Blue Plus (HMO Minnesota)
Plan Name
2004
Reporting Year
General Info
Submission #
1
Last Refreshed:
8
9/30/2005 11:21:42 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
Blue Plus (HMO Minnesota)
Childhood Immunization Status
Data Last Refreshed:
Sep 30, 2005 11:21 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
1430
62.45%
1541
67.29%
2004
87.51%
1499
65.46%
1411
61.62%
1814
79.21%
1128
49.26%
1048
45.76%
239
62.73%
237
62.20%
337
88.45%
231
60.63%
217
56.96%
291
76.38%
168
44.09%
154
40.42%
214
223
295
216
213
262
172
160
84
87
11
77
88
20
98
96
88.96%
85.45%
92.46%
92.54%
89.57%
95.50%
91.34%
88.18%
94.50%
87.46%
83.77%
91.16%
89.85%
86.47%
93.23%
84.18%
80.12%
88.24%
80.60%
76.21%
84.98%
76.42%
71.72%
81.11%
381
0
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
MMR
335
13.73%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
IPV/OPV
HO
S
2290
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
DTaP/DT
335
Page 3
Effectiveness of Care
Blue Plus (HMO Minnesota)
Adolescent Immunization Status
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
Data Elements
General
Measure
Data
MMR
Hepatitis B
VZV
Combo 1
Combo 2
1575
682
124
543
27
47.60%
20.61%
3.75%
16.41%
0.82%
238
107
20
87
5
51.52%
23.16%
4.33%
18.83%
1.08%
Numerator Events by Admin Data
163
70
28
45
12
Numerator Events by Medical Record
Data Collection Methodology
Sampling Method Used
Eligible Member Population
HO
S
3309
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
411
12.40%
462
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
195
238
111
263
106
Reported Rate
87.10%
74.94%
33.82%
74.94%
28.71%
Lower 95% Confidence Interval
Upper 95% Confidence Interval
83.74%
90.47%
70.63%
79.25%
29.12%
38.52%
70.63%
79.25%
24.21%
33.21%
HEDIS 2005 (Reporting Year 2004)
Page 4
Effectiveness of Care
Blue Plus (HMO Minnesota)
Appropriate Treatment for Children with Upper
Respiratory Infection
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
Member Months
Age
<1
31603
1-4
130082
5-9
178553
10-14
207899
15-17
136936
685073
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
3626
3530
96
504
495
9
Reported Rate
86.10%
Lower 95% Confidence Interval
84.96%
Upper 95% Confidence Interval
87.24%
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
Blue Plus (HMO Minnesota)
Appropriate Testing for Children with Pharyngitis
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
Data Elements
Data Collection Methodology
General
Measure
Data
A
Eligible Member Population
3374
Eligible population by non-ER/Urgent Care
Visits*
3287
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*
87
2919
2847
72
Reported Rate
86.51%
Lower 95% Confidence Interval
85.35%
Upper 95% Confidence Interval
87.68%
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
Blue Plus (HMO Minnesota)
Colorectal Cancer Screening
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Data Elements
Data collection methodology (administrative or hybrid)
Sampling method used (see User's Guide for entry descriptions)
Commercial
HO
S
Eligible population
43346
Number of numerator events by administrative data in eligible population (before exclusions)
20059
Current year's administrative rate (before exclusions)
46.28%
Minimum required sample size (MRSS) or other sample size
407
Oversampling rate
0.1
Final sample size (FSS)
448
Number of numerator events by administrative data in FSS
232
Administrative rate on FSS
Medicare +
Choice
51.79%
Number of original sample records excluded because of valid data errors
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
