UCare Minnesota
Plan Name
2003
Reporting Year
General Info
Submission #
1
Last Refreshed:
17
9/1/2004 4:20:33 PM
Page
Title
Disclaimers
Effectiveness of
Care Measures
Plan ID
2
Access / Availability
of Care
Page
Measure
Page
Childhood Immunization Rate
3
Adults' Access to Preventive/Ambulatory Health Services
55
Adolescent Immunization Rate
6
Children's Access to Primary Care Practitioners
59
Breast Cancer Screening
9
Prenatal and Postpartum Care
61
Cervical Cancer Screening
10
Chlamydia Screening in Women
11
Controlling High Blood Pressure
12
Beta Blocker Treatment after a Heart Attack
13
Cholesterol Management
14
Comprehensive Diabetes Care
15
Practitioner Turnover
63
Appropriate Medications for People with Asthma
20
Years in Business / Total Membership
65
Follow-up After Hospitalization For Mental Illness
22
Antidepressant Medication Management
23
Measure
Use of Services
Measures
Measure
Health Plan Stability
Measure
Page
Health Plan
Descriptive
Information
Measure
Page
Page
Well-Child Visits In The First 15 Months of Life
27
Board Certification / Residency Completion
67
Well-Child Visits In The Third, Fourth, Fifth And Sixth Year of Life
29
Total Enrollment by Percentage
68
Adolescent Well-Care Visits
30
Enrollment by Product Line (Age & Sex)
69
Inpatient Utilization - General Hospital/Acute Care
31
Ambulatory Care
35
Inpatient Utilization - Nonacute Care
38
Mental Health Utilization - Inpatient Discharges and Average Length of Stay
41
Mental Health Utilization - Percentage of Members Receiving Inpatient and Ambulatory Services
44
Chemical Dependency Utilization - Inpatient Discharges and Average Length of Stay
47
Chemical Dependency Utilization - Percentage of Members Receiving Inpatient and Ambulatory Services
50
Outpatient Drug Utilization
53
HEDIS 2004 (Reporting Year 2003)
DISCLAIMERS
-1
0. Disclaimer Query located below
1. For this reporting period, DHS has waived the reporting by all Managed Care Organizations (MCOs)
of all HEDIS measures for the distinct MNCare and GAMC populations.
2. For BCBS, Medica, MHP and UCare (Community Measurement Project "CMP") participants: three
Effectiveness of Care measures (Childhood Immunization Status, Adolescent Immunization Status
and Comprehensive Diabetes Care) are reported under the category "Medicaid." For 2003 data
reported in 2004 only, "Medicaid" results are based on the combined PMAP, MNCare and GAMC
populations but do not include MSHO.
3. Although HealthPartners participates in the CMP, it has reported all 14 Effectiveness of Care
measures for its PMAP population only.
4. All MCOs that do not participate in the CMP reported commercial, PMAP, MSHO and
Medicare+Choice measures.
HEDIS 2004 (Reporting Year 2003)
Page 2
Effectiveness of Care
UCare Minnesota
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Data Elements
General
Measure
Data
DTaP/DT
IPV/OPV
MMR
HiB
Hepatitis B
VZV
Combo 1
Combo 2
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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
Number of Records Excluded because of
Contraindications by Admin Data
Number of Records Excluded because of
Contraindications by Medical Record
Review
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 3
Effectiveness of Care
UCare Minnesota
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 4:20 PM
PMAP
Data Elements
General
Measure
Data
DTaP/DT
IPV/OPV
MMR
HiB
Hepatitis B
VZV
Combo 1
Combo 2
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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
Number of Records Excluded because of
Contraindications by Admin Data
Number of Records Excluded because of
Contraindications by Medical Record
Review
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 4
Effectiveness of Care
UCare Minnesota
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Medicaid
Data Elements
General
Measure
Data
DTaP/DT
IPV/OPV
MMR
HiB
Hepatitis B
VZV
Combo 1
Combo 2
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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
Number of Records Excluded because of
Contraindications by Admin Data
Number of Records Excluded because of
Contraindications by Medical Record
Review
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 5
Effectiveness of Care
UCare Minnesota
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Data Elements
General
Measure
Data
MMR
Hepatitis B
VZV
Combo 1
Combo 2
NR
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
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of Records Excluded because of
Contraindications by Admin Data
Number of Records Excluded because of
Contraindications by Medical Record
Review
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 6
Effectiveness of Care
UCare Minnesota
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 4:20 PM
PMAP
Data Elements
General
Measure
Data
MMR
Hepatitis B
VZV
Combo 1
Combo 2
NR
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
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of Records Excluded because of
Contraindications by Admin Data
Number of Records Excluded because of
Contraindications by Medical Record
Review
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 7
Effectiveness of Care
UCare Minnesota
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Medicaid
Data Elements
General
Measure
Data
MMR
Hepatitis B
VZV
Combo 1
Combo 2
NR
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
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of Records Excluded because of
Contraindications by Admin Data
Number of Records Excluded because of
Contraindications by Medical Record
Review
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 8
