HealthPartners / Group Health (Combined)
Plan Name
2003
Reporting Year
General Info
Submission #
1
Last Refreshed:
37
9/1/2004 3:45:19 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 / Group Health (Combined)
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Combo 1
Combo 2
3607
61.34%
3832
65.17%
5060
86.05%
3740
63.61%
3652
62.11%
4487
76.31%
2912
49.52%
2587
44.00%
227
58.96%
250
64.94%
324
84.16%
234
60.78%
232
60.26%
273
70.91%
189
49.09%
164
42.60%
214
113
89.34%
86.05%
92.64%
234
108
93.44%
90.77%
96.12%
307
19
89.07%
85.74%
92.40%
217
94
84.97%
81.18%
88.77%
217
114
90.44%
87.29%
93.59%
261
24
77.87%
73.48%
82.26%
176
102
75.96%
71.44%
80.47%
153
97
68.31%
63.40%
73.21%
385
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
366
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
5880
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
366
Page 3
Effectiveness of Care
HealthPartners / Group Health (Combined)
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 3:45 PM
PMAP
Data Elements
General
Measure
Data
DTaP/DT
IPV/OPV
MMR
HiB
Hepatitis B
VZV
Combo 1
Combo 2
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of Records Excluded because of
Contraindications by Admin Data
Number of Records Excluded because of
Contraindications by Medical Record
Review
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 4
Effectiveness of Care
HealthPartners / Group Health (Combined)
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Combo 1
Combo 2
3444
45.75%
1714
22.77%
195
2.59%
1267
16.83%
50
0.66%
182
42.13%
99
22.92%
10
2.31%
69
15.97%
3
0.69%
174
185
87.35%
84.01%
90.68%
94
186
68.13%
63.50%
72.75%
9
239
60.34%
55.49%
65.19%
66
206
66.18%
61.48%
70.88%
2
197
48.42%
43.47%
53.37%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
2
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
2
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
7528
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 6
Effectiveness of Care
HealthPartners / Group Health (Combined)
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 3:45 PM
PMAP
Data Elements
General
Measure
Data
MMR
Hepatitis B
VZV
Combo 1
Combo 2
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of Records Excluded because of
Contraindications by Admin Data
Number of Records Excluded because of
Contraindications by Medical Record
Review
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 7
Effectiveness of Care
HealthPartners / Group Health (Combined)
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Breast Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
HO
S
36984
28831
77.96%
240
5.00%
252
197
78.17%
0
Records Excluded because of contraindications
through Admin data
0
Records Excluded because of contraindications
through Medical Record Review
1
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)
Medicare + Choice
1
240
189
9
82.50%
77.48%
87.52%
NR
NR
NR
NR
NR
Page 9
Effectiveness of Care
HealthPartners / Group Health (Combined)
Cervical Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
HO
S
109860
87511
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
79.66%
279
5.00%
293
231
78.84%
0
Records Excluded because of contraindications
through Admin data
0
Records Excluded because of contraindications
through Medical Record Review
14
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)
PMAP
14
279
231
7
85.30%
80.97%
89.64%
NR
NR
NR
NR
NR
Page 10
Effectiveness of Care
HealthPartners / Group Health (Combined)
Chlamydia Screening in Women
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Data Elements
Data Collection Methodology
Eligible Member Population
Current Year's Admin Rate (before exclusions)
Records Excluded - Contraindications/Admin
Data
Denominator
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
General
Measure Ages 16-20 Ages 21-25
Data
PMAP
Total
General
Measure Ages 16-20 Ages 21-25
Data
Total
A
7810
34.72%
9496
33.44%
17306
34.02%
134
60
194
NR
7676
2712
35.33%
34.26%
36.41%
9436
3175
33.65%
32.69%
34.61%
17112
5887
34.40%
33.69%
35.12%
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 11
Effectiveness of Care
HealthPartners / Group Health (Combined)
Controlling High Blood Pressure
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Data Elements
Data Collection Methodology (Hybrid)