232
Denominator
407
Numerator events by administrative data
214
NR
NR
FOBT by administrative data*
Flexible sigmoidoscopy by administrative data*
DCBE by administrative data*
Colonoscopy by administrative data*
Numerator events by medical records
28
FOBT by medical records*
Flexible sigmoidoscopy by medical records*
DCBE by medical records*
Colonoscopy by medical records*
Reported rate
59.46%
NR
Lower 95% confidence interval
54.57%
NR
Upper 95% confidence interval
64.35%
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
Blue Plus (HMO Minnesota)
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 11:21 AM
Commercial
HO
S
19709
15088
76.55%
270
5.00%
284
216
76.06%
0
Records Excluded because of contraindications
through Admin data
0
Records Excluded because of contraindications
through Medical Record Review
2
Number of employee/dependent medical records
excluded
0
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)
Medicare + Choice
2
270
208
1
77.41%
72.23%
82.58%
NR
NR
NR
NR
NR
Page 8
Effectiveness of Care
Blue Plus (HMO Minnesota)
Cervical Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
HO
S
52561
Numerator Events by Admin Data on Eligible
Population (before exclusions)
41066
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
78.13%
196
10.00%
216
167
77.31%
0
Records Excluded because of contraindications
through Admin Data
0
Records Excluded because of contraindications
through Medical Record Review
6
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)
6
196
155
5
81.63%
75.96%
87.31%
Page 9
Effectiveness of Care
Blue Plus (HMO Minnesota)
Chlamydia Screening in Women
Data Last Refreshed:
Sep 30, 2005 11:21 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
3440
3514
6954
0
0
0
3440
814
23.66%
22.23%
25.10%
3514
778
22.14%
20.75%
23.53%
6954
1592
22.89%
21.90%
23.89%
Page 10
Effectiveness of Care
Blue Plus (HMO Minnesota)
Controlling High Blood Pressure
Data Last Refreshed:
Sep 30, 2005 11:21 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
S
8557
0
0.00%
395
16.96%
462
0.00%
27
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
0
0
27
395
0
277
70.13%
65.49%
74.77%
NR
NR
NR
Page 11
Effectiveness of Care
Blue Plus (HMO Minnesota)
Beta Blocker Treatment after Heart Attack
Data Elements
Data Collection Methodology
Sampling Method Used
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
HO
N
Eligible Member Population
148
Numerator Events by Admin Data on Eligible
Population
125
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
84.46%
NR
148
0.00%
Final Sample Size (FSS)
148
Numerator events by admin data in FSS
125
Admin rate on FSS
Medicare + Choice
84.46%
Records Excluded because of Valid Data
Errors
1
Records Excluded because of
contraindications through Admin Data
0
Records Excluded because of
contraindications through Medical Record
Review
2
Number of employee/dependent medical
records excluded
0
Records Added from the Oversample List
0
Denominator
145
Numerator Events by Admin Data
125
Numerator Events by Medical Record
14
NR
Reported Rate
95.86%
NR
Lower 95% Confidence Interval
92.28%
NR
Upper 95% Confidence Interval
99.45%
NR
HEDIS 2005 (Reporting Year 2004)
Page 12
Effectiveness of Care
Blue Plus (HMO Minnesota)
Cholesterol Management After Acute
Cardiovascular Events
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 30, 2005 11:21 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
0
Additional Records Added from the
Oversample List
3
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
5650
85.68%
0
0.00%
3617
54.85%
5811
88.13%
0
