HealthPartners, Inc. Plan Name 2003 Reporting Year General Info Submission # 1 Last Refreshed: 4 9/1/2004 3:43:56 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 HealthPartners, Inc. Childhood Immunization Rate Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Childhood Immunization Rate Data Last Refreshed: Sep 1, 2004 3:43 PM PMAP Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population General Measure Data HiB Hepatitis B VZV Combo 1 Combo 2 304 19.22% 430 27.18% 806 50.95% 404 25.54% 380 24.02% 687 43.43% 189 11.95% 149 9.42% 89 20.60% 125 28.94% 225 52.08% 115 26.62% 112 25.93% 193 44.68% 56 12.96% 46 10.65% 87 218 74.21% 69.86% 78.56% 120 239 87.35% 84.01% 90.68% 214 127 82.97% 79.21% 86.72% 111 197 74.94% 70.63% 79.25% 107 240 84.43% 80.80% 88.06% 185 122 74.70% 70.37% 79.02% 55 185 58.39% 53.51% 63.28% 45 174 53.28% 48.34% 58.23% 432 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 411 5.00% Number of Records Excluded Because of Valid Data Errors Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval IPV/OPV HO S 1582 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 411 Page 4 Effectiveness of Care HealthPartners, Inc. Childhood Immunization Rate Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Adolescent Immunization Status Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Adolescent Immunization Status Data Last Refreshed: Sep 1, 2004 3:43 PM PMAP Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population General Measure Data Combo 1 Combo 2 119 24.90% 24 5.02% 27 5.65% 17 3.56% 1 0.21% 107 24.77% 22 5.09% 23 5.32% 16 3.70% 1 0.23% 100 240 82.73% 78.95% 86.50% 22 211 56.69% 51.78% 61.60% 21 157 43.31% 38.40% 48.22% 16 214 55.96% 51.04% 60.88% 1 129 31.63% 27.01% 36.25% 432 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 411 5.00% Number of Records Excluded Because of Valid Data Errors Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval Hepatitis B HO S 478 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 411 Page 7 Effectiveness of Care HealthPartners, Inc. Adolescent Immunization Status Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Breast Cancer Screening Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population Data Last Refreshed: Sep 1, 2004 3:43 PM Commercial 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 Medicare + Choice HO S 1786 1463 NR NR 81.91% 229 5.00% 241 200 82.99% 0 Records Excluded because of contraindications through Admin data 0 Records Excluded because of contraindications through Medical Record Review 2 Number of employee/dependent medical records excluded 0 Records Added from Auxiliary List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2004 (Reporting Year 2003) NR NR NR 2 229 193 1 84.72% 79.84% 89.60% Page 9 Effectiveness of Care HealthPartners, Inc. Cervical Cancer Screening Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population Data Last Refreshed: Sep 1, 2004 3:43 PM Commercial Numerator Events by Admin Data on Eligible Population (before exclusions) Current Year's Admin Rate Minimum Required Sample Size Oversampling Rate Final Sample Size (FSS) Numerator events by admin data in FSS Admin Rate on FSS Records Excluded because of Valid Data Errors PMAP HO S 3274 2388 NR NR 72.94% 411 5.00% 432 305 70.60% 0 Records Excluded because of contraindications through Admin data 0 Records Excluded because of contraindications through Medical Record Review 8 Number of employee/dependent medical records excluded 0 Records Added from Auxiliary List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2004 (Reporting Year 2003) NR NR NR 8 411 296 27 78.59% 74.50% 82.68% Page 10 Effectiveness of Care HealthPartners, Inc. Chlamydia Screening in Women Data Last Refreshed: Sep 1, 2004 3:43 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 571 63.57% 767 62.97% 1338 63.23% Records Excluded - Contraindications/Admin Data NR 8 