HealthPartners / Group Health (Combined)
Plan Name
2004
Reporting Year
General Info
Submission #
1
Last Refreshed:
37
9/30/2005 11:38:04 AM
Page
Title
Disclaimers
Effectiveness of
Care Measures
Plan ID
2
Measure
Page
Use of Services
Measures
Measure
Page
Childhood Immunization Status
3
Well-Child Visits In The First 15 Months of Life
21
Adolescent Immunization Status
4
Well-Child Visits In The Third, Fourth, Fifth And Sixth Year of Life
22
Appropriate Treatment of Children w/ Upper Respiratory Infection
5
Adolescent Well-Care Visits
23
Appropriate Testing for Children with Pharyngitis
6
Frequency of Selected Procedures
24
Colorectal Cancer Screening
7
Inpatient Utilization - General Hospital/Acute Care
25
Breast Cancer Screening
8
Ambulatory Care
27
Cervical Cancer Screening
9
Inpatient Utilization - Nonacute Care
29
Chlamydia Screening in Women
10
Mental Health Utilization - Inpatient Discharges and Average Length of Stay
31
Controlling High Blood Pressure
11
Mental Health Utilization - % of Members Receiving Inpatient and Ambulatory Services
33
Beta Blocker Treatment after a Heart Attack
12
Chemical Dependency Utilization - Inpatient Discharges and Average Length of Stay
35
Cholesterol Management
13
Identification of Alcohol and Other Drug Services
37
Comprehensive Diabetes Care
14
Outpatient Drug Utilization
39
Appropriate Medications for People with Asthma
16
Follow-up After Hospitalization For Mental Illness
17
Antidepressant Medication Management
18
Osteoporosis Management in Women
20
Access /
Availability of
Care
Measure
Measure
Page
Practitioner Turnover
47
Years in Business / Total Membership
48
Page
Adults' Access to Preventive/Ambulatory Health Services
41
Children's Access to Primary Care Practitioners
43
Prenatal and Postpartum Care
44
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
45
HEDIS 2005 (Reporting Year 2004)
Health Plan
Stability
Health Plan
Descriptive
Information
Measure
Enrollment by Product Line (Age & Sex)
Page
49
DISCLAIMERS
-1
0. Disclaimer Query located below
1. The MN Department of Human Services was responsible for collecting and reporting PMAP, GAMC,
MNCare and MSHO product data for the 2004 reporting year.
For information regarding these products, please contact:
Vicki Kunerth, Director - Performance Measurement Quality Improvement
Minnesota Department of Human Services
[email protected]
(651) 431-2618
HEDIS 2005 (Reporting Year 2004)
Page 2
Effectiveness of Care
HealthPartners / Group Health (Combined)
Childhood Immunization Status
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
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
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
HiB
Hepatitis B
VZV
Combo 1
Combo 2
3581
62.25%
3829
66.56%
4969
86.37%
3733
64.89%
3688
64.11%
4613
80.18%
2942
51.14%
2721
47.30%
225
59.52%
251
66.40%
325
85.98%
240
63.49%
242
64.02%
300
79.37%
185
48.94%
169
44.71%
218
241
313
232
233
286
178
162
101
95
14
80
97
25
91
91
88.61%
85.19%
92.03%
93.33%
90.62%
96.05%
90.83%
87.71%
93.95%
86.67%
83.02%
90.32%
91.67%
88.67%
94.66%
86.39%
82.71%
90.07%
74.72%
70.09%
79.35%
70.28%
65.42%
75.14%
378
0
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
MMR
360
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
IPV/OPV
HO
S
5753
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
DTaP/DT
360
Page 3
Effectiveness of Care
HealthPartners / Group Health (Combined)
Adolescent Immunization Status
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Data Elements
General
Measure
Data
MMR
Hepatitis B
VZV
Combo 1
Combo 2
3681
1903
371
1498
89
52.90%
27.35%
5.33%
21.53%
1.28%
227
134
21
107
6
52.55%
31.02%
4.86%
24.77%
1.39%
Numerator Events by Admin Data
213
131
20
104
6
Numerator Events by Medical Record
Data Collection Methodology
Sampling Method Used
Eligible Member Population
HO
S
6959
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
411
5.00%
432
Numerator events by admin data in FSS
Admin rate on FSS
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
411
145
181
238
192
209
Reported Rate
87.10%
75.91%
62.77%
72.02%
52.31%
Lower 95% Confidence Interval
Upper 95% Confidence Interval
83.74%
90.47%
71.66%
80.17%
57.98%
67.57%
67.56%
76.48%
47.36%
57.26%
HEDIS 2005 (Reporting Year 2004)
Page 4
Effectiveness of CareHealthPartners / Group Health (Combined)
Appropriate Treatment for Children with Upper
Respiratory Infection
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Member Months
Age
<1
87658
1-4
351765
5-9
450083
10-14
494651
15-17
306609
1690766
Total
Data Elements
Data Collection Methodology
Eligible Member Population
Eligible population by non-ER/Urgent Care
Visits*
Eligible Population by ER/Urgent Care
Visits*
Numerator Events by Admin Data
Numerator by non-ER/Urgent Care Visits*
Numerator by ER/Urgent Care Visits*
General
Measure
Data
A
10363
10168
195
1205
1189
16
Reported Rate
88.37%
Lower 95% Confidence Interval
87.75%
