505
2005
HO
S
3505
2005
HO
S
3505
2005
HO
S
3505
2005
HO
S
3505
2005
HO
S
3505
2005
HO
S
3505
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
2615
74.61%
411
10%
453
303
66.89%
3505
100.00%
411
10%
453
453
100.00%
1918
54.72%
411
10%
453
228
50.33%
2850
81.31%
411
10%
453
337
74.39%
6
0.17%
411
10%
453
2
0.44%
3
0.09%
411
10%
453
2
0.44%
1923
54.86%
411
10%
453
213
47.02%
Number of Records Excluded Because of
Valid Data Errors
0
0
0
0
0
0
0
Records Excluded because of
contraindications through Admin Data
1
1
1
1
1
1
1
Records Excluded because of
contraindications through Medical Record
Review
2
2
2
2
2
2
2
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
3
411
303
54
86.86%
83.47%
90.25%
3
411
0
107
26.03%
21.67%
30.40%
3
411
228
26
61.80%
56.98%
66.62%
3
411
337
38
91.24%
88.39%
94.10%
3
411
2
290
71.05%
66.54%
75.55%
3
411
2
197
48.42%
43.47%
53.37%
3
411
213
37
60.83%
55.99%
65.67%
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator events by admin data in eligible
population
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 2006 (Reporting Year 2005)
Page 16
Effectiveness of Care
Medica Health Plans
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
Data Elements
HbA1c
Testing
Poor HbA1c
Control
Eye Exam
LDL-C
Screening
LDL-C Level
<130 mg/dL
LDL-C Level
<100 mg/dL
Monitoring for
Diabetic
Nephropathy
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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
Sampling Method Used
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
Records Excluded because of
contraindications through Admin Data
Records Excluded because of
contraindications 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 2006 (Reporting Year 2005)
Page 17
Effectiveness of Care
Medica Health Plans
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 11:34 AM
MSHO
HbA1c
Testing
Poor HbA1c
Control
Eye Exam
LDL-C
Screening
LDL-C Level
<130 mg/dL
LDL-C Level
<100 mg/dL
Monitoring for
Diabetic
Nephropathy
2005
HO
S
222
HO
S
222
HO
S
222
HO
S
222
HO
S
222
HO
S
222
HO
S
222
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
118
53.15%
222
0%
222
118
53.15%
226
NR
222
0%
222
222
100.00%
150
67.57%
222
0%
222
150
67.57%
123
55.41%
222
0%
222
122
54.95%
11
4.95%
222
0%
222
11
4.95%
8
3.60%
222
0%
222
8
3.60%
109
49.10%
222
0%
222
108
48.65%
Number of Records Excluded Because of
Valid Data Errors
0
0
0
0
0
0
0
Records Excluded because of
contraindications through Admin Data
0
0
0
0
0
0
0
Records Excluded because of
contraindications through Medical Record
Review
0
0
0
0
0
0
0
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
222
118
68
83.78%
78.71%
88.86%
0
222
0
60
27.03%
20.96%
33.09%
0
222
150
7
70.72%
64.51%
76.93%
0
222
122
49
77.03%
71.27%
82.79%
0
222
11
123
60.36%
53.70%
67.02%
0
222
8
91
44.59%
37.83%
51.36%
0
222
108
21
58.11%
51.39%
64.82%
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator events by admin data in eligible
population
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 2006 (Reporting Year 2005)
Page 18
Effectiveness of Care
Medica Health Plans
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicaid
HbA1c
Testing
Poor HbA1c
Control
Eye Exam
LDL-C
Screening
LDL-C Level
<130 mg/dL
LDL-C Level
<100 mg/dL
Monitoring for
Diabetic
Nephropathy
2005
HO
S
2583
2005
HO
S
2583
2005
HO
S
2583
2005
HO
S
2583
2005
HO
S
2583
2005
HO
S
2583
2005
HO
S
2583
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
1288
49.86%
411
10%
453
210
46.36%
2583
100.00%
411
10%
453
453
100.00%
1387
53.70%
411
10%
453
226
49.89%
1352
52.34%
411
10%
453
219
48.34%
66
2.56%
411
10%
453
8
1.77%
44
1.70%
411
10%
453
7
1.55%
998
38.64%
411
10%
453
156
34.44%
Number of Records Excluded Because of
Valid Data Errors
0
0
0
0
0
0
0
Records Excluded because of
contraindications through Admin Data
1
1
1
1
1
1
1
Records Excluded because of
contraindications through Medical Record
Review
4
4
4
4
4
4
4
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
5
411
210
131
82.97%
79.21%
86.72%
5
411
0
125
30.41%
25.84%
34.98%
5
411
226
21
60.10%
55.24%
64.95%
5
411
219
102
78.10%
73.98%
82.22%
5
411
8
226
56.93%
52.03%
61.84%
5
411
7
150
38.20%
33.38%
43.02%
5
411
156
78
56.93%
52.03%
61.84%
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator events by admin data in eligible
population
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 2006 (Reporting Year 2005)
Page 19
Effectiveness of Care
Medica Health Plans
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
Total
165
160
96.97%
94.05%
99.89%
278
263
94.60%
91.77%
97.44%
1143
1029
90.03%
88.25%
91.81%
1586
1452
91.55%
90.15%
92.95%
2005
A
Page 20
Effectiveness of Care
Medica Health Plans
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
Total
246
234
95.12%
92.23%
98.02%
380
345
90.79%
87.75%
93.83%
533
443
83.11%
79.84%
86.39%
1159
1022
88.18%
86.28%
90.08%
2005
A
Page 21
Effectiveness of Care
Medica Health Plans
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
202
18.91%
16.52%
21.31%
711
66.57%
63.70%
69.45%
532
49.81%
46.77%
52.86%
2005
A
1068
Page 22
Effectiveness of Care
Medica Health Plans
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
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 23
Effectiveness of Care
Medica Health Plans