2 10 Denominator Numerator Events by Admin Data Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval NR NR NR NR NR 563 363 64.48% 60.43% 68.52% 765 483 63.14% 59.65% 66.62% 1328 846 63.70% 61.08% 66.33% HEDIS 2004 (Reporting Year 2003) NR NR NR NR NR NR NR NR Page 11 Effectiveness of Care HealthPartners, Inc. Controlling High Blood Pressure Data Last Refreshed: Sep 1, 2004 3:43 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 HO S 4157 371 5.00% 390 0 0 Records Excluded because of ESRD or non-acute admission identified by Admin Data 0 Records Excluded because of ESRD or non-acute admission identified by Medical Record 7 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) NR NR NR 7 371 269 72.51% 67.83% 77.18% MSHO NR NR NR Page 12 Effectiveness of Care HealthPartners, Inc. Beta Blocker Treatment after Heart Attack Data Elements Data Last Refreshed: Sep 1, 2004 3:43 PM Commercial Data Collection Methodology Medicare + Choice HO Sampling Method Used N Eligible Member Population 62 Numerator Events by Admin Data on Eligible Population 42 Current Year's Admin Rate NR Minimum Required Sample Size 62 Oversampling Rate 0.00% Final Sample Size (FSS) 62 Numerator events by admin data in FSS Admin rate on FSS 67.74% 42 NR 67.74% Records Excluded because of Valid Data Errors 0 Records Excluded Contraindications/Admin Data 0 Records Excluded Contraindications/Medical Record Review 2 Number of employee/dependent medical records excluded 0 Records Added from Auxiliary List 0 Denominator 60 Numerator Events by Admin Data 42 Numerator Events by Medical Record 16 Reported Rate NR Lower 95% Confidence Interval Upper 95% Confidence Interval NR 91.29% NR 100.00% HEDIS 2004 (Reporting Year 2003) 96.67% Page 13 Effectiveness of Care HealthPartners, Inc. Cholesterol Management After Acute Cardiovascular Events Data Last Refreshed: Sep 1, 2004 3:43 PM Commercial Data Elements General Measure Data Medicare + Choice LDL-C LDL-C Level of screening 60- <130 mg/dL 60365 Days 365 Days Data Collection Methodology Sampling Method Used Eligible Member Population General Measure Data HO S 114 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 5 Number of employee/dependent medical records excluded 0 HEDIS 2004 (Reporting Year 2003) 74 16 64.91% 14.04% 74 16 64.91% 14.04% 72 13 16 59 77.98% 69.74% 86.22% 68.81% 59.65% 77.96% 114 0.00% 114 Records Excluded because of Valid Data Errors Records Added from Auxiliary List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval LDL-C LDL-C Level of screening 60- <130 mg/dL 60365 Days 365 Days 0 109 NR NR NR NR NR NR Page 14 Effectiveness of Care HealthPartners, Inc. Comprehensive Diabetes Care Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Comprehensive Diabetes Care Data Last Refreshed: Sep 1, 2004 3:43 PM Medicare + Choice Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population General Measure Data LDL-C Screening LDL-C Level <130 mg/dL LDL-C Level <100 mg/dL Monitoring for Diabetic Nephropathy 962 70.37% 1142 83.54% 902 65.98% 1015 74.25% 190 13.90% 124 9.07% 673 49.23% 328 72.41% 378 83.44% 304 67.11% 343 75.72% 64 14.13% 39 8.61% 231 50.99% 306 85 95.13% 92.93% 97.34% 13 24 9.00% 6.11% 11.89% 274 23 72.26% 67.81% 76.71% 317 77 95.86% 93.82% 97.91% 61 266 79.56% 75.54% 83.58% 36 181 52.80% 47.85% 57.75% 212 65 67.40% 62.74% 72.05% 453 6 Number of employee/dependent records excluded 0 Additional Records Added from the Auxiliary List 6 HEDIS 2004 (Reporting Year 2003) Eye Exam 411 10.00% Number of Records Excluded Because of Valid Data Errors Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval Poor HbA1c Control HO S 1367 Numerator events by admin data in eligible population Current Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Final Sample Size (FSS) Numerator events by admin data in FSS Admin rate on FSS HbA1c Testing 411 Page 16 Effectiveness of Care HealthPartners, Inc. Comprehensive