First Plan of Minnesota
Plan Name
2003
Reporting Year
General Info
Submission #
1
Last Refreshed:
2
9/1/2004 3:34:16 PM
Page
Title
Disclaimers
Effectiveness of
Care Measures
Plan ID
2
Access / Availability
of Care
Page
Measure
Page
Childhood Immunization Rate
3
Adults' Access to Preventive/Ambulatory Health Services
55
Adolescent Immunization Rate
6
Children's Access to Primary Care Practitioners
59
Breast Cancer Screening
9
Prenatal and Postpartum Care
61
Cervical Cancer Screening
10
Chlamydia Screening in Women
11
Controlling High Blood Pressure
12
Beta Blocker Treatment after a Heart Attack
13
Cholesterol Management
14
Comprehensive Diabetes Care
15
Practitioner Turnover
63
Appropriate Medications for People with Asthma
20
Years in Business / Total Membership
65
Follow-up After Hospitalization For Mental Illness
22
Antidepressant Medication Management
23
Measure
Use of Services
Measures
Measure
Health Plan Stability
Measure
Page
Health Plan
Descriptive
Information
Measure
Page
Page
Well-Child Visits In The First 15 Months of Life
27
Board Certification / Residency Completion
67
Well-Child Visits In The Third, Fourth, Fifth And Sixth Year of Life
29
Total Enrollment by Percentage
68
Adolescent Well-Care Visits
30
Enrollment by Product Line (Age & Sex)
69
Inpatient Utilization - General Hospital/Acute Care
31
Ambulatory Care
35
Inpatient Utilization - Nonacute Care
38
Mental Health Utilization - Inpatient Discharges and Average Length of Stay
41
Mental Health Utilization - Percentage of Members Receiving Inpatient and Ambulatory Services
44
Chemical Dependency Utilization - Inpatient Discharges and Average Length of Stay
47
Chemical Dependency Utilization - Percentage of Members Receiving Inpatient and Ambulatory Services
50
Outpatient Drug Utilization
53
HEDIS 2004 (Reporting Year 2003)
DISCLAIMERS
-1
0. Disclaimer Query located below
1. For this reporting period, DHS has waived the reporting by all Managed Care Organizations (MCOs)
of all HEDIS measures for the distinct MNCare and GAMC populations.
2. For BCBS, Medica, MHP and UCare (Community Measurement Project "CMP") participants: three
Effectiveness of Care measures (Childhood Immunization Status, Adolescent Immunization Status
and Comprehensive Diabetes Care) are reported under the category "Medicaid." For 2003 data
reported in 2004 only, "Medicaid" results are based on the combined PMAP, MNCare and GAMC
populations but do not include MSHO.
3. Although HealthPartners participates in the CMP, it has reported all 14 Effectiveness of Care
measures for its PMAP population only.
4. All MCOs that do not participate in the CMP reported commercial, PMAP, MSHO and
Medicare+Choice measures.
HEDIS 2004 (Reporting Year 2003)
Page 2
Effectiveness of Care
First Plan of Minnesota
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
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
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)
IPV/OPV
MMR
HiB
Hepatitis B
VZV
Combo 1
Combo 2
12
50.00%
14
58.33%
22
91.67%
12
50.00%
14
58.33%
18
75.00%
8
33.33%
6
25.00%
12
NR
14
NR
22
NR
12
NR
14
NR
18
NR
8
NR
6
NR
12
8
NA
NA
NA
14
8
NA
NA
NA
22
1
NA
NA
NA
12
7
NA
NA
NA
14
8
NA
NA
NA
18
1
NA
NA
NA
8
9
NA
NA
NA
6
9
NA
NA
NA
HO
N
24
Numerator events by admin data in eligible
population
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
DTaP/DT
24
Page 3
Effectiveness of Care
First Plan of Minnesota
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 3:34 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
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
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)
IPV/OPV
MMR
HiB
Hepatitis B
VZV
Combo 1
Combo 2
32
22.70%
33
23.40%
59
41.84%
27
19.15%
32
22.70%
45
31.91%
19
13.48%
15
10.64%
32
NR
33
NR
59
NR
27
NR
32
NR
45
NR
19
NR
15
NR
32
68
70.92%
63.07%
78.77%
33
76
77.30%
70.04%
84.57%
59
54
80.14%
