First Plan of Minnesota
Plan Name
2005
Reporting Year
Submission #
Title
General Info
1
Last Refreshed:
2
10/7/2009 11:20:40 AM
Page
Disclaimers
Effectiveness of
Care Measures
Plan ID
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
First Plan of Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
MMR
HiB
Hepatitis B
VZV
Combo 3
7
43.75%
10
62.50%
12
75.00%
7
43.75%
9
56.25%
13
81.25%
5
31.25%
5
31.25%
3
18.75%
7
43.75%
10
62.50%
12
75.00%
7
43.75%
9
56.25%
13
81.25%
5
31.25%
5
31.25%
3
18.75%
7
5
NA
NA
NA
10
5
NA
NA
NA
12
2
NA
NA
NA
7
5
NA
NA
NA
9
4
NA
NA
NA
13
1
NA
NA
NA
5
3
NA
NA
NA
5
5
NA
NA
NA
3
3
NA
NA
NA
16
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
16
HEDIS 2006 (Reporting Year 2005)
IPV
2005
HO
N
16
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
Page 3
Effectiveness of Care
First Plan of Minnesota
Childhood Immunization Status
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
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
HiB
Hepatitis B
VZV
Combo 3
36
19.67%
29
15.85%
119
65.03%
31
16.94%
37
20.22%
118
64.48%
20
10.93%
13
7.10%
5
2.73%
36
19.67%
29
15.85%
119
65.03%
31
16.94%
37
20.22%
118
64.48%
20
10.93%
13
7.10%
5
2.73%
36
102
75.41%
68.90%
81.92%
29
125
84.15%
78.59%
89.72%
119
43
88.52%
83.63%
93.42%
31
124
84.70%
79.21%
90.19%
37
122
86.89%
81.72%
92.05%
118
41
86.89%
81.72%
92.05%
20
62
44.81%
37.33%
52.29%
13
107
65.57%
58.42%
72.73%
5
63
37.16%
29.88%
44.43%
183
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
N
183
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
183
Page 4
Effectiveness of Care
First Plan of Minnesota
Adolescent Immunization Status
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Commercial
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
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)
VZV
Combo 2
13
61.90%
10
47.62%
4
19.05%
2
9.52%
13
61.90%
10
47.62%
4
19.05%
2
9.52%
13
4
NA
NA
NA
10
5
NA
NA
NA
4
7
NA
NA
NA
2
5
NA
NA
NA
21
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
N
21
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
21
Page 5
Effectiveness of Care
First Plan of Minnesota
Adolescent Immunization Status
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Medicaid
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
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)
VZV
Combo 2
61
44.20%
23
16.67%
20
14.49%
3
2.17%
61
44.20%
23
16.67%
20
14.49%
3
2.17%
61
53
82.61%
75.92%
89.30%
23
68
65.94%
57.67%
74.21%
20
48
49.28%
40.57%
57.98%
3
51
39.13%
30.63%
47.64%
138
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
N
138
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
138
Page 6
Effectiveness of Care
First Plan of Minnesota
Appropriate Treatment for Children with Upper
Respiratory Infection
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Commercial
Data Elements
Measurement Year
General
Measure
Data
2005
Data Collection Methodology
A
Eligible Member Population
17
Numerator Events by Admin Data
3
Reported Rate
NA
Lower 95% Confidence Interval
NA
Upper 95% Confidence Interval
NA
HEDIS 2006 (Reporting Year 2005)
Page 7
Effectiveness of Care
First Plan of Minnesota
Colorectal Cancer Screening
Data Elements
Measurement Year
Data collection methodology (administrative or hybrid)
Sampling method used (see User's Guide for entry descriptions)
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Commercial
MSHO
NR
NR
NR
NR
2005
HO
N
Eligible population
267
Number of numerator events by administrative data in eligible
population (before exclusions)
154
Current year's administrative rate (before exclusions)
Medicare
Advantage
57.68%
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
267
Number of numerator events by administrative data in FSS