Effectiveness of Care
UCare Minnesota
Breast Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Medicare + Choice
A
1401
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
78.59%
NR
NR
Records Excluded because of contraindications
through Admin data
0
Records Excluded because of contraindications
through Medical Record Review
Number of employee/dependent medical records
excluded
Records Added from Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
1401
1101
NR
NR
NR
78.59%
76.40%
80.77%
Page 9
Effectiveness of Care
UCare Minnesota
Cervical Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
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
PMAP
HO
S
4405
2847
NR
NR
64.63%
411
10.00%
453
303
66.89%
0
Records Excluded because of contraindications
through Admin data
0
Records Excluded because of contraindications
through Medical Record Review
0
Number of employee/dependent medical records
excluded
0
Records Added from Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
NR
NR
NR
0
411
274
46
77.86%
73.72%
81.99%
Page 10
Effectiveness of Care
UCare Minnesota
Chlamydia Screening in Women
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Data Elements
Data Collection Methodology
Eligible Member Population
Current Year's Admin Rate (before exclusions)
General
Measure Ages 16-20 Ages 21-25
Data
PMAP
Total
General
Measure Ages 16-20 Ages 21-25
Data
Total
A
NR
NR
807
56.88%
983
49.64%
1790
52.91%
Records Excluded - Contraindications/Admin
Data
NR
0
0
0
Denominator
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NR
NR
NR
NR
NR
807
459
56.88%
53.40%
60.36%
983
488
49.64%
46.47%
52.82%
1790
947
52.91%
50.56%
55.25%
HEDIS 2004 (Reporting Year 2003)
NR
NR
NR
NR
NR
NR
NR
NR
Page 11
Effectiveness of Care
UCare Minnesota
Controlling High Blood Pressure
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Data Elements
Data Collection Methodology (Hybrid)
Sampling Method Used
Eligible Member Population
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Records Excluded because of Valid Data Errors
Records Excluded - False positive diagnosis
Medicare + Choice
HO
S
5696
411
5.00%
432
2
0
MSHO
HO
S
404
411
5.00%
392
3
0
Records Excluded because of ESRD or non-acute
admission identified by Admin Data
0
0
Records Excluded because of ESRD or non-acute
admission identified by Medical Record
0
0
Number of employee/dependent medical records
excluded
0
0
2
411
236
57.42%
52.52%
62.32%
0
389
257
66.07%
61.23%
70.90%
Records Added from Auxiliary List
Denominator
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Commercial
NR
NR
NR
Page 12
Effectiveness of Care
UCare Minnesota
Beta Blocker Treatment after Heart Attack
Data Elements
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Data Collection Methodology
Medicare + Choice
HO
Sampling Method Used
S
Eligible Member Population
164
Numerator Events by Admin Data on
Eligible Population
119
Current Year's Admin Rate
NR
Minimum Required Sample Size
411
Oversampling Rate
5.00%
Final Sample Size (FSS)
160
Numerator events by admin data in FSS
Admin rate on FSS
72.56%
116
NR
72.50%
Records Excluded because of Valid Data
Errors
2
Records Excluded Contraindications/Admin Data
0
Records Excluded Contraindications/Medical Record Review
4
Number of employee/dependent medical
records excluded
0
Records Added from Auxiliary List
0
Denominator
153
Numerator Events by Admin Data
116
Numerator Events by Medical Record
21
Reported Rate
NR
89.54%
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NR
84.37%
NR
94.72%
HEDIS 2004 (Reporting Year 2003)
Page 13
Effectiveness of Care
UCare Minnesota
Cholesterol Management After Acute Cardiovascular Events
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Data Elements
General
Measure
Data
Medicare + Choice
LDL-C
LDL-C Level of
screening 60- <130 mg/dL 60365 Days
365 Days
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
HO
S
135
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
0
Number of employee/dependent medical
records excluded
0
HEDIS 2004 (Reporting Year 2003)
102
8
75.56%
5.93%
102
8
75.56%
5.93%
102
4
8
86
78.52%
71.22%
85.82%
69.63%
61.50%
77.76%
411
5.00%
135
Records Excluded because of Valid Data
Errors
Records Added from Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
LDL-C
LDL-C Level of
screening 60- <130 mg/dL 60365 Days
365 Days
0
135
NR
NR
NR
NR
NR
NR
Page 14
Effectiveness of Care
UCare Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
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
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 15
Effectiveness of Care
UCare Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Medicare + Choice
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure Data
LDL-C
Screening
LDL-C Level
<130 mg/dL
LDL-C Level
<100 mg/dL
Monitoring for
Diabetic
Nephropathy
1314
90.50%
1452
100.00%
931
64.12%
1287
88.64%
215
14.81%
0
0.00%
791
54.48%
389
90.05%
432
100.00%
266
61.57%
391
90.51%
73
16.90%
0
0.00%
247
57.18%
377
6
93.19%
90.63%
95.74%
0
57
13.87%
10.41%
17.33%
254
25
67.88%
63.25%
72.52%
376
5
92.70%
90.06%
95.34%
71
227
72.51%
68.07%
76.94%
0
192
46.72%
41.77%
51.66%
238
26
64.23%
59.48%
68.99%
432
11
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
10
HEDIS 2004 (Reporting Year 2003)
Eye Exam
411
5.00%
Number of Records Excluded Because
of Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Poor HbA1c
Control
HO
S
1452
Numerator events by admin data in
eligible population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
HbA1c
Testing
411
Page 16
Effectiveness of Care
UCare Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
MSHO
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure Data
LDL-C
Screening
LDL-C Level