73.20%
87.08%
27
69
68.09%
60.04%
76.13%
32
87
84.40%
78.05%
90.74%
45
51
68.09%
60.04%
76.13%
19
57
53.90%
45.32%
62.48%
15
55
49.65%
41.04%
58.25%
HO
N
141
Numerator events by admin data in eligible
population
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
DTaP/DT
141
Page 4
Effectiveness of Care
First Plan of Minnesota
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
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
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)
Hepatitis B
VZV
Combo 1
Combo 2
26
83.87%
7
22.58%
2
6.45%
7
22.58%
0
0.00%
NR
NR
NR
NR
NR
26
5
100.00%
98.39%
100.00%
7
12
61.29%
42.53%
80.05%
2
8
32.26%
14.19%
50.33%
7
11
58.06%
39.08%
77.05%
0
9
29.03%
11.44%
46.62%
HO
N
31
Numerator events by admin data in eligible
population
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
MMR
31
Page 6
Effectiveness of Care
First Plan of Minnesota
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 3:34 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
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
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)
Hepatitis B
VZV
Combo 1
Combo 2
23
48.94%
10
21.28%
3
6.38%
8
17.02%
1
2.13%
23
NR
10
NR
3
NR
8
NR
1
NR
23
17
85.11%
73.86%
96.35%
10
20
63.83%
49.03%
78.63%
3
2
10.64%
0.76%
20.52%
8
21
61.70%
46.74%
76.66%
1
3
8.51%
0.00%
17.55%
HO
N
47
Numerator events by admin data in eligible
population
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
MMR
47
Page 7
Effectiveness of Care
First Plan of Minnesota
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
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 3:34 PM
Commercial
HO
N
161
131
81.37%
NR
NR
0
NR
Records Excluded because of contraindications
through Admin data
1
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)
Medicare + Choice
0
158
131
1
83.54%
77.45%
89.64%
NR
NR
NR
Page 9
Effectiveness of Care
First Plan of Minnesota
Cervical Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
HO
S
355
PMAP
HO
N
360
265
258
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
74.65%
270
10.00%
297
230
77.44%
0
71.67%
Records Excluded because of contraindications
through Admin data
10
3
Records Excluded because of contraindications
through Medical Record Review
11
1
Number of employee/dependent medical records
excluded
0
0
21
270
226
8
86.67%
82.43%
90.91%
0
356
258
30
80.90%
76.67%
85.12%
Numerator Events by Admin Data on Eligible
Population (before exclusions)
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
0
Page 10
Effectiveness of Care
First Plan of Minnesota
Chlamydia Screening in Women
Data Last Refreshed:
Sep 1, 2004 3:34 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
A
General
Measure Ages 16-20 Ages 21-25
Data
Total
A
39
30.77%
45
22.22%
84
26.19%
88
46.59%
107
43.93%
195
45.13%
0
0
0
0
0
0
39
12
30.77%
15.00%
46.54%
45
10
22.22%
8.96%
35.48%
84
22
26.19%
16.19%
36.19%
88
41
46.59%
35.60%
57.58%
107
47
43.93%
34.05%
53.80%
195
88
45.13%
37.89%
52.37%
Page 11
Effectiveness of Care
First Plan of Minnesota
Controlling High Blood Pressure
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Data Elements
Data Collection Methodology (Hybrid)
Sampling Method Used
Eligible Member Population
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Records Excluded because of Valid Data Errors
Records Excluded - False positive diagnosis
Commercial
HO
N
68
0
Records Excluded because of ESRD or non-acute
admission identified by Medical Record
0
Number of employee/dependent medical records
excluded
0
HEDIS 2004 (Reporting Year 2003)
MSHO
NR
NR
NR
NR
NR
NR
2
Records Excluded because of ESRD or non-acute
admission identified by Admin Data
Records Added from Auxiliary List
Denominator
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Medicare + Choice
0
66
38
57.58%
44.89%
70.26%
Page 12
Effectiveness of Care
First Plan of Minnesota