154
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
57.68%
0
0
0
Number of employee/dependent medical records excluded
0
Records added from the oversample list
0
Denominator
267
Numerator events by administrative data
154
FOBT by administrative data*
113
DCBE by administrative data*
0
Numerator events by medical records
6
Flexible sigmoidoscopy by medical records*
1
DCBE by medical records*
0
Colonoscopy by medical records*
4
Reported rate
59.93%
NR
NR
Lower 95% confidence interval
53.86%
NR
NR
Upper 95% confidence interval
65.99%
NR
NR
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
First Plan of Minnesota
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 11:20 AM
Commercial
2005
A
116
92
79.31%
71.51%
87.11%
Medicare
Advantage
NR
NR
NR
Medicaid
2005
A
259
159
61.39%
55.27%
67.51%
Page 9
Effectiveness of Care
First Plan of Minnesota
Cervical Cancer Screening
Data Elements
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Commercial
Medicaid
Measurement Year
Data Collection Methodology
Sampling Method Used
2005
A
2005
A
Eligible Member Population
329
1607
79.64%
71.56%
NR
NR
262
1150
#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
First Plan of Minnesota
Chlamydia Screening in Women
Data Last Refreshed:
Oct 7, 2009 11:20 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
23
9
NA
NA
NA
12
5
NA
NA
NA
35
14
40.00%
22.34%
57.66%
172
57
33.14%
25.81%
40.47%
227
82
36.12%
29.65%
42.59%
399
139
34.84%
30.04%
39.64%
Page 11
Effectiveness of Care
First Plan of Minnesota
Controlling High Blood Pressure
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Data Elements
Measurement Year
Data Collection Methodology (Hybrid)
Commercial
2005
HO
Sampling Method Used
N
Eligible Member Population
54
Numerator Events by Admin Data on
Eligible Population (before exclusions)
0
Current Year's Admin Rate
Medicare Advantage
0.00%
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
54
Numerator events by admin data in FSS
0
Admin rate on FSS
0.00%
Records Excluded because of Valid Data
Errors
0
Records Excluded because of
contraindications through Admin Data
0
Records Excluded because of
contraindications through Medical Record
Review
4
Number of employee/dependent medical
records excluded
0
Records Added from the OverSample List
0
Denominator
50
Numerator Events by Admin Data
0
Numerator Events by Medical Record
36
NR
Reported Rate
72.00%
NR
Lower 95% Confidence Interval
58.55%
NR
Upper 95% Confidence Interval
85.45%
NR
HEDIS 2006 (Reporting Year 2005)
Page 12
Effectiveness of Care
First Plan of Minnesota
Beta Blocker Treatment after Heart Attack
Data Elements
Measurement Year
Data Collection Methodology
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Commercial
Medicare Advantage
MSHO
NR
NR
NR
NR
2005
HO
Sampling Method Used
N
Eligible Member Population
1
Numerator Events by Admin Data on
Eligible Population
Current Year's Admin Rate
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
0
NR
Records Excluded because of Valid Data
Errors
0
Records Excluded because of
contraindications through Admin Data
0
Records Excluded because of
contraindications through Medical Record
Review
0
Number of employee/dependent medical
records excluded
0
Records Added from the Oversample List
0
Denominator
1
Numerator Events by Admin Data
0
Numerator Events by Medical Record
0
Reported Rate
NA
NR
NR
Lower 95% Confidence Interval
NA
NR
NR
Upper 95% Confidence Interval
NA
NR
NR
HEDIS 2006 (Reporting Year 2005)
Page 13
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 11:20 AM
Medicare Advantage
MSHO
2005
Data Collection Methodology
A
Eligible Member Population
1
Numerator Events by Admin Data on
Eligible Population
0