Upper 95% Confidence Interval
88.99%
Data Elements with an Asterisk(*) are OPTIONAL and
are not used in any calculation or total
HEDIS 2005 (Reporting Year 2004)
Page 5
Effectiveness of Care
HealthPartners / Group Health (Combined)
Appropriate Testing for Children with Pharyngitis
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Data Elements
Data Collection Methodology
General
Measure
Data
A
Eligible Member Population
7981
Eligible population by non-ER/Urgent Care
Visits*
7858
Eligible Population by ER/Urgent Care Visits*
123
Numerator Events by Admin Data
Numerator by non-ER/Urgent Care Visits*
Numerator by ER/Urgent Care Visits*
7436
7343
93
Reported Rate
93.17%
Lower 95% Confidence Interval
92.61%
Upper 95% Confidence Interval
93.73%
Data Elements with an Asterisk(*) are OPTIONAL and
are not used in any calculation or total
HEDIS 2005 (Reporting Year 2004)
Page 6
Effectiveness of Care
HealthPartners / Group Health (Combined)
Colorectal Cancer Screening
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Medicare +
Choice
HO
HO
S
S
Eligible population
86309
13392
Number of numerator events by administrative data in eligible population (before exclusions)
47250
9044
Current year's administrative rate (before exclusions)
Data Elements
Data collection methodology (administrative or hybrid)
Sampling method used (see User's Guide for entry descriptions)
54.75%
67.53%
Minimum required sample size (MRSS) or other sample size
411
411
Oversampling rate
0.05
0.05
Final sample size (FSS)
432
432
Number of numerator events by administrative data in FSS
235
274
Administrative rate on FSS
54.40%
63.43%
Number of original sample records excluded because of valid data errors
0
0
Records Excluded - Contraindications/Admin Data
0
0
Records Excluded - Contraindications/Medical Record Review
0
0
Number of employee/dependent medical records excluded
0
0
Records added from the oversample list
235
274
Denominator
411
411
Numerator events by administrative data
226
262
9
5
101
107
4
19
Colonoscopy by administrative data*
112
131
Numerator events by medical records
16
29
FOBT by medical records*
1
6
Flexible sigmoidoscopy by medical records*
10
7
DCBE by medical records*
0
0
Colonoscopy by medical records*
FOBT by administrative data*
Flexible sigmoidoscopy by administrative data*
DCBE by administrative data*
5
16
Reported rate
58.88%
70.80%
Lower 95% confidence interval
54.00%
66.29%
Upper 95% confidence interval
63.76%
75.32%
Data Elements with an Asterisk(*) are OPTIONAL and are not used in any calculation or total
HEDIS 2005 (Reporting Year 2004)
Page 7
Effectiveness of Care
HealthPartners / Group Health (Combined)
Breast Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
HO
S
39037
75.10%
250
5.00%
263
207
78.71%
0
0
Records Excluded because of contraindications
through Medical Record Review
2
Number of employee/dependent medical records
excluded
0
HEDIS 2005 (Reporting Year 2004)
2588
29318
Records Excluded because of contraindications
through Admin data
Records Added from Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Medicare + Choice
A
2
250
198
4
80.80%
75.72%
85.88%
NR
NR
2147
82.96%
81.49%
84.43%
Page 8
Effectiveness of Care
HealthPartners / Group Health (Combined)
Cervical Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
HO
S
109586
Numerator Events by Admin Data on Eligible
Population (before exclusions)
86334
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
78.78%
219
5.00%
230
185
80.43%
0
Records Excluded because of contraindications
through Admin Data
0
Records Excluded because of contraindications
through Medical Record Review
10
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
10
219
184
3
85.39%
80.48%
90.29%
Page 9
Effectiveness ofHealthPartners
Care
/ Group Health (Combined)
Chlamydia Screening in Women
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Data Elements
Data Collection Methodology
Eligible Member Population
Records Excluded - Contraindications/Admin Data
Denominator
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
General
Measure
Data
Ages 16-20 Ages 21-25
Total
A
7757
8836
16593
165
62
227
7592
2875
37.87%
36.77%
38.97%
8774
3167
36.10%
35.08%
37.11%
16366
6042
36.92%
36.18%
37.66%
Page 10
Effectiveness of Care
HealthPartners / Group Health (Combined)
Controlling High Blood Pressure
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Data Elements
Commercial
HO
S
17938
Medicare + Choice
HO
S
5536
0
0
0.00%
376
5.00%
395
0.00%
335
5.00%
352
0
0
0.00%
0.00%
Records Excluded because of Valid Data Errors
0
0
Records Excluded because of contraindications
through Admin Data
0
0
3
3
0
0
3
3
376
0
269
71.54%
66.85%
76.24%
335
0
249
74.33%
69.50%
79.16%
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
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 2005 (Reporting Year 2004)
Page 11
Effectiveness of Care
HealthPartners / Group Health (Combined)
Beta Blocker Treatment after Heart Attack
