Sioux Valley Health Plan
Plan Name
2003
Reporting Year
General Info
Submission #
1
Last Refreshed:
21
9/1/2004 4:03:16 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
Sioux Valley Health Plan
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Combo 1
Combo 2
3
17.65%
3
17.65%
5
29.41%
3
17.65%
2
11.76%
4
23.53%
1
5.88%
1
5.88%
3
17.65%
3
17.65%
5
29.41%
3
17.65%
2
11.76%
4
23.53%
1
5.88%
1
5.88%
3
12
NA
NA
NA
3
13
NA
NA
NA
5
11
NA
NA
NA
3
12
NA
NA
NA
2
14
NA
NA
NA
4
8
NA
NA
NA
1
13
NA
NA
NA
1
10
NA
NA
NA
17
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
Additional Records Added from the
Auxiliary List
0
HEDIS 2004 (Reporting Year 2003)
MMR
17
0.00%
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
IPV/OPV
HO
N
17
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
DTaP/DT
17
Page 3
Effectiveness of Care
Sioux Valley Health Plan
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 4:03 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
Sioux Valley Health Plan
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 4:03 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
Sioux Valley Health Plan
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Combo 1
Combo 2
2
6.25%
2
6.25%
1
3.13%
1
3.13%
0
0.00%
2
6.25%
2
6.25%
1
3.13%
1
3.13%
0
0.00%
2
25
84.38%
70.23%
98.52%
2
20
68.75%
51.13%
86.37%
1
3
12.50%
0.00%
25.52%
1
18
59.38%
40.80%
77.95%
0
3
9.38%
0.00%
21.04%
32
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
Additional Records Added from the
Auxiliary List
0
HEDIS 2004 (Reporting Year 2003)
VZV
32
0.00%
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
Hepatitis B
HO
N
32
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
MMR
32
Page 6
Effectiveness of Care
Sioux Valley Health Plan
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 4:03 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
Sioux Valley Health Plan
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 4:03 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
Sioux Valley Health Plan
Breast Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
A
Medicare + Choice
210
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
Records Excluded because of contraindications
through Admin data
83.81%
NR
NR
NR
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)
210
176
83.81%
78.59%
89.03%
NR
NR
NR
Page 9
Effectiveness of Care
Sioux Valley Health Plan
Cervical Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
A
PMAP
285
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
Records Excluded because of contraindications
through Admin data
80.70%
NR
NR
NR
4
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)
281
230
81.85%
77.17%
86.54%
NR
NR
NR
Page 10
Effectiveness of Care
Sioux Valley Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
Data Elements
Data Collection Methodology
Eligible Member Population
Current Year's Admin Rate (before exclusions)
Records Excluded - Contraindications/Admin
Data
Denominator
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
General
Measure Ages 16-20 Ages 21-25
Data
PMAP
Total
General
Measure Ages 16-20 Ages 21-25
Data
Total
A
37
10.81%
35
17.14%
72
13.89%
0
0
0
NR
37
4
10.81%
0.00%
22.17%
35
6
17.14%
3.23%
31.06%
72
10
13.89%
5.21%
22.57%
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 11
Effectiveness of Care
Sioux Valley Health Plan
Controlling High Blood Pressure
Data Last Refreshed:
Sep 1, 2004 4:03 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
Commercial
HO
N
33
33
0.00%
33
0
0
Records Excluded because of ESRD or non-acute
admission identified by Admin Data
1
Records Excluded because of ESRD or non-acute
admission identified by Medical Record
0
Number of employee/dependent medical records
excluded
0
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)
0
32
20
62.50%
44.16%
80.84%
Medicare + Choice
MSHO
NR
NR
NR
NR
NR
NR
Page 12
Effectiveness of Care
Sioux Valley Health Plan
Beta Blocker Treatment after Heart Attack
Data Elements
Data Collection Methodology
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
HO
Sampling Method Used
N
Eligible Member Population
0