Beta Blocker Treatment after Heart Attack
Data Elements
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
Medicare + Choice
NR
NR
NR
NR
Reported Rate
NR
NR
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NR
NR
NR
NR
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Records Excluded because of Valid Data
Errors
Records Excluded Contraindications/Admin Data
Records Excluded Contraindications/Medical Record Review
Number of employee/dependent medical
records excluded
Records Added from Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
HEDIS 2004 (Reporting Year 2003)
Page 13
Effectiveness of Care
First Plan of Minnesota
Cholesterol Management After Acute Cardiovascular Events
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
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
0
Number of employee/dependent medical
records excluded
0
HEDIS 2004 (Reporting Year 2003)
LDL-C
LDL-C Level of
screening 60- <130 mg/dL 60365 Days
365 Days
General
Measure
Data
LDL-C
LDL-C Level of
screening 60- <130 mg/dL 60365 Days
365 Days
HO
N
9
Numerator Events by Admin Data on
Eligible Population
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
Medicare + Choice
8
0
88.89%
0.00%
NR
NR
NR
NR
NR
NR
8
0
0
5
NA
NA
NA
NA
NA
NA
NR
NR
NR
NR
NR
NR
0
9
Page 14
Effectiveness of Care
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure Data
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
6
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2004 (Reporting Year 2003)
Poor HbA1c
Control
61
76.25%
Monitoring for
Diabetic
Nephropathy
Eye Exam
LDL-C
Screening
LDL-C Level
<130 mg/dL
LDL-C Level
<100 mg/dL
NR
61
76.25%
67
83.75%
NR
NR
47
58.75%
NR
NR
NR
NR
NR
NR
NR
61
1
83.78%
74.71%
92.86%
0
24
32.43%
21.09%
43.77%
57
0
77.03%
66.77%
87.29%
65
1
89.19%
81.44%
96.94%
0
45
60.81%
49.01%
72.61%
0
31
41.89%
29.97%
53.81%
46
1
63.51%
51.87%
75.16%
HO
N
80
Numerator events by admin data in
eligible population
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HbA1c
Testing
74
Page 15
Effectiveness of Care
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:34 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure Data
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
1
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2004 (Reporting Year 2003)
Poor HbA1c
Control
Eye Exam
LDL-C
Screening
LDL-C Level
<130 mg/dL
LDL-C Level
<100 mg/dL
Monitoring for
Diabetic
Nephropathy
41
64.06%
0
0.00%
54
84.38%
36
56.25%
0
0.00%
0
0.00%
39
60.94%
41
NR
0
NR
54
NR
36
NR
0
NR
0
NR
39
NR
40
12
82.54%
72.37%
92.71%
0
25
39.68%
26.81%
52.56%
53
0
84.13%
74.31%
93.94%
35
12
74.60%
63.06%
86.15%
0
31
49.21%
36.07%
62.35%
0
21
33.33%
20.90%
45.77%
39
3
66.67%
54.23%
79.10%
HO
N
64
Numerator events by admin data in
eligible population
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HbA1c
Testing
63
Page 18
Effectiveness of Care
First Plan of Minnesota
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 1, 2004 3:34 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
3
NA
0
3
3
NA
NA
NA
5
NA
0
5
5
NA
NA
NA
33
84.85%
0
33
28
84.85%
71.10%
98.60%
41
87.80%
0
41
36
87.80%
76.57%
99.04%
A
Page 20
Effectiveness of Care
First Plan of Minnesota
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 1, 2004 3:34 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
4
NA
0
4
3
NA
NA
NA
8
NA
0
8
3
NA
NA
NA
11
NA
0
11
6
NA
NA
NA
23
NA
0
23
12
NA
NA
NA
A
Page 21
Effectiveness of Care
First Plan of Minnesota
Follow-Up After Hospitalization for Mental Illness
Data Last Refreshed:
Sep 1, 2004 3:34 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
9
9
NA
NA
NA
9
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
NR
NR
NR
PMAP
General
W/in 7 Days of W/in 30 Days of
Measure
Discharge
Discharge
Data
W/in 7 Days of W/in 30 Days of
Discharge
Discharge
A
24
NR
NR
NR
NR
NR
NR
13
NA
NA
NA
16
NA
NA
NA
Page 22
Effectiveness of Care