<130 mg/dL
LDL-C Level
<100 mg/dL
Monitoring for
Diabetic
Nephropathy
178
83.18%
214
100.00%
126
58.88%
156
72.90%
58
27.10%
0
0.00%
111
51.87%
177
83.10%
213
100.00%
125
58.69%
155
72.77%
58
27.23%
0
0.00%
110
51.64%
174
16
91.35%
87.28%
95.41%
0
64
30.77%
24.26%
37.28%
123
13
65.38%
58.68%
72.09%
152
6
75.96%
69.91%
82.01%
57
62
57.21%
50.25%
64.18%
0
78
37.50%
30.68%
44.32%
108
10
56.73%
49.76%
63.70%
213
4
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2004 (Reporting Year 2003)
Eye Exam
411
5.00%
Number of Records Excluded Because
of Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Poor HbA1c
Control
HO
S
214
Numerator events by admin data in
eligible population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
HbA1c
Testing
208
Page 17
Effectiveness of Care
UCare Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
PMAP
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
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 18
Effectiveness of Care
UCare Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Medicaid
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
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 19
Effectiveness of Care
UCare Minnesota
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Data Elements
Data Collection Methodology
Eligible Member Population
Current Year's Admin Rate
Total Exclusions
Denominator
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 20
Effectiveness of Care
UCare Minnesota
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 1, 2004 4:20 PM
PMAP
Data Elements
Data Collection Methodology
Eligible Member Population
Current Year's Admin Rate
Total Exclusions
Denominator
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
Total
131
63.36%
0
131
83
63.36%
54.73%
71.99%
170
58.82%
0
170
100
58.82%
51.13%
66.52%
171
66.67%
0
171
114
66.67%
59.31%
74.02%
472
62.92%
0
472
297
62.92%
58.46%
67.39%
A
Page 21
Effectiveness of Care
UCare Minnesota
Follow-Up After Hospitalization for Mental Illness
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Data Elements
General
Measure
Data
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Medicare + Choice
General
W/in 7 Days of W/in 30 Days of
Measure
Discharge
Discharge
Data
A
40
NR
NR
NR
25
62.50%
46.25%
78.75%
NR
NR
NR
MSHO
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
W/in 7 Days of W/in 30 Days of
Discharge
Discharge
General
Measure
Data
27
67.50%
51.73%
83.27%
PMAP
General
W/in 7 Days of W/in 30 Days of
Measure
Discharge
Discharge
Data
A
2
W/in 7 Days of W/in 30 Days of
Discharge
Discharge
A
231
1
NA
NA
NA
1
NA
NA
NA
147
63.64%
57.22%
70.06%
165
71.43%
65.39%
77.47%
Page 22
Effectiveness of Care
UCare Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 4:20 PM
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 2004 (Reporting Year 2003)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 23
Effectiveness of Care
UCare Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 4:20 PM
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 2004 (Reporting Year 2003)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
16
8.70%
4.35%
13.04%
104
56.52%
49.09%
63.96%
81
44.02%
36.58%
51.47%
A
184
Page 24
Effectiveness of Care
UCare Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 4:20 PM
MSHO
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
3
NA
NA
NA
12
NA
NA
NA
9
NA
NA
NA
A
28
Page 25
Effectiveness of Care
UCare Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 4:20 PM
PMAP
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
54
17.82%
13.35%
22.30%
141
46.53%
40.75%
52.32%
94
31.02%
25.65%
36.40%
A
303
Page 26
Use of Services
UCare Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Data Elements
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
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
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
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 27
Use of Services
UCare Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 1, 2004 4:20 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
0
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2004 (Reporting Year 2003)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
59
3.05%
80
4.13%
123
6.35%
178
9.19%
327
16.88%
433
22.35%
737
38.05%
11
2.55%
12
2.78%
26
6.02%
26
6.02%
79
18.29%
96
22.22%
182
42.13%
4
0
0.97%
0.00%
2.04%
3
1
0.97%
0.00%
2.04%
15
5
4.87%
2.66%
7.07%
18
5
5.60%
3.25%
7.94%
55
8
15.33%
11.72%
18.93%
76
14
21.90%
17.78%
26.02%
174
33
50.36%
45.41%
55.32%
411
5.00%
432
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
1 visit
HO
S
1937
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Zero Visits
411
Page 28
Use of Services
UCare 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
Commercial
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
HEDIS 2004 (Reporting Year 2003)
PMAP
HO
S
4132
2185
NR
52.88%
411
5.00%
432
239
NR
55.32%
0
Number of employee/dependent medical records
excluded
Records Added from Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Data Last Refreshed:
Sep 1, 2004 4:20 PM
0
NR
NR
NR
0
411
226
24
60.83%
55.99%
65.67%
Page 29
Use of Services
UCare Minnesota
Adolescent Well-Care Visits
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
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
2337
NR
32.66%
411
5.00%
432
148
NR
34.26%
0
Number of employee/dependent medical records
excluded
Records Added from Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
PMAP
HO
S
7156
0
NR
NR
NR
0
411
138
52
46.23%
41.29%
51.17%
Page 30
Use of Services
UCare Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
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
Member Months
NR
Discharges