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
0
NA
NA
NA
11
NA
NA
NA
9
NA
NA
NA
2005
A
21
Page 24
Effectiveness of Care
Medica Health Plans
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
138
14.84%
12.50%
17.18%
472
50.75%
47.49%
54.02%
331
35.59%
32.46%
38.72%
2005
A
930
Page 25
Effectiveness of Care
Medica Health Plans
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 2006 (Reporting Year 2005)
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare
Advantage
NR
NR
NR
MSHO
2005
A
86
7
8.14%
1.78%
14.50%
Page 26
Effectiveness of Care
Medica Health Plans
Glaucoma Screening in Older Adults
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 2006 (Reporting Year 2005)
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare
Advantage
NR
NR
NR
MSHO
2005
A
1252
11
979
78.19%
75.87%
80.52%
Page 27
Use of Services
Medica Health Plans
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
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
10
13
11
31
92
227
1111
0.67%
0.22%
1.12%
0.87%
0.37%
1.37%
0.74%
0.27%
1.20%
2.07%
1.32%
2.83%
6.15%
4.90%
7.41%
15.18%
13.33%
17.04%
74.31%
72.07%
76.56%
2005
A
1495
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 2006 (Reporting Year 2005)
Page 28
Use of Services
Medica Health Plans
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
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
57
76
135
343
766
1387
502
1.75%
1.28%
2.21%
2.33%
1.79%
2.86%
4.13%
3.44%
4.83%
10.50%
9.44%
11.57%
23.45%
21.99%
24.92%
42.47%
40.76%
44.18%
15.37%
14.12%
16.62%
2005
A
3266
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 2006 (Reporting Year 2005)
Page 29
Use of Services
Medica Health Plans
Well Child Visits in the 3rd, 4th,
5th and 6th Years of Life
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Medicaid
2005
A
2005
A
6054
9408
NR
NR
NR
NR
3795
5954
62.69%
61.46%
63.91%
63.29%
62.31%
64.27%
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 2006 (Reporting Year 2005)
Page 30
Use of Services
Medica Health Plans
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Medicaid
2005
A
2005
A
15226
15841
NR
NR
NR
NR
5115
5534
33.59%
32.84%
34.35%
34.93%
34.19%
35.68%
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 2006 (Reporting Year 2005)
Page 31
Use of Services
Medica Health Plans
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Measurement Year
2005
Member Months
Total
125920
250109
373265
249076
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
759
207
226
83
Procedures /
1,000 Member
Months
6.03
0.55
0.90
0.33
Member Months
Male
Female
447187
377244
386628
483246
240871
256288
11489
9862
Male
Procedure
Age
Dilation & Curettage 15-44
45-64
Hysterectomy,
15-44
Abdominal
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
Angioplasty (PTCA) 45-64
65+
Cardiac
45-64
Catheterization
65+
CABG
45-64
65+
Prostatectomy
45-64
65+
Mastectomy
15-44
45-64
65+
Lumpectomy
15-44
45-64
65+
HEDIS 2006 (Reporting Year 2005)
Number of
Procedures
19
2
63
2
320
392
153
11
176
18
33
4
56
7
Female
Procedures /
1,000 Member
Months
Number of
Procedures
42
38
93
119
4
96
77
7
Procedures /
1,000 Member
Months
0.09
0.15
0.21
0.46
0.41
0.21
0.30
0.71
0.04
0.17
0.13
0.17
0.85
1.63
0.64
0.96
0.73
1.57
0.14
0.35
0.23
0.61
16
14
2
0.04
0.05
0.20
172
108
5
442
446
36
7
83
8
8
0
0.38
0.42
0.51
1.14
1.74
0.14
0.71
0.32
0.81
0.03
0.00
32
62
2
85
119
4
0.07
0.24
0.20
0.19
0.46
0.41
Page 32
Use of Services
Medica Health Plans
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
Measurement Year
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)
Hysterectomy
Abdominal
Hysterectomy,
Vaginal
Prostatectomy
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 2006 (Reporting Year 2005)
Number of
Procedures
Female
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
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 33
Use of Services
Medica Health Plans
Inpatient Utilization - General Hospital/Acute Care
Commercial
Measurement
Year
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
65-74
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 11:34 AM
2005
Member Months
26343
223766
249076
763872
497159
18733
2318
300
0
1781567
Discharges
Discharges /
1,000 Member
Months
293
286
318
4121
2720
231
58
14
0
8041
11.12
1.28
1.28
5.39
5.47
12.33
25.02
46.67
247
212
146
673
1106
104
37
11
0
2536
9.38
0.95
0.59
0.88
2.22
5.55
15.96
36.67
40
69
113
1002
1590
125
21
3
0
2963
1.52
0.31
0.45
1.31
3.20
6.67
9.06
10.00
55
2432
0
0
0
2487
0.22
3.18
0.00
0.00
HEDIS 2006 (Reporting Year 2005)
4.51
1.42
1.66
1.63
Days
Days / 1,000
Member
Months
2028
852
998
11728
9958
945
284
68
0
26861
76.98
3.81
4.01
15.35
20.03
50.45
122.52
226.67
1649
507
419
1974
3548
354
121
56
0
8628
62.60
2.27
1.68
2.58
7.14
18.90
52.20
186.67
351
336
416
3134
6352
583
163
12
0
11347
13.32
1.50
1.67
4.10
12.78
31.12
70.32
40.00
141
6530
0
0
0
6671
0.57
8.55
0.00
0.00
15.08
4.84
6.37
4.36
Average
Length of Stay
6.92
2.98
3.14
2.85
3.66
4.09
4.90
4.86
NA
3.34
6.68
2.39
2.87
2.93
3.21
3.40
3.27
5.09
NA
3.40
8.78
4.87
3.68
3.13
3.99
4.66
7.76
4.00
NA
3.83
2.56
2.69
NA
NA
NA
2.68
Page 34
Use of Services
Medica Health Plans
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
Measurement
Year
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
65-74
Unknown
