Itasca Medical Care Plan Name 2003 Reporting Year General Info Submission # 1 Last Refreshed: 22 9/1/2004 3:49:25 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 Itasca Medical Care Childhood Immunization Rate Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Childhood Immunization Rate Data Last Refreshed: Sep 1, 2004 3:49 PM PMAP Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population General Measure Data DTaP/DT IPV/OPV MMR HiB Hepatitis B VZV Combo 1 Combo 2 0 0.00% 3 2.46% 57 46.72% 54 44.26% 53 43.44% 25 20.49% 0 0.00% 0 0.00% NR NR NR NR NR NR NR NR 0 111 90.98% 85.49% 96.48% 3 117 98.36% 95.70% 100.00% 57 62 97.54% 94.38% 100.00% 54 66 98.36% 95.70% 100.00% 53 64 95.90% 91.97% 99.83% 25 65 73.77% 65.55% 81.99% 0 106 86.89% 80.49% 93.29% 0 70 57.38% 48.19% 66.56% HO N 122 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) 122 Page 4 Effectiveness of Care Itasca Medical Care Childhood Immunization Rate Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Adolescent Immunization Status Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Adolescent Immunization Status Data Last Refreshed: Sep 1, 2004 3:49 PM PMAP Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population General Measure Data MMR Hepatitis B VZV Combo 1 Combo 2 25 50.00% 14 28.00% 1 2.00% 11 22.00% 1 2.00% NR NR NR NR NR 25 23 96.00% 89.57% 100.00% 14 12 52.00% 37.15% 66.85% 1 0 2.00% 0.00% 6.88% 11 9 40.00% 25.42% 54.58% 1 0 2.00% 0.00% 6.88% HO N 50 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) 50 Page 7 Effectiveness of Care Itasca Medical Care Adolescent Immunization Status Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Breast Cancer Screening Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population Data Last Refreshed: Sep 1, 2004 3:49 PM Commercial Medicare + Choice NR NR NR NR NR NR NR NR NR NR 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 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) Page 9 Effectiveness of Care Itasca Medical Care Cervical Cancer Screening Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population Data Last Refreshed: Sep 1, 2004 3:49 PM Commercial PMAP A 239 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 NR 76.15% 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) 239 182 NR NR NR 76.15% 70.54% 81.76% Page 10 Effectiveness of Care Itasca Medical Care Chlamydia Screening in Women Data Last Refreshed: Sep 1, 2004 3:49 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 68 45.59% 77 37.66% 145 41.38% 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 68 31 45.59% 33.02% 58.16% 77 29 37.66% 26.19% 49.13% 145 60 41.38% 33.02% 49.74% HEDIS 2004 (Reporting Year 2003) NR NR NR NR NR NR NR NR Page 11 Effectiveness of Care Itasca Medical Care Controlling High Blood Pressure Data Last Refreshed: Sep 1, 2004 3:49 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 Medicare + Choice MSHO NR NR NR NR NR NR NR NR NR Records Excluded because of ESRD or non-acute admission identified by Admin Data Records Excluded because of ESRD or non-acute admission identified by Medical Record Number of employee/dependent medical records excluded 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) Page 12 Effectiveness of Care Itasca Medical Care Beta Blocker Treatment after Heart Attack Data Elements Data Last Refreshed: Sep 1, 2004 3:49 PM Commercial Medicare + Choice NR NR NR NR Reported Rate NR NR Lower 95% Confidence Interval Upper 95% Confidence Interval NR NR NR NR Data Collection Methodology Sampling Method Used Eligible Member Population Numerator Events by Admin Data on Eligible Population Current Year's Admin Rate Minimum Required Sample Size Oversampling Rate Final Sample Size (FSS) Numerator events by admin data in FSS Admin rate on FSS Records Excluded because of Valid Data Errors Records Excluded Contraindications/Admin Data Records Excluded Contraindications/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 HEDIS 2004 (Reporting Year 2003) Page 13 Effectiveness of Care Itasca Medical Care Cholesterol Management After Acute Cardiovascular Events Data Last Refreshed: Sep 1, 2004 3:49 PM Commercial Data Elements General Measure Data Medicare + Choice LDL-C LDL-C Level of screening 60- <130 mg/dL 60365 Days 365 Days General Measure Data LDL-C LDL-C Level of screening 60- <130 mg/dL 60365 Days 365 Days Data Collection Methodology Sampling Method Used Eligible Member