Discharges /
1,000 Member
Months
Days
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2004 (Reporting Year 2003)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Days / 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
Average Length
of Stay
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 31
Use of Services
UCare Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
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
Member Months
0
0
0
473
5201
115551
127549
61188
0
309962
Discharges
0
0
0
6
190
2068
3662
2470
0
8396
Discharges /
1,000 Member
Months
NA
NA
NA
12.68
36.53
17.90
28.71
40.37
27.09
0
0
0
3
116
1289
2581
1830
0
5819
NA
NA
NA
6.34
22.30
11.16
20.24
29.91
0
0
0
3
74
779
1081
640
0
2577
NA
NA
NA
6.34
14.23
6.74
8.48
10.46
HEDIS 2004 (Reporting Year 2003)
18.77
8.31
Days
0
0
0
23
862
8772
16504
11041
0
37202
Days / 1,000
Member
Months
NA
NA
NA
48.63
165.74
75.91
129.39
180.44
120.02
0
0
0
9
485
5410
11175
7807
0
24886
NA
NA
NA
19.03
93.25
46.82
87.61
127.59
0
0
0
14
377
3362
5329
3234
0
12316
NA
NA
NA
29.60
72.49
29.10
41.78
52.85
80.29
39.73
Average Length
of Stay
NA
NA
NA
3.83
4.54
4.24
4.51
4.47
NA
4.43
NA
NA
NA
3.00
4.18
4.20
4.33
4.27
NA
4.28
NA
NA
NA
4.67
5.09
4.32
4.93
5.05
NA
4.78
Page 32
Use of Services
UCare Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Minnesota Senior Health Options
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
Member Months
0
0
0
0
0
8474
8867
9196
0
26537
Discharges
0
0
0
0
0
331
276
245
0
852
Discharges /
1,000 Member
Months
NA
NA
NA
NA
NA
39.06
31.13
26.64
32.11
0
0
0
0
0
226
199
176
0
601
NA
NA
NA
NA
NA
26.67
22.44
19.14
0
0
0
0
0
105
77
69
0
251
NA
NA
NA
NA
NA
12.39
8.68
7.50
HEDIS 2004 (Reporting Year 2003)
22.65
9.46
Days
0
0
0
0
0
1818
1324
1086
0
4228
Days / 1,000
Member
Months
NA
NA
NA
NA
NA
214.54
149.32
118.09
159.32
0
0
0
0
0
1141
870
714
0
2725
NA
NA
NA
NA
NA
134.65
98.12
77.64
0
0
0
0
0
677
454
372
0
1503
NA
NA
NA
NA
NA
79.89
51.20
40.45
102.69
56.64
Average Length
of Stay
NA
NA
NA
NA
NA
5.49
4.80
4.43
NA
4.96
NA
NA
NA
NA
NA
5.05
4.37
4.06
NA
4.53
NA
NA
NA
NA
NA
6.45
5.90
5.39
NA
5.99
Page 33
Use of Services
UCare Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
PMAP
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
Member Months
35776
206628
159373
119944
11534
21209
19135
17451
0
591050
Discharges
486
573
810
2977
133
454
548
399
0
6380
Discharges /
1,000 Member
Months
13.58
2.77
5.08
24.82
11.53
21.41
28.64
22.86
10.79
418
480
173
447
88
431
541
394
0
2972
11.68
2.32
1.09
3.73
7.63
20.32
28.27
22.58
66
93
128
275
43
23
7
5
0
640
1.84
0.45
0.80
2.29
3.73
1.08
0.37
0.29
509
2255
2
0
0
2766
3.19
18.80
0.17
0.00
HEDIS 2004 (Reporting Year 2003)
5.03
1.08
7.93
Days
Days / 1,000
Member
Months
2681
1577
2429
7872
494
2176
2480
1832
0
21541
74.94
7.63
15.24
65.63
42.83
102.60
129.61
104.98
1878
1149
495
1245
259
2007
2441
1790
0
11264
52.49
5.56
3.11
10.38
22.46
94.63
127.57
102.57
800
428
638
936
232
169
39
42
0
3284
22.36
2.07
4.00
7.80
20.11
7.97
2.04
2.41
1296
5691
3
0
0
6990
8.13
47.45
0.26
0.00
36.45
19.06
5.56
20.05
Average Length
of Stay
5.52
2.75
3.00
2.64
3.71
4.79
4.53
4.59
NA
3.38
4.49
2.39
2.86
2.79
2.94
4.66
4.51
4.54
NA
3.79
12.12
4.60
4.98
3.40
5.40
7.35
5.57
8.40
NA
5.13
2.55
2.52
1.50
NA
NA
2.53
Page 34
Use of Services
UCare Minnesota
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
NR
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 2004 (Reporting Year 2003)
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Emergency Room Visits
Visits
NR
Visits/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Ambulatory
Surgery/Procedures
Procedures
NR
Procedures/
1,000 Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Observation Room Stays
Resulting in Discharge
Stays
NR
Stays/ 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 35
Use of Services
UCare Minnesota
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Medicare + Choice
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
0
473
5201
115551
127549
61188
0
309962
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
0
217
3622
59072
79217
39273
0
181401
HEDIS 2004 (Reporting Year 2003)
Visits/ 1,000
Member
Months
NA
NA
NA
458.77
696.40
511.22
621.07
641.84
585.24
Emergency Room Visits
Visits
0
0
0
18
123
1324
2046
1290
0
4801
Visits/ 1,000
Member
Months
NA
NA
NA
38.05
23.65
11.46
16.04
21.08
15.49
Ambulatory
Surgery/Procedures
Procedures
0
0
0
5
165
3300
4047
1294
0
8811
Procedures/
1,000 Member
Months
NA
NA
NA
10.57
31.72
28.56
31.73
21.15
28.43
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
8
147
340
207
0
702
Stays/ 1,000
Member
Months
NA
NA
NA
0.00
1.54
1.27
2.67
3.38
2.26
Page 36
Use of Services
UCare Minnesota
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Minnesota Senior Health Options
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
0
0
0
8474
8867
9196
0
26537
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
0
0
0
5929
6361
7121
0
19411
HEDIS 2004 (Reporting Year 2003)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
699.67
717.38
774.36
731.47
Emergency Room Visits
Visits
0
0
0
0
0
215
268
140
0
623
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
25.37
30.22
15.22
23.48
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
0
219
172
70
0
461
Procedures/
1,000 Member
Months
NA
NA
NA
NA
NA
25.84
19.40
7.61
17.37
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
4
18
9
0
31
Stays/ 1,000
Member
Months
NA
NA
NA
NA
NA
0.47
2.03
0.98
1.17
Page 37
Use of Services
UCare Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Member
Months
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
NR
Total
Age
Discharges
Discharges /
1,000 Member
Months
Days