0.00%
0
0.00%
3638
55.17%
419
88.96%
0
0.00%
266
56.48%
431
91.51%
0
0.00%
0
0.00%
264
56.05%
351
32
93.19%
0
85
20.68%
207
24
56.20%
375
25
97.32%
0
276
67.15%
0
144
35.04%
232
21
61.56%
90.63%
95.74%
16.64%
24.72%
51.29%
61.12%
95.64%
99.01%
62.49%
71.82%
30.30%
39.77%
56.73%
66.38%
471
Number of Records Excluded Because of
Valid Data Errors
Reported Rate
Lower 95% Confidence Interval
Eye Exam
411
14.59%
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
6594
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
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 30, 2005 11:21 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
313
0
313
254
81.15%
76.66%
85.64%
587
0
587
461
78.53%
75.13%
81.94%
2288
0
2288
1787
78.10%
76.39%
79.82%
3188
0
3188
2502
78.48%
77.04%
79.92%
A
Page 16
Effectiveness of Care
Blue Plus (HMO Minnesota)
Follow-Up After Hospitalization for Mental Illness
Data Last Refreshed:
Sep 30, 2005 11:21 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
431
233
54.06%
49.24%
58.88%
360
83.53%
79.91%
87.14%
NR
NR
NR
NR
NR
NR
Page 17
Effectiveness of Care
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Sep 30, 2005 11:21 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
244
15.05%
13.28%
16.82%
1128
69.59%
67.32%
71.86%
858
52.93%
50.47%
55.39%
A
1621
Page 18
Effectiveness of Care
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Osteoporosis Management in Women Who
had a Fracture
Data Elements
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 30, 2005 11:21 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
22
22
24
46
101
410
1523
1.02%
0.58%
1.47%
1.02%
0.58%
1.47%
1.12%
0.65%
1.59%
2.14%
1.51%
2.78%
4.70%
3.78%
5.62%
19.09%
17.40%
20.77%
70.90%
68.96%
72.85%
A
2148
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
Blue Plus (HMO 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 11:21 AM
Commercial
A
10103
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)
5818
57.59%
56.62%
58.56%
Page 22
Use of Services
Blue Plus (HMO Minnesota)
Adolescent Well-Care Visits
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
A
32204
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)
9777
30.36%
29.86%
30.86%
Page 23
Use of Services
Blue Plus (HMO Minnesota)
Frequency of Selected Procedures
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
Age
0-4
0-9
5-19
10-19
15-44
20-64
30-64
45-64
65+
Male
858289
724685
430599
15197
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
166733
352058
635100
449775
614878
964840
464149
9148
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
516
148
288
136
158
223
152
209
4
138
159
2
23
34
48
0
1
151
201
215
9
6
253
241
312
90
20
2
355
200
22
10
69
15
10
3
110
8
Procedures /
1,000 Member
Months
3.09
0.23
0.82
0.30
0.26
0.48
0.25
0.45
0.44
0.22
0.34
0.22
0.03
0.06
0.10
0.00
0.11
0.21
0.33
0.46
0.59
0.66
0.29
0.25
0.72
0.19
1.32
0.22
0.82
0.43
1.45
1.09
0.16
0.03
0.66
0.33
0.26
0.53
Page 24
Use of Services
Blue Plus (HMO 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 11:21 AM
Member Months
32402
319656
449775
928381
894748
22685
1460
200
0
2649307
Discharges
Discharges /
1,000 Member
Months
398
577
802
5810
6738
402
49
5
0
14781
12.28
1.81
1.78
6.26
7.53
17.72
33.56
25.00
304
392
358
1167
3262
238
32
3
0
5756
9.38
1.23
0.80
1.26
3.65
10.49
21.92
15.00
94
185
339
1647
3470
164
17
2
0
5918
2.90
0.58
0.75
1.77
3.88
7.23
11.64
10.00
105
2996
6
0
0
3107
0.23
3.23
0.01
0.00
HEDIS 2005 (Reporting Year 2004)
5.58
2.17
2.23
1.35
Days
Days / 1,000
Member
Months
3254
1491
2509
16252
23884
1677
312
51
0
49430