Reported Rate
NA
NR
NR
Lower 95% Confidence Interval
NA
NR
NR
Upper 95% Confidence Interval
NA
NR
NR
HEDIS 2006 (Reporting Year 2005)
Page 14
Effectiveness of Care
First Plan of Minnesota
Cholesterol Management for
Patients with Cardiovascular
Data Last Refreshed:
Oct 7, 2009 11:20 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
0
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
11
0
0
78.57%
0.00%
0.00%
11
0
0
78.57%
0.00%
0.00%
11
0
0
7
0
9
NA
NA
NA
NA
NA
NA
NA
NA
NA
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
14
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
N
14
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
0
14
Page 15
Effectiveness of Care
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Commercial
Data Elements
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
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
N
64
2005
HO
N
64
2005
HO
N
64
2005
HO
N
64
2005
HO
N
64
2005
HO
N
64
2005
HO
N
64
58
90.63%
0
0.00%
62
96.88%
61
95.31%
0
0.00%
0
0.00%
51
79.69%
NR
NR
NR
NR
NR
NR
NR
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
2
2
2
2
2
2
2
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
62
58
2
96.77%
91.57%
100.00%
0
62
0
13
20.97%
10.03%
31.91%
0
62
60
0
96.77%
91.57%
100.00%
0
62
59
1
96.77%
91.57%
100.00%
0
62
0
50
80.65%
70.00%
91.29%
0
62
0
35
56.45%
43.30%
69.60%
0
62
50
0
80.65%
70.00%
91.29%
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
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 11:20 AM
MSHO
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 18
Effectiveness of Care
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Oct 7, 2009 11:20 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
N
196
2005
HO
N
196
2005
HO
N
196
2005
HO
N
196
2005
HO
N
196
2005
HO
N
196
2005
HO
N
196
165
84.18%
0
0.00%
191
97.45%
157
80.10%
0
0.00%
0
0.00%
139
70.92%
196
165
84.18%
196
0
0.00%
196
191
97.45%
196
157
80.10%
196
0
0.00%
196
0
0.00%
196
139
70.92%
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
9
9
9
9
9
9
9
Number of employee/dependent medical
records excluded
0
0
0
0
0
0
0
0
187
162
9
91.44%
87.17%
95.72%
0
187
0
48
25.67%
19.14%
32.20%
0
187
182
0
97.33%
94.75%
99.91%
0
187
152
9
86.10%
80.87%
91.32%
0
187
0
112
59.89%
52.60%
67.19%
0
187
0
70
37.43%
30.23%
44.64%
0
187
135
4
74.33%
67.80%
80.86%
Data Elements
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
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
First Plan of Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 11:20 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
4
4
NA
NA
NA
10
8
NA
NA
NA
29
25
NA
NA
NA
43
37
86.05%
74.53%
97.57%
2005
A
Page 20
Effectiveness of Care
First Plan of Minnesota
Use of Appropriate Medications for People with Asthma
Data Last Refreshed:
Oct 7, 2009 11:20 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
29
23
NA
NA
NA
59
36
61.02%
47.72%
74.31%
132
84
63.64%
55.05%
72.22%
220
143
65.00%
58.47%
71.53%
2005
A
Page 21
Effectiveness of Care
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 11:20 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
0
NA
NA
NA
7
NA
NA
NA
5
NA
NA
NA
2005
A
9
Page 22
Effectiveness of Care
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 11:20 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 24
Effectiveness of Care
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Oct 7, 2009 11:20 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
12
20.34%
9.22%
31.46%
40
67.80%
55.03%
80.57%
26
44.07%
30.55%
57.58%
2005
A
59
Page 25
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 2006 (Reporting Year 2005)
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Medicare
Advantage
MSHO
NR
NR
NR
NR
NR
NR
Page 26