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 3:34 PM
PMAP
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
4
NA
NA
NA
12
NA
NA
NA
6
NA
NA
NA
A
21
Page 26
Use of Services
First Plan of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
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
0
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2004 (Reporting Year 2003)
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
0
0.00%
0
0.00%
0
0.00%
0
0.00%
1
4.55%
3
13.64%
5
22.73%
NR
NR
NR
NR
NR
NR
NR
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
1
3
NA
NA
NA
3
1
NA
NA
NA
5
9
NA
NA
NA
HO
N
22
Numerator events by admin data in eligible
population
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Zero Visits
22
Page 27
Use of Services
First Plan of Minnesota
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 1, 2004 3:34 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
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
0
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2004 (Reporting Year 2003)
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
3
1.97%
5
3.29%
2
1.32%
1
0.66%
6
3.95%
23
15.13%
30
19.74%
NR
NR
NR
NR
NR
NR
NR
3
0
1.97%
0.00%
4.51%
5
1
3.95%
0.52%
7.37%
2
1
1.97%
0.00%
4.51%
1
1
1.32%
0.00%
3.46%
6
8
9.21%
4.28%
14.14%
23
20
28.29%
20.80%
35.78%
30
50
52.63%
44.36%
60.90%
HO
N
152
Numerator events by admin data in eligible
population
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Zero Visits
152
Page 28
Use of Services
First Plan of Minnesota
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
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 3:34 PM
Commercial
HO
N
76
PMAP
HO
N
284
52
152
68.42%
53.52%
NR
0
NR
0
0
0
0
76
52
0
68.42%
57.31%
79.53%
0
284
152
6
55.63%
49.68%
61.59%
Page 29
Use of Services
First Plan of Minnesota
Adolescent Well-Care Visits
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
A
291
PMAP
A
N
473
32.65%
28.96%
NR
NR
291
95
473
137
32.65%
27.09%
38.21%
28.96%
24.77%
33.16%
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)
Page 30
Use of Services
First Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 3:34 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
166
2768
4316
11572
8536
162
4
0
0
27524
Discharges
Discharges /
1,000 Member
Months
2
7
11
71
56
1
0
0
0
148
12.05
2.53
2.55
6.14
6.56
6.17
0.00
NA
2
6
4
13
24
1
0
0
0
50
12.05
2.17
0.93
1.12
2.81
6.17
0.00
NA
0
1
5
20
32
0
0
0
0
58
0.00
0.36
1.16
1.73
3.75
0.00
0.00
NA
2
38
0
0
0
40
HEDIS 2004 (Reporting Year 2003)
5.38
1.82
2.11
0.46
3.28
0.00
0.00
1.63
Days
2
25
26
216
190
3
0
0
0
462
Days / 1,000
Member
Months
12.05
9.03
6.02
18.67
22.26
18.52
0.00
NA
16.79
2
19
8
28
74
3
0
0
0
134
12.05
6.86
1.85
2.42
8.67
18.52
0.00
NA
0
6
14
89
116
0
0
0
0
225
0.00
2.17
3.24
7.69
13.59
0.00
0.00
NA
4
99
0
0
0
103
0.93
8.56
0.00
0.00
4.87
8.17
4.19
Average Length
of Stay
1.00
3.57
2.36
3.04
3.39
3.00
NA
NA
NA
3.12
1.00
3.17
2.00
2.15
3.08
3.00
NA
NA
NA
2.68
NA
6.00
2.80
4.45
3.63
NA
NA
NA
NA
3.88
2.00
2.61
NA
NA
NA
2.58
Page 31
Use of Services
First Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 3:34 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
1618
13979
10874
11945
781
2483
2973
3798
0
48451
Discharges
34
41
72
283
16
56
77
82
0
661
Discharges /
1,000 Member
Months
21.01
2.93
6.62
23.69
20.49
22.55
25.90
21.59
13.64
33
38
19
50
9
48
60
68
0
325
20.40
2.72
1.75
4.19
11.52
19.33
20.18
17.90
1
3
5
31
6
8
17
14
0
85
0.62
0.21
0.46
2.60
7.68
3.22
5.72
3.69
48
202
1
0
0
251
HEDIS 2004 (Reporting Year 2003)
6.71
1.75
4.41
16.91
1.28
0.00
7.64
Days
Days / 1,000
Member
Months
77
91
166
865
52
244
383
348
0
2226
47.59
6.51
15.27
72.42
66.58
98.27
128.83
91.63
76
70
31
173
23
207
266
273
0
1119
46.97
5.01
2.85
14.48
29.45
83.37
89.47
71.88
45.94
23.10
1
21
14
79
27
37
117
75
0
371
0.62
1.50
1.29
6.61
34.57
14.90
39.35
19.75
121
613
2
0