Days / 1,000
Member
Months
Average Length
of Stay
<1
NR
NR
NR
1-9
NR
NR
NR
10-19
NR
NR
NR
20-44
NR
NR
NR
45-64
NR
NR
NR
65-74
NR
NR
NR
75-84
NR
NR
NR
85+
NR
NR
NR
NR
NR
NR
Unknown
Total
HEDIS 2004 (Reporting Year 2003)
NR
NR
NR
Page 38
Use of Services
UCare Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Medicare + Choice
Member
Months
Age
<1
0
1-9
0
10-19
0
20-44
473
45-64
5201
65-74
115551
75-84
127549
85+
61188
Unknown
0
309962
Total
Days
Days / 1,000
Member
Months
Average Length
of Stay
NA
0
NA
NA
0
NA
0
NA
NA
0
NA
0
NA
NA
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
10-19
Age
20-44
0
0.00
0
0.00
NA
45-64
35
6.73
642
123.44
18.34
65-74
366
3.17
4552
39.39
12.44
75-84
1344
10.54
18552
145.45
13.80
85+
1619
26.46
23743
388.03
14.67
Unknown
0
3364
10.85
0
47489
153.21
NA
14.12
Total
HEDIS 2004 (Reporting Year 2003)
Page 39
Use of Services
UCare Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Minnesota Senior Health Options
Member
Months
Age
<1
0
1-9
0
10-19
0
20-44
0
45-64
0
65-74
8474
75-84
8867
85+
9196
Unknown
0
26537
Total
Days
Days / 1,000
Member
Months
Average Length
of Stay
NA
0
NA
NA
0
NA
0
NA
NA
10-19
0
NA
0
NA
NA
20-44
0
NA
0
NA
NA
45-64
0
NA
0
NA
NA
65-74
131
15.46
2453
289.47
18.73
75-84
191
21.54
4721
532.42
24.72
85+
226
24.58
4599
500.11
20.35
Unknown
0
548
20.65
0
11773
443.64
NA
21.48
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
Age
Total
HEDIS 2004 (Reporting Year 2003)
Page 40
Use of Services
UCare Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
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
M
Unknown
NR
F
NR
Total
NR
NR
NR
M
Total
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 2004 (Reporting Year 2003)
Page 41
Use of Services
UCare Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Medicare + Choice
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Male
Female
Total
0
0
2500
109624
0
112124
0
0
3174
194664
0
197838
0
0
5674
304288
0
309962
Discharges
Discharges /
1,000 Member
Months
Days*
Average Length
of Stay
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
M
13-17
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
M
18-64
4
1.60
25
6.25
F
11
3.47
60
5.45
Total
15
2.64
85
5.67
M
65+
52
0.47
588
11.31
F
127
0.65
1104
8.69
Total
179
0.59
1692
9.45
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
56
0.50
613
10.95
F
138
0.70
1164
8.43
TOTAL
194
0.63
1777
9.16
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization should not be included in this table
HEDIS 2004 (Reporting Year 2003)
Page 42
Use of Services
UCare Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Minnesota Senior Health Options
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Male
Female
Total
0
0
0
6147
0
6147
0
0
0
20390
0
20390
0
0
0
26537
0
26537
Discharges
Discharges /
1,000 Member
Months
Days*
Average Length
of Stay
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
13-17
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
18-64
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
65+
M
15
2.44
299
19.93
F
23
1.13
310
13.48
Total
38
1.43
609
16.03
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
15
2.44
299
19.93
F
23
1.13
310
13.48
TOTAL
38
1.43
609
16.03
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization should not be included in this table
HEDIS 2004 (Reporting Year 2003)
Page 43
Use of Services
UCare Minnesota
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
NR
NR
Member Months (Inpatient)
Total
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Member Months (Day/Night)
Total
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Member Months (Ambulatory)
Total
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Any Mental Health Services
Inpatient Mental Health Services
Day/Night Mental Health Services
Ambulatory Mental Health Services
Number
Number
Number
Number
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2004 (Reporting Year 2003)
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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
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
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 44
Use of Services
UCare Minnesota
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Medicare + Choice
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
2500
109624
0
112124
Female
0
0
3174
194664
0
197838
Member Months (Inpatient)
Total
0
0
5674
304288
0
309962
Male
0
0
2500
109624
0
112124
Female
0
0
3174
194664
0
197838
Total
0
0
5674
304288
0
309962
Any Mental Health Services
Inpatient Mental Health Services
Number
0
0
0
0
0
0
39
67
106
159
446
605
0
0
0
198
513
711
Number
0
0
0
0
0
0
3
7
10
43
101
144
0
0
0
46
108
154
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2004 (Reporting Year 2003)
Percent
NA
NA
NA
NA
NA
NA
18.72%
25.33%
22.42%
1.74%
2.75%
2.39%
NA
NA
NA
2.12%
3.11%
2.75%
Percent
NA
NA
NA
NA
NA
NA
1.44%
2.65%
2.11%
0.47%
0.62%
0.57%
NA
NA
NA
0.49%
0.66%
0.60%
Member Months (Day/Night)
Male
0
0
2500
109624
0
112124
Female
0
0
3174
194664
0
197838
Total
0
0
5674
304288
0
309962
Day/Night Mental Health Services
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Member Months (Ambulatory)
Male
0
0
2500
109624
0
112124
Female
0
0
3174
194664
0
197838
Total
0
0
5674
304288
0
309962
Ambulatory Mental Health Services
Number
0
0
0
0
0
0
38
65
103
118
378
496
0
0
0
156
443
599
Percent
NA
NA
NA
NA
NA
NA
18.24%
24.57%
21.78%
1.29%
2.33%
1.96%
NA
NA
NA
1.67%
2.69%
2.32%
Page 45
Use of Services
UCare Minnesota
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Minnesota Senior Health Options
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
0
6147
0
6147
Female
0
0
0
20390
0
20390
Member Months (Inpatient)