Diabetes Care Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Comprehensive Diabetes Care Data Last Refreshed: Sep 1, 2004 3:43 PM PMAP 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 375 65.56% 447 78.15% 308 53.85% 323 56.47% 99 17.31% 54 9.44% 248 43.36% 295 65.12% 357 78.81% 240 52.98% 250 55.19% 79 17.44% 44 9.71% 187 41.28% 279 77 86.62% 83.20% 90.03% 45 66 27.01% 22.59% 31.42% 218 28 59.85% 54.99% 64.71% 233 65 72.51% 68.07% 76.94% 77 138 52.31% 47.36% 57.26% 43 85 31.14% 26.54% 35.74% 175 66 58.64% 53.75% 63.52% 453 21 Number of employee/dependent records excluded 0 Additional Records Added from the Auxiliary List 21 HEDIS 2004 (Reporting Year 2003) Eye Exam 411 10.00% Number of Records Excluded Because of Valid Data Errors Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval Poor HbA1c Control HO S 572 Numerator events by admin data in eligible population Current Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Final Sample Size (FSS) Numerator events by admin data in FSS Admin rate on FSS HbA1c Testing 411 Page 18 Effectiveness of Care HealthPartners, Inc. Comprehensive Diabetes Care Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Appropriate Medications for People with Asthma Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Appropriate Medications for People with Asthma Data Last Refreshed: Sep 1, 2004 3:43 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 63 63.49% 0 63 40 63.49% 50.81% 76.17% 105 62.86% 1 104 66 63.46% 53.73% 73.20% 112 47.32% 16 96 53 55.21% 44.74% 65.68% 280 56.79% 17 263 159 60.46% 54.36% 66.56% A Page 21 Effectiveness of Care HealthPartners, Inc. Follow-Up After Hospitalization for Mental Illness Data Last Refreshed: Sep 1, 2004 3:43 PM Commercial Data Elements General Measure Data Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval Medicare + Choice General W/in 7 Days of W/in 30 Days of Measure Discharge Discharge Data A 22 NR NR NR 8 NA NA NA NR NR NR MSHO Data Elements Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2004 (Reporting Year 2003) W/in 7 Days of W/in 30 Days of Discharge Discharge General Measure Data 14 NA NA NA 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 153 NR NR NR NR NR NR 59 38.56% 30.52% 46.60% 111 72.55% 65.15% 79.95% Page 22 Effectiveness of Care HealthPartners, Inc. Antidepressant Medication Management Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Antidepressant Medication Management Data Last Refreshed: Sep 1, 2004 3:43 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 17 13.28% 7.01% 19.55% 97 75.78% 67.97% 83.59% 79 61.72% 52.91% 70.53% A 128 Page 24 Effectiveness of Care HealthPartners, Inc. Antidepressant Medication Management Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Antidepressant Medication Management Data Last Refreshed: Sep 1, 2004 3:43 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 46 20.91% 15.31% 26.51% 88 40.00% 33.30% 46.70% 53 24.09% 18.21% 29.97% A 220 Page 26 Use of Services HealthPartners, Inc. Well Child Visits in the First 15 Months of Life Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Well Child Visits in the First 15 Months of Life Data Last Refreshed: Sep 1, 2004 3:43 PM PMAP Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population General Measure Data 0 Number of employee/dependent medical records excluded 0 Additional Records Added from the Auxiliary List 0 HEDIS 2004 (Reporting Year 2003) 2 visits 3 visits 4 visits 5 visits 6 or more visits 32 2.46% 43 3.31% 59 4.54% 102 7.85% 224 17.24% 342 26.33% 497 38.26% 11 2.63% 14 3.35% 17 4.07% 33 7.89% 76 18.18% 114 27.27% 153 36.60% 0 2 0.50% 0.00% 1.32% 0 5 1.26% 0.04% 2.48% 0 12 3.02% 1.21% 4.82% 0 22 5.53% 3.16% 7.90% 0 35 8.79% 5.89% 11.70% 0 81 20.35% 16.27% 24.43% 147 94 60.55% 55.63% 65.48% 398 5.00% 418 Number of Records Excluded Because of Valid Data Errors Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval 1 visit HO S 1299 Numerator events by admin data in eligible population Currect Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Final sample size (FSS) Numerator events by admin data in FSS Administrative rate on FSS Zero Visits 398 Page 28 Use of Services HealthPartners, Inc. Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population Commercial Numerator events by admin data in eligible population Current Year's Admin Rate Minimum Required Sample Size Oversampling Rate Final sample size (FSS) Numerator events by admin data in FSS Administrative rate on FSS Records Excluded because of Valid Data Errors HEDIS 2004 (Reporting Year 2003) PMAP HO S 2479 1362 NR 54.94% 376 5.00% 395 219 NR 55.44% 0 Number of employee/dependent medical records excluded Records Added from Auxiliary List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval Data Last Refreshed: Sep 1, 2004 3:43 PM 0 NR NR NR 0 376 209 28 63.03% 58.02% 68.04% Page 29 Use of Services HealthPartners, Inc. Adolescent Well-Care Visits Data Elements Data Collection Methodology Sampling Method Used Eligible Member Population Data Last Refreshed: Sep 1, 2004 3:43 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 1302 NR 35.08% 411 5.00% 432 140 NR 32.41% 0 Number of employee/dependent medical records excluded Records Added from Auxiliary List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Reported Rate Lower 95% Confidence Interval Upper 95% Confidence Interval HEDIS 2004 (Reporting Year 2003) PMAP HO S 3711 0 NR NR NR 0 411 137 48 45.01% 40.08% 49.94% Page 30 Use of Services HealthPartners, Inc. Inpatient Utilization - General Hospital/Acute Care Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Inpatient Utilization - General Hospital/Acute Care Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Inpatient Utilization - General Hospital/Acute Care Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Inpatient Utilization - General Hospital/Acute Care Data Last Refreshed: Sep 1, 2004 3:43 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 25178 122641 87004 84216 8042 19735 13714 9646 0 370176 Discharges 241 317 483 2148 87 476 374 247 0 4373 Discharges / 1,000 Member Months 9.57 2.58 5.55 25.51 10.82 24.12 27.27 25.61 11.81 206 276 114 298 50 367 312 209 0 1832 8.18 2.25 1.31 3.54 6.22 18.60 22.75 21.67 33 41 58 196 32 109 61 38 0 568 1.31 0.33 0.67 2.33 3.98 5.52 4.45 3.94 310 1653 5 0 0 1968 3.56 19.63 0.62 0.00 HEDIS 2004 (Reporting Year 2003) 4.95 1.53 8.85 Days Days / 1,000 Member Months 1148 704 1523 5688 245 2212 1625 1075 0 14220 45.60 5.74 17.50 67.54 30.47 112.09 118.49 111.45 704 580 434 808 104 1501 1259 859 0 6249 27.96 4.73 4.99 9.59 12.93 76.06 91.80 89.05 434 124 260 599 129 711 364 216 0 2837 17.24 1.01 2.99 7.11 16.04 36.03 26.54 22.39 828 4276 12 0 0 5116 9.52 50.77 1.49 0.00 38.41 16.88 7.66 23.01 Average Length of Stay 4.76 2.22 3.15 2.65 2.82 4.65 4.34 4.35 NA 3.25 3.42 2.10 3.81 2.71 2.08 4.09 4.04 4.11 NA 3.41 13.15 3.02 4.48 3.06 4.03 6.52 5.97 5.68 NA 4.99 2.67 2.59 2.40 NA NA 2.60 Page 34 Use of Services HealthPartners, Inc. Ambulatory Care Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Ambulatory Care Data Last Refreshed: Sep 1, 2004 3:43 PM Medicare + Choice Age <1 1-9 10-19 20-44 45-64 65-74 75-84 85+ Unknown Total Member Months 0 0 0 337 3280 80257 81510 33489 0 198873 Outpatient Visits (Excludes MH/CD) Age <1 1-9 10-19 20-44 45-64 65-74 75-84 85+ Unknown Total Visits 0 0 0 240 2302 44686 57068 23741 0 128037 HEDIS 2004 (Reporting Year 2003) Visits/ 1,000 Member Months NA NA NA 712.17 701.83 556.79 700.13 708.92 643.81 Emergency Room Visits Visits 0 0 0 11 61 862 1228 682 0 2844 Visits/ 1,000 Member Months NA NA NA 32.64 18.60 10.74 15.07 20.36 14.30 Ambulatory Surgery/Procedures Procedures 0 0 0 8 93 1905 1959 491 0 4456 Procedures/ 1,000 Member Months NA NA NA 23.74 28.35 23.74 24.03 14.66 22.41 Observation Room Stays Resulting in Discharge Stays 0 0 0 0 2 5 4 1 0 12 Stays/ 1,000 Member Months NA NA NA 0.00 0.61 0.06 0.05 0.03 0.06 Page 36 Use of Services HealthPartners, Inc. Ambulatory Care Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Inpatient Utilization - Nonacute Care Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Inpatient Utilization - Nonacute Care Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Inpatient Utilization - Nonacute Care Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. 