First Plan of Minnesota
Plan Name
2004
Reporting Year
General Info
Submission #
1
Last Refreshed:
2
9/30/2005 11:26:10 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
First Plan of Minnesota
Childhood Immunization Status
Data Last Refreshed:
Sep 30, 2005 11:26 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
0
Number of employee/dependent records
excluded
0
Records Added from the Oversample List
0
Denominator
Numerator Events by Admin Data
22
HEDIS 2005 (Reporting Year 2004)
HiB
Hepatitis B
VZV
Combo 1
Combo 2
11
50.00%
11
50.00%
18
81.82%
13
59.09%
13
59.09%
17
77.27%
11
50.00%
9
40.91%
11
NR
11
NR
18
NR
13
NR
13
NR
17
NR
11
NR
9
NR
11
11
18
13
13
17
11
9
7
6
2
6
6
2
5
6
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0
0
Upper 95% Confidence Interval
MMR
0
0.00%
Number of Records Excluded Because of
Valid Data Errors
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
IPV/OPV
HO
N
22
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
DTaP/DT
Page 3
Effectiveness of Care
First Plan of Minnesota
Adolescent Immunization Status
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
Data Elements
Data Collection Methodology
General
Measure
Data
N
Eligible Member Population
17
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Oversampling Rate
Final Sample Size (FSS)
Combo 2
13
10
2
10
2
76.47%
58.82%
11.76%
58.82%
11.76%
13
10
2
10
2
76.47%
58.82%
11.76%
58.82%
11.76%
13
10
2
10
2
17
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
Numerator Events by Medical Record
Combo 1
0.00%
Admin rate on FSS
Numerator Events by Admin Data
VZV
0
Numerator events by admin data in FSS
Denominator
Hepatitis B
HO
Sampling Method Used
Minimum Required Sample Size
MMR
17
3
1
2
1
1
Reported Rate
NA
NA
NA
NA
NA
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
HEDIS 2005 (Reporting Year 2004)
Page 4
Effectiveness of Care
First Plan of Minnesota
Appropriate Treatment for Children with Upper
Respiratory Infection
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
Member Months
Age
<1
87
1-4
1198
5-9
1329
10-14
1685
15-17
1244
5543
Total
Data Elements
General
Measure
Data
Data Collection Methodology
A
Eligible Member Population
21
Eligible population by non-ER/Urgent Care
Visits*
Eligible Population by ER/Urgent Care
Visits*
Numerator Events by Admin Data
2
Numerator by non-ER/Urgent Care Visits*
Numerator by ER/Urgent Care Visits*
Reported Rate
NA
Lower 95% Confidence Interval
NA
Upper 95% Confidence Interval
NA
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
First Plan of Minnesota
Appropriate Testing for Children with Pharyngitis
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
Data Elements
General
Measure
Data
Data Collection Methodology
A
Eligible Member Population
16
Eligible population by non-ER/Urgent Care
Visits*
Eligible Population by ER/Urgent Care Visits*
Numerator Events by Admin Data
13
Numerator by non-ER/Urgent Care Visits*
Numerator by ER/Urgent Care Visits*
Reported Rate
NA
Lower 95% Confidence Interval
NA
Upper 95% Confidence Interval
NA
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
First Plan of Minnesota
Colorectal Cancer Screening
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Data Elements
Data collection methodology (administrative or hybrid)
Commercial
Medicare +
Choice
A
Sampling method used (see User's Guide for entry descriptions)
Eligible population
343
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
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 administrative data
180
FOBT by administrative data*
Flexible sigmoidoscopy by administrative data*
DCBE by administrative data*
Colonoscopy by administrative data*
Numerator events by medical records
FOBT by medical records*
Flexible sigmoidoscopy by medical records*
DCBE by medical records*
Colonoscopy by medical records*
Reported rate
NR
NR
Lower 95% confidence interval
NR
NR
Upper 95% confidence interval
NR
NR
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
First Plan of Minnesota
Breast Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
A
Medicare + Choice
154
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
NR
NR
NR
NR
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 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)
128
83.12%
76.88%
89.36%
NR
NR
NR
Page 8
Effectiveness of Care
First Plan of Minnesota
Cervical Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
A
270
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
82.22%
NR
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 2005 (Reporting Year 2004)
222
#VALUE!