Numerator Events by Admin Data on
Eligible Population
0
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
Medicare + Choice
NR
NR
0
0.00%
0
0
NR
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 Auxiliary List
0
Denominator
0
Numerator Events by Admin Data
0
Numerator Events by Medical Record
0
NR
Reported Rate
NA
NR
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NA
NR
NA
NR
HEDIS 2004 (Reporting Year 2003)
Page 13
Effectiveness of Care
Sioux Valley Health Plan
Cholesterol Management After Acute Cardiovascular Events
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
0
Number of employee/dependent medical
records excluded
0
HEDIS 2004 (Reporting Year 2003)
General
Measure
Data
LDL-C
LDL-C Level of
screening 60- <130 mg/dL 60365 Days
365 Days
5
0
100.00%
0.00%
5
0
100.00%
0.00%
5
0
0
5
NA
NA
NA
NA
NA
NA
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
5
0.00%
5
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
HO
N
5
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
Medicare + Choice
0
5
Page 14
Effectiveness of Care
Sioux Valley Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
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
51
73.91%
0
0.00%
20
28.99%
48
69.57%
0
0.00%
0
0.00%
21
30.43%
51
73.91%
0
0.00%
20
28.99%
48
69.57%
0
0.00%
0
0.00%
21
30.43%
51
6
87.69%
78.94%
96.45%
0
12
18.46%
8.26%
28.66%
20
11
47.69%
34.78%
60.60%
48
5
81.54%
71.34%
91.74%
0
35
53.85%
40.96%
66.73%
0
18
27.69%
16.04%
39.34%
21
8
44.62%
31.76%
57.47%
69
4
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2004 (Reporting Year 2003)
Eye Exam
69
0.00%
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
N
69
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
65
Page 15
Effectiveness of Care
Sioux Valley Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 4:03 PM
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
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 16
Effectiveness of Care
Sioux Valley Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 4:03 PM
MSHO
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 17
Effectiveness of Care
Sioux Valley Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 4:03 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
Sioux Valley Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 4:03 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
Sioux Valley Health Plan
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 1, 2004 4:03 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
Total
2
NA
0
2
2
NA
NA
NA
8
NA
0
8
5
NA
NA
NA
15
NA
0
15
12
NA
NA
NA
25
NA
0
25
19
NA
NA
NA
A
Page 20
Effectiveness of Care
Sioux Valley Health Plan
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 1, 2004 4:03 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 21
Effectiveness of Care
Sioux Valley Health Plan
Follow-Up After Hospitalization for Mental Illness
Data Last Refreshed:
Sep 1, 2004 4:03 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
General
Measure
Data
Medicare + Choice
General
W/in 7 Days of W/in 30 Days of
Measure
Discharge
Discharge
Data
A
12
8
NA
NA
NA
11
NA
NA
NA
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
NR
NR
NR
PMAP
General
W/in 7 Days of W/in 30 Days of
Measure
Discharge
Discharge
Data
NR
NR
NR
NR
NR
NR
NR
NR
NR
W/in 7 Days of W/in 30 Days of
Discharge
Discharge
NR
NR
NR
NR
NR
NR
Page 22
Effectiveness of Care
Sioux Valley Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 4:03 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
Sioux Valley Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 4:03 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 24
Effectiveness of Care
Sioux Valley Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 4:03 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 25
Effectiveness of Care
Sioux Valley Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 4:03 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
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 26
Use of Services
Sioux Valley Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 1, 2004 4:03 PM
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