Total
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 2006 (Reporting Year 2005)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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
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
NR
Page 35
Use of Services
Medica Health Plans
Inpatient Utilization - General Hospital/Acute Care
MSHO
Measurement
Year
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
65-74
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 11:34 AM
2005
Member Months
0
0
0
0
0
11422
11717
11900
0
35039
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
345
318
207
0
870
NA
NA
NA
NA
NA
30.20
27.14
17.39
0
0
0
0
0
255
234
158
0
647
NA
NA
NA
NA
NA
22.33
19.97
13.28
0
0
0
0
0
81
69
41
0
191
NA
NA
NA
NA
NA
7.09
5.89
3.45
0
0
0
0
0
0
HEDIS 2006 (Reporting Year 2005)
24.83
18.47
5.45
NA
NA
NA
0.00
0.00
Days
Days / 1,000
Member
Months
0
0
0
0
0
1634
1636
917
0
4187
NA
NA
NA
NA
NA
143.06
139.63
77.06
0
0
0
0
0
1118
1041
640
0
2799
NA
NA
NA
NA
NA
97.88
88.85
53.78
0
0
0
0
0
484
536
242
0
1262
NA
NA
NA
NA
NA
42.37
45.75
20.34
0
0
0
0
0
0
119.50
79.88
36.02
NA
NA
NA
0.00
0.00
Average
Length of Stay
NA
NA
NA
NA
NA
4.74
5.14
4.43
NA
4.81
NA
NA
NA
NA
NA
4.38
4.45
4.05
NA
4.33
NA
NA
NA
NA
NA
5.98
7.77
5.90
NA
6.61
NA
NA
NA
NA
NA
NA
Page 36
Use of Services
Medica Health Plans
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Measurement
Year
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
2005
Member
Months
26343
223766
249076
763872
497159
18733
2318
300
0
1781567
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
24323
73691
58199
203485
176471
9585
1570
144
0
547468
HEDIS 2006 (Reporting Year 2005)
Visits/ 1,000
Member
Months
923.32
329.32
233.66
266.39
354.96
511.66
677.31
480.00
307.30
Emergency Room Visits
Visits
774
3646
2876
9557
5442
305
52
12
0
22664
Visits/ 1,000
Member
Months
29.38
16.29
11.55
12.51
10.95
16.28
22.43
40.00
12.72
Ambulatory
Surgery/Procedures
Procedures
189
991
783
5018
8944
471
72
9
0
16477
Procedures/
1,000 Member
Months
7.17
4.43
3.14
6.57
17.99
25.14
31.06
30.00
9.25
Observation Room Stays
Resulting in Discharge
Stays
20
43
47
606
165
6
2
0
0
889
Stays/ 1,000
Member
Months
0.76
0.19
0.19
0.79
0.33
0.32
0.86
0.00
0.50
Page 37
Use of Services
Medica Health Plans
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
Measurement
Year
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
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 2006 (Reporting Year 2005)
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Emergency Room Visits
Visits
NR
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Ambulatory
Surgery/Procedures
Procedures
NR
Procedures/
1,000 Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Observation Room Stays
Resulting in Discharge
Stays
NR
Stays/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 38
Use of Services
Medica Health Plans
Inpatient Utilization - Nonacute Care
Commercial
Measurement
Year
Age
2005
Member
Months
<1
26343
1-9
223766
10-19
249076
20-44
763872
45-64
497159
65-74
18733
75-84
2318
85+
300
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 11:34 AM
0
1781567
Discharges
Discharges /
1,000 Member
Months
Days
Days / 1,000
Member
Months
Average Length
of Stay
<1
0
1-9
0
0.00
0
0.00
NA
0.00
0
0.00
NA
10-19
0
0.00
0
0.00
NA
20-44
11
0.01
185
0.24
16.82
45-64
37
0.07
367
0.74
9.92
65-74
4
0.21
38
2.03
9.50
75-84
0
0.00
0
0.00
NA
85+
0
0.00
0
0.00
NA
0.03
0
590
0.33
NA
11.35
Age
Unknown
Total
0
52
HEDIS 2006 (Reporting Year 2005)
Page 39
Use of Services
Medica Health Plans
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
Measurement
Year
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 2006 (Reporting Year 2005)
NR
NR
Page 40
Use of Services
Medica Health Plans
Inpatient Utilization - Nonacute Care
MSHO
Measurement
Year
Age
Data Last Refreshed:
Oct 7, 2009 11:34 AM
2005
Member
Months
<1
0
1-9
0
10-19
0
20-44
0
45-64
0
65-74
11422
75-84
11717
85+
11900
Unknown
Total
0
35039
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
Days
Days / 1,000
Member
Months
Average Length
of Stay
NA
0
NA
NA
0
NA
0
NA
NA
10-19
0
NA
0
NA
NA
20-44
0
NA
0
NA
NA
45-64
0
NA
0
NA
NA
65-74
8
0.70
129
11.29
16.13
75-84
15
1.28
93
7.94
6.20
8
0.67
39
3.28
4.88
0
31
0.88
0
261
7.45
NA
8.42
Age
85+
Unknown
Total
HEDIS 2006 (Reporting Year 2005)
Page 41
Use of Services
Medica Health Plans
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Commercial
Measurement
Year
Age
0-12
13-17
18-64
65+
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 11:34 AM
2005
Male
Member Months
Female
Total
164981
64944
641307
11489
0
882721
160387
63139
665452
9862
0
898840
325368
128083
1306759
21351
0
1781561
Discharges
Discharges /
1,000 Member
Months
Age
0-12
Days*
Average
Length of Stay
Gender
M
23
0.14
1002
43.57
F
2
0.01
24
12.00
Total
25
0.08
1026
41.04
M
13-17
46
0.71
661
14.37
F
94
1.49
2647
28.16
Total
140
1.09
3308
23.63
M
18-64
161
0.25
1338
8.31
F
232
0.35
2006
8.65
Total
393
0.30
3344
8.51
65+
M
1
0.09
2
2.00
F
4
0.41
20
5.00
Total
5
0.23
22
4.40
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
231
0.26
3003
13.00
F
332
0.37
4697
14.15
TOTAL
563
0.32
7700
13.68
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization
should not be included in this table.