Data Elements
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Medicare + Choice
HO
HO
N
N
Eligible Member Population
303
67
Numerator Events by Admin Data on Eligible
Population
255
52
84.16%
77.61%
303
67
Data Collection Methodology
Sampling Method Used
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
0.00%
0.00%
Final Sample Size (FSS)
303
67
Numerator events by admin data in FSS
255
52
Admin rate on FSS
84.16%
77.61%
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
11
2
Number of employee/dependent medical
records excluded
0
0
Records Added from the Oversample List
0
0
Denominator
292
65
Numerator Events by Admin Data
255
52
Numerator Events by Medical Record
26
13
Reported Rate
96.23%
100.00%
Lower 95% Confidence Interval
93.88%
99.23%
Upper 95% Confidence Interval
98.59%
100.00%
HEDIS 2005 (Reporting Year 2004)
Page 12
Effectiveness of Care
HealthPartners / Group Health (Combined)
Cholesterol Management After Acute
Cardiovascular Events
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare + Choice
Data Elements
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
1
Number of employee/dependent medical records
excluded
0
HEDIS 2005 (Reporting Year 2004)
126
52
56
75.90%
31.33%
33.73%
126
52
56
75.90%
31.33%
33.73%
15
69
81
85.45%
79.77%
91.14%
73.33%
66.28%
80.38%
83.03%
77.00%
89.06%
166
0.00%
166
Records Excluded because of Valid Data Errors
Records Added from the Oversample List
Denominator
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
LDL-C Level of LDL-C Level of
<100 mg/dL 60- <130 mg/dL 60365 Days
365 Days
HO
N
166
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 60365 Days
0
165
Page 13
Effectiveness of Care
HealthPartners / Group Health (Combined)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure Data
11
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
Additional Records Added from the
Oversample List
11
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
LDL-C
Screening
LDL-C Level
<130 mg/dL
LDL-C Level
<100 mg/dL
Monitoring for
Diabetic
Nephropathy
12208
86.01%
10407
73.32%
7238
50.99%
12690
89.40%
3695
26.03%
2585
18.21%
8886
62.60%
382
84.33%
339
74.83%
238
52.54%
398
87.86%
116
25.61%
73
16.11%
271
59.82%
356
20
91.48%
64
39
25.06%
217
23
58.39%
364
19
93.19%
106
195
73.24%
68
134
49.15%
251
28
67.88%
88.66%
94.30%
20.75%
29.37%
53.51%
63.28%
90.63%
95.74%
68.83%
77.64%
44.19%
54.10%
63.25%
72.52%
453
Number of Records Excluded Because of
Valid Data Errors
Reported Rate
Lower 95% Confidence Interval
Eye Exam
411
10.00%
Numerator events by admin data in FSS
Admin rate on FSS
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Poor HbA1c
Control
HO
S
14194
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
HbA1c
Testing
411
Page 14
Effectiveness of Care
HealthPartners / Group Health (Combined)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare + Choice
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure Data
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
11
Records Excluded because of
contraindications through Admin Data
0
Records Excluded because of
contraindications through Medical Record
Review
0
Number of employee/dependent records
excluded
0
Additional Records Added from the
Oversample List
11
Denominator
411
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
LDL-C
Screening
LDL-C Level
<130 mg/dL
LDL-C Level
<100 mg/dL
Monitoring for
Diabetic
Nephropathy
1409
75.19%
1276
68.09%
1304
69.58%
1495
79.78%
583
31.11%
464
24.76%
1068
56.99%
352
77.70%
307
67.77%
314
69.32%
374
82.56%
143
31.57%
113
24.94%
252
55.63%
322
57
92.21%
21
36
13.87%
291
25
76.89%
338
56
95.86%
127
203
80.29%
100
151
61.07%
230
49
67.88%
89.50%
94.93%
10.41%
17.33%
72.69%
81.08%
93.82%
97.91%
76.32%
84.26%
56.23%
65.91%
63.25%
72.52%
453
Number of Records Excluded Because of
Valid Data Errors
Numerator Events by Medical Record
Eye Exam
411
10.00%
Admin rate on FSS
Numerator Events by Admin Data
Poor HbA1c
Control
HO
S
1874
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
HbA1c
Testing
Page 15
Effectiveness of Care
HealthPartners / Group Health (Combined)
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Data Elements
Data Collection Methodology
Eligible Member Population
Total Exclusions
Denominator
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
Total
722
21
701
568
81.03%
78.05%
84.00%
1301
27
1274
973
76.37%
74.00%
78.75%
5252
629
4623
3511
75.95%
74.70%
77.19%
7275
677
6598
5052
76.57%
75.54%
77.60%
A
Page 16
Effectiveness of Care
HealthPartners / Group Health (Combined)
Follow-Up After Hospitalization for Mental Illness
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
General
Measure
Data
Medicare + Choice
W/in 7 Days of W/in 30 Days of
Discharge
Discharge
A
1320
General
Measure
Data
W/in 7 Days of W/in 30 Days of
Discharge
Discharge
A
28
664
50.30%
47.57%
53.04%
955
72.35%
69.90%
74.80%
7
NA
NA
NA
13
NA
NA
NA
Page 17