Effectiveness of Care
First Plan of Minnesota
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 11:20 AM
Medicare
Advantage
MSHO
NR
NR
NR
NR
NR
NR
Page 27
Use of Services
First Plan of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 11:20 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
0
0
0
1
3
4
1
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
2005
A
9
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
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
First Plan of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Oct 7, 2009 11:20 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
7
0
3
4
13
35
11
9.59%
2.15%
17.03%
0.00%
0.00%
0.68%
4.11%
0.00%
9.35%
5.48%
0.00%
11.39%
17.81%
8.35%
27.27%
47.95%
35.80%
60.09%
15.07%
6.18%
23.96%
2005
A
73
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
First Plan of Minnesota
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 11:20 AM
Commercial
Medicaid
2005
A
2005
A
44
473
NR
NR
NR
NR
33
307
75.00%
61.07%
88.93%
64.90%
60.50%
69.31%
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
First Plan of Minnesota
Adolescent Well-Care Visits
Data Elements
Measurement Year
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Commercial
Medicaid
2005
A
2005
A
180
1139
NR
NR
NR
NR
61
356
33.89%
26.70%
41.08%
31.26%
28.52%
33.99%
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
First Plan of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Commercial
Measurement Year
2005
Member Months
Total
Age
0-4
0-9
5-19
10-19
1039
1841
3323
2521
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
8
2
2
4
Procedures /
1,000 Member
Months
7.70
0.60
1.09
1.59
Member Months
Male
Female
4438
3156
3821
4865
3040
2991
97
55
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
0
0
1
0
2
3
3
0
3
0
1
0
1
0
Female
Procedures /
1,000 Member
Months
Number of
Procedures
0
0
3
1
0
0
2
0
Procedures /
1,000 Member
Months
0.00
0.00
0.68
0.33
0.00
0.00
0.67
0.00
0.00
0.00
0.21
0.00
0.63
0.99
0.99
0.00
0.99
0.00
0.33
0.00
0.33
0.00
1
0
0
0.23
0.00
0.00
3
1
0
9
7
1
0
3
0
0
0
0.68
0.33
0.00
2.36
2.34
0.33
0.00
1.00
0.00
0.00
0.00
0
0
0
2
3
0
0.00
0.00
0.00
0.45
1.00
0.00
Page 32
Use of Services
First Plan of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
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 11:20 AM
2005
Member Months
268
1573
2521
6977
6031
144
8
0
0
17522
Discharges
Discharges /
1,000 Member
Months
5
2
4
61
42
2
0
0
0
116
18.66
1.27
1.59
8.74
6.96
13.89
0.00
NA
3
1
3
11
16
1
0
0
0
35
11.19
0.64
1.19
1.58
2.65
6.94
0.00
NA
2
1
1
20
26
1
0
0
0
51
7.46
0.64
0.40
2.87
4.31
6.94
0.00
NA
0
30
0
0
0
30
0.00
4.30
0.00
0.00
HEDIS 2006 (Reporting Year 2005)
6.62
2.00
2.91
1.91
Days
14
2
6
239
152
7
0
0
0
420
Days / 1,000
Member
Months
52.24
1.27
2.38
34.26
25.20
48.61
0.00
NA
23.97
3
1
5
36
62
5
0
0
0
112
11.19
0.64
1.98
5.16
10.28
34.72
0.00
NA
11
1
1
135
90
2
0
0
0
240
41.04
0.64
0.40
19.35
14.92
13.89
0.00
NA
0
68
0
0
0
68
0.00
9.75
0.00
0.00
6.39
13.70
4.34
Average
Length of Stay
2.80
1.00
1.50
3.92
3.62
3.50
NA
NA
NA
3.62
1.00
1.00
1.67
3.27
3.88
5.00
NA
NA
NA
3.20
5.50
1.00
1.00
6.75
3.46
2.00
NA
NA
NA
4.71
NA
2.27
NA
NA
NA
2.27
Page 34
Use of Services
First Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Oct 7, 2009 11:20 AM
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
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 36
Use of Services
First Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Commercial
Measurement
Year
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
2005
Member
Months
268
1573
2521
6977
6031
144
8
0
0
17522
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
202
436
511
1658
1849
109
0
0
0
4765
HEDIS 2006 (Reporting Year 2005)