#VALUE!
#VALUE!
Page 9
Effectiveness of Care
First Plan of Minnesota
Chlamydia Screening in Women
Data Last Refreshed:
Sep 30, 2005 11:26 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
43
30
73
0
0
0
43
12
27.91%
13.34%
42.48%
30
11
36.67%
17.76%
55.58%
73
23
31.51%
20.17%
42.85%
Page 10
Effectiveness of Care
First Plan of Minnesota
Controlling High Blood Pressure
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Data Elements
Data Collection Methodology (Hybrid)
Sampling Method Used
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Commercial
HO
N
59
0
0.00%
0
0.00%
59
0.00%
0
Records Excluded because of contraindications
through Admin Data
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)
NR
0
Records Excluded because of Valid Data Errors
Records Excluded because of contraindications
through Medical Record Review
Number of employee/dependent medical records
excluded
Medicare + Choice
NR
3
0
0
56
0
39
69.64%
56.71%
82.58%
NR
NR
NR
Page 11
Effectiveness of Care
First Plan of Minnesota
Beta Blocker Treatment after Heart Attack
Data Elements
Data Collection Methodology
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
Medicare + Choice
A
Sampling Method Used
Eligible Member Population
1
Numerator Events by Admin Data on Eligible
Population
Current Year's Admin Rate
NR
NR
NR
NR
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
1
Numerator Events by Medical Record
Reported Rate
NR
NR
Lower 95% Confidence Interval
NR
NR
Upper 95% Confidence Interval
NR
NR
HEDIS 2005 (Reporting Year 2004)
Page 12
Effectiveness of Care
First Plan of Minnesota
Cholesterol Management After Acute
Cardiovascular Events
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Medicare + Choice
Data Elements
General
Measure
Data
LDL-C
screening 60365 Days
LDL-C Level of LDL-C Level of
<100 mg/dL 60- <130 mg/dL 60365 Days
365 Days
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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
Page 13
Effectiveness of Care
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
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
3
Number of employee/dependent medical
records excluded
1
Additional Records Added from the
Oversample List
0
Upper 95% Confidence Interval
HEDIS 2005 (Reporting Year 2004)
LDL-C
Screening
LDL-C Level
<130 mg/dL
LDL-C Level
<100 mg/dL
NR
74
93.67%
70
88.61%
NR
NR
47
59.49%
67
84.81%
NR
74
93.67%
70
88.61%
NR
NR
47
59.49%
67
0
89.33%
25
33.33%
71
0
94.67%
67
0
89.33%
46
61.33%
34
45.33%
47
0
62.67%
81.68%
96.99%
22.00%
44.67%
88.91%
100.00%
81.68%
96.99%
49.65%
73.02%
33.40%
57.27%
51.05%
74.28%
79
Number of Records Excluded Because of
Valid Data Errors
Reported Rate
Lower 95% Confidence Interval
67
84.81%
Monitoring for
Diabetic
Nephropathy
Eye Exam
0
0.00%
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
N
79
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
75
Page 14
Effectiveness of Care
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Medicare + Choice
Data Elements
General
Measure Data
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
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 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 2005 (Reporting Year 2004)
Page 15
Effectiveness of Care
First Plan of Minnesota
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 30, 2005 11:26 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
3
0
3
2
NA
NA
NA
6
0
6
6
NA
NA
NA
29
0
29
22
NA
NA
NA
38
0
38
30
78.95%
64.67%
93.23%
A
Page 16
Effectiveness of Care
First Plan of Minnesota
Follow-Up After Hospitalization for Mental Illness
Data Last Refreshed:
Sep 30, 2005 11:26 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
General
Measure
Data