Population Numerator Events by Admin Data on Eligible Population Current Year's Admin Rate Minimum Required Sample Size Oversampling Rate Final Sample Size (FSS) Numerator events by admin data in FSS Admin rate on FSS NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR Records Excluded because of Valid Data Errors 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) Page 14 Effectiveness of Care Itasca Medical Care Comprehensive Diabetes Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Comprehensive Diabetes Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Comprehensive Diabetes Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Comprehensive Diabetes Care Data Last Refreshed: Sep 1, 2004 3:49 PM PMAP Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population 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 40 85.11% 10 21.28% 28 59.57% 31 65.96% 28 59.57% 17 36.17% 25 53.19% NR NR NR NR NR NR NR 6 34 85.11% 73.86% 96.35% 0 10 21.28% 8.51% 34.04% 8 20 59.57% 44.48% 74.67% 2 29 65.96% 51.35% 80.57% 0 28 59.57% 44.48% 74.67% 0 17 36.17% 21.37% 50.97% 1 24 53.19% 37.86% 68.52% HO N 47 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) 47 Page 18 Effectiveness of Care Itasca Medical Care Comprehensive Diabetes Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Appropriate Medications for People with Asthma Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Appropriate Medications for People with Asthma Data Last Refreshed: Sep 1, 2004 3:49 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 5 NA 0 5 4 NA NA NA 8 NA 0 8 8 NA NA NA 9 NA 0 9 6 NA NA NA 22 NA 0 22 18 NA NA NA A Page 21 Effectiveness of Care Itasca Medical Care Follow-Up After Hospitalization for Mental Illness Data Last Refreshed: Sep 1, 2004 3:49 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 NR NR NR NR NR NR 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) General Measure Data W/in 7 Days of W/in 30 Days of Discharge Discharge NR NR NR PMAP General W/in 7 Days of W/in 30 Days of Measure Discharge Discharge Data W/in 7 Days of W/in 30 Days of Discharge Discharge A 17 NR NR NR NR NR NR 6 NA NA NA 9 NA NA NA Page 22 Effectiveness of Care Itasca Medical Care Antidepressant Medication Management Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Antidepressant Medication Management Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Antidepressant Medication Management Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Antidepressant Medication Management Data Last Refreshed: Sep 1, 2004 3:49 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 4 NA NA NA 4 NA NA NA 4 NA NA NA A 13 Page 26 Use of Services Itasca Medical Care Well Child Visits in the First 15 Months of Life Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Well Child Visits in the First 15 Months of Life Data Last Refreshed: Sep 1, 2004 3:49 PM PMAP 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 3.36% 2.52% 2.52% 4.20% 14.29% 24.37% 48.74% NR NR NR NR NR NR NR 4 3 3 5 17 29 58 3.36% 0.00% 7.02% 2.52% 0.00% 5.76% 2.52% 0.00% 5.76% 4.20% 0.18% 8.23% 14.29% 7.58% 20.99% 24.37% 16.24% 32.50% 48.74% 39.34% 58.14% A 119 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) 119 Page 28 Use of Services Itasca Medical Care 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 Data Last Refreshed: Sep 1, 2004 3:49 PM PMAP A 235 Numerator events by admin data in eligible population Current Year's Admin Rate Minimum Required Sample Size Oversampling Rate Final sample size (FSS) Numerator events by admin data in FSS Administrative rate on FSS Records Excluded because of Valid Data Errors NR 60.85% 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) 235 143 NR NR NR 60.85% 54.40% 67.30% Page 29 Use of Services Itasca Medical Care Adolescent Well-Care Visits Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population Data Last Refreshed: Sep 1, 2004 3:49 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 187 NR 50.54% NR NR 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 N 370 0 NR NR NR 0 370 116 71 50.54% 45.31% 55.77% Page 30 Use of Services Itasca Medical Care Inpatient Utilization - General Hospital/Acute Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Inpatient Utilization - General Hospital/Acute Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Inpatient Utilization - General Hospital/Acute Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Inpatient