HEDIS 2006 (Reporting Year 2005)
Page 42
Use of Services
Medica Health Plans
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
Measurement
Year
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
Discharges
Age
0-12
Discharges /
1,000 Member
Months
Days*
Average
Length of Stay
Gender
M
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
13-17
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
18-64
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
65+
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
Unknown
NR
F
NR
Total
NR
NR
NR
Total
M
NR
NR
NR
NR
F
NR
NR
NR
NR
TOTAL
NR
NR
NR
NR
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization
should not be included in this table.
HEDIS 2006 (Reporting Year 2005)
Page 43
Use of Services
Medica Health Plans
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
MSHO
Measurement
Year
Age
0-12
13-17
18-64
65+
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 11:34 AM
2005
Male
Member Months
Female
Total
0
0
0
7376
0
7376
0
0
0
23281
0
23281
0
0
0
30657
0
30657
Discharges
Discharges /
1,000 Member
Months
Age
0-12
Days*
Average
Length of Stay
Gender
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
M
13-17
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
M
18-64
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
M
65+
13
1.76
88
6.77
F
19
0.82
186
9.79
Total
32
1.04
274
8.56
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
13
1.76
88
6.77
F
19
0.82
186
9.79
TOTAL
32
1.04
274
8.56
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization
should not be included in this table.
HEDIS 2006 (Reporting Year 2005)
Page 44
Use of Services
Medica Health Plans
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Measurement Year
2005
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
0-12
Member Months (Ambulatory)
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
164981
64944
160387
63139
325368
128083
164981
64944
160387
63139
325368
128083
164981
64944
160387
63139
325368
128083
164981
64944
160387
63139
325368
128083
641307
11489
0
882721
665452
9862
0
898840
1306759
21351
0
1781561
641307
11489
0
882721
665452
9862
0
898840
1306759
21351
0
1781561
641307
11489
0
882721
665452
9862
0
898840
1306759
21351
0
1781561
641307
11489
0
882721
665452
9862
0
898840
1306759
21351
0
1781561
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
Age
Member Months (Inpatient)
Male
Number
Percent
Inpatient Mental Health Services
Percent
Number
Day/Night Mental Health Services
Percent
Number
Ambulatory Mental Health Services
Percent
Number
846
525
1371
707
792
1499
3754
7088
10842
32
40
72
0
0
0
5339
8445
13784
6.15%
3.93%
5.06%
13.06%
15.05%
14.04%
7.02%
12.78%
9.96%
3.34%
4.87%
4.05%
NA
NA
NA
7.26%
11.27%
9.28%
18
2
20
35
67
102
135
187
322
1
4
5
0
0
0
189
260
449
0
0
0
3
11
14
3
15
18
0
0
0
0
0
0
6
26
32
842
525
1367
706
782
1488
3716
7062
10778
31
38
69
0
0
0
5295
8407
13702
HEDIS 2006 (Reporting Year 2005)
0.13%
0.01%
0.07%
0.65%
1.27%
0.96%
0.25%
0.34%
0.30%
0.10%
0.49%
0.28%
NA
NA
NA
0.26%
0.35%
0.30%
0.00%
0.00%
0.00%
0.06%
0.21%
0.13%
0.01%
0.03%
0.02%
0.00%
0.00%
0.00%
NA
NA
NA
0.01%
0.03%
0.02%
6.12%
3.93%
5.04%
13.05%
14.86%
13.94%
6.95%
12.73%
9.90%
3.24%
4.62%
3.88%
NA
NA
NA
7.20%
11.22%
9.23%
Page 45
Use of Services
Medica Health Plans
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
Measurement Year
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
Female
NR
Member Months (Inpatient)
Total
0-12
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 2006 (Reporting Year 2005)
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
Age
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
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 46
Use of Services
Medica Health Plans
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 7, 2009 11:34 AM
MSHO
Measurement Year
2005
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months (Inpatient)
0-12
Female
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
7376
0
7376
0
23281
0
23281
0
30657
0
30657
0
7376
0
7376
0
23281
0
23281
0
30657
0
30657
0
7376
0
7376
0
23281
0
23281
0
30657