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 3:43 PM Member Months 0 0 217 2400 68475 42819 10479 0 124390 Specification Documentation: Prescription is defined as (Enter "A" or "B"): Age 0-9 10-19 20-44 45-64 65-74 75-84 85+ Unknown Total Total Cost of Prescriptions $0.00 $0.00 $142,062.00 $909,259.91 $10,342,441.87 $7,524,377.17 $1,818,172.38 $0.00 $20,736,313.33 HEDIS 2004 (Reporting Year 2003) A Avg. Cost of Prescriptions / Per Member Per Month NA NA $654.66 $378.86 $151.04 $175.73 $173.51 $166.70 Total Number of Prescriptions 0 0 1204 13431 238176 191303 50802 0 494916 Avg. Num. Of Prescriptions / Per Member Per Year NA NA 66.58 67.16 41.74 53.61 58.18 47.74 Page 53 Use of Services HealthPartners, Inc. Outpatient Drug Utilization Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Adult's Access to Preventive/Ambulatory Health Services Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Adult's Access to Preventive/Ambulatory Health Services Data Last Refreshed: Sep 1, 2004 3:43 PM Medicare + Choice Data Elements Data collection methodology (Administrative only) Eligible member population (i.e. members who meet all denominator criteria) Numerator events by administrative data Reported rate Lower 95% confidence interval Upper 95% confidence interval HEDIS 2004 (Reporting Year 2003) General Measure Data Ages 20-44 Ages 45-64 Ages 65+ 23 246 15865 21 232 15325 NA NA NA 94.31% 91.21% 97.41% 96.60% 96.31% 96.88% A Page 56 Access/Availability of Care HealthPartners, Inc. Adult's Access to Preventive/Ambulatory Health Services Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Adult's Access to Preventive/Ambulatory Health Services Data Last Refreshed: Sep 1, 2004 3:43 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+ 3291 406 2922 2969 352 2676 90.22% 89.19% 91.25% 86.70% 83.27% 90.13% 91.58% 90.56% 92.61% A Page 58 Access/Availability of Care HealthPartners, Inc. Children's Access to Primary Care Practitioners Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Children's Access to Primary Care Practitioners Data Last Refreshed: Sep 1, 2004 3:43 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. 1686 3346 1718 2295 1620 2896 1394 1949 96.09% 95.13% 97.04% 86.55% 85.38% 87.72% 81.14% 79.26% 83.02% 84.92% 83.44% 86.41% A Page 60 Access/Availability of Care HealthPartners, Inc. Prenatal and Postpartum Care Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Prenatal and Postpartum Care Data Last Refreshed: Sep 1, 2004 3:43 PM PMAP Timeliness of Prenatal Care Postpartum Care HO HO S S 1442 1442 1019 579 70.67% 40.15% Minimum required sample size (MRSS) or other sample size 411 411 Oversampling rate Final sample size (FSS) 5% 432 5% 432 Number of numerator events by administrative data in FSS 303 181 70.14% 41.90% Number of original sample records excluded because of valid data errors 2 2 Number of employee/dependent medical records excluded 0 0 2 411 134 220 2 411 134 124 86.13% 82.67% 89.59% 62.77% 57.98% 67.57% Data collection methodology (Administrative or Hybrid) Sampling method used (see User's Guide for entry descriptions) Eligible member population (i.e. members who meet all denominator criteria) Number of numerator events by administrative data in eligible population (before exclusions) Current year's administrative rate (before exclusions) Administrative rate on FSS Additional