NA
NA
NA
NA
NA
NA
NA
NR
NR
NR
NR
NR
NR
NR
0
0
0
0
3
10
13
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
A
26
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)
26
Page 27
Use of Services
Sioux Valley Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 1, 2004 4:03 PM
PMAP
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 28
Use of Services
Sioux Valley Health Plan
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
A
Data Last Refreshed:
Sep 1, 2004 4:03 PM
PMAP
106
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
47.17%
NR
NR
NR
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)
106
50
47.17%
37.19%
57.14%
NR
NR
NR
Page 29
Use of Services
Sioux Valley Health Plan
Adolescent Well-Care Visits
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
A
PMAP
391
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
23.53%
NR
NR
NR
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)
391
92
23.53%
19.20%
27.86%
NR
NR
NR
Page 30
Use of Services
Sioux Valley Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 4:03 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
315
3243
5315
9281
9709
371
24
0
0
28258
Discharges
Discharges /
1,000 Member
Months
3
9
8
71
96
7
0
0
0
194
9.52
2.78
1.51
7.65
9.89
18.87
0.00
NA
2
8
2
14
54
3
0
0
0
83
6.35
2.47
0.38
1.51
5.56
8.09
0.00
NA
6.87
2.94
1
1
2
13
42
4
0
0
0
63
3.17
0.31
0.38
1.40
4.33
10.78
0.00
NA
4
44
0
0
0
48
0.75
4.74
0.00
0.00
HEDIS 2004 (Reporting Year 2003)
2.23
1.94
Days
9
23
23
172
317
28
0
0
0
572
Days / 1,000
Member
Months
28.57
7.09
4.33
18.53
32.65
75.47
0.00
NA
20.24
5
21
11
26
151
10
0
0
0
224
15.87
6.48
2.07
2.80
15.55
26.95
0.00
NA
4
2
7
40
166
18
0
0
0
237
12.70
0.62
1.32
4.31
17.10
48.52
0.00
NA
5
106
0
0
0
111
0.94
11.42
0.00
0.00
7.93
8.39
4.49
Average Length
of Stay
3.00
2.56
2.88
2.42
3.30
4.00
NA
NA
NA
2.95
2.50
2.63
5.50
1.86
2.80
3.33
NA
NA
NA
2.70
4.00
2.00
3.50
3.08
3.95
4.50
NA
NA
NA
3.76
1.25
2.41
NA
NA
NA
2.31
Page 31
Use of Services
Sioux Valley Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 4:03 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
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 2004 (Reporting Year 2003)
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 32
Use of Services
Sioux Valley Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 4:03 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
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 2004 (Reporting Year 2003)
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 33
Use of Services
Sioux Valley Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 4:03 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
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 34
Use of Services
Sioux Valley Health Plan
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
315
3243
5315
9281
9709
371
24
0
0
28258
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
325
973
942
2119
3071
147
2
0
0
7579
HEDIS 2004 (Reporting Year 2003)
Visits/ 1,000
Member
Months
1031.75
300.03
177.23
228.32
316.30
396.23
83.33
NA
268.21
Emergency Room Visits
Visits
17
52
60
102
78
8
0
0
0
317
Visits/ 1,000
Member
Months
53.97
16.03
11.29
10.99
8.03
21.56
0.00
NA
11.22
Ambulatory
Surgery/Procedures
Procedures
4
12
13
64
172
5
0
0
0
270
Procedures/
1,000 Member
Months
12.70
3.70
2.45
6.90
17.72
13.48
0.00
NA
9.55
Observation Room Stays
Resulting in Discharge
Stays
0
1
2
12
8
1
0
0
0
24
Stays/ 1,000
Member
Months
0.00
0.31
0.38
1.29
0.82
2.70
0.00
NA
0.85
Page 35
Use of Services
Sioux Valley Health Plan
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Medicare + Choice
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 36
Use of Services
Sioux Valley Health Plan
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Minnesota Senior Health Options
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 37
Use of Services
Sioux Valley Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
Member
Months
Age
<1
315
1-9
3243
10-19
5315
20-44
9281
45-64
9709
65-74
371
75-84
24
85+
0
Unknown
0
28258
Total
Days
Days / 1,000
Member
Months
Average Length
of Stay
0.00
0
0.00
NA
0
0.00