Total
0
0
0
26537
0
26537
Male
0
0
0
6147
0
6147
Female
0
0
0
20390
0
20390
Member Months (Day/Night)
Total
0
0
0
26537
0
26537
Male
0
0
0
6147
0
6147
Female
0
0
0
20390
0
20390
Total
0
0
0
26537
0
26537
Member Months (Ambulatory)
Male
0
0
0
6147
0
6147
Female
0
0
0
20390
0
20390
Total
0
0
0
26537
0
26537
Any Mental Health Services
Inpatient Mental Health Services
Day/Night Mental Health Services
Ambulatory Mental Health Services
Number
0
0
0
0
0
0
0
0
0
49
102
151
0
0
0
49
102
151
Number
0
0
0
0
0
0
0
0
0
14
15
29
0
0
0
14
15
29
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
0
0
0
0
0
0
0
0
0
36
93
129
0
0
0
36
93
129
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2004 (Reporting Year 2003)
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
9.57%
6.00%
6.83%
NA
NA
NA
9.57%
6.00%
6.83%
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
2.73%
0.88%
1.31%
NA
NA
NA
2.73%
0.88%
1.31%
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
7.03%
5.47%
5.83%
NA
NA
NA
7.03%
5.47%
5.83%
Page 46
Use of Services
UCare Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
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
M
13-17
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
18-64
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
65+
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
Unknown
NR
F
NR
Total
NR
NR
NR
Total
M
NR
NR
NR
NR
F
NR
NR
NR
NR
TOTAL
NR
NR
NR
NR
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization should not be included in this table
HEDIS 2004 (Reporting Year 2003)
Page 47
Use of Services
UCare Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Medicare + Choice
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Male
Female
Total
0
0
2500
109624
0
112124
0
0
3174
194664
0
197838
0
0
5674
304288
0
309962
Discharges
Discharges /
1,000 Member
Months
Days
Average Length
of Stay
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
13-17
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
18-64
M
0
0.00
0
NA
F
2
0.63
2
1.00
Total
2
0.35
2
1.00
65+
M
6
0.05
54
9.00
F
13
0.07
84
6.46
Total
19
0.06
138
7.26
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
6
0.05
54
9.00
F
15
0.08
86
5.73
TOTAL
21
0.07
140
6.67
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization should not be included in this table
HEDIS 2004 (Reporting Year 2003)
Page 48
Use of Services
UCare Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Minnesota Senior Health Options
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Male
Female
Total
0
0
0
6147
0
6147
0
0
0
20390
0
20390
0
0
0
26537
0
26537
Discharges
Discharges /
1,000 Member
Months
Days
Average Length
of Stay
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
13-17
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
18-64
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
65+
M
6
0.98
23
3.83
F
4
0.20
55
13.75
Total
10
0.38
78
7.80
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
6
0.98
23
3.83
F
4
0.20
55
13.75
TOTAL
10
0.38
78
7.80
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization should not be included in this table
HEDIS 2004 (Reporting Year 2003)
Page 49
Use of Services
UCare Minnesota
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
NR
NR
Member Months (Inpatient)
Total
NR
NR
NR
NR
NR
NR
Any Chemical Dependency Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2004 (Reporting Year 2003)
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Member Months (Day/Night)
Total
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Member Months (Ambulatory)
Total
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
Number
Number
NR
NR
NR
NR
NR
NR
NR
NR
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
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
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 50
Use of Services
UCare Minnesota
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Medicare + Choice
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
2500
109624
0
112124
Female
0
0
3174
194664
0
197838
Member Months (Inpatient)
Total
0
0
5674
304288
0
309962
Any Chemical Dependency Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2004 (Reporting Year 2003)
Number
0
0
0
0
0
0
0
6
6
13
17
30
0
0
0
13
23
36
Percent
NA
NA
NA
NA
NA
NA
0.00%
2.27%
1.27%
0.14%
0.10%
0.12%
NA
NA
NA
0.14%
0.14%
0.14%
Male
0
0
2500
109624
0
112124
Female
0
0
3174
194664
0
197838
Total
0
0
5674
304288
0
309962
Member Months (Day/Night)
Male
0
0
2500
109624
0
112124
Female
0
0
3174
194664
0
197838
Total
0
0
5674
304288
0
309962
Member Months (Ambulatory)
Male
0
0
2500
109624
0
112124
Female
0
0
3174
194664
0
197838
Total
0
0
5674
304288
0
309962
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
0
0
0
0
0
0
0
2
2
6
13
19
0
0
0
6
15
21
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
0
0
0
0
0
0
0
4
4
7
4
11
0
0
0
7
8
15
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.76%
0.42%
0.07%
0.08%
0.07%
NA
NA
NA
0.06%
0.09%
0.08%
Percent
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Percent
NA
NA
NA
NA
NA
NA
0.00%
1.51%
0.85%
0.08%
0.02%
0.04%
NA
NA
NA
0.07%
0.05%
0.06%
Page 51
Use of Services
UCare Minnesota
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Minnesota Senior Health Options
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
0
6147
0
6147
Female
0
0
0
20390
0
20390
Member Months (Inpatient)
Total
0
0
0
26537
0
26537
Any Chemical Dependency Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2004 (Reporting Year 2003)
Number
0
0
0
0
0
0
0
0
0
10
7
17
0
0
0
10
7
17
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
1.95%
0.41%
0.77%
NA
NA
NA
1.95%
0.41%
0.77%
Male
0
0
0
6147
0
6147
Female
0
0
0
20390
0
20390
Member Months (Day/Night)