Effectiveness of Care
HealthPartners / Group Health (Combined)
Antidepressant Medication Management
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
745
18.21%
17.01%
19.40%
2874
70.23%
68.82%
71.65%
2193
53.59%
52.05%
55.13%
A
4092
Page 18
Effectiveness of Care
HealthPartners / Group Health (Combined)
Antidepressant Medication Management
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare + Choice
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
17
11.26%
5.89%
16.63%
108
71.52%
63.99%
79.05%
90
59.60%
51.44%
67.76%
A
151
Page 19
Effectiveness of Care HealthPartners / Group Health (Combined)
Osteoporosis Management in Women Who
had a Fracture
Data Elements
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare +
Choice
Data Collection Methodology
Eligible Member Population
Nonduplicated prior to bone mineral density
exclusions*
A
246
Nonduplicated prior to prescription exclusions*
167
Nonduplicated other exclusions*
Total nonduplicated exclusions
Numerator events for bone mineral density by
administrative data*
Numerator events for precription by administrative
data*
Numerator events for both bone density and
prescription by administrative data*
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
64
0
188
25
40
65
54
21.95%
16.58%
27.33%
Page 20
Use of Services
HealthPartners / Group Health (Combined)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
0
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Oversample List
0
HEDIS 2005 (Reporting Year 2004)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
74
1.37%
52
0.96%
75
1.39%
97
1.79%
318
5.88%
1194
22.08%
3597
66.52%
7
1.99%
4
1.14%
3
0.85%
12
3.41%
19
5.40%
78
22.16%
229
65.06%
0
2
0.60%
0.00%
1.57%
0
2
0.60%
0.00%
1.57%
0
1
0.30%
0.00%
1.03%
0
9
2.69%
0.81%
4.57%
0
12
3.58%
1.44%
5.72%
0
46
13.73%
9.90%
17.57%
217
46
78.51%
73.96%
83.06%
335
5.00%
352
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
1 visit
HO
S
5407
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Zero Visits
335
Page 21
Use of Services
HealthPartners / Group Health (Combined)
Well Child Visits in the 3rd, 4th, 5th and 6th Years
of Life
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
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
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
HO
S
26010
14369
55.24%
409
5.00%
430
246
57.21%
0
Records Excluded - Contraindications/Admin Data
0
Records Excluded - Contraindications/Medical
Record Review
0
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
0
409
235
14
60.88%
56.03%
65.73%
Page 22
Use of Services
HealthPartners / Group Health (Combined)
Adolescent Well-Care Visits
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
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
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
HO
S
72676
22026
30.31%
411
5.00%
432
134
31.02%
0
Records Excluded - Contraindications/Admin Data
0
Records Excluded - Contraindications/Medical
Record Review
0
Number of employee/dependent medical records
excluded
0
Records Added from the Oversample List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
0
411
129
33
39.42%
34.57%
44.26%
Page 23
Use of Services HealthPartners / Group Health (Combined)
Frequency of Selected Procedures
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Age
0-4
0-9
5-19
10-19
15-44
20-64
30-64
45-64
65+
Male
2013701
1662843
888357
58020
Procedure
Myringotomy
Age
0-4
5-19
Tonsillectomy
0-9
10-19
Dilation &
15-44
Curettage
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+
65+
Cholecystectomy, 30-64
Closed
15-44
45-64
65+
65+
Laminectomy /
20-64
Diskectomy
20-64
Angioplasty (PTCA) 45-64
45-64
65+
65+
Cardiac
45-64
Catheterization
45-64
65+
65+
CABG
45-64
45-64
65+
65+
Prostatectomy
45-64
65+
HEDIS 2005 (Reporting Year 2004)
Member Months
Female
Total
439423
889506
1440285
990202
1499883
2216341
960640
50564
Sex
Total
Total
Total
Total
F
F
F
F
F
F
F
F
M
F
F
M
F
M
F
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
F
M
M
Number of
Procedures
1066
241
616
284
302
432
289
372
17
265
270
7
69
118
87
1
2
273
501
420
18
21
581
482
559
153
87
32
635
366
102
48
169
40
35
8
212
53
Procedures /
1,000 Member
Months
2.43
0.17
0.69
0.29
0.20
0.45
0.19
0.39
0.34
0.18
0.28
0.14
0.04
0.08
0.09
0.02
0.04
0.16
0.33
0.44
0.31
0.42
0.29
0.22
0.63
0.16
1.50
0.63
0.71
0.38
1.76
0.95
0.19
0.04
0.60
0.16
0.24
0.91
Page 24
Use of Services
HealthPartners / Group Health (Combined)
Inpatient Utilization - General Hospital/Acute Care
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
65+
Unknown
Total
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Member Months
87658
801848
990202
2381045
1848997
84328
20432
3824
0
6218334
Discharges
Discharges /
1,000 Member
Months
598
1287
1513
14246
12681
1227
511
141
0
32204
6.82
1.61
1.53
5.98
6.86
14.55
25.01
36.87
485
971
724
2801
6001
610
329
113
0
12034
5.53
1.21
0.73
1.18
3.25
7.23
16.10
29.55
113
316
574
3520