0
0.00
NA
10-19
0
0.00
0
0.00
NA
20-44
1
0.11
2
0.22
2.00
45-64
5
0.51
8
0.82
1.60
65-74
0
0.00
0
0.00
NA
75-84
0
0.00
0
0.00
NA
85+
0
NA
0
NA
NA
Unknown
0
6
0.21
0
10
0.35
NA
1.67
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
Age
Total
HEDIS 2004 (Reporting Year 2003)
Page 38
Use of Services
Sioux Valley Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Medicare + Choice
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 39
Use of Services
Sioux Valley Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Minnesota Senior Health Options
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 40
Use of Services
Sioux Valley Health Plan
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Male
Female
Total
2341
1379
8245
176
0
12141
2608
1401
11889
219
0
16117
4949
2780
20134
395
0
28258
Discharges
Discharges /
1,000 Member
Months
Days*
Average Length
of Stay
M
0
0.00
0
NA
F
1
0.38
8
8.00
Total
1
0.20
8
8.00
13-17
M
1
0.73
4
4.00
F
0
0.00
0
NA
Total
1
0.36
4
4.00
18-64
M
0
0.00
0
NA
F
13
1.09
105
8.08
Total
13
0.65
105
8.08
65+
M
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
M
Total
1
0.08
4
4.00
F
14
0.87
113
8.07
TOTAL
15
0.53
117
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 41
Use of Services
Sioux Valley Health Plan
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Medicare + Choice
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 42
Use of Services
Sioux Valley Health Plan
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Minnesota Senior Health Options
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
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 2004 (Reporting Year 2003)
Page 43
Use of Services
Sioux Valley Health Plan
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 4:03 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
2341
1379
8245
176
0
12141
Female
2608
1401
11889
219
0
16117
Member Months (Inpatient)
Total
4949
2780
20134
395
0
28258
Male
2341
1379
8245
176
0
12141
Female
2608
1401
11889
219
0
16117
Member Months (Day/Night)
Total
4949
2780
20134
395
0
28258
Male
2341
1379
8245
176
0
12141
Female
2608
1401
11889
219
0
16117
Total
4949
2780
20134
395
0
28258
Member Months (Ambulatory)
Male
2341
1379
8245
176
0
12141
Female
2608
1401
11889
219
0
16117
Total
4949
2780
20134
395
0
28258
Any Mental Health Services
Inpatient Mental Health Services
Day/Night Mental Health Services
Ambulatory Mental Health Services
Number
4
4
8
8
10
18
27
55
82
0
0
0
0
0
0
39
69
108
Number
0
1
1
1
0
1
0
6
6
0
0
0
0
0
0
1
7
8
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
4
4
8
8
10
18
27
55
82
0
0
0
0
0
0
39
69
108
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
2.05%
1.84%
1.94%
6.96%
8.57%
7.77%
3.93%
5.55%
4.89%
0.00%
0.00%
0.00%
NA
NA
NA
3.85%
5.14%
4.59%
Percent
0.00%
0.46%
0.24%
0.87%
0.00%
0.43%
0.00%
0.61%
0.36%
0.00%
0.00%
0.00%
NA
NA
NA
0.10%
0.52%
0.34%
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Percent
2.05%
1.84%
1.94%
6.96%
8.57%
7.77%
3.93%
5.55%
4.89%
0.00%
0.00%
0.00%
NA
NA
NA
3.85%
5.14%
4.59%
Page 44
Use of Services
Sioux Valley Health Plan
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 4:03 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
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
Any Mental Health Services
Inpatient Mental Health Services
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
Male
Female
NR
NR
Member Months (Ambulatory)
Total
NR
NR
NR
NR
NR
NR
Day/Night Mental Health Services
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Ambulatory Mental Health Services
Number
NR
NR
NR
NR
NR
NR
NR
NR
Percent
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 45
Use of Services
Sioux Valley Health Plan
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 4:03 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
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 46
Use of Services
Sioux Valley Health Plan
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Male
Female
Total
2341
1379
8245
176
0
12141
2608
1401
11889
219
0
16117
4949
2780
20134
395
0
28258
Discharges
Discharges /
1,000 Member
Months
Days
Average Length