Total
0
0
0
26537
0
26537
Male
0
0
0
6147
0
6147
Female
0
0
0
20390
0
20390
Total
0
0
0
26537
0
26537
Member Months (Ambulatory)
Male
0
0
0
6147
0
6147
Female
0
0
0
20390
0
20390
Total
0
0
0
26537
0
26537
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
0
0
0
0
0
0
0
0
0
4
3
7
0
0
0
4
3
7
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
0
0
0
0
0
0
0
0
0
7
4
11
0
0
0
7
4
11
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.78%
0.18%
0.32%
NA
NA
NA
0.78%
0.18%
0.32%
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
1.37%
0.24%
0.50%
NA
NA
NA
1.37%
0.24%
0.50%
Page 52
Use of Services
UCare 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 1, 2004 4:20 PM
Member Months
0
0
473
5201
115551
127549
61188
0
309962
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
$0.00
$0.00
$22,119.17
$401,475.58
$7,892,691.89
$8,488,904.76
$3,801,815.43
$0.00
$20,607,006.83
HEDIS 2004 (Reporting Year 2003)
A
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
$46.76
$77.19
$68.30
$66.55
$62.13
$66.48
Total Number of
Prescriptions
0
0
643
11349
199150
270092
145655
0
626889
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
16.31
26.18
20.68
25.41
28.57
24.27
Page 53
Use of Services
UCare Minnesota
Outpatient Drug Utilization
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Minnesota Senior Health Options
Age
Member Months
0-9
0
10-19
0
20-44
0
45-64
0
65-74
8474
75-84
8867
85+
9196
Unknown
0
Total
26537
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
$0.00
$0.00
$0.00
$0.00
$2,121,944.38
$2,150,480.91
$2,047,405.06
$0.00
$6,319,830.35
HEDIS 2004 (Reporting Year 2003)
A
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
NA
NA
$250.41
$242.53
$222.64
$238.15
Total Number of
Prescriptions
0
0
0
0
45707
56235
65833
0
167775
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
NA
NA
64.73
76.10
85.91
75.87
Page 54
Access/Availability of Care
UCare Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
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 2004 (Reporting Year 2003)
Page 55
Access/Availability of Care
UCare Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Medicare + Choice
Data Elements
Data collection methodology
(Administrative only)
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2004 (Reporting Year 2003)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
31
345
23543
27
330
22560
87.10%
73.68%
100.00%
95.65%
93.36%
97.95%
95.82%
95.57%
96.08%
A
Page 56
Access/Availability of Care
UCare Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Minnesota Senior Health Options
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 2004 (Reporting Year 2003)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
0
0
1957
0
0
1897
NA
NA
NA
NA
NA
NA
96.93%
96.14%
97.72%
A
Page 57
Access/Availability of Care
UCare Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 4:20 PM
PMAP
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 2004 (Reporting Year 2003)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
4725
600
3557
4168
519
3340
88.21%
87.28%
89.14%
86.50%
83.68%
89.32%
93.90%
93.10%
94.70%
A
Page 58
Access/Availability of Care
UCare Minnesota
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Data Elements
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
12-19 yrs.
NR
NR
NR
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 2004 (Reporting Year 2003)
Page 59
Access/Availability of Care
UCare Minnesota
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 1, 2004 4:20 PM
PMAP
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 2004 (Reporting Year 2003)
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
12-19 yrs.
2526
5547
3482
4856
2397
4709
2844
4040
94.89%
94.01%
95.77%
84.89%
83.94%
85.84%
81.68%
80.38%
82.98%
83.20%
82.13%
84.26%
A
Page 60
Access/Availability of Care
UCare Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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)
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 auxiliary list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2004 (Reporting Year 2003)
Page 61
Access/Availability of Care
UCare Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 1, 2004 4:20 PM
PMAP
Timeliness of
Prenatal Care
Postpartum
Care
HO
HO
S
S
2079
2079
1154
1048
55.51%
50.41%
Minimum required sample size (MRSS) or other sample size
411
411
Oversampling rate
Final sample size (FSS)
5%
432
5%
432
Number of numerator events by administrative data in FSS
238
230
55.09%
53.24%
Number of original sample records excluded because of
valid data errors
5
0
Number of employee/dependent medical records excluded
0
0
5
411
229
98
5
411
218
26
79.56%
75.54%
83.58%
59.37%
54.50%
64.24%
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)
Number of numerator events by administrative data in
eligible population (before exclusions)
Current year's administrative rate (before exclusions)
Administrative rate on FSS
Additional records added from the auxiliary list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2004 (Reporting Year 2003)
Page 62
Health Plan Stability
UCare Minnesota
Practitioner Turnover
Medicare + Choice
Practitioner Types
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Number of
Practitioners as of
12/31/2002
Number of
Practitioners who
were not affiliated
with the plan as of
12/31/2003
Practitioner
Turnover Rate
Primary Care
Physicians
1784
171
9.59%
Non-Physician Primary
Care Practitioners
527
66
12.52%
HEDIS 2004 (Reporting Year 2003)
Page 63
Health Plan Stability
UCare Minnesota
Practitioner Turnover
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Minnesota Senior Health Options
Practitioner Types
Number of
Practitioners as of
12/31/2002
Number of