6675
617
182
28
0
12025
1.29
0.39
0.58
1.48
3.61
7.32
8.91
7.32
215
7925
5
0
0
8145
0.22
3.33
0.00
0.00
HEDIS 2005 (Reporting Year 2004)
5.18
1.94
1.93
1.53
Days
Days / 1,000
Member
Months
2188
3510
4910
39869
43953
4692
2218
569
0
101909
24.96
4.38
4.96
16.74
23.77
55.64
108.56
148.80
1369
2588
2344
8141
18940
2050
1171
401
0
37004
15.62
3.23
2.37
3.42
10.24
24.31
57.31
104.86
819
922
1965
10734
24997
2642
1047
168
0
43294
9.34
1.15
1.98
4.51
13.52
31.33
51.24
43.93
601
20994
16
0
0
21611
0.61
8.82
0.01
0.00
16.39
5.95
6.96
4.06
Average
Length of Stay
3.66
2.73
3.25
2.80
3.47
3.82
4.34
4.04
NA
3.16
2.82
2.67
3.24
2.91
3.16
3.36
3.56
3.55
NA
3.07
7.25
2.92
3.42
3.05
3.74
4.28
5.75
6.00
NA
3.60
2.80
2.65
3.20
NA
NA
2.65
Page 25
Use of Services
HealthPartners / Group Health (Combined)
Inpatient Utilization - General Hospital/Acute Care
Medicare + Choice
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
Data Last Refreshed:
Sep 30, 2005 11:38 AM
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
HEDIS 2005 (Reporting Year 2004)
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
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
Page 26
Use of Services
HealthPartners / Group Health (Combined)
Ambulatory Care
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
87658
801848
990202
2381045
1848997
84328
20432
3824
0
6218334
Outpatient Visits
(Excludes MH/CD)
Emergency Room Visits
Ambulatory
Surgery/Procedures
Observation Room Stays
Resulting in Discharge
Stays/ 1,000
Member
Months
0.32
0.08
<1
1-9
Visits
76315
230417
Visits/ 1,000
Member
Months
870.60
287.36
10-19
205764
207.80
8923
9.01
2717
2.74
94
0.09
20-44
45-64
65-74
585634
610724
39568
245.96
330.30
469.22
22830
14824
922
9.59
8.02
10.93
14748
29907
2136
6.19
16.17
25.33
1412
62
4
0.59
0.03
0.05
75-84
12637
618.49
359
17.57
678
33.18
1
0.05
2558
0
1763617
668.93
81
0
60114
21.18
74
0
54131
19.35
0
0
1664
0.00
Age
85+
Unknown
Total
HEDIS 2005 (Reporting Year 2004)
283.62
Visits
2193
9982
Visits/ 1,000
Member
Months
25.02
12.45
9.67
Procedures
500
3371
Procedures/
1,000 Member
Months
5.70
4.20
8.71
Stays
28
63
0.27
Page 27
Use of Services
HealthPartners / Group Health (Combined)
Ambulatory Care
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare + Choice
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
0
319
4247
107825
98584
39173
0
250148
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
Visits
0
0
Emergency Room Visits
Visits/ 1,000
Member
Months
NA
NA
Visits
0
0
Ambulatory
Surgery/Procedures
Visits/ 1,000
Member
Months
NA
NA
Procedures
0
0
Observation Room Stays
Resulting in Discharge
Procedures/
1,000 Member
Months
NA
NA
Stays
0
0
Stays/ 1,000
Member
Months
NA
NA
10-19
0
NA
0
NA
0
NA
0
NA
20-44
45-64
65-74
210
3030
62718
658.31
713.44
581.66
6
73
1194
18.81
17.19
11.07
9
130
3113
28.21
30.61
28.87
0
0
10
0.00
0.00
0.09
75-84
70494
715.07
1644
16.68
2905
29.47
3
0.03
85+
Unknown
29022
0
165474
740.87
868
0
3785
22.16
701
0
6858
17.89
5
0
18
0.13
Total
HEDIS 2005 (Reporting Year 2004)
661.50
15.13
27.42
0.07
Page 28
Use of Services
HealthPartners / Group Health (Combined)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Age
Member Months
<1
87658
1-9
801848
10-19
990202
20-44
2381045
45-64
1848997
65-74
84328
75-84
20432
85+
3824
Unknown
Total
0
6218334
Discharges
Discharges /
1,000 Member
Months
<1
0
0.00
0
0.00
NA
1-9
1
0.00
5
0.01
5.00
10-19
10
0.01
136
0.14
13.60
20-44
97
0.04
1723
0.72
17.76
45-64
616
0.33
8535
4.62
13.86
65-74
101
1.20
2470
29.29
24.46
75-84
50
2.45
1784
87.31
35.68
85+
25
6.54
769
201.10
30.76
Unknown
0
900
0.14
0
15422
2.48
NA
17.14
Age
Total
HEDIS 2005 (Reporting Year 2004)
Days
Days / 1,000 Average Length
Member Months
of Stay
Page 29
Use of Services
HealthPartners / Group Health (Combined)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare + Choice
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 Average Length
Member Months
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
HEDIS 2005 (Reporting Year 2004)
NR
NR
NR
Page 30
Use of Services
HealthPartners / Group Health (Combined)
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Male
Member Months
Female
Total
604905
261343
2107789
58020
0
3032057
575796
248722
2311195
50564
0
3186277
1180701
510065
4418984
108584
0
6218334
Discharges
Discharges /
1,000 Member
Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Days*
Average Length
of Stay
M
58
0.10
714
12.31
F
34
0.06
557
16.38
Total
92
0.08
1271
13.82
13-17
M
178
0.68
4054
22.78
F
303
1.22
4733
15.62
Total
481
0.94
8787
18.27
18-64
M
543
0.26
4671
8.60
F
852
0.37
6644
7.80
Total
1395
0.32
11315
8.11
M
65+
8
0.14
100
12.50
F
14
0.28
118
8.43
Total
22
0.20
218
9.91
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
M
Total
787
0.26
9539
12.12
F
1203
0.38
12052
10.02
TOTAL
1990
0.32
21591
10.85
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization
should not be included in this table.