Visits/ 1,000
Member
Months
753.73
277.18
202.70
237.64
306.58
756.94
0.00
NA
271.94
Emergency Room Visits
Visits
11
41
51
149
104
6
0
0
0
362
Visits/ 1,000
Member
Months
41.04
26.06
20.23
21.36
17.24
41.67
0.00
NA
20.66
Ambulatory
Surgery/Procedures
Procedures
0
3
7
51
80
2
0
0
0
143
Procedures/
1,000 Member
Months
0.00
1.91
2.78
7.31
13.26
13.89
0.00
NA
8.16
Observation Room Stays
Resulting in Discharge
Stays
3
0
0
57
3
2
0
0
0
65
Stays/ 1,000
Member
Months
11.19
0.00
0.00
8.17
0.50
13.89
0.00
NA
3.71
Page 37
Use of Services
First Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Commercial
Measurement
Year
Age
2005
Member
Months
<1
268
1-9
1573
10-19
2521
20-44
6977
45-64
6031
65-74
144
75-84
8
85+
0
Unknown
Total
Data Last Refreshed:
Oct 7, 2009 11:20 AM
0
17522
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
0
0.00
0
0.00
NA
45-64
4
0.66
84
13.93
21.00
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
Total
0
4
0.23
0
84
4.79
NA
21.00
Age
HEDIS 2006 (Reporting Year 2005)
Page 39
Use of Services
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Oct 7, 2009 11:20 AM
MSHO
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 41
Use of Services
First Plan of Minnesota
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 11:20 AM
2005
Male
Member Months
Female
Total
1375
705
6494
125
0
8699
1040
555
7128
100
0
8823
2415
1260
13622
225
0
17522
Discharges
Discharges /
1,000 Member
Months
Age
0-12
Days*
Average
Length of Stay
Gender
M
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
M
13-17
1
1.42
3
3.00
F
0
0.00
0
NA
Total
1
0.79
3
3.00
M
18-64
2
0.31
6
3.00
F
1
0.14
1
1.00
Total
3
0.22
7
2.33
65+
M
1
8.00
2
2.00
F
0
0.00
0
NA
Total
1
4.44
2
2.00
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
4
0.46
11
2.75
F
1
0.11
1
1.00
TOTAL
5
0.29
12
2.40
* 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
First Plan of Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Oct 7, 2009 11:20 AM
MSHO
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
Unknown
M
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 44
Use of Services
First Plan of Minnesota
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 7, 2009 11:20 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
1375
705
1040
555
2415
1260
1375
705
1040
555
2415
1260
1375
705
1040
555
2415
1260
1375
705
1040
555
2415
1260
6494
125
0
8699
7128
100
0
8823
13622
225
0
17522
6494
125
0
8699
7128
100
0
8823
13622
225
0
17522
6494
125
0
8699
7128
100
0
8823
13622
225
0
17522
6494
125
0
8699
7128
100
0
8823
13622
225
0
17522
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
7
7
14
7
5
12
21
50
71
1
0
1
0
0
0
36
62
98
6.11%
8.08%
6.96%
11.91%
10.81%
11.43%
3.88%
8.42%
6.25%
9.60%
0.00%
5.33%
NA
NA
NA
4.97%
8.43%
6.71%
0
0
0
1
0
1
2
1
3
1
0
1
0
0
0
4
1
5
0
0
0
0
0
0
0
2
2
0
0
0
0
0
0
0
2
2
7
7
14
6
5
11
21
50
71
1
0
1
0
0
0
35
62
97
HEDIS 2006 (Reporting Year 2005)
0.00%
0.00%
0.00%
1.70%
0.00%
0.95%
0.37%
0.17%
0.26%
9.60%
0.00%
5.33%
NA
NA
NA
0.55%
0.14%
0.34%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.34%
0.18%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.27%
0.14%
6.11%
8.08%
6.96%
10.21%
10.81%
10.48%
3.88%
8.42%
6.25%
9.60%
0.00%
5.33%
NA
NA
NA
4.83%
8.43%
6.64%
Page 45
Use of Services
First Plan of Minnesota
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 7, 2009 11:20 AM
MSHO
Measurement Year
Member Months (Any)
Age
Male
Female
0-12
13-17
18-64
65+
Unknown
Total
NR
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
Percent
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Day/Night Mental Health Services
Percent
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Ambulatory Mental Health Services
Percent
Number