0
30657
0
7376
0
7376
0
23281
0
23281
0
30657
0
30657
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)
Male
Any Mental Health Services
Age
Member Months (Day/Night)
Number
Percent
Inpatient Mental Health Services
Percent
Number
Day/Night Mental Health Services
Percent
Number
Ambulatory Mental Health Services
Percent
Number
0
0
0
0
0
0
0
0
0
42
114
156
0
0
0
42
114
156
NA
NA
NA
NA
NA
NA
NA
NA
NA
6.83%
5.88%
6.11%
NA
NA
NA
6.83%
5.88%
6.11%
0
0
0
0
0
0
0
0
0
8
17
25
0
0
0
8
17
25
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
37
107
144
0
0
0
37
107
144
HEDIS 2006 (Reporting Year 2005)
NA
NA
NA
NA
NA
NA
NA
NA
NA
1.30%
0.88%
0.98%
NA
NA
NA
1.30%
0.88%
0.98%
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
NA
NA
NA
NA
NA
NA
NA
NA
NA
6.02%
5.52%
5.64%
NA
NA
NA
6.02%
5.52%
5.64%
Page 47
Use of Services
Medica Health Plans
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicaid
Measurement Year
2005
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
0-12
Member Months (Ambulatory)
Male
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
321425
89137
647474
177675
326049
88538
321425
89137
647474
177675
326049
88538
321425
89137
647474
177675
326049
88538
321425
89137
647474
177675
211100
32819
0
658506
426820
83254
0
920636
637920
116073
0
1579142
211100
32819
0
658506
426820
83254
0
920636
637920
116073
0
1579142
211100
32819
0
658506
426820
83254
0
920636
637920
116073
0
1579142
211100
32819
0
658506
426820
83254
0
920636
637920
116073
0
1579142
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)
326049
88538
Any Mental Health Services
Age
Member Months (Inpatient)
Number
Percent
Inpatient Mental Health Services
Percent
Number
Day/Night Mental Health Services
Percent
Number
Ambulatory Mental Health Services
Percent
Number
2690
1760
4450
1344
1410
2754
3317
7949
11266
265
661
926
0
0
0
7616
11780
19396
9.90%
6.57%
8.25%
18.22%
18.98%
18.60%
18.86%
22.35%
21.19%
9.69%
9.53%
9.57%
NA
NA
NA
13.88%
15.35%
14.74%
54
31
85
78
128
206
361
492
853
21
66
87
0
0
0
514
717
1231
3
3
6
4
14
18
7
35
42
0
0
0
0
0
0
14
52
66
2681
1754
4435
1330
1381
2711
3206
7839
11045
254
631
885
0
0
0
7471
11605
19076
HEDIS 2006 (Reporting Year 2005)
0.20%
0.12%
0.16%
1.06%
1.72%
1.39%
2.05%
1.38%
1.60%
0.77%
0.95%
0.90%
NA
NA
NA
0.94%
0.93%
0.94%
0.01%
0.01%
0.01%
0.05%
0.19%
0.12%
0.04%
0.10%
0.08%
0.00%
0.00%
0.00%
NA
NA
NA
0.03%
0.07%
0.05%
9.87%
6.55%
8.22%
18.03%
18.59%
18.31%
18.22%
22.04%
20.78%
9.29%
9.10%
9.15%
NA
NA
NA
13.61%
15.13%
14.50%
Page 48
Use of Services
Medica Health Plans
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Commercial
Measurement
Year
Age
0-12
13-17
18-64
65+
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 11:34 AM
2005
Male
Member Months
Female
Total
164981
64944
641307
11489
0
882721
160387
63139
665452
9862
0
898840
325368
128083
1306759
21351
0
1781561
Discharges
Discharges /
1,000 Member
Months
Age
0-12
Days
Average
Length of Stay
M
0
0.00
0
NA
F
1
0.01
4
4.00
Total
1
0.00
4
4.00
13-17
M
19
0.29
205
10.79
F
34
0.54
652
19.18
Total
53
0.41
857
16.17
18-64
M
136
0.21
1125
8.27
F
111
0.17
886
7.98
Total
247
0.19
2011
8.14
65+
M
1
0.09
1
1.00
F
0
0.00
0
NA
Total
1
0.05
1
1.00
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
M
Total
156
0.18
1331
8.53
F
146
0.16
1542
10.56
TOTAL
302
0.17
2873
9.51
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization
should not be included in this table.
HEDIS 2006 (Reporting Year 2005)
Page 49
Use of Services
Medica Health Plans
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
Measurement
Year
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
Discharges
Age
0-12
Discharges /
1,000 Member
Months
Days
Average
Length of Stay
M
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
13-17
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
18-64
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
65+
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
Unknown
NR
F
NR
Total
NR
NR
NR
Total
M
NR
NR
NR
NR
F
NR
NR
NR
NR
TOTAL
NR
NR
NR
NR
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization
should not be included in this table.