100.43
4.66
5.58
17.51
26.69
73.93
213.70
255.00
2184
831
1025
3212
9791
895
156
13
0
18107
67.40
2.60
2.28
3.46
10.94
39.45
106.85
65.00
1070
660
1158
4956
14078
782
156
38
0
22898
33.02
2.06
2.57
5.34
15.73
34.47
106.85
190.00
326
8084
15
0
0
8425
0.72
8.71
0.02
0.00
18.66
6.83
8.64
3.67
Average
Length of Stay
8.18
2.58
3.13
2.80
3.54
4.17
6.37
10.20
NA
3.34
7.18
2.12
2.86
2.75
3.00
3.76
4.88
4.33
NA
3.15
11.38
3.57
3.42
3.01
4.06
4.77
9.18
19.00
NA
3.87
3.10
2.70
2.50
NA
NA
2.71
Page 25
Use of Services
Blue Plus (HMO 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 11:21 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
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
32402
319656
449775
928381
894748
22685
1460
200
0
2649307
Outpatient Visits
(Excludes MH/CD)
Emergency Room Visits
Ambulatory
Surgery/Procedures
Observation Room Stays
Resulting in Discharge
Stays
52
142
Stays/ 1,000
Member
Months
1.60
0.44
2.90
176
0.39
6.96
17.02
25.88
1212
747
51
1.31
0.83
2.25
Visits
29351
88085
Visits/ 1,000
Member
Months
905.84
275.56
10-19
94504
210.11
5384
11.97
1304
20-44
45-64
65-74
233840
307383
11158
251.88
343.54
491.87
11198
9072
292
12.06
10.14
12.87
6461
15226
587
75-84
917
628.08
43
29.45
37
25.34
1
0.68
64
0
765302
320.00
4
0
32330
20.00
1
0
25304
5.00
0
0
2381
0.00
Age
<1
1-9
85+
Unknown
Total
HEDIS 2005 (Reporting Year 2004)
288.87
Visits
1087
5250
Visits/ 1,000
Member
Months
33.55
16.42
Procedures
234
1454
Procedures/
1,000 Member
Months
7.22
4.55
12.20
9.55
0.90
Page 27
Use of Services
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
Age
Member Months
<1
32402
1-9
319656
10-19
449775
20-44
928381
45-64
894748
65-74
22685
75-84
1460
85+
200
Unknown
Total
0
2649307
Discharges
Discharges /
1,000 Member
Months
<1
0
0.00
0
0.00
NA
1-9
1
0.00
15
0.05
15.00
10-19
24
0.05
474
1.05
19.75
20-44
55
0.06
702
0.76
12.76
45-64
366
0.41
5215
5.83
14.25
65-74
66
2.91
1155
50.91
17.50
75-84
20
13.70
309
211.64
15.45
85+
0
0.00
0
0.00
NA
0.20
0
7870
2.97
NA
14.79
Age
Unknown
Total
HEDIS 2005 (Reporting Year 2004)
0
532
Days
Days / 1,000 Average Length
Member Months
of Stay
Page 29
Use of Services
Blue Plus (HMO Minnesota)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
Male
Member Months
Female
Total
246087
120558
903295
15197
0
1285137
230989
115708
1008325
9148
0
1364170
477076
236266
1911620
24345
0
2649307
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
62
0.25
969
15.63
F
12
0.05
121
10.08
Total
74
0.16
1090
14.73
13-17
M
151
1.25
2535
16.79
F
174
1.50
1951
11.21
Total
325
1.38
4486
13.80
18-64
M
210
0.23
1547
7.37
F
323
0.32
2787
8.63
Total
533
0.28
4334
8.13
M
65+
1
0.07
1
1.00
F
5
0.55
51
10.20
Total
6
0.25
52
8.67
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
M
Total
424
0.33
5052
11.92
F
514
0.38
4910
9.55
TOTAL
938
0.35
9962
10.62
* 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
Blue Plus (HMO Minnesota)
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 30, 2005 11:21 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
246087
230989
477076
246087
230989
477076
246087
230989
477076
246087
230989
477076
13-17
120558
115708
236266
120558
115708
236266
120558
115708
236266
120558
115708
236266
18-64
903295
1008325
1911620
903295
1008325
1911620
903295
1008325
1911620
903295
1008325
1911620
65+
15197
9148
24345
15197
9148
24345
15197
9148
24345
15197
9148
24345
0
1285137
0
1364170
0
2649307
0
1285137
0
1364170
0
2649307
0
1285137
0
1364170
0
2649307
0
1285137
0
1364170
0
2649307
Age
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
1260
6.14%