of Stay
M
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
M
13-17
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
M
18-64
0
0.00
0
NA
F
1
0.08
12
12.00
Total
1
0.05
12
12.00
M
65+
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
0
0.00
0
NA
F
1
0.06
12
12.00
TOTAL
1
0.04
12
12.00
* 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
Sioux Valley Health Plan
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Medicare + Choice
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
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 2004 (Reporting Year 2003)
Page 48
Use of Services
Sioux Valley Health Plan
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Minnesota Senior Health Options
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
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 2004 (Reporting Year 2003)
Page 49
Use of Services
Sioux Valley Health Plan
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
2341
1379
8245
176
0
12141
Female
2608
1401
11889
219
0
16117
Member Months (Inpatient)
Total
4949
2780
20134
395
0
28258
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
3
1
4
0
1
1
0
0
0
3
2
5
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.44%
0.10%
0.24%
0.00%
5.48%
3.04%
NA
NA
NA
0.30%
0.15%
0.21%
Male
2341
1379
8245
176
0
12141
Female
2608
1401
11889
219
0
16117
Member Months (Day/Night)
Total
4949
2780
20134
395
0
28258
Male
2341
1379
8245
176
0
12141
Female
2608
1401
11889
219
0
16117
Total
4949
2780
20134
395
0
28258
Member Months (Ambulatory)
Male
2341
1379
8245
176
0
12141
Female
2608
1401
11889
219
0
16117
Total
4949
2780
20134
395
0
28258
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
0
0
0
0
0
0
0
1
1
0
1
1
0
0
0
0
2
2
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
3
0
3
0
0
0
0
0
0
3
0
3
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.10%
0.06%
0.00%
5.48%
3.04%
NA
NA
NA
0.00%
0.15%
0.08%
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.44%
0.00%
0.18%
0.00%
0.00%
0.00%
NA
NA
NA
0.30%
0.00%
0.13%
Page 50
Use of Services
Sioux Valley Health Plan
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Medicare + Choice
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 51
Use of Services
Sioux Valley Health Plan
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Minnesota Senior Health Options
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 52
Use of Services
Sioux Valley Health Plan
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 4:03 PM
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 2004 (Reporting Year 2003)
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 53
Use of Services
Sioux Valley Health Plan
Outpatient Drug Utilization
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Minnesota Senior Health Options
Age
Member Months
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
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 2004 (Reporting Year 2003)
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 54
Access/Availability of Care
Sioux Valley Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 4:03 PM
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 2004 (Reporting Year 2003)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
169
292
5
159
280
4
94.08%
90.23%
97.94%
95.89%
93.44%
98.34%
NA
NA
NA
A
Page 55
Access/Availability of Care
Sioux Valley Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 4:03 PM
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 2004 (Reporting Year 2003)
Page 56
Access/Availability of Care
Sioux Valley Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Minnesota Senior Health Options
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 57
Access/Availability of Care
Sioux Valley Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 4:03 PM
PMAP
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 58
Access/Availability of Care
Sioux Valley Health Plan
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 1, 2004 4:03 PM
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 2004 (Reporting Year 2003)
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
12-19 yrs.