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 47
Use of Services
First Plan of Minnesota
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Oct 7, 2009 11:20 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
14951
5667
30016
10850
15065
5183
14951
5667
30016
10850
15065
5183
14951
5667
30016
10850
15065
5183
14951
5667
30016
10850
22901
1851
0
45000
35193
5910
0
61721
58094
7761
0
106721
22901
1851
0
45000
35193
5910
0
61721
58094
7761
0
106721
22901
1851
0
45000
35193
5910
0
61721
58094
7761
0
106721
22901
1851
0
45000
35193
5910
0
61721
58094
7761
0
106721
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)
15065
5183
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
169
115
284
119
122
241
405
651
1056
17
38
55
0
0
0
710
926
1636
13.46%
9.23%
11.35%
27.55%
25.83%
26.65%
21.22%
22.20%
21.81%
11.02%
7.72%
8.50%
NA
NA
NA
18.93%
18.00%
18.40%
4
2
6
10
16
26
35
35
70
4
5
9
0
0
0
53
58
111
5
5
10
7
6
13
12
23
35
0
1
1
0
0
0
24
35
59
165
113
278
117
116
233
385
635
1020
16
34
50
0
0
0
683
898
1581
HEDIS 2006 (Reporting Year 2005)
0.32%
0.16%
0.24%
2.32%
3.39%
2.88%
1.83%
1.19%
1.45%
2.59%
1.02%
1.39%
NA
NA
NA
1.41%
1.13%
1.25%
0.40%
0.40%
0.40%
1.62%
1.27%
1.44%
0.63%
0.78%
0.72%
0.00%
0.20%
0.15%
NA
NA
NA
0.64%
0.68%
0.66%
13.14%
9.07%
11.11%
27.09%
24.56%
25.77%
20.17%
21.65%
21.07%
10.37%
6.90%
7.73%
NA
NA
NA
18.21%
17.46%
17.78%
Page 48
Use of Services
First Plan of Minnesota
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 11:20 AM
2005
Male
Member Months
Female
Total
1375
705
6494
125
0
8699
1040
555
7128
100
0
8823
2415
1260
13622
225
0
17522
Discharges
Discharges /
1,000 Member
Months
Age
0-12
Days
Average
Length of Stay
M
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
13-17
M
2
2.84
3
1.50
F
0
0.00
0
NA
Total
2
1.59
3
1.50
18-64
M
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
65+
M
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
M
Total
2
0.23
3
1.50
F
0
0.00
0
NA
TOTAL
2
0.11
3
1.50
* 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
First Plan of Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Oct 7, 2009 11:20 AM
MSHO
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
Unknown
M
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 51
Use of Services
First Plan of Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Commercial
Measurement Year
2005
Member Months (Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
1375
705
779
1430
4285
125
0
8699
Female
1040
555
875
1548
4705
100
0
8823
Total
2415
1260
1654
2978
8990
225
0
17522
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
3
0
3
1
2
3
4
1
5
5
1
6
1
0
1
0
0
0
14
4
18
HEDIS 2006 (Reporting Year 2005)
Percent
0.00%
0.00%
0.00%
5.11%
0.00%
2.86%
NR
NR
NA
3.49%
1.15%
2.48%
1.40%
0.26%
0.80%
9.60%
0.00%
5.33%
NA
NA
NA
1.93%
0.54%
1.23%
Member Months (Inpatient)
Male
1375
705
779
1430
4285
125
0
8699
Female
1040
555
875
1548
4705
100
0
8823
Total
2415
1260
1654
2978
8990
225
0
17522
Member Months (Day/Night)
Member Months (Ambulatory)
Male
1375
705
779
1430
4285
125
0
8699
Male
1375
705
779
1430
4285
125
0
8699
Female
1040
555
875
1548
4705
100
0
8823
Total
2415
1260
1654
2978
8990
225
0
17522
Female
1040
555
875
1548
4705
100
0
8823
Total
2415
1260
1654
2978
8990
225
0
17522
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
2
0
2
0
1
1
3
0
3
1
0
1
0
0
0
0
0
0
0
0
0
6
1
7
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
3
0
3
0
0
0
2
0
2
4
1
5
1
0
1
0
0
0
0
0
0
10
1
11
Percent
1.75%
0.00%
0.99%
0.00%
2.16%
0.95%
NR
NR
NA
0.87%
0.00%
0.50%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.83%
0.14%
0.48%
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
2.62%
0.00%
1.49%
0.00%
0.00%
0.00%
NR
NR
NA
3.49%
1.15%
2.48%
0.28%