20
0.10%
10
0.05%
1257
6.13%
F
719
3.74%
12
0.06%
3
0.02%
717
3.72%
Total
1979
4.98%
32
0.08%
13
0.03%
1974
4.97%
M
1153
11.48%
58
0.58%
19
0.19%
1144
11.39%
Sex
M
F
1314
13.63%
106
1.10%
33
0.34%
1304
13.52%
Total
2467
12.53%
164
0.83%
52
0.26%
2448
12.43%
M
4734
6.29%
175
0.23%
35
0.05%
4694
6.24%
F
8888
10.58%
240
0.29%
87
0.10%
8852
10.53%
Total
13622
8.55%
415
0.26%
122
0.08%
13546
8.50%
41
3.24%
2
0.16%
0
0.00%
40
3.16%
M
F
29
3.80%
4
0.52%
0
0.00%
26
3.41%
Total
70
3.45%
6
0.30%
0
0.00%
66
3.25%
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
7188
6.71%
255
0.24%
64
0.06%
7135
6.66%
F
10950
18138
9.63%
8.22%
362
617
0.32%
0.28%
123
187
0.11%
0.08%
10899
18034
9.59%
8.17%
Total
HEDIS 2005 (Reporting Year 2004)
Page 33
Use of Services
Blue Plus (HMO Minnesota)
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
Male
Member Months
Female
Total
246087
120558
903295
15197
0
1285137
230989
115708
1008325
9148
0
1364170
477076
236266
1911620
24345
0
2649307
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
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
13-17
M
96
0.80
1658
17.27
F
49
0.42
859
17.53
Total
145
0.61
2517
17.36
18-64
M
253
0.28
2915
11.52
F
158
0.16
1790
11.33
Total
411
0.22
4705
11.45
65+
M
1
0.07
18
18.00
F
0
0.00
0
NA
Total
1
0.04
18
18.00
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
350
0.27
4591
13.12
F
207
0.15
2649
12.80
TOTAL
557
0.21
7240
13.00
* 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
Blue Plus (HMO Minnesota)
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
Member Months (Any)
Age
Male
Female
0-12
246087
230989
13-17
120558
18-64
903295
65+
15197
0
1285137
Unknown
Total
Member Months (Inpatient)
Total
477076
Male
Female
246087
230989
115708
236266
120558
1008325
1911620
903295
9148
24345
15197
0
1364170
0
2649307
0
1285137
Member Months (Day/Night)
Total
477076
Male
Female
246087
230989
115708
236266
120558
1008325
1911620
903295
9148
24345
15197
0
1364170
0
2649307
0
1285137
Member Months (Ambulatory)
Total
477076
Male
Female
246087
230989
115708
236266
120558
115708
236266
1008325
1911620
903295
1008325
1911620
9148
24345
15197
9148
24345
0
1364170
0
2649307
0
1285137
0
1364170
0
2649307
Total
477076
Any Chemical Dependency
Services
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
Number
0
Percent
0.00%
Number
1
Percent
0.00%
Number
3
Percent
0.01%
2
Percent
0.01%
0
3
0.00%
0.01%
0
1
0.00%
0.00%
0
0
0.00%
0.00%
0
2
0.00%
0.01%
254
2.53%
75
0.75%
2
0.02%
234
2.33%
Total
M
146
400
1.51%
2.03%
54
129
0.56%
0.66%
0
2
0.00%
0.01%
130
364
1.35%
1.85%
1353
1.80%
359
0.48%
10
0.01%
1182
1.57%
F
Total
762
2115
0.91%
1.33%
214
573
0.25%
0.36%
16
26
0.02%
0.02%
667
1849
0.79%
1.16%
12
2
0.95%
0.26%
5
2
0.39%
0.26%
0
0
0.00%
0.00%
10
0
0.79%
0.00%
Unknown
M
F
Total
M
0.69%
NA
NA
7
0
0
0.35%
NA
NA
0
0
0
0.00%
NA
NA
10
0
0
0.49%
NA
NA
Total
F
Total
M
14
0
0
0
1622
910
2532
NA
1.51%
0.80%
1.15%
0
440
270
710
NA
0.41%
0.24%
0.32%
0
12
16
28
NA
0.01%
0.01%
0.01%
0
1428
797
2225
NA
1.33%
0.70%
1.01%
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
Blue Plus (HMO Minnesota)
Identification of Alcohol and Other Drug Services
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Outpatient Drug Utilization
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member Months
340238
427756
895287
825262
21697
1325
150
0
2511715
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
$4,955,346.71
$10,017,603.29
$33,564,791.52
$72,389,775.39
$2,716,220.16
$214,576.94
$11,822.69
$578.86
$123,870,715.56
HEDIS 2005 (Reporting Year 2004)
A