30
118
121
342
30
108
105
307
100.00%
98.33%
100.00%
91.53%
86.08%
96.97%
86.78%
80.33%
93.23%
89.77%
86.41%
93.12%
A
Page 59
Access/Availability of Care
Sioux Valley Health Plan
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 1, 2004 4:03 PM
PMAP
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 60
Access/Availability of Care
Sioux Valley Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
HO
HO
Sampling method used (see User's Guide for entry
descriptions)
N
N
Eligible member population (i.e. members who meet all
denominator criteria)
46
46
11
31
23.91%
67.39%
Minimum required sample size (MRSS) or other sample size
46
46
Oversampling rate
Final sample size (FSS)
0%
46
0%
46
Number of numerator events by administrative data in FSS
11
31
23.91%
67.39%
Number of original sample records excluded because of
valid data errors
2
2
Number of employee/dependent medical records excluded
0
0
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
0
44
11
33
0
44
31
9
100.00%
98.86%
100.00%
90.91%
81.28%
100.00%
Data collection methodology (Administrative or Hybrid)
Number of numerator events by administrative data in
eligible population (before exclusions)
Current year's administrative rate (before exclusions)
Administrative rate on FSS
HEDIS 2004 (Reporting Year 2003)
Page 61
Access/Availability of Care
Sioux Valley Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 1, 2004 4:03 PM
PMAP
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 62
Health Plan Stability
Sioux Valley Health Plan
Practitioner Turnover
Medicare + Choice
Practitioner Types
Data Last Refreshed:
Sep 1, 2004 4:03 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
NR
Non-Physician Primary
Care Practitioners
NR
HEDIS 2004 (Reporting Year 2003)
Page 63
Health Plan Stability
Sioux Valley Health Plan
Practitioner Turnover
Minnesota Senior Health Options
Practitioner Types
Number of
Practitioners as of
12/31/2002
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Number of
Practitioners who
were not affiliated
with the plan as of
12/31/2003
Practitioner
Turnover Rate
Primary Care
Physicians
NR
Non-Physician Primary
Care Practitioners
NR
HEDIS 2004 (Reporting Year 2003)
Page 64
Health Plan Stability
Sioux Valley Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Sep 1, 2004 4:03 PM
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, 2003
HEDIS 2004 (Reporting Year 2003)
Page 65
Health Plan Stability
Sioux Valley Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Minnesota Senior Health Options
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, 2003
HEDIS 2004 (Reporting Year 2003)
Page 66
Health Plan Descriptive Information
Sioux Valley Health Plan
Board Certification / Residency Completion
Data Last Refreshed:
Sep 1, 2004 4:03 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
Sioux Valley Health Plan
Total Enrollment by Percentage
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
Medicaid
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Commercial
Product Line
Medicare
Other
Total
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Total
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
M
F
M
F
M
F
M
F
M
F
M
F
Total
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
M
F
M
F
M
F
M
F
M
F
Total
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Total
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
Age Unknown
Total
0.00%
0.00%
Note: Row entries should add up to 100%.
HEDIS 2004 (Reporting Year 2003)
Page 68
Health Plan Descriptive Information
Sioux Valley Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 4:03 PM
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
1824
7152
11436
14184
10044
6960
Member Months
Female
1956
9612
10716
16056
9768
6768
Total
3780
16764
22152
30240
19812
13728
51600
35.42%
8436
3672
9060
9264
12276
54876
28.37%
12132
11232
13236
13332
18732
106476
31.40%
42708
29.31%
17412
13656
10992
7212
68664
35.50%
23952
19056
13116
11112
111372
32.84%
49272
33.82%
1524
588
0
0
0
0
67236
34.76%
1764
576
228
60
0
0
116508
34.36%
2112
1.45%
0
2628
1.36%
0
4740
1.40%
145692
193404
HEDIS 2004 (Reporting Year 2003)
20568
14904
22296
22596
31008
41364
32712
24108
18324
3288
1164
228
60
0
0
0
339096
Page 69
Health Plan Descriptive Information
Sioux Valley Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 4:03 PM
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
NR
NR
NR
NR
NR
NR
NR
HEDIS 2004 (Reporting Year 2003)
Page 70
Health Plan Descriptive Information
Sioux Valley Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 4:03 PM
Minnesota Senior Health Options
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 71
Health Plan Descriptive Information
Sioux Valley Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 4:03 PM
PMAP
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 72