W/in 7 Days of W/in 30 Days of
Discharge
Discharge
A
6
6
NA
NA
NA
5
NA
NA
NA
NR
NR
NR
NR
NR
NR
Page 17
Effectiveness of Care
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Sep 30, 2005 11:26 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
2
NA
NA
NA
8
NA
NA
NA
7
NA
NA
NA
A
12
Page 18
Effectiveness of Care
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Sep 30, 2005 11:26 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 19
Effectiveness of Care
First Plan of Minnesota
Osteoporosis Management in Women Who
had a Fracture
Data Elements
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Medicare +
Choice
Data Collection Methodology
Eligible Member Population
Nonduplicated prior to bone mineral density
exclusions*
Nonduplicated prior to prescription exclusions*
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)
NR
NR
NR
Page 20
Use of Services
First Plan of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
Data Elements
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
3
3
9
4
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
A
19
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 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 2005 (Reporting Year 2004)
Page 21
Use of Services
First Plan of Minnesota
Well Child Visits in the 3rd, 4th, 5th and 6th Years
of Life
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
A
79
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
NR
NR
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 2005 (Reporting Year 2004)
51
64.56%
53.38%
75.74%
Page 22
Use of Services
First Plan of Minnesota
Adolescent Well-Care Visits
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
A
265
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
NR
NR
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 2005 (Reporting Year 2004)
91
34.34%
28.43%
40.25%
Page 23
Use of Services
First Plan of Minnesota
Frequency of Selected Procedures
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
Age
0-4
0-9
5-19
10-19
15-44
20-64
30-64
45-64
65+
Male
8556
6620
3988
108
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
1285
2614
5152
3823
6530
9605
4114
100
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
7
2
2
3
5
2
6
2
0
1
0
0
1
1
0
0
0
1
2
3
0
0
2
3
1
0
0
0
4
5
0
0
2
0
1
0
0
0
Procedures /
1,000 Member
Months
5.45
0.39
0.77
0.78
0.77
0.49
0.92
0.49
0.00
0.15
0.00
0.00
0.15
0.15
0.00
0.00
0.00
0.15
0.31
0.73
0.00
0.00
0.23
0.31
0.25
0.00
0.00
0.00
1.00
1.22
0.00
0.00
0.50
0.00
9.26
0.00
0.00
0.00
Page 24
Use of Services
First Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
65+
Unknown
Total
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Member Months
87
2527
3823
10059
8102
196
12
0
0
24806
Discharges
Discharges /
1,000 Member
Months
4
4
14
66
62
5
0
0
0
155
45.98
1.58
3.66
6.56
7.65
25.51
0.00
NA
Days
Days / 1,000
Member
Months
114.94
3.17
14.13
17.50
32.34
122.45
0.00
NA
6.25
10
8
54
176
262
24
0
0
0
534
3
4
8
15
26
3
0
0
0
59
34.48
1.58
2.09
1.49
3.21
15.31
0.00
NA
8
8
27
39
91
7
0
0
91.95
3.17
7.06
3.88
11.23
35.71
0.00
NA
2.38
180
7.26
1
0
4
21
36
2
0
0
0
64
11.49
0.00
1.05
2.09
4.44
10.20
0.00
NA
2
0
18
50
171
17
0
0
22.99
0.00
4.71
4.97
21.11
86.73
0.00
NA
2.58
258
10.40
2
30
0
0
0
32
0.52
2.98
0.00
0.00
9
87
2.35
8.65
NR
NR
1.44
96
4.33
HEDIS 2005 (Reporting Year 2004)
21.53
Average
Length of Stay
2.50
2.00
3.86
2.67
4.23
4.80
NA
NA
NA
3.45
2.67
2.00
3.38
2.60
3.50
2.33
NA
NA
NR
3.05
2.00
NA
4.50
2.38
4.75
8.50
NA
NA
NR
4.03
4.50
2.90
NR
NR
NR
3.00
Page 25
Use of Services
First Plan of Minnesota
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 11:26 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
First Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