Practitioners who
were not affiliated
with the plan as of
12/31/2003
Practitioner
Turnover Rate
Primary Care
Physicians
1852
217
11.72%
Non-Physician Primary
Care Practitioners
657
98
14.92%
HEDIS 2004 (Reporting Year 2003)
Page 64
Health Plan Stability
UCare Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Medicare + Choice
Product/Product Line
HMO (Total)
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other (specify)
PPO (Total)
Commercial
Medicare (cost or risk)
Self-insured
Other (specify)
POS (Total)
Commercial
Medicare (cost or risk)
Self-insured
Other (specify)
Total
Years in Business
16.00
16.00
0.00
5.50
0.00
8.00
Members*
105085
76530
0
25895
0
2660
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
105085
* Total number of members in each category as of December 31, 2003
HEDIS 2004 (Reporting Year 2003)
Page 65
Health Plan Stability
UCare Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Minnesota Senior Health Options
Product/Product Line
HMO (Total)
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other (specify)
PPO (Total)
Commercial
Medicare (cost or risk)
Self-insured
Other (specify)
POS (Total)
Commercial
Medicare (cost or risk)
Self-insured
Other (specify)
Total
Years in Business
16.00
16.00
0.00
5.50
0.00
8.00
Members*
105085
76530
0
25895
0
2660
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
105085
* Total number of members in each category as of December 31, 2003
HEDIS 2004 (Reporting Year 2003)
Page 66
Health Plan Descriptive Information
UCare Minnesota
Board Certification / Residency Completion
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Minnesota Senior Health Options
Type of Practitioner
Primary Care Practitioners
Number of
Practitioners in Each
Practice Area
Geriatricians
Other practitioner
Specialists
HEDIS 2004 (Reporting Year 2003)
Board Certification
Number
Percent
NR
NR
NR
Page 67
Health Plan Descriptive Information
UCare Minnesota
Total Enrollment by Percentage
Medicaid
Commercial
Product Line
Medicare
Other
Total
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Total
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
M
F
M
F
M
F
M
F
M
F
M
F
Total
100.00%
0.00%
0.00%
0.00%
99.97%
0.00%
0.03%
0.00%
100.00%
0.00%
0.00%
0.00%
99.95%
0.00%
0.05%
0.00%
99.84%
0.00%
0.16%
0.00%
99.96%
0.00%
0.04%
0.00%
99.85%
0.00%
0.15%
0.00%
99.75%
0.00%
0.25%
0.00%
99.36%
0.00%
0.64%
0.00%
99.46%
0.00%
0.54%
0.00%
99.81%
0.00%
0.19%
0.00%
99.85%
0.00%
0.15%
0.00%
99.84%
0.00%
0.16%
0.00%
M
F
M
F
M
F
M
F
M
F
Total
98.33%
0.00%
1.67%
0.00%
98.17%
0.00%
1.83%
0.00%
96.83%
0.00%
3.17%
0.00%
96.79%
0.00%
3.21%
0.00%
92.56%
0.00%
7.44%
0.00%
92.13%
0.00%
7.87%
0.00%
84.54%
0.00%
15.46%
0.00%
87.91%
0.00%
12.09%
0.00%
94.61%
0.00%
5.39%
0.00%
94.69%
0.00%
5.31%
0.00%
94.66%
0.00%
5.34%
0.00%
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Total
20.74%
0.00%
79.26%
0.00%
23.04%
0.00%
76.96%
0.00%
17.31%
0.00%
82.69%
0.00%
20.47%
0.00%
79.53%
0.00%
13.30%
0.00%
86.70%
0.00%
16.93%
0.00%
83.07%
0.00%
14.45%
0.00%
85.55%
0.00%
20.12%
0.00%
79.88%
0.00%
16.16%
0.00%
83.84%
0.00%
23.24%
0.00%
76.76%
0.00%
25.38%
0.00%
74.62%
0.00%
37.16%
0.00%
62.84%
0.00%
16.86%
0.00%
83.14%
0.00%
22.61%
0.00%
77.39%
0.00%
20.69%
0.00%
79.31%
0.00%
0.00%
0.00%
0.00%
0.00%
74.13%
0.00%
25.87%
0.00%
Age/Sex
<1
1-4
5-9
10-14
15-17
18-19
Subtotal: 0-19
20-24
25-29
30-34
35-39
40-44
Subtotal: 20-44
45-49
50-54
55-59
60-64
Subtotal: 45-64
65-69
70-74
75-79
80-84
85-89
>=90
Subtotal: >=65
Age Unknown
Total
Data Last Refreshed:
Sep 1, 2004 4:20 PM
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
0.00%
100.00%
Note: Row entries should add up to 100%.
HEDIS 2004 (Reporting Year 2003)
Page 68
Health Plan Descriptive Information
UCare Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Commercial
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
NR
NR
NR
NR
NR
NR
NR
HEDIS 2004 (Reporting Year 2003)
Page 69
Health Plan Descriptive Information
UCare Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Medicare + Choice
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
0
0
24
24
144
0
0.00%
12
24
24
60
168
0
0.00%
192
0.17%
264
372
636
1032
288
0.15%
336
480
756
1320
480
0.15%
2304
2.05%
22500
23976
26448
19596
12516
4596
2892
1.46%
32052
37020
43560
37944
28428
15648
5196
1.68%
109632
97.77%
0
194652
98.39%
0
304284
98.17%
112128
197832
HEDIS 2004 (Reporting Year 2003)
12
24
48
84
312
600
852
1392
2352
54552
60996
70008
57540
40944
20244
0
309960
Page 70
Health Plan Descriptive Information
UCare Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 4:20 PM
Minnesota Senior Health Options
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0.00%
0
0
0
0
0
0.00%
0
0
0
0
0
0.00%
0
0.00%
1308
1344
1200
1092
756
444
0
0.00%
2472
3360
3120
3444
3696
4296
0
0.00%
6144
100.00%
0
20388
100.00%
0
26532
100.00%
6144
20388
HEDIS 2004 (Reporting Year 2003)
0
0
0
0
0
0
0
0
0
3780
4704
4320
4536
4452
4740
0
26532
Page 71
Health Plan Descriptive Information
UCare Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 4:20 PM
PMAP
<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
18714
57402
47101
45377
21999
9090
Member Months
Female
17062
54849
47276
45632
23056
14219
Total
35776
112251
94377
91009
45055
23309
199683
81.69%
5604
4220
4842
4771
4224
202094
58.31%
31720
23310
18950
12954
9349
401777
67.98%
23661
9.68%
2388
1488
514
219
96283
27.78%
4217
1841
531
336
119944
20.29%
4609
1.89%
4151
3669
3066
2427
1808
1374
6925
2.00%
6795
6594
6540
7102
6326
7943
11534
1.95%
16495
6.75%
0
41300
11.92%
0
57795
9.78%
244448
346602
HEDIS 2004 (Reporting Year 2003)
37324
27530
23792
17725
13573
6605
3329
1045
555
10946
10263
9606
9529
8134
9317
0
591050
Page 72