HEDIS 2005 (Reporting Year 2004)
Page 31
Use of Services
HealthPartners / Group Health (Combined)
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare + Choice
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
Member Months
Female
Total
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
13-17
M
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
18-64
M
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
65+
M
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 2005 (Reporting Year 2004)
Page 32
Use of Services
HealthPartners / Group Health (Combined)
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Member Months (Day/Night)
Member Months (Ambulatory)
Male
Member Months (Any)
Female
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total
0-12
604905
575796
1180701
604905
575796
1180701
604905
575796
1180701
604905
575796
1180701
13-17
261343
248722
510065
261343
248722
510065
261343
248722
510065
261343
248722
510065
18-64
2107789
2311195
4418984
2107789
2311195
4418984
2107789
2311195
4418984
2107789
2311195
4418984
58020
50564
108584
58020
50564
108584
58020
50564
108584
58020
50564
108584
0
3032057
0
3186277
0
6218334
0
3032057
0
3186277
0
6218334
0
3032057
0
3186277
0
6218334
0
3032057
0
3186277
0
6218334
Age
65+
Unknown
Total
Age
0-12
13-17
18-64
65+
Unknown
Any Mental Health Services
Inpatient Mental Health Services
Day/Night Mental Health Services
Ambulatory Mental Health Services
Number
Percent
Number
Percent
Number
Percent
Number
Percent
2916
5.78%
43
0.09%
16
0.03%
2904
5.76%
F
1633
3.40%
23
0.05%
5
0.01%
1626
3.39%
Total
4549
4.62%
66
0.07%
21
0.02%
4530
4.60%
M
2512
11.53%
134
0.62%
25
0.11%
2473
11.36%
Sex
M
F
2811
13.56%
210
1.01%
25
0.12%
2773
13.38%
Total
5323
12.52%
344
0.81%
50
0.12%
5246
12.34%
M
11409
6.50%
448
0.26%
40
0.02%
11298
6.43%
F
21202
11.01%
655
0.34%
117
0.06%
21068
10.94%
Total
32611
8.86%
1103
0.30%
157
0.04%
32366
8.79%
162
3.35%
8
0.17%
0
0.00%
156
3.23%
M
F
164
3.89%
14
0.33%
2
0.05%
154
3.65%
Total
326
3.60%
22
0.24%
2
0.02%
310
3.43%
M
0
NA
0
NA
0
NA
0
NA
F
0
NA
0
NA
0
NA
0
NA
Total
Total
Member Months (Inpatient)
0
NA
0
NA
0
NA
0
NA
M
16999
6.73%
633
0.25%
81
0.03%
16831
6.66%
F
25810
42809
9.72%
8.26%
902
1535
0.34%
0.30%
149
230
0.06%
0.04%
25621
42452
9.65%
8.19%
Total
HEDIS 2005 (Reporting Year 2004)
Page 33
Use of Services
HealthPartners / Group Health (Combined)
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare + Choice
Member Months (Any)
Age
Male
Female
Total
Member Months (Inpatient)
Male
Female
Total
Member Months (Day/Night)
Member Months (Ambulatory)
Male
Male
Female
Total
Female
Total
0-12
NR
NR
NR
NR
13-17
NR
NR
NR
NR
18-64
NR
NR
NR
NR
65+
NR
NR
NR
NR
Unknown
Total
Age
0-12
NR
NR
NR
NR
NR
NR
NR
NR
NR
Day/Night Mental Health Services
Ambulatory Mental Health Services
Number
Number
NR
Percent
Percent
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
F
NR
NR
NR
NR
NR
NR
NR
NR
NR
M
NR
NR
NR
F
NR
NR
NR
NR
M
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
M
F
Total
NR
Number
Total
Unknown
NR
NR
Inpatient Mental Health Services
Total
65+
NR
Number
Sex
M
Total
18-64
NR
Any Mental Health Services
F
13-17
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
M
NR
NR
NR
NR
F
NR
NR
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
M
NR
NR
NR
NR
NR
NR
NR
NR
F
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
HEDIS 2005 (Reporting Year 2004)
Page 34
Use of Services
HealthPartners / Group Health (Combined)
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Male
Member Months
Female
Total
604905
261343
2107789
58020
0
3032057
575796
248722
2311195
50564
0
3186277
1180701
510065
4418984
108584
0
6218334
Discharges
Discharges /
1,000 Member
Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Days
Average Length
of Stay
M
1
0.00
1
1.00
F
0
0.00
0
NA
Total
1
0.00
1
1.00
13-17
M
141
0.54
1443
10.23
F
114
0.46
1122
9.84
Total
255
0.50
2565
10.06
18-64
M
641
0.30
4198
6.55
F
390
0.17
3039
7.79
Total
1031
0.23
7237
7.02
65+
M
5
0.09
39
7.80
F
5
0.10
34
6.80
Total
10
0.09
73
7.30
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
788
0.26
5681
7.21
F
509
0.16
4195
8.24
TOTAL
1297
0.21
9876
7.61
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization
should not be included in this table.