Sampling Method Used
Eligible Member Population
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Records Excluded because of Valid Data Errors
Records Excluded - False positive diagnosis
Commercial
HO
S
17498
405
5.00%
426
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
6
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)
6
405
267
65.93%
61.19%
70.67%
Medicare + Choice
MSHO
NR
NR
NR
NR
NR
NR
Page 12
Effectiveness of Care
HealthPartners / Group Health (Combined)
Beta Blocker Treatment after Heart Attack
Data Elements
Data Collection Methodology
Sampling Method Used
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
HO
N
Eligible Member Population
303
Numerator Events by Admin Data on
Eligible Population
255
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Medicare + Choice
84.16%
NR
303
0.00%
303
255
84.16%
Records Excluded because of Valid Data
Errors
0
Records Excluded Contraindications/Admin Data
0
Records Excluded Contraindications/Medical Record Review
11
Number of employee/dependent medical
records excluded
0
Records Added from Auxiliary List
0
Denominator
292
Numerator Events by Admin Data
255
Numerator Events by Medical Record
26
NR
Reported Rate
96.23%
NR
Lower 95% Confidence Interval
Upper 95% Confidence Interval
93.88%
NR
98.59%
NR
HEDIS 2004 (Reporting Year 2003)
Page 13
Effectiveness of Care
HealthPartners / Group Health (Combined)
Cholesterol Management After Acute Cardiovascular Events
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
26
Number of employee/dependent medical
records excluded
0
HEDIS 2004 (Reporting Year 2003)
General
Measure
Data
LDL-C
LDL-C Level of
screening 60- <130 mg/dL 60365 Days
365 Days
735
215
76.17%
22.28%
358
98
75.69%
20.72%
326
6
91
191
80.78%
76.85%
84.71%
68.61%
64.00%
73.22%
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
411
15.00%
473
Records Excluded because of Valid Data
Errors
Records Added from Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
LDL-C
LDL-C Level of
screening 60- <130 mg/dL 60365 Days
365 Days
HO
S
965
Numerator Events by Admin Data on
Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Medicare + Choice
26
411
Page 14
Effectiveness of Care
HealthPartners / Group Health (Combined)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure Data
LDL-C
Screening
LDL-C Level
<130 mg/dL
LDL-C Level
<100 mg/dL
Monitoring for
Diabetic
Nephropathy
11886
85.71%
10416
75.11%
7071
50.99%
12097
87.23%
3058
22.05%
1716
12.37%
8351
60.22%
388
85.65%
342
75.50%
214
47.24%
383
84.55%
77
17.00%
42
9.27%
265
58.50%
359
20
92.21%
89.50%
94.93%
66
35
24.57%
20.29%
28.86%
192
15
50.36%
45.41%
55.32%
352
19
90.27%
87.28%
93.25%
75
196
65.94%
61.23%
70.64%
42
109
36.74%
31.96%
41.52%
249
29
67.64%
63.00%
72.28%
453
13
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
13
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
13868
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 15
Effectiveness of Care
HealthPartners / Group Health (Combined)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:45 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
HealthPartners / Group Health (Combined)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:45 PM
PMAP
Data Elements
General
Measure Data
HbA1c
Testing
Poor HbA1c
Control
Eye Exam
LDL-C
Screening
LDL-C Level
<130 mg/dL
LDL-C Level
<100 mg/dL
Monitoring for
Diabetic
Nephropathy
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator events by admin data in
eligible population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because
of Valid Data Errors
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 18
Effectiveness of Care
HealthPartners / Group Health (Combined)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Data Elements
Data Collection Methodology
Eligible Member Population
Current Year's Admin Rate
Total Exclusions
Denominator
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
Total
691
74.24%
11
680
513
75.44%
72.13%
78.75%
1458
71.47%
15
1443
1042
72.21%
69.86%
74.56%
5488
68.48%
455
5033
3758
74.67%
73.46%
75.88%
7637
69.57%
481
7156
5313
74.25%
73.23%
75.27%
A
Page 20
Effectiveness of Care
HealthPartners / Group Health (Combined)
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 1, 2004 3:45 PM
PMAP
Data Elements