Utilization - General Hospital/Acute Care Data Last Refreshed: Sep 1, 2004 3:49 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 838 12233 9048 8245 591 1936 1856 2341 0 37088 Discharges Discharges / 1,000 Member Months 127 32 32 184 11 41 43 63 0 533 151.55 2.62 3.54 22.32 18.61 21.18 23.17 26.91 125 27 9 17 7 29 37 55 0 306 149.16 2.21 0.99 2.06 11.84 14.98 19.94 23.49 2 5 6 14 4 12 6 8 0 57 2.39 0.41 0.66 1.70 6.77 6.20 3.23 3.42 17 153 0 0 0 170 HEDIS 2004 (Reporting Year 2003) 14.37 8.25 1.54 1.88 18.56 0.00 0.00 7.08 Days Days / 1,000 Member Months 484 98 63 487 39 233 184 228 0 1816 577.57 8.01 6.96 59.07 65.99 120.35 99.14 97.39 475 56 22 34 25 150 144 192 0 1098 566.83 4.58 2.43 4.12 42.30 77.48 77.59 82.02 9 42 9 36 14 83 40 36 0 269 10.74 3.43 0.99 4.37 23.69 42.87 21.55 15.38 32 417 0 0 0 449 3.54 50.58 0.00 0.00 48.96 29.61 7.25 18.70 Average Length of Stay 3.81 3.06 1.97 2.65 3.55 5.68 4.28 3.62 NA 3.41 3.80 2.07 2.44 2.00 3.57 5.17 3.89 3.49 NA 3.59 4.50 8.40 1.50 2.57 3.50 6.92 6.67 4.50 NA 4.72 1.88 2.73 NA NA NA 2.64 Page 34 Use of Services Itasca Medical Care Ambulatory Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Ambulatory Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Ambulatory Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Inpatient Utilization - Nonacute Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Inpatient Utilization - Nonacute Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Inpatient Utilization - Nonacute Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care 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 3:49 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 Itasca Medical Care Outpatient Drug Utilization Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Adult's Access to Preventive/Ambulatory Health Services Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Adult's Access to Preventive/Ambulatory Health Services Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Adult's Access to Preventive/Ambulatory Health Services Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Adult's Access to Preventive/Ambulatory Health Services Data Last Refreshed: Sep 1, 2004 3:49 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+ 279 28 408 243 20 352 87.10% 82.98% 91.21% NA NA NA 86.27% 82.81% 89.74% A Page 58 Access/Availability of Care Itasca Medical Care Children's Access to Primary Care Practitioners Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Children's Access to Primary Care Practitioners Data Last Refreshed: Sep 1, 2004 3:49 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. 132 252 177 223 130 247 162 208 98.48% 96.02% 100.00% 98.02% 96.10% 99.94% 91.53% 87.14% 95.91% 93.27% 89.76% 96.79% A Page 60 Access/Availability of Care Itasca Medical Care Prenatal and Postpartum Care Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Prenatal and Postpartum Care Data Last Refreshed: Sep 1, 2004 3:49 PM PMAP Data collection methodology (Administrative or Hybrid) Timeliness of Prenatal Care Postpartum Care A A 66 66 22.73% 42.42% NR NR 66 15 66 28 22.73% 11.86% 33.60% 42.42% 29.74% 55.11% 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 Itasca Medical Care Practitioner Turnover Medicare + Choice Practitioner Types Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Practitioner Turnover Minnesota Senior Health Options Practitioner Types Number of Practitioners as of 12/31/2002 Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Years in Business / Total Membership Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Years in Business / Total Membership Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Board Certification / Residency Completion Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care 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 3:49 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 Itasca Medical Care Enrollment by Product Line (Age & Sex) Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Enrollment by Product Line (Age & Sex) Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Enrollment by Product Line (Age & Sex) Data Last Refreshed: Sep 1, 2004 3:49 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 Itasca Medical Care Enrollment by Product Line (Age & Sex) Data Last Refreshed: Sep 1, 2004 3:49 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
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