HEDIS 2006 (Reporting Year 2005)
Page 50
Use of Services
Medica Health Plans
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
MSHO
Measurement
Year
Age
0-12
13-17
18-64
65+
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 11:34 AM
2005
Male
Member Months
Female
Total
0
0
0
7376
0
7376
0
0
0
23281
0
23281
0
0
0
30657
0
30657
Discharges
Discharges /
1,000 Member
Months
Age
0-12
Days
Average
Length of Stay
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
M
13-17
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
M
18-64
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
M
65+
2
0.27
4
2.00
F
2
0.09
9
4.50
Total
4
0.13
13
3.25
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
2
0.27
4
2.00
F
2
0.09
9
4.50
TOTAL
4
0.13
13
3.25
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization
should not be included in this table.
HEDIS 2006 (Reporting Year 2005)
Page 51
Use of Services
Medica Health Plans
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Measurement Year
2005
Member Months (Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
164981
64944
84370
146808
410129
11489
0
882721
Female
160387
63139
85215
152508
427729
9862
0
898840
Total
325368
128083
169585
299316
837858
21351
0
1781561
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
1
1
2
103
113
216
171
104
275
239
114
353
646
439
1085
16
4
20
0
0
0
1176
775
1951
HEDIS 2006 (Reporting Year 2005)
Percent
0.01%
0.01%
0.01%
1.90%
2.15%
2.02%
NR
NR
NA
1.74%
0.85%
1.30%
1.89%
1.23%
1.55%
1.67%
0.49%
1.12%
NA
NA
NA
1.60%
1.03%
1.31%
Member Months (Inpatient)
Male
164981
64944
84370
146808
410129
11489
0
882721
Female
160387
63139
85215
152508
427729
9862
0
898840
Total
325368
128083
169585
299316
837858
21351
0
1781561
Member Months (Day/Night)
Male
164981
64944
84370
146808
410129
11489
0
882721
Female
160387
63139
85215
152508
427729
9862
0
898840
Total
325368
128083
169585
299316
837858
21351
0
1781561
Member Months (Ambulatory)
Male
164981
64944
84370
146808
410129
11489
0
882721
Female
160387
63139
85215
152508
427729
9862
0
898840
Total
325368
128083
169585
299316
837858
21351
0
1781561
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
1
1
2
27
46
73
37
23
60
43
26
69
173
141
314
5
2
7
0
0
0
286
239
525
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
95
92
187
153
93
246
216
95
311
542
376
918
13
2
15
0
0
0
1019
658
1677
Percent
0.01%
0.01%
0.01%
0.50%
0.87%
0.68%
NR
NR
NA
0.31%
0.19%
0.25%
0.51%
0.40%
0.45%
0.52%
0.24%
0.39%
NA
NA
NA
0.39%
0.32%
0.35%
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%
1.76%
1.75%
1.75%
NR
NR
NA
1.57%
0.71%
1.15%
1.59%
1.05%
1.31%
1.36%
0.24%
0.84%
NA
NA
NA
1.39%
0.88%
1.13%
Page 52
Use of Services
Medica Health Plans
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
Measurement Year
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 2006 (Reporting Year 2005)
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)
Member Months (Ambulatory)
Male
Female
Male
Female
NR
NR
NR
NR
Total
NR
NR
NR
NR
NR
NR
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 53
Use of Services
Medica Health Plans
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 11:34 AM
MSHO
Measurement Year
2005
Member Months (Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
0
0
0
0
0
7376
0
7376
Female
0
0
0
0
0
23281
0
23281
Total
0
0
0
0
0
30657
0
30657
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
28
26
54
0
0
0
28
26
54
HEDIS 2006 (Reporting Year 2005)
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
NA
NA
NA
4.56%
1.34%
2.11%
NA
NA
NA
4.56%
1.34%
2.11%
Member Months (Inpatient)
Male
0
0
0
0
0
7376
0
7376
Female
0
0
0
0
0
23281
0
23281
Total
0
0
0
0
0
30657
0
30657
Member Months (Day/Night)
Member Months (Ambulatory)
Male
0
0
0
0
0
7376
0
7376
Male
0
0
0
0
0
7376
0
7376
Female
0
0
0
0
0
23281
0
23281
Total
0
0
0
0
0
30657
0
30657
Female
0
0
0
0
0
23281
0
23281
Total
0
0
0
0
0
30657
0
30657
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
13
16
29
0
0
0
13
16
29
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
19
13
32
0
0
0
19
13
32
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
NA
NA
NA
2.11%
0.82%
1.14%
NA
NA
NA
2.11%
0.82%
1.14%
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Percent
NA
NA
NA
NA
NA
NA
NR
NR
NA
NA
NA
NA
NA
NA
NA
3.09%
0.67%
1.25%
NA
NA
NA
3.09%
0.67%
1.25%
Page 54
Use of Services
Medica Health Plans
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicaid
Measurement Year
2005
Member Months (Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
326049
88538
51407
52392
107301
32819
0
658506
Female
321425
89137
121934
141884
163002
83254
0
920636
Total
647474
177675
173341
194276
270303
116073
0
1579142
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
22
7
29
270
229
499
417
572
989
592
949
1541
1604
1233
2837
72
70
142
0
0
0
2977
3060
6037
HEDIS 2006 (Reporting Year 2005)
Percent
0.08%
0.03%
0.05%
3.66%
3.08%
3.37%
NR
NR
NA
2.18%
3.54%
2.86%
17.94%
9.08%
12.59%
2.63%
1.01%
1.47%
NA
NA
NA
5.43%
3.99%
4.59%
Member Months (Inpatient)
Male
326049
88538
51407
52392
107301
32819
0
658506
Female
321425
89137
121934
141884
163002
83254
0
920636
Total
647474
177675
173341
194276
270303
116073
0
1579142
Member Months (Day/Night)
Male
326049
88538
51407
52392