Data Collection Methodology
Eligible Member Population
Current Year's Admin Rate
Total Exclusions
Denominator
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 21
Effectiveness of Care
HealthPartners / Group Health (Combined)
Follow-Up After Hospitalization for Mental Illness
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
General
Measure
Data
Medicare + Choice
General
W/in 7 Days of W/in 30 Days of
Measure
Discharge
Discharge
Data
A
1438
724
50.35%
47.73%
52.97%
1081
75.17%
72.91%
77.44%
MSHO
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
W/in 7 Days of W/in 30 Days of
Discharge
Discharge
General
Measure
Data
NR
NR
NR
PMAP
General
W/in 7 Days of W/in 30 Days of
Measure
Discharge
Discharge
Data
NR
NR
NR
NR
NR
NR
NR
NR
NR
W/in 7 Days of W/in 30 Days of
Discharge
Discharge
NR
NR
NR
NR
NR
NR
Page 22
Effectiveness of Care
HealthPartners / Group Health (Combined)
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 3:45 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
HealthPartners / Group Health (Combined)
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 3:45 PM
PMAP
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 26
Use of Services
HealthPartners / Group Health (Combined)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
0
Number of employee/dependent medical
records excluded
0
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
74
1.37%
52
0.96%
75
1.39%
97
1.79%
318
5.88%
1194
22.08%
3597
66.52%
7
1.99%
4
1.14%
3
0.85%
12
3.41%
19
5.40%
78
22.16%
229
65.06%
0
2
0.60%
0.00%
1.57%
0
2
0.60%
0.00%
1.57%
0
1
0.30%
0.00%
1.03%
0
9
2.69%
0.81%
4.57%
0
12
3.58%
1.44%
5.72%
0
46
13.73%
9.90%
17.57%
217
46
78.51%
73.96%
83.06%
335
5.00%
352
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
5407
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
335
Page 27
Use of Services
HealthPartners / Group Health (Combined)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 1, 2004 3:45 PM
PMAP
Data Elements
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of employee/dependent medical
records excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Page 28
Use of Services
HealthPartners / Group Health (Combined)
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
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
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)
Commercial
HO
S
26010
Data Last Refreshed:
Sep 1, 2004 3:45 PM
PMAP
14369
55.24%
409
5.00%
430
246
NR
57.21%
0
NR
0
0
409
235
14
60.88%
56.03%
65.73%
NR
NR
NR
Page 29
Use of Services
HealthPartners / Group Health (Combined)
Adolescent Well-Care Visits
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
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
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)
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
HO
S
72676
PMAP
22026
30.31%
411
5.00%
432
134
NR
31.02%
0
NR
0
0
411
129
33
39.42%
34.57%
44.26%
NR
NR
NR
Page 30
Use of Services
HealthPartners / Group Health (Combined)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 3:45 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
89692
839454
1039526
2526381
1861837
82046
19162
3639
0
6461737
Discharges
Discharges /
1,000 Member
Months
606
1277
1785
14876
12588
1185
434
113
0
32864
6.76
1.52
1.72
5.89
6.76
14.44
22.65
31.05
467
986
898
3081
6123
643
280
82
0
12560
5.21
1.17
0.86
1.22
3.29
7.84
14.61
22.53
138
289
657
3676
6447
540
152
31
0
11930
1.54
0.34
0.63
1.46
3.46
6.58
7.93
8.52
229
8114
12
0
0
8355
HEDIS 2004 (Reporting Year 2003)
5.09
1.94
1.85
0.22
3.21
0.01
0.00
1.51
Days
Days / 1,000
Member
Months
2607
3795
5607
42949
45111
4950
1865
488
0
107372
29.07
4.52
5.39
17.00
24.23
60.33
97.33
134.10
1444
2522
2854
9225
19400
2240
1115
281
0
39081
16.10
3.00
2.75
3.65
10.42
27.30
58.19
77.22
1147
1235
2188
11658
25667
2697
747
207
0
45546
12.79
1.47
2.10
4.61
13.79
32.87
38.98
56.88
564
22058
27
0
0
22649
0.54
8.73
0.01
0.00
16.62
6.05
7.05
4.09
Average Length
of Stay
4.30
2.97
3.14
2.89
3.58
4.18
4.30
4.32
NA
3.27
3.09
2.56
3.18
2.99
3.17
3.48
3.98
3.43
NA
3.11
8.31
4.27
3.33
3.17
3.98
4.99
4.91
6.68
NA
3.82
2.46
2.72
2.25
NA
NA
2.71
Page 31
Use of Services
HealthPartners / Group Health (Combined)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 3:45 PM
PMAP