87
2527
3823
10059
8102
196
12
0
0
24806
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
Visits
223
614
Visits/ 1,000
Member
Months
2563.22
242.98
Emergency Room Visits
Visits
12
50
Visits/ 1,000
Member
Months
137.93
19.79
Ambulatory
Surgery/Procedures
Procedures
1
2
Procedures/
1,000 Member
Months
11.49
0.79
Observation Room Stays
Resulting in Discharge
Stays
0
2
Stays/ 1,000
Member
Months
0.00
0.79
10-19
809
211.61
73
19.09
8
2.09
4
1.05
20-44
45-64
65-74
2397
2463
70
238.29
304.00
357.14
163
130
4
16.20
16.05
20.41
64
112
7
6.36
13.82
35.71
41
9
0
4.08
1.11
0.00
0
0.00
0
0.00
NR
0
0.00
0
0
6576
NA
0
0
432
NA
NR
0
0
56
NA
75-84
85+
Unknown
Total
HEDIS 2005 (Reporting Year 2004)
265.10
17.42
194
7.82
2.26
Page 27
Use of Services
First Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Medicare + Choice
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Member
Months
NR
Total
Outpatient Visits
(Excludes MH/CD)
Age
Visits
<1
1-9
Visits/ 1,000
Member
Months
NR
NR
Emergency Room Visits
Visits
Visits/ 1,000
Member
Months
NR
NR
Ambulatory
Surgery/Procedures
Procedures
Procedures/
1,000 Member
Months
NR
NR
Observation Room Stays
Resulting in Discharge
Stays
Stays/ 1,000
Member
Months
NR
NR
10-19
NR
NR
NR
NR
20-44
45-64
65-74
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
75-84
NR
NR
NR
NR
85+
Unknown
NR
NR
NR
NR
Total
NR
HEDIS 2005 (Reporting Year 2004)
NR
NR
NR
NR
NR
NR
NR
Page 28
Use of Services
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
Age
Member Months
<1
87
1-9
2527
10-19
3823
20-44
10059
45-64
8102
65-74
196
75-84
12
85+
0
Unknown
Total
0
24806
Discharges
Discharges /
1,000 Member
Months
<1
0
0.00
0
0.00
NA
1-9
0
0.00
0
0.00
NA
10-19
0
0.00
0
0.00
NA
20-44
1
0.10
1
0.10
1.00
45-64
2
0.25
20
2.47
10.00
65-74
3
15.31
80
408.16
26.67
75-84
0
0.00
0
0.00
NA
85+
0
NA
0
NA
NA
Unknown
0
6
0.24
0
101
4.07
NA
16.83
Age
Total
HEDIS 2005 (Reporting Year 2004)
Days
Days / 1,000 Average Length
Member Months
of Stay
Page 29
Use of Services
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 30, 2005 11:26 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
First Plan of Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
Age
Male
Member Months
Female
Total
0-12
13-17
18-64
65+
Unknown
Total
1899
1039
8994
108
0
12040
1764
841
10061
100
0
12766
3663
1880
19055
208
0
24806
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
1
0.96
4
4.00
F
2
2.38
11
5.50
Total
3
1.60
15
5.00
18-64
M
1
0.11
4
4.00
F
2
0.20
10
5.00
Total
3
0.16
14
4.67
M
65+
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
M
Total
2
0.17
8
4.00
F
4
0.31
21
5.25
TOTAL
6
0.24
29
4.83
* 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
First Plan of Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 30, 2005 11:26 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
First Plan of Minnesota
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 30, 2005 11:26 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
1899
1764
3663
1899
1764
3663
1899
1764
3663
1899
1764
3663
13-17
1039
841
1880
1039
841
1880
1039
841
1880
1039
841
1880
18-64
8994
10061
19055
8994
10061
19055
8994
10061
19055
8994
10061
19055
65+
108
100
208
108
100
208
108
100
208
108
100
208
0
12040
0
12766
0
24806
0
12040
0
12766
0
24806
0
12040
0
12766
0
24806
0
12040
0
12766
0
24806
Age
Unknown
Total
Age
0-12
13-17
18-64
65+
Unknown
Total
Member Months (Inpatient)
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
11
6.95%
0
0.00%
0
0.00%
11
6.95%
F
10
6.80%
0
0.00%
0
0.00%
10
6.80%
Total
21
6.88%
0
0.00%
0
0.00%
21
6.88%
M
10
11.55%
1
1.15%
0
0.00%
10
11.55%
Sex
M
F
12
17.12%
2
2.85%
0
0.00%
11
15.70%
Total
22
14.04%
3
1.91%
0
0.00%
21
13.40%
M
30