0
736
11.13
51.32
2.56
0.00
7.66
22.40
Average Length
of Stay
2.26
2.22
2.31
3.06
3.25
4.36
4.97
4.24
NA
3.37
2.30
1.84
1.63
3.46
2.56
4.31
4.43
4.01
NA
3.44
1.00
7.00
2.80
2.55
4.50
4.63
6.88
5.36
NA
4.36
2.52
3.03
2.00
NA
NA
2.93
Page 34
Use of Services
First Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
166
2768
4316
11572
8536
162
4
0
0
27524
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
239
790
906
2713
2437
52
0
0
0
7137
HEDIS 2004 (Reporting Year 2003)
Visits/ 1,000
Member
Months
1439.76
285.40
209.92
234.45
285.50
320.99
0.00
NA
259.30
Emergency Room Visits
Visits
15
70
75
193
98
3
0
0
0
454
Visits/ 1,000
Member
Months
90.36
25.29
17.38
16.68
11.48
18.52
0.00
NA
16.49
Ambulatory
Surgery/Procedures
Procedures
2
19
38
143
230
10
0
0
0
442
Procedures/
1,000 Member
Months
12.05
6.86
8.80
12.36
26.94
61.73
0.00
NA
16.06
Observation Room Stays
Resulting in Discharge
Stays
2
5
9
37
8
0
0
0
0
61
Stays/ 1,000
Member
Months
12.05
1.81
2.09
3.20
0.94
0.00
0.00
NA
2.22
Page 35
Use of Services
First Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
Member
Months
Age
<1
166
1-9
2768
10-19
4316
20-44
11572
45-64
8536
65-74
162
75-84
4
85+
0
Unknown
0
27524
Total
Days
Days / 1,000
Member
Months
Average Length
of Stay
0.00
0
0.00
NA
0
0.00
0
0.00
NA
10-19
0
0.00
0
0.00
NA
20-44
1
0.09
9
0.78
9.00
45-64
0
0.00
0
0.00
NA
65-74
0
0.00
0
0.00
NA
75-84
0
0.00
0
0.00
NA
85+
0
NA
0
NA
NA
Unknown
0
1
0.04
0
9
0.33
NA
9.00
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
Age
Total
HEDIS 2004 (Reporting Year 2003)
Page 38
Use of Services
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Male
Female
Total
2049
1214
9656
120
0
13039
1992
1008
11439
46
0
14485
4041
2222
21095
166
0
27524
Discharges
Discharges /
1,000 Member
Months
Days*
Average Length
of Stay
M
1
0.49
6
6.00
F
0
0.00
0
NA
Total
1
0.25
6
6.00
13-17
M
2
1.65
10
5.00
F
0
0.00
0
NA
Total
2
0.90
10
5.00
18-64
M
6
0.62
13
2.17
F
4
0.35
14
3.50
Total
10
0.47
27
2.70
65+
M
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
M
Total
9
0.69
29
3.22
F
4
0.28
14
3.50
TOTAL
13
0.47
43
3.31
* 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
First Plan of Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:34 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
2049
1214
9656
120
0
13039
Female
1992
1008
11439
46
0
14485
Member Months (Inpatient)
Total
4041
2222
21095
166
0
27524
Male
2049
1214
9656
120
0
13039
Female
1992
1008
11439
46
0
14485
Member Months (Day/Night)
Total
4041
2222
21095
166
0
27524
Male
2049
1214
9656
120
0
13039
Female
1992
1008
11439
46
0
14485
Total
4041
2222
21095
166
0
27524
Member Months (Ambulatory)
Male
2049
1214
9656
120
0
13039
Female
1992
1008
11439
46
0
14485
Total
4041
2222
21095
166
0
27524
Any Mental Health Services
Inpatient Mental Health Services
Day/Night Mental Health Services
Ambulatory Mental Health Services
Number
12
7
19
10
13
23
40
94
134
1
0
1
0
0
0
63
114
177
Number
1
0
1
1
0
1
3
4
7
0
0
0
0
0
0
5
4
9
Number
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
1
1
Number
12
7
19
10
13
23
39
92
131
1
0
1
0
0
0
62
112
174
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
7.03%
4.22%
5.64%
9.88%
15.48%
12.42%
4.97%
9.86%
7.62%
10.00%
0.00%
7.23%
NA
NA
NA
5.80%
9.44%
7.72%
Percent
0.59%
0.00%
0.30%
0.99%
0.00%
0.54%
0.37%
0.42%
0.40%
0.00%
0.00%
0.00%
NA
NA
NA
0.46%
0.33%
0.39%
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.10%
0.06%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.08%
0.04%
Percent
7.03%
4.22%
5.64%
9.88%
15.48%
12.42%
4.85%
9.65%
7.45%
10.00%
0.00%
7.23%
NA
NA
NA
5.71%
9.28%
7.59%
Page 44
Use of Services
First Plan of Minnesota
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Male
Female
Total
2049
1214
9656
120
0
13039
1992
1008
11439
46
0
14485
4041
2222
21095
166
0
27524
Discharges
Discharges /
1,000 Member
Months
Days
Average Length
of Stay
M