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Age
Total Inpatient
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Medicine
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Surgery
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Maternity
10-19
20-44
45-64
65+
Unknown
Total
Member Months
NR
Discharges
Discharges /
1,000 Member
Months
Days
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2004 (Reporting Year 2003)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Days / 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
Average Length
of Stay
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 34
Use of Services
HealthPartners / Group Health (Combined)
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
89692
839454
1039526
2526381
1861837
82046
19162
3639
0
6461737
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
80437
258559
225349
627005
616349
37289
11008
2191
0
1858187
HEDIS 2004 (Reporting Year 2003)
Visits/ 1,000
Member
Months
896.81
308.01
216.78
248.18
331.04
454.49
574.47
602.09
287.57
Emergency Room Visits
Visits
2405
11396
10097
24667
14567
831
265
46
0
64274
Visits/ 1,000
Member
Months
26.81
13.58
9.71
9.76
7.82
10.13
13.83
12.64
9.95
Ambulatory
Surgery/Procedures
Procedures
501
3584
2855
14510
25190
1613
459
75
0
48787
Procedures/
1,000 Member
Months
5.59
4.27
2.75
5.74
13.53
19.66
23.95
20.61
7.55
Observation Room Stays
Resulting in Discharge
Stays
34
65
98
1454
59
1
1
3
0
1715
Stays/ 1,000
Member
Months
0.38
0.08
0.09
0.58
0.03
0.01
0.05
0.82
0.27
Page 35
Use of Services
HealthPartners / Group Health (Combined)
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 3:45 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
HealthPartners / Group Health (Combined)
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Member
Months
Age
<1
89692
1-9
839454
10-19
1039526
20-44
2526381
45-64
1861837
65-74
82046
75-84
19162
85+
3639
Unknown
0
6461737
Total
Days
Days / 1,000
Member
Months
Average Length
of Stay
0.00
0
0.00
NA
3
0.00
110
0.13
36.67
9
0.01
191
0.18
21.22
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
10-19
Age
20-44
99
0.04
1626
0.64
16.42
45-64
668
0.36
8833
4.74
13.22
65-74
126
1.54
2525
30.78
20.04
75-84
81
4.23
2633
137.41
32.51
85+
42
11.54
1565
430.06
37.26
0
1028
0.16
0
17483
2.71
NA
17.01
Unknown
Total
HEDIS 2004 (Reporting Year 2003)
Page 38
Use of Services
HealthPartners / Group Health (Combined)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
Total
634833
274427
2179903
55677
0
3144840
603465
262099
2402163
49170
0
3316897
1238298
536526
4582066
104847
0
6461737
Discharges
Discharges /
1,000 Member
Months
Age
0-12
Days*
Average Length
of Stay
M
44
0.07
501
11.39
F
32
0.05
445
13.91
Total
76
0.06
946
12.45
13-17
M
189
0.69
4403
23.30
F
336
1.28
4787
14.25
Total
525
0.98
9190
17.50
18-64
M
512
0.23
4433
8.66
F
908
0.38
8232
9.07
Total
1420
0.31
12665
8.92
65+
M
12
0.22
75
6.25
F
19
0.39
777
40.89
Total
31
0.30
852
27.48
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
M
Total
757
0.24
9412
12.43
F
1295
0.39
14241
11.00
TOTAL
2052
0.32
23653
11.53
* 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 / Group Health (Combined)
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:45 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
634833
274427
2179903
55677
0
3144840
Female
603465
262099
2402163
49170
0
3316897
Member Months (Inpatient)
Total
1238298
536526
4582066
104847
0
6461737
Male
634833
274427
2179903
55677
0
3144840
Female
603465
262099
2402163
49170
0
3316897
Total
1238298
536526
4582066
104847
0
6461737
Member Months (Day/Night)
Male
634833
274427
2179903
55677
0
3144840
Female
603465
262099
2402163
49170
0
3316897
Total
1238298
536526
4582066
104847
0
6461737
Member Months (Ambulatory)
Male
634833
274427
2179903
55677
0
3144840
Female
603465
262099
2402163
49170
0
3316897
Total
1238298
536526
4582066
104847
0
6461737
Any Mental Health Services
Inpatient Mental Health Services
Day/Night Mental Health Services
Ambulatory Mental Health Services
Number
3045
1707
4752
2713
2926
5639
11397
21602
32999
138
172
310
0
0
0
17293
26407
43700
Number
37
21
58
142
239
381
432
680
1112
12
19
31
0
0
0
623
959
1582
Number
13
8
21
30
66
96
46
152
198
0
0
0
0
0
0
89
226
315
Number
3033
1704
4737
2675
2884