0.00%
0.13%
0.00%
0.00%
0.00%
NA
NA
NA
1.38%
0.14%
0.75%
Page 52
Use of Services
First Plan of Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 11:20 AM
MSHO
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 54
Use of Services
First Plan of Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Medicaid
Measurement Year
2005
Member Months (Any)
Age
0-12
13-17
18-24
25-34
35-64
65+
Unknown
Total
Male
15065
5183
5506
5089
12306
1851
0
45000
Female
14951
5667
9311
9010
16872
5910
0
61721
Total
30016
10850
14817
14099
29178
7761
0
106721
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
15
6
21
25
25
50
35
35
70
71
41
112
4
0
4
0
0
0
150
107
257
HEDIS 2006 (Reporting Year 2005)
Percent
0.00%
0.00%
0.00%
3.47%
1.27%
2.32%
NR
NR
NA
2.79%
2.81%
2.80%
6.92%
2.92%
4.61%
2.59%
0.00%
0.62%
NA
NA
NA
4.00%
2.08%
2.89%
Member Months (Inpatient)
Male
15065
5183
5506
5089
12306
1851
0
45000
Female
14951
5667
9311
9010
16872
5910
0
61721
Total
30016
10850
14817
14099
29178
7761
0
106721
Member Months (Day/Night)
Male
15065
5183
5506
5089
12306
1851
0
45000
Female
14951
5667
9311
9010
16872
5910
0
61721
Total
30016
10850
14817
14099
29178
7761
0
106721
Member Months (Ambulatory)
Male
15065
5183
5506
5089
12306
1851
0
45000
Female
14951
5667
9311
9010
16872
5910
0
61721
Total
30016
10850
14817
14099
29178
7761
0
106721
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
0
0
0
5
4
9
11
10
21
11
4
15
31
17
48
3
0
3
0
0
0
61
35
96
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
14
4
18
17
19
36
30
35
65
52
36
88
2
0
2
0
0
0
115
94
209
Percent
0.00%
0.00%
0.00%
1.16%
0.85%
1.00%
NR
NR
NA
0.88%
0.32%
0.60%
3.02%
1.21%
1.97%
1.94%
0.00%
0.46%
NA
NA
NA
1.63%
0.68%
1.08%
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%
3.24%
0.85%
1.99%
NR
NR
NA
2.39%
2.81%
2.60%
5.07%
2.56%
3.62%
1.30%
0.00%
0.31%
NA
NA
NA
3.07%
1.83%
2.35%
Page 55
Use of Services
First Plan of Minnesota
Outpatient Drug Utilization
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Commercial
Measurement
Year
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
2005
Member Months
1841
2521
6977
6031
144
8
0
0
17522
Total Cost of
Prescriptions
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
$19,321.52
$48,094.73
$386,541.19
$698,179.69
$57,456.08
$0.00
$0.00
$0.00
$1,209,593.21
HEDIS 2006 (Reporting Year 2005)
Avg. Cost of
Prescriptions /
Per Member Per
Month
$10.50
$19.08
$55.40
$115.77
$399.00
$0.00
NA
$69.03
Total Number of
Prescriptions
445
868
5550
12005
531
0
0
0
19399
Avg. Num. Of
Prescriptions /
Per Member Per
Year
2.90
4.13
9.55
23.89
44.25
0.00
NA
13.29
Page 56
Use of Services
First Plan of Minnesota
Outpatient Drug Utilization
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 11:20 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+
251
392
10
242
376
10
96.41%
93.91%
98.91%
95.92%
93.83%
98.00%
NA
NA
NA
2005
A
Page 58
Access/Availability of Care
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 11:20 AM
MSHO
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 60
Access/Availability of Care
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Oct 7, 2009 11:20 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+
1726
981
492
2005
A
1434
848
428
83.08%
81.28%
84.88%
86.44%
84.25%
88.64%
86.99%
83.92%
90.07%
Page 61
Access/Availability of Care
First Plan of Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 11:20 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.
12
57
54
140
11
52
44
121
NA
NA
NA
91.23%
83.01%
99.45%
81.48%
70.19%
92.77%
86.43%
80.40%
92.46%
2005
A
Page 62
Access/Availability of Care
First Plan of Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Oct 7, 2009 11:20 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.