HEDIS 2005 (Reporting Year 2004)
Page 35
Use of Services
HealthPartners / Group Health (Combined)
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare + Choice
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
Member Months
Female
Total
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
13-17
M
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
18-64
M
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
65+
M
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 2005 (Reporting Year 2004)
Page 36
Use of Services
HealthPartners / Group Health (Combined)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Member Months (Any)
Age
0-12
Male
Female
604905
575796
Total
1180701
Member Months (Inpatient)
Male
Female
604905
575796
Total
1180701
Member Months (Day/Night)
Male
Female
604905
575796
Total
1180701
Member Months (Ambulatory)
Male
Female
604905
575796
Total
1180701
13-17
261343
248722
510065
261343
248722
510065
261343
248722
510065
261343
248722
510065
18-64
2107789
2311195
4418984
2107789
2311195
4418984
2107789
2311195
4418984
2107789
2311195
4418984
58020
50564
108584
58020
50564
108584
58020
50564
108584
58020
50564
108584
0
3032057
0
3186277
0
6218334
0
3032057
0
3186277
0
6218334
0
3032057
0
3186277
0
6218334
0
3032057
0
3186277
0
6218334
65+
Unknown
Total
Any Chemical Dependency
Services
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
Number
2
Percent
0.00%
Number
1
Percent
0.00%
Number
8
Percent
0.02%
7
Percent
0.01%
8
16
0.02%
0.02%
2
3
0.00%
0.00%
2
4
0.00%
0.00%
6
13
0.01%
0.01%
572
2.63%
148
0.68%
166
0.76%
490
2.25%
Total
M
332
904
1.60%
2.13%
121
269
0.58%
0.63%
64
230
0.31%
0.54%
284
774
1.37%
1.82%
3816
2.17%
998
0.57%
415
0.24%
3280
1.87%
F
Total
2045
5861
1.06%
1.59%
604
1602
0.31%
0.44%
183
598
0.10%
0.16%
1767
5047
0.92%
1.37%
73
38
1.51%
0.90%
35
26
0.72%
0.62%
1
0
0.02%
0.00%
52
18
1.08%
0.43%
Unknown
M
F
Total
M
1.23%
NA
NA
61
0
0
0.67%
NA
NA
1
0
0
0.01%
NA
NA
70
0
0
0.77%
NA
NA
Total
F
Total
M
111
0
0
0
4469
2423
6892
NA
1.77%
0.91%
1.33%
0
1182
753
1935
NA
0.47%
0.28%
0.37%
0
584
249
833
NA
0.23%
0.09%
0.16%
0
3829
2075
5904
NA
1.52%
0.78%
1.14%
Age
0-12
Sex
M
F
13-17
Total
M
F
18-64
65+
F
Total
HEDIS 2005 (Reporting Year 2004)
Page 37
Use of Services
HealthPartners / Group Health (Combined)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare + Choice
Member Months (Any)
Age
Male
Female
Member Months (Inpatient)
Male
Female
Member Months (Ambulatory)
Male
Male
Female
Total
NR
13-17
NR
NR
NR
NR
18-64
NR
NR
NR
NR
65+
NR
NR
NR
NR
Unknown
NR
NR
NR
NR
NR
NR
Age
0-12
NR
NR
NR
NR
NR
NR
NR
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
Number
Number
Number
Sex
M
Total
M
Total
M
F
Total
65+
M
F
Total
Unknown
M
F
Total
Total
NR
Inpatient Chemical Dependency
Services
NR
F
18-64
NR
Total
NR
Any Chemical Dependency
Services
F
13-17
NR
Total
NR
Female
0-12
Total
Total
NR
Member Months (Day/Night)
M
F
Total
NR
NR
Percent
NR
NR
NR
NR
Percent
NR
NR
NR
NR
Percent
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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 2005 (Reporting Year 2004)
Page 38
Use of Services
HealthPartners / Group Health (Combined)
Outpatient Drug Utilization
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
784417
879978
2126991
1677553
79096
20091
3846
0
5571972
Specification Documentation:
Prescription is defined as (Enter "A"
or "B"):
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Total Cost of
Prescriptions
$8,354,785.93
$20,362,766.44
$77,373,222.56
$137,832,322.55
$10,627,342.42
$3,187,273.25
$593,733.55
$0.00
$258,331,446.70
HEDIS 2005 (Reporting Year 2004)
A
Avg. Cost of
Prescriptions /
Per Member Per
Month
$10.65
$23.14
$36.38
$82.16
$134.36
$158.64
$154.38
$46.36
Total Number of
Prescriptions
192606
325719
1478736
2725895
240477
77365
15883
0
5056681
Avg. Num. Of
Prescriptions /
Per Member Per
Year
2.95
4.44
8.34
19.50
36.48
46.21
49.56
10.89
Page 39
Use of Services
HealthPartners / Group Health (Combined)
Outpatient Drug Utilization
Medicare + Choice
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Member Months
0
0
187
2461
90107
60161
15098
0
168014
Specification Documentation:
Prescription is defined as (Enter "A"
or "B"):
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
HEDIS 2005 (Reporting Year 2004)
Total Cost of
Prescriptions
$0.00
$0.00
$151,714.77
$1,033,118.03
$14,790,731.29
$11,001,427.39
$2,727,966.13
$0.00
$29,704,957.61
A
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
$811.31
$419.80
$164.15
$182.87
$180.68
$176.80
Total Number of
Prescriptions
0
0
1113
13560
323024
263879
72007
0
673583
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
71.42
66.12
43.02
52.63
57.23
48.11
Page 40
Access/Availability of Care
HealthPartners / Group Health (Combined)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Data Elements
Data collection methodology
(Administrative 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 2005 (Reporting Year 2004)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
98744
110960
7671
94310
107256
7500
95.51%
95.38%
95.64%
96.66%
96.56%
96.77%
97.77%
97.43%
98.11%
A
Page 41
Access/Availability of Care
HealthPartners / Group Health (Combined)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare + Choice
Data Elements
Data collection methodology
(Administrative 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 2005 (Reporting Year 2004)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
23
308
20474
20
298
19818
NA
NA
NA
96.75%
94.61%
98.90%
96.80%
96.55%
97.04%
A
Page 42
Access/Availability of Care
HealthPartners / Group Health (Combined)
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
Data Elements
General Measure
Data
Data collection methodology (Administrative
only)
A
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 2005 (Reporting Year 2004)
12-24 months
25 months - 6
yrs.
7-11 yrs.