5559
11294
21479
32773
129
156
285
0
0
0
17131
26223
43354
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2004 (Reporting Year 2003)
Percent
5.76%
3.39%
4.61%
11.86%
13.40%
12.61%
6.27%
10.79%
8.64%
2.97%
4.20%
3.55%
NA
NA
NA
6.60%
9.55%
8.12%
Percent
0.07%
0.04%
0.06%
0.62%
1.09%
0.85%
0.24%
0.34%
0.29%
0.26%
0.46%
0.35%
NA
NA
NA
0.24%
0.35%
0.29%
Percent
0.02%
0.02%
0.02%
0.13%
0.30%
0.21%
0.03%
0.08%
0.05%
0.00%
0.00%
0.00%
NA
NA
NA
0.03%
0.08%
0.06%
Percent
5.73%
3.39%
4.59%
11.70%
13.20%
12.43%
6.22%
10.73%
8.58%
2.78%
3.81%
3.26%
NA
NA
NA
6.54%
9.49%
8.05%
Page 44
Use of Services
HealthPartners / Group Health (Combined)
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Male
Female
Total
634833
274427
2179903
55677
0
3144840
603465
262099
2402163
49170
0
3316897
1238298
536526
4582066
104847
0
6461737
Discharges
Discharges /
1,000 Member
Months
Days
Average Length
of Stay
M
1
0.00
2
2.00
F
0
0.00
0
NA
Total
1
0.00
2
2.00
M
13-17
184
0.67
1751
9.52
F
92
0.35
1082
11.76
Total
276
0.51
2833
10.26
M
18-64
651
0.30
3972
6.10
F
404
0.17
2036
5.04
Total
1055
0.23
6008
5.69
M
65+
3
0.05
23
7.67
F
1
0.02
2
2.00
Total
4
0.04
25
6.25
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
839
0.27
5748
6.85
F
497
0.15
3120
6.28
TOTAL
1336
0.21
8868
6.64
* 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 / Group Health (Combined)
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
634833
274427
2179903
55677
0
3144840
Female
603465
262099
2402163
49170
0
3316897
Member Months (Inpatient)
Total
1238298
536526
4582066
104847
0
6461737
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
6
2
8
496
225
721
2018
938
2956
8
4
12
0
0
0
2528
1169
3697
Percent
0.01%
0.00%
0.01%
2.17%
1.03%
1.61%
1.11%
0.47%
0.77%
0.17%
0.10%
0.14%
NA
NA
NA
0.96%
0.42%
0.69%
Male
634833
274427
2179903
55677
0
3144840
Female
603465
262099
2402163
49170
0
3316897
Total
1238298
536526
4582066
104847
0
6461737
Member Months (Day/Night)
Male
634833
274427
2179903
55677
0
3144840
Female
603465
262099
2402163
49170
0
3316897
Total
1238298
536526
4582066
104847
0
6461737
Member Months (Ambulatory)
Male
634833
274427
2179903
55677
0
3144840
Female
603465
262099
2402163
49170
0
3316897
Total
1238298
536526
4582066
104847
0
6461737
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
1
0
1
151
80
231
494
305
799
3
1
4
0
0
0
649
386
1035
Number
1
1
2
206
80
286
362
153
515
1
1
2
0
0
0
570
235
805
Number
5
1
6
351
168
519
1583
707
2290
8
3
11
0
0
0
1947
879
2826
Percent
0.00%
0.00%
0.00%
0.66%
0.37%
0.52%
0.27%
0.15%
0.21%
0.06%
0.02%
0.05%
NA
NA
NA
0.25%
0.14%
0.19%
Percent
0.00%
0.00%
0.00%
0.90%
0.37%
0.64%
0.20%
0.08%
0.13%
0.02%
0.02%
0.02%
NA
NA
NA
0.22%
0.09%
0.15%
Percent
0.01%
0.00%
0.01%
1.53%
0.77%
1.16%
0.87%
0.35%
0.60%
0.17%
0.07%
0.13%
NA
NA
NA
0.74%
0.32%
0.52%
Page 50
Use of Services
HealthPartners / Group Health (Combined)
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
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 3:45 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
HealthPartners / Group Health (Combined)
Outpatient Drug Utilization
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Data Elements
Data collection methodology
(Administrative only)
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2004 (Reporting Year 2003)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
100365
108451
7166
95868
104889
7017
95.52%
95.39%
95.65%
96.72%
96.61%
96.82%
97.92%
97.58%
98.26%
A
Page 55
Access/Availability of Care
HealthPartners / Group Health (Combined)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 3:45 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
HealthPartners / Group Health (Combined)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 3:45 PM
PMAP
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data collection methodology
(Administrative only)
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2004 (Reporting Year 2003)
Page 58
Access/Availability of Care
HealthPartners / Group Health (Combined)
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Data Elements
Data collection methodology
(Administrative only)
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2004 (Reporting Year 2003)
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
12-19 yrs.