214
616
435
745
2005
A
196
537
384
672
91.59%
87.64%
95.54%
87.18%
84.45%
89.90%
88.28%
85.14%
91.41%
90.20%
88.00%
92.40%
Page 63
Access/Availability of Care
First Plan of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Commercial
Measurement Year
Data collection methodology (Administrative or Hybrid)
Timeliness of
Prenatal Care
Postpartum
Care
2005
A
2005
A
26
26
NR
NR
NR
NR
16
21
NR
NR
NR
NR
NR
NR
Sampling method used (see User's Guide for entry
descriptions)
Eligible member population (i.e. members who meet all
denominator criteria)
Number of numerator events by administrative data in
eligible population (before exclusions)
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample
size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of
valid data errors
Number of 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 2006 (Reporting Year 2005)
Page 64
Access/Availability of Care
First Plan of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Oct 7, 2009 11:20 AM
Medicaid
Measurement Year
Data collection methodology (Administrative or Hybrid)
Timeliness of
Prenatal Care
Postpartum
Care
2005
A
2005
A
Sampling method used (see User's Guide for entry
descriptions)
Eligible member population (i.e. members who meet all
denominator criteria)
254
Number of numerator events by administrative data in
eligible population (before exclusions)
Current year's administrative rate (before exclusions)
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 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 2006 (Reporting Year 2005)
183
NR
NR
NR
NR
NR
NR
Page 65
Access/Availability of Care
First Plan of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 11:20 AM
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
3
2
3
5
0
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
13
3
1
0
0
2
1
3
0
0
0
8
2
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 2006 (Reporting Year 2005)
Page 66
Access/Availability of Care
First Plan of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Oct 7, 2009 11:20 AM
MSHO
13-17 Year Olds
Data Elements
General
Measure
Data
Initiation of
AOD
Treatment
18-25 Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
26-34 Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
35-64 Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
65+ Year Olds
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Overall Rate
Engagement Initiation of
of AOD
AOD
Treatment
Treatment
Engagement
of AOD
Treatment
Measurement Year
Data collection methodology
(Administrative only)
Eligible member population (i.e. members
who meet all denominator criteria)
NR
Numerator events by administrative data
NR
NR
Reported rate
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Lower 95% confidence interval
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
HEDIS 2006 (Reporting Year 2005)
Page 68
Health Plan Stability
First Plan of Minnesota
Practitioner Turnover
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
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 11:20 AM
2005
Male
96
480
432
648
420
276
Member Months
Female
48
360
360
504
336
288
2352
27.00%
504
792
648
504
648
1896
21.44%
588
744
804
768
912
3096
35.54%
984
984
696
468
3816
43.15%
936
936
768
396
3132
35.95%
96
24
0
12
0
0
3036
34.33%
96
0
0
0
0
0
132
1.52%
96
1.09%
8712
8844
HEDIS 2006 (Reporting Year 2005)
Total
144
840
792
1152
756
564
4248
24.20%
1092
1536
1452
1272
1560
6912
39.37%
1920
1920
1464
864
6168
35.13%
192
24
0
12
0
0
228
1.30%
NR
17556
Page 71
Health Plan Descriptive Information
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 11:20 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
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Oct 7, 2009 11:20 AM
MSHO
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 73
Health Plan Descriptive Information
First Plan of Minnesota
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 11:20 AM
2005
Male
2016
5521
4904
5509
2843
1729
Member Months
Female
2109
5443
4838
5480
3405
2342
22522
50.05%
3613
2783
2144
2370
2879
23617
38.26%
6983
4733
4015
3433
4154
13789
30.64%
2577
2259
1275
773
23318
37.78%
3534
2117
1699
1673
6884
15.30%
531
219
292
333
257
173
9023
14.62%
838
415
675
1072
1283
1480
1805
4.01%
0
5763
9.34%
0
45000
61721
HEDIS 2006 (Reporting Year 2005)
Total
4125
10964
9742
10989
6248
4071
46139
43.23%
10596
7516
6159
5803
7033
37107
34.77%
6111
4376
2974
2446
15907
14.91%
1369
634
967
1405
1540
1653
7568
7.09%
0
106721
Page 74