4.00%
1
0.13%
0
0.00%
30
4.00%
F
67
7.99%
2
0.24%
2
0.24%
66
7.87%
Total
97
6.11%
3
0.19%
2
0.13%
96
6.05%
M
1
11.11%
0
0.00%
0
0.00%
1
11.11%
F
0
0.00%
0
0.00%
0
0.00%
0
0.00%
Total
1
5.77%
0
0.00%
0
0.00%
1
5.77%
M
0
NA
0
NA
0
NA
0
NA
F
0
NA
0
NA
0
NA
0
NA
Total
0
NA
0
NA
0
NA
0
NA
M
52
5.18%
2
0.20%
0
0.00%
52
5.18%
F
89
141
8.37%
6.82%
4
6
0.38%
0.29%
2
2
0.19%
0.10%
87
139
8.18%
6.72%
Total
HEDIS 2005 (Reporting Year 2004)
Page 33
Use of Services
First Plan of Minnesota
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 30, 2005 11:26 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
First Plan of Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
Age
Male
Member Months
Female
Total
0-12
13-17
18-64
65+
Unknown
Total
1899
1039
8994
108
0
12040
1764
841
10061
100
0
12766
3663
1880
19055
208
0
24806
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
0
0.00
0
NA
F
1
1.19
45
45.00
Total
1
0.53
45
45.00
18-64
M
10
1.11
40
4.00
F
0
0.00
0
NA
Total
10
0.52
40
4.00
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
Total
M
10
0.83
40
4.00
F
1
0.08
45
45.00
TOTAL
11
0.44
85
7.73
* 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
First Plan of Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 30, 2005 11:26 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
First Plan of Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
Member Months (Any)
Age
Member Months (Inpatient)
Female
Male
Female
1899
1764
1899
1764
Female
1899
1764
13-17
1039
841
1880
1039
841
1880
1039
841
1880
1039
841
1880
18-64
8994
10061
19055
8994
10061
19055
8994
10061
19055
8994
10061
19055
65+
108
100
208
108
100
208
108
100
208
108
100
208
0
12040
0
12766
0
24806
0
12040
0
12766
0
24806
0
12040
0
12766
0
24806
0
12040
0
12766
0
24806
Total
1764
Male
Male
Unknown
Female
1899
Member Months (Ambulatory)
0-12
Total
3663
Male
Member Months (Day/Night)
Total
3663
Total
3663
Total
3663
Any Chemical Dependency
Services
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
Number
0
Percent
0.00%
Number
0
Percent
0.00%
Number
0
Percent
0.00%
0
Percent
0.00%
0
0
0.00%
0.00%
0
0
0.00%
0.00%
0
0
0.00%
0.00%
0
0
0.00%
0.00%
0
0.00%
0
0.00%
0
0.00%
0
0.00%
Total
M
2
2
2.85%
1.28%
1
1
1.43%
0.64%
0
0
0.00%
0.00%
1
1
1.43%
0.64%
11
1.47%
3
0.40%
0
0.00%
11
1.47%
F
Total
2
13
0.24%
0.82%
0
3
0.00%
0.19%
0
0
0.00%
0.00%
2
13
0.24%
0.82%
0
0
0.00%
0.00%
0
0
0.00%
0.00%
0
0
0.00%
0.00%
0
0
0.00%
0.00%
Unknown
M
F
Total
M
0.00%
NA
NA
0
0
0
0.00%
NA
NA
0
0
0
0.00%
NA
NA
0
0
0
0.00%
NA
NA
Total
F
Total
M
0
0
0
0
11
4
15
NA
1.10%
0.38%
0.73%
0
3
1
4
NA
0.30%
0.09%
0.19%
0
0
0
0
NA
0.00%
0.00%
0.00%
0
11
3
14
NA
1.10%
0.28%
0.68%
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
First Plan of Minnesota
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Sep 30, 2005 11:26 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
First Plan of Minnesota
Outpatient Drug Utilization
Commercial
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Member Months
2614
3823
10059
8102
196
12
0
0
24806
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
$27,727.62
$76,561.67
$636,081.99
$750,135.93
$44,170.99
$0.00
$0.00
$0.00
$1,534,678.20
A
Avg. Cost of
Prescriptions /
Per Member Per
Month
$10.61
$20.03
$63.24
$92.59
$225.36
$0.00
NA
$61.87
Total Number of
Prescriptions
619
1417
8412
14369
383
0
0
0
25200
Avg. Num. Of
Prescriptions /
Per Member Per
Year
2.84
4.45
10.04
21.28
23.45
0.00
NA
12.19
Page 39
Use of Services
First Plan of Minnesota
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 11:26 AM
Member Months
NR
Specification Documentation:
Prescription is defined as (Enter "A"
or "B"):
Age
Total Cost of
Prescriptions
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