6569
31655
29497
52585
6482
28471
26366
47553
98.68%
98.39%
98.96%
89.94%
89.61%
90.27%
89.39%
89.03%
89.74%
90.43%
90.18%
90.68%
A
Page 59
Access/Availability of Care
HealthPartners / Group Health (Combined)
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 1, 2004 3:45 PM
PMAP
Data Elements
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
12-19 yrs.
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data collection methodology
(Administrative only)
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2004 (Reporting Year 2003)
Page 60
Access/Availability of Care
HealthPartners / Group Health (Combined)
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
HO
HO
S
S
7057
7057
5654
3960
80.12%
56.11%
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
331
248
76.62%
57.41%
Number of original sample records excluded because of
valid data errors
1
1
Number of employee/dependent medical records excluded
0
0
1
411
181
200
1
411
181
152
92.70%
90.06%
95.34%
81.02%
77.11%
84.93%
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 61
Access/Availability of Care
HealthPartners / Group Health (Combined)
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 1, 2004 3:45 PM
PMAP
Timeliness of
Prenatal Care
Postpartum
Care
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data collection methodology (Administrative or Hybrid)
Sampling method used (see User's Guide for entry
descriptions)
Eligible member population (i.e. members who meet all
denominator criteria)
Number of numerator events by administrative data in
eligible population (before exclusions)
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of
valid data errors
Number of employee/dependent medical records excluded
Additional records added from the auxiliary list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2004 (Reporting Year 2003)
Page 62
Health Plan Stability
HealthPartners / Group Health (Combined)
Practitioner Turnover
Medicare + Choice
Practitioner Types
Data Last Refreshed:
Sep 1, 2004 3:45 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
HealthPartners / Group Health (Combined)
Practitioner Turnover
Minnesota Senior Health Options
Practitioner Types
Number of
Practitioners as of
12/31/2002
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Years in Business / Total Membership
Data Last Refreshed:
Sep 1, 2004 3:45 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
HealthPartners / Group Health (Combined)
Years in Business / Total Membership
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
Board Certification / Residency Completion
Data Last Refreshed:
Sep 1, 2004 3:45 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 / Group Health (Combined)
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 3:45 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
HealthPartners
Information/ Group Health (Combined)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 3:45 PM
Commercial
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
46428
185772
244056
267792
165216
96960
Member Months
Female
43260
177720
231924
255756
156912
96900
Total
89688
363492
475980
523548
322128
193860
1006224
32.00%
180576
184908
242496
269952
310704
962472
29.02%
211572
221268
267744
295128
342036
1968696
30.47%
1188636
37.80%
294132
263064
203712
133404
1337748
40.33%
327072
290592
213000
136848
2526384
39.10%
894312
28.44%
31608
13080
6348
3192
1128
324
967512
29.17%
26076
11292
6396
3228
1524
672
1861824
28.81%
55680
1.77%
0
49188
1.48%
0
104868
1.62%
3144852
3316920
HEDIS 2004 (Reporting Year 2003)
392148
406176
510240
565080
652740
621204
553656
416712
270252
57684
24372
12744
6420
2652
996
0
6461772
Page 69
Health Plan Descriptive
HealthPartners
Information/ Group Health (Combined)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 3:45 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
HealthPartners
Information/ Group Health (Combined)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 3:45 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
HealthPartners
Information/ Group Health (Combined)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 3:45 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