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
M
13-17
2
1.65
29
14.50
F
0
0.00
0
NA
Total
2
0.90
29
14.50
M
18-64
1
0.10
1
1.00
F
2
0.17
25
12.50
Total
3
0.14
26
8.67
M
65+
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
3
0.23
30
10.00
F
2
0.14
25
12.50
TOTAL
5
0.18
55
11.00
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization should not be included in this table
HEDIS 2004 (Reporting Year 2003)
Page 47
Use of Services
First Plan of Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
2049
1214
9656
120
0
13039
Female
1992
1008
11439
46
0
14485
Member Months (Inpatient)
Total
4041
2222
21095
166
0
27524
Any Chemical Dependency Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2004 (Reporting Year 2003)
Number
0
0
0
2
2
4
6
4
10
0
0
0
0
0
0
8
6
14
Percent
0.00%
0.00%
0.00%
1.98%
2.38%
2.16%
0.75%
0.42%
0.57%
0.00%
0.00%
0.00%
NA
NA
NA
0.74%
0.50%
0.61%
Male
2049
1214
9656
120
0
13039
Female
1992
1008
11439
46
0
14485
Member Months (Day/Night)
Total
4041
2222
21095
166
0
27524
Male
2049
1214
9656
120
0
13039
Female
1992
1008
11439
46
0
14485
Total
4041
2222
21095
166
0
27524
Member Months (Ambulatory)
Male
2049
1214
9656
120
0
13039
Female
1992
1008
11439
46
0
14485
Total
4041
2222
21095
166
0
27524
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
0
0
0
2
0
2
1
1
2
0
0
0
0
0
0
3
1
4
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
0
0
0
1
2
3
5
3
8
0
0
0
0
0
0
6
5
11
Percent
0.00%
0.00%
0.00%
1.98%
0.00%
1.08%
0.12%
0.10%
0.11%
0.00%
0.00%
0.00%
NA
NA
NA
0.28%
0.08%
0.17%
Percent
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Percent
0.00%
0.00%
0.00%
0.99%
2.38%
1.62%
0.62%
0.31%
0.46%
0.00%
0.00%
0.00%
NA
NA
NA
0.55%
0.41%
0.48%
Page 50
Use of Services
First Plan of Minnesota
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Outpatient Drug Utilization
Medicare + Choice
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Outpatient Drug Utilization
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 3:34 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+
459
512
8
434
489
8
94.55%
92.37%
96.74%
95.51%
93.62%
97.40%
NA
NA
NA
A
Page 55
Access/Availability of Care
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 3:34 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+
458
37
627
403
32
553
87.99%
84.91%
91.08%
86.49%
74.12%
98.85%
88.20%
85.59%
90.80%
A
Page 58
Access/Availability of Care
First Plan of Minnesota
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 1, 2004 3:34 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.
25
96
112
230
24
85
95
196
NA
NA
NA
88.54%
81.65%
95.43%
84.82%
77.73%
91.91%
85.22%
80.41%
90.02%
A
Page 59
Access/Availability of Care
First Plan of Minnesota
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 1, 2004 3:34 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.
217
374
160
254
206
323
142
235
94.93%
91.78%
98.08%
86.36%
82.75%
89.98%
88.75%
83.54%
93.96%
92.52%
89.09%
95.95%
A
Page 60
Access/Availability of Care
First Plan of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Commercial
Data collection methodology (Administrative or Hybrid)
Timeliness of
Prenatal Care
Postpartum
Care
A
A
34
34
70.59%
61.76%
NR
NR
34
24
34
21
70.59%
53.80%
87.37%
61.76%
43.96%
79.57%
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
First Plan of Minnesota
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 1, 2004 3:34 PM
PMAP
Data collection methodology (Administrative or Hybrid)
Timeliness of
Prenatal Care
Postpartum
Care
A
A
181
181
39.78%
69.06%
NR
NR
181
72
181
125
39.78%
32.37%
47.19%
69.06%
62.05%
76.07%
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
First Plan of Minnesota
Practitioner Turnover
Medicare + Choice
Practitioner Types
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Practitioner Turnover
Minnesota Senior Health Options
Practitioner Types
Number of
Practitioners as of