12-19 yrs.
6633
31234
27494
49234
6575
28083
24601
44680
99.13%
98.89%
99.36%
89.91%
89.58%
90.25%
89.48%
89.11%
89.84%
90.75%
90.49%
91.01%
Page 43
Access/Availability of Care
HealthPartners / Group Health (Combined)
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
General Measure
Data
Timeliness of
Prenatal Care
Postpartum Care
Number of numerator events by administrative data in
eligible population (before exclusions)
5586
3874
Current year's administrative rate (before exclusions)
80.70%
55.97%
225
159
82.42%
58.24%
121
125
121
103
94.62%
91.68%
97.55%
86.15%
81.76%
90.54%
Data collection methodology (Administrative or Hybrid)
Sampling method used (see User's Guide for entry descriptions)
Eligible member population (i.e. members who meet all
denominator criteria)
HO
S
6922
Minimum required sample size (MRSS) or other sample size
260
Oversampling rate
Final sample size (FSS)
5%
273
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of
valid data errors
0
Number of employee/dependent medical records excluded
0
Additional 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 2005 (Reporting Year 2004)
0
260
Page 44
Access/Availability of Care
HealthPartners / Group Health (Combined)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
18-25 Year Olds
Data Elements
Data collection methodology
(Administrative only)
General
Measure
Data
Initiation of
AOD
Treatment
HEDIS 2005 (Reporting Year 2004)
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
35-64 Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
65+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Overall Rate
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
A
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
Engagement
of AOD
Treatment
26-34 Year Olds
877
570
2158
76
3681
303
108
224
95
1068
329
58
5
1653
537
34.55%
31.35%
37.75%
12.31%
10.08%
14.55%
39.30%
35.20%
43.40%
16.67%
13.52%
19.81%
49.49%
47.36%
51.62%
15.25%
13.71%
16.79%
76.32%
66.10%
86.53%
6.58%
0.35%
12.81%
44.91%
43.29%
46.53%
14.59%
13.43%
15.74%
Page 45
Access/Availability of Care
HealthPartners / Group Health (Combined)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare + Choice
18-25 Year Olds
Data Elements
Data collection methodology
(Administrative 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 2005 (Reporting Year 2004)
General
Measure
Data
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
26-34 Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
35-64 Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
65+ Year Olds
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
Overall Rate
Initiation of
AOD
Treatment
Engagement
of AOD
Treatment
A
0
0
144
7
151
0
0
0
0
7
2
120
1
127
3
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
83.33%
76.90%
89.77%
0.69%
0.00%
2.40%
84.11%
77.94%
90.27%
1.99%
0.00%
4.54%
Page 46
Health Plan Stability
HealthPartners / Group Health (Combined)
Practitioner Turnover
Medicare + Choice
Practitioner Types
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Number of
Practitioners as of
12/31/2003
Number of
Practitioners who
were not affiliated
with the plan as of
12/31/2004
Practitioner
Turnover Rate
Primary Care Physicians
Non-Physician Primary
Care Practitioners
HEDIS 2005 (Reporting Year 2004)
3979
112
2.81%
832
29
3.49%
Page 47
Health Plan Stability
HealthPartners / Group Health (Combined)
Years in Business / Total Membership
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare + Choice
Product/Product Line
HMO (Total)
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other (specify)
PPO (Total)
Commercial
Medicare (cost or risk)
Self-insured
Other (specify)
POS (Total)
Commercial
Medicare (cost or risk)
Self-insured
Other (specify)
Total
Years in Business
49.00
19.00
49.00
49.00
17.00
49.00
Members*
401505
51106
69753
34557
242513
3576
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
21.00
21.00
0.00
0.00
0.00
214165
214165
0
0
0
615670
* Total number of members in each category as of December 31, 2004
HEDIS 2005 (Reporting Year 2004)
Page 48
Health Plan Descriptive Information
HealthPartners / Group Health (Combined)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Commercial
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
45072
178920
230880
254100
157284
94092
Member Months
Female
42588
172848
219204
240552
149328
94860
Total
87660
351768
450084
494652
306612
188952
960348
31.67%
172212
178644
224568
255588
294324
919380
28.85%
196128
213948
248664
275616
321360
1879728
30.23%
1125336
37.11%
285960
258804
209460
134124
1255716
39.41%
317844
286716
218508
137580
2381052
38.29%
888348
29.30%
32436
13836
6636
3492
1296
312
960648
30.15%
26628
11424
6624
3672
1572
648
1848996
29.73%
58008
1.91%
0
50568
1.59%
0
108576
1.75%
3032040
3186312
HEDIS 2005 (Reporting Year 2004)
368340
392592
473232
531204
615684
603804
545520
427968
271704
59064
25260
13260
7164
2868
960
0
6218352
Page 49
Health Plan Descriptive Information
HealthPartners / Group Health (Combined)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 30, 2005 11:38 AM
Medicare + Choice
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
0
0
24
48
84
0
0.00%
0
0
24
48
96
0
0.00%
156
0.16%
180
324
372
972
168
0.11%
144
360
540
1368
324
0.13%
1848
1.89%
24156
22920
20268
17220
8028
3192
2412
1.58%
32232
28536
30924
30168
18240
9708
4260
1.70%
95784
97.95%
0
149808
98.31%
0
97788
152388
HEDIS 2005 (Reporting Year 2004)
0
0
48
96
180
324
684
912
2340
56388
51456
51192
47388
26268
12900
245592
98.17%
0
250176
Page 50