107301
32819
0
658506
Female
321425
89137
121934
141884
163002
83254
0
920636
Total
647474
177675
173341
194276
270303
116073
0
1579142
Member Months (Ambulatory)
Male
326049
88538
51407
52392
107301
32819
0
658506
Female
321425
89137
121934
141884
163002
83254
0
920636
Total
647474
177675
173341
194276
270303
116073
0
1579142
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
7
0
7
80
70
150
116
177
293
172
289
461
531
409
940
30
40
70
0
0
0
936
985
1921
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
16
7
23
228
194
422
351
477
828
510
822
1332
1400
1083
2483
52
41
93
0
0
0
2557
2624
5181
Percent
0.03%
0.00%
0.01%
1.08%
0.94%
1.01%
NR
NR
NA
0.63%
1.08%
0.85%
5.94%
3.01%
4.17%
1.10%
0.58%
0.72%
NA
NA
NA
1.71%
1.28%
1.46%
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
0.06%
0.03%
0.04%
3.09%
2.61%
2.85%
NR
NR
NA
1.88%
3.07%
2.47%
15.66%
7.97%
11.02%
1.90%
0.59%
0.96%
NA
NA
NA
4.66%
3.42%
3.94%
Page 55
Use of Services
Medica Health Plans
Outpatient Drug Utilization
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Measurement
Year
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
2005
Member Months
250109
249076
763865
497141
18733
2318
300
1781542
Total Cost of
Prescriptions
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
$3,504,549.00
$6,980,908.00
$31,798,372.00
$47,624,837.00
$2,987,231.00
$430,821.00
$55,159.00
$0.00
$93,381,877.00
HEDIS 2006 (Reporting Year 2005)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$14.01
$28.03
$41.63
$95.80
$159.46
$185.86
$183.86
$52.42
Total Number of
Prescriptions
65199
84924
420634
644187
44123
7018
1023
0
1267108
Avg. Num. Of
Prescriptions /
Per Member Per
Year
3.13
4.09
6.61
15.55
28.26
36.33
40.92
8.53
Page 56
Use of Services
Medica Health Plans
Outpatient Drug Utilization
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
Measurement
Year
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
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 2006 (Reporting Year 2005)
NR
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 57
Access/Availability of Care
Medica Health Plans
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
Ages 20-44
Ages 45-64
Ages 65+
25557
25536
1383
24536
24789
1358
96.01%
95.76%
96.25%
97.07%
96.87%
97.28%
98.19%
97.45%
98.93%
2005
A
Page 58
Access/Availability of Care
Medica Health Plans
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
Page 59
Access/Availability of Care
Medica Health Plans
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
Ages 20-44
Ages 45-64
Ages 65+
0
0
2081
2005
A
0
0
2029
NA
NA
NA
NA
NA
NA
97.50%
96.81%
98.20%
Page 60
Access/Availability of Care
Medica Health Plans
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
Ages 20-44
Ages 45-64
Ages 65+
18999
6530
7842
2005
A
16768
5793
7532
88.26%
87.80%
88.72%
88.71%
87.94%
89.49%
96.05%
95.61%
96.48%
Page 61
Access/Availability of Care
Medica Health Plans
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
12-19 yrs.
1579
7471
6519
10842
1564
6780
5819
9718
99.05%
98.54%
99.56%
90.75%
90.09%
91.41%
89.26%
88.50%
90.02%
89.63%
89.05%
90.21%
2005
A
Page 62
Access/Availability of Care
Medica Health Plans
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
12-19 yrs.
4474
11867
6938
9934
2005
A
4400
10597
6090
8810
98.35%
97.96%
98.73%
89.30%
88.74%
89.86%
87.78%
87.00%
88.56%
88.69%
88.06%
89.31%
Page 63
Access/Availability of Care
Medica Health Plans
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
2005
HO
2005
HO
S
S
Eligible member population (i.e. members who meet all
denominator criteria)
2230
2230
Number of numerator events by administrative data in
eligible population (before exclusions)
1825
1400
Current year's administrative rate (before exclusions)
Measurement Year
Data collection methodology (Administrative or Hybrid)
Sampling method used (see User's Guide for entry
descriptions)
81.84%
62.78%
Minimum required sample size (MRSS) or other sample
size
392
392
Oversampling rate
Final sample size (FSS)
5%
412
5%
412
Number of numerator events by administrative data in FSS
314
247
76.21%
59.95%
Number of original sample records excluded because of
valid data errors
0
0
Number of employee/dependent medical records
excluded
0
0
2
392
314
35
2
392
247
42
89.03%
85.81%
92.25%
73.72%
69.24%
78.21%
Administrative rate on FSS
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2006 (Reporting Year 2005)
Page 64
Access/Availability of Care
Medica Health Plans
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicaid
Timeliness of
Prenatal Care
Postpartum
Care
2004
HO
2004
HO
S
S
Eligible member population (i.e. members who meet all
denominator criteria)
5314
5314
Number of numerator events by administrative data in
eligible population (before exclusions)
3043
2977
Current year's administrative rate (before exclusions)
Measurement Year
Data collection methodology (Administrative or Hybrid)
Sampling method used (see User's Guide for entry
descriptions)
57.26%
56.02%
Minimum required sample size (MRSS) or other sample
size
411
411
Oversampling rate
Final sample size (FSS)
10%
432
10%
432
Number of numerator events by administrative data in FSS
243
247
56.25%
57.18%
Number of original sample records excluded because of
valid data errors