records added from the auxiliary list Denominator Numerator events by administrative data Numerator events by medical record Reported rate Lower 95% confidence interval Upper 95% confidence interval HEDIS 2004 (Reporting Year 2003) Page 62 Health Plan Stability HealthPartners, Inc. Practitioner Turnover Medicare + Choice Practitioner Types Data Last Refreshed: Sep 1, 2004 3:43 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 3350 85 2.54% Non-Physician Primary Care Practitioners 689 18 2.61% HEDIS 2004 (Reporting Year 2003) Page 63 Health Plan Stability HealthPartners, Inc. Practitioner Turnover Minnesota Senior Health Options Practitioner Types Number of Practitioners as of 12/31/2002 Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Years in Business / Total Membership Data Last Refreshed: Sep 1, 2004 3:43 PM Medicare + Choice Product/Product Line HMO (Total) Medicaid Commercial Medicare (cost or risk) Self-insured Other (specify) PPO (Total) Commercial Medicare (cost or risk) Self-insured Other (specify) POS (Total) Commercial Medicare (cost or risk) Self-insured Other (specify) Total Years in Business 48.00 18.00 48.00 48.00 16.00 48.00 Members* 427172 49919 106959 33251 232983 4060 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 20.00 20.00 0.00 0.00 0.00 198869 198869 0 0 0 626041 * Total number of members in each category as of December 31, 2003 HEDIS 2004 (Reporting Year 2003) Page 65 Health Plan Stability HealthPartners, Inc. Years in Business / Total Membership Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Board Certification / Residency Completion Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. 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 3:43 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 HealthPartners, Inc. Enrollment by Product Line (Age & Sex) Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Enrollment by Product Line (Age & Sex) Data Last Refreshed: Sep 1, 2004 3:43 PM Medicare + Choice <1 1-4 5-9 10-14 15-17 18-19 0-19 Subtotal 0-19 Subtotal: % 20-24 25-29 30-34 35-39 40-44 20-44 Subtotal 20-44 Subtotal: % 45-49 50-54 55-59 60-64 45-64 Subtotal 45-64 Subtotal: % 65-69 70-74 75-79 80-84 85-89 >=90 >=65 Subtotal >=65 Subtotal: % Age Unknown Total Male 0 0 0 0 0 0 Member Months Female 0 0 0 0 0 0 Total 0 0 0 0 0 0 0 0.00% 0 0 24 60 84 0 0.00% 0 0 12 36 120 0 0.00% 168 0.22% 168 216 264 780 168 0.14% 144 228 444 1044 336 0.17% 1428 1.86% 18504 16788 16452 13788 6864 2688 1860 1.52% 23508 21456 25704 25572 15372 8568 3288 1.65% 75084 97.92% 0 120180 98.34% 0 195264 98.18% 76680 122208 HEDIS 2004 (Reporting Year 2003) 0 0 36 96 204 312 444 708 1824 42012 38244 42156 39360 22236 11256 0 198888 Page 70 Health Plan Descriptive Information HealthPartners, Inc. Enrollment by Product Line (Age & Sex) Data Last Refreshed: Sep 1, 2004 3:43 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 HealthPartners, Inc. Enrollment by Product Line (Age & Sex) Data Last Refreshed: Sep 1, 2004 3:43 PM PMAP <1 1-4 5-9 10-14 15-17 18-19 0-19 Subtotal 0-19 Subtotal: % 20-24 25-29 30-34 35-39 40-44 20-44 Subtotal 20-44 Subtotal: % 45-49 50-54 55-59 60-64 45-64 Subtotal 45-64 Subtotal: % 65-69 70-74 75-79 80-84 85-89 >=90 >=65 Subtotal >=65 Subtotal: % Age Unknown Total Male 12983 35270 26979 24166 12101 5176 Member Months Female 12195 32672 27720 24454 12623 8484 Total 25178 67942 54699 48620 24724 13660 116675 79.97% 3626 2676 2937 2644 2420 118148 52.68% 23435 17024 13228 9642 6584 234823 63.44% 14303 9.80% 1554 678 328 206 69913 31.17% 3067 1424 612 173 84216 22.75% 2766 1.90% 3783 3175 2009 1764 760 655 5276 2.35% 6639 6138 5425 4516 4179 4052 8042 2.17% 12146 8.33% 0 30949 13.80% 0 43095 11.64% 145890 224286 HEDIS 2004 (Reporting Year 2003) 27061 19700 16165 12286 9004 4621 2102 940 379 10422 9313 7434 6280 4939 4707 0 370176 Page 72
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