HEDIS 2005 (Reporting Year 2004)
NR
Avg. Cost of
Prescriptions /
Per Member Per
Month
NR
NR
NR
NR
NR
NR
NR
NR
Total Number of
Prescriptions
NR
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NR
NR
NR
NR
NR
NR
NR
NR
Page 40
Access/Availability of Care
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 30, 2005 11:26 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+
438
504
13
422
481
13
96.35%
94.48%
98.22%
95.44%
93.52%
97.36%
NA
NA
NA
A
Page 41
Access/Availability of Care
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Medicare + Choice
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
NR
NR
NR
NR
NR
NR
NR
NR
NR
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)
Page 42
Access/Availability of Care
First Plan of Minnesota
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Sep 30, 2005 11:26 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.
25
101
101
212
24
87
92
185
NA
NA
NA
86.14%
78.90%
93.37%
91.09%
85.04%
97.14%
87.26%
82.54%
91.99%
Page 43
Access/Availability of Care
First Plan of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Commercial
General Measure
Data
Data collection methodology (Administrative or Hybrid)
Timeliness of
Prenatal Care
Postpartum Care
79.31%
82.76%
NR
NR
23
24
NR
NR
NR
NR
NR
NR
A
Sampling method used (see User's Guide for entry descriptions)
Eligible member population (i.e. members who meet all
denominator criteria)
29
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
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)
Page 44
Access/Availability of Care
First Plan of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Sep 30, 2005 11:26 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
4
1
10
0
15
3
1
0
0
4
1
0
0
7
2
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Page 45
Access/Availability of Care
First Plan of Minnesota
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Medicare + Choice
18-25 Year Olds
Data Elements
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
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)
NR
NR
NR
NR
NR
NR
NR
NR
NR
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
Health Plan Stability
First Plan of Minnesota
Practitioner Turnover
Medicare + Choice
Practitioner Types
Data Last Refreshed:
Sep 30, 2005 11:26 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
NR
Non-Physician Primary
Care Practitioners
HEDIS 2005 (Reporting Year 2004)
NR
Page 47
Health Plan Stability
First Plan of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Medicare + Choice
Product/Product Line
HMO (Total)
Years in Business
NR
Members*
NR
NR
NR
NR
NR
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
NR
* Total number of members in each category as of December 31, 2004
HEDIS 2005 (Reporting Year 2004)
Page 48
Health Plan Descriptive Information
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 30, 2005 11:26 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
36
672
636
936
660
432
Member Months
Female
60
528
684
744
588
456
Total
96
1200
1320
1680
1248
888
3372
28.02%
972
960
828
720
1080
3060
23.99%
792
1272
1068
1152
1200
6432
25.94%
4560
37.89%
1416
1140
888
552
5484
42.99%
1440
1284
1008
384
10044
40.51%
3996
33.20%
72
24
0
12
0
0
4116
32.27%
96
0
0
0
0
0
8112
32.72%
108
0.90%
0
96
0.75%
0
204
0.82%
12036
12756
HEDIS 2005 (Reporting Year 2004)
1764
2232
1896
1872
2280
2856
2424
1896
936
168
24
0
12
0
0
0
24792
Page 49
Health Plan Descriptive Information
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 30, 2005 11:26 AM
Medicare + Choice
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
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2005 (Reporting Year 2004)
NR
NR
NR
NR
NR
NR
NR
Page 50