Avg. Cost of
Prescriptions /
Per Member Per
Month
$14.56
$23.42
$37.49
$87.72
$125.19
$161.94
$78.82
$49.32
Total Number of
Prescriptions
75759
129120
489665
1069068
98256
27439
4998
2
1894307
Avg. Num. Of
Prescriptions /
Per Member Per
Year
2.67
3.62
6.56
15.55
54.34
248.50
399.84
9.05
Page 39
Use of Services
Blue Plus (HMO 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 11:21 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
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 30, 2005 11:21 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+
43921
58400
1761
41796
56301
1682
95.16%
94.96%
95.36%
96.41%
96.25%
96.56%
95.51%
94.52%
96.51%
A
Page 41
Access/Availability of Care
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Children's and Adolescents' Access to Primary Care Practitioners
Data Last Refreshed:
Sep 30, 2005 11:21 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.
2551
12240
12313
24454
2514
10854
10928
22168
98.55%
98.07%
99.03%
88.68%
88.11%
89.24%
88.75%
88.19%
89.31%
90.65%
90.28%
91.02%
Page 43
Access/Availability of Care
Blue Plus (HMO Minnesota)
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 30, 2005 11:21 AM
Commercial
General Measure
Data
Timeliness of
Prenatal Care
Postpartum Care
Number of numerator events by administrative data in
eligible population (before exclusions)
909
1648
Current year's administrative rate (before exclusions)
35.27%
63.95%
97
184
34.15%
64.79%
95
160
175
33
94.44%
91.53%
97.36%
77.04%
71.83%
82.24%
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
2577
Minimum required sample size (MRSS) or other sample size
270
Oversampling rate
Final sample size (FSS)
5%
284
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of
valid data errors
1
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)
1
270
Page 44
Access/Availability of Care
Blue Plus (HMO Minnesota)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Sep 30, 2005 11:21 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
284
136
890
10
1320
99
16
36
8
275
51
3
0
413
75
34.86%
29.14%
40.58%
5.63%
2.78%
8.49%
26.47%
18.69%
34.25%
5.88%
1.56%
10.20%
30.90%
27.81%
33.99%
5.73%
4.15%
7.31%
NA
NA
NA
NA
NA
NA
31.29%
28.75%
33.83%
5.68%
4.40%
6.97%
Page 45
Access/Availability of Care
Blue Plus (HMO Minnesota)
Initiation/Engagement of Alcohol & Other Drug Dependence Treatment
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Practitioner Turnover
Medicare + Choice
Practitioner Types
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Years in Business / Total Membership
Data Last Refreshed:
Sep 30, 2005 11:21 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
Blue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 30, 2005 11:21 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
16596
69576
95436
111504
73524
45012
Member Months
Female
15804
64752
89892
105552
70704
43488
Total
32400
134328
185328
217056
144228
88500
411648
32.03%
72012
61584
79752
97044
117300
390192
28.60%
84168
75648
92436
109452
138984
801840
30.27%
427692
33.28%
128544
127716
105792
68544
500688
36.70%
147480
141096
107244
68328
928380
35.04%
430596
33.51%
11796
2340
756
180
60
60
464148
34.02%
7140
1416
420
108
24
48
894744
33.77%
15192
1.18%
0
9156
0.67%
0
24348
0.92%
1285128
1364184
HEDIS 2005 (Reporting Year 2004)
156180
137232
172188
206496
256284
276024
268812
213036
136872
18936
3756
1176
288
84
108
0
2649312
Page 49
Health Plan Descriptive Information
Blue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 30, 2005 11:21 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