0
0
Number of employee/dependent medical records
excluded
0
0
1
411
234
120
1
411
236
37
86.13%
82.67%
89.59%
66.42%
61.74%
71.11%
Administrative rate on FSS
Records added from the oversample list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2006 (Reporting Year 2005)
Page 65
Access/Availability of Care
Medica Health Plans
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Commercial
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
2005
A
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
18-25 Year Olds
127
281
228
752
16
1404
39
8
53
12
59
17
197
37
3
0
351
74
Reported rate
30.71%
6.30%
18.86%
4.27%
25.88%
7.46%
26.20%
4.92%
NA
NA
25.00%
5.27%
Lower 95% confidence interval
22.29%
1.68%
14.11%
1.73%
19.97%
3.83%
22.99%
3.31%
NA
NA
22.70%
4.07%
Upper 95% confidence interval
39.13%
10.92%
23.61%
6.81%
31.78%
11.09%
29.41%
6.53%
NA
NA
27.30%
6.48%
HEDIS 2006 (Reporting Year 2005)
Page 66
Access/Availability of Care
Medica Health Plans
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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 2006 (Reporting Year 2005)
Page 67
Access/Availability of Care
Medica Health Plans
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 11:34 AM
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
2005
A
Eligible member population (i.e. members
who meet all denominator criteria)
Numerator events by administrative data
18-25 Year Olds
27
27
0
0
0
0
0
0
0
0
13
1
13
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 2006 (Reporting Year 2005)
Page 68
Health Plan Stability
Medica Health Plans
Practitioner Turnover
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
Measurement Year
Practitioner Types
Number of
Practitioners
as of
12/31/2004
Number of
Practitioners who
were not affiliated
with the plan as of
12/31/2005
Practitioner
Turnover Rate
Practitioner
Retention Rate
Primary Care
Physicians
NR
NR
Non-Physician Primary
Care Practitioners
NR
NR
HEDIS 2006 (Reporting Year 2005)
Page 69
Health Plan Stability
Medica Health Plans
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
Measurement Year
Product/Product Line
Years in Business
Members*
NR
NR
NR
NR
NR
NR
HMO (Total)
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other
PPO (Total)
Commercial
Medicare (cost or risk)
Self-insured
Other
POS (Total)
Commercial
Medicare (cost or risk)
Self-insured
Other
NR
Total
* Total number of members in each category as of December 31, 2005
HEDIS 2006 (Reporting Year 2005)
Page 70
Health Plan Descriptive Information
Medica Health Plans
Enrollment by Product Line (Age & Sex)
Commercial
Measurement Year
<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
Data Last Refreshed:
Oct 7, 2009 11:34 AM
2005
Male
13140
50544
63360
63732
39144
23196
Member Months
Female
13200
49032
60828
62448
38028
22536
253116
28.67%
61176
73692
73116
80028
89244
246072
27.38%
62676
76848
75660
81912
89532
377256
42.74%
82944
71760
53628
32532
386628
43.01%
86124
74760
59004
36408
240864
27.29%
7488
2712
744
384
156
12
256296
28.51%
6708
1824
732
468
108
36
11496
1.30%
0
9876
1.10%
0
882732
898872
HEDIS 2006 (Reporting Year 2005)
Total
26340
99576
124188
126180
77172
45732
499188
28.02%
123852
150540
148776
161940
178776
763884
42.88%
169068
146520
112632
68940
497160
27.91%
14196
4536
1476
852
264
48
21372
1.20%
0
1781604
Page 71
Health Plan Descriptive Information
Medica Health Plans
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 11:34 AM
Medicare Advantage
Measurement Year
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: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Member Months
Female
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2006 (Reporting Year 2005)
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
Page 72
Health Plan Descriptive Information
Medica Health Plans
Enrollment by Product Line (Age & Sex)
MSHO
Measurement Year
<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
Data Last Refreshed:
Oct 7, 2009 11:34 AM
2005
Male
0
0
0
0
0
0
Member Months
Female
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
0
0
0
0.00%
0
0
0
0
0
0.00%
1896
1968
1536
1428
972
588
0
0.00%
3408
4152
4044
4704
4380
5952
8388
100.00%
0
26640
100.00%
0
8388
26640
HEDIS 2006 (Reporting Year 2005)
Total
0
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0
0
0
0
0.00%
5304
6120
5580
6132
5352
6540
35028
100.00%
0
35028
Page 73
Health Plan Descriptive Information
Medica Health Plans
Enrollment by Product Line (Age & Sex)
Medicaid
Measurement Year
<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
Data Last Refreshed:
Oct 7, 2009 11:34 AM
2005
Male
46827
115488
107290
94080
50902
22344
Member Months
Female
43607
112951
107413
94784
51807
30948
436931
66.35%
29063
25792
26600
26938
27744
441510
47.96%
90986
80240
61644
51856
41207
136137
20.67%
22452
15218
9389
5560
325933
35.40%
29795
19126
12993
8025
52619
7.99%
8665
7346
6228
5047
3184
2349
69939
7.60%
14531
13202
14036
14891
12895
13699
32819
4.98%
0
83254
9.04%
0
658506
920636
HEDIS 2006 (Reporting Year 2005)
Total
90434
228439
214703
188864
102709
53292
878441
55.63%
120049
106032
88244
78794
68951
462070
29.26%
52247
34344
22382
13585
122558
7.76%
23196
20548
20264
19938
16079
16048
116073
7.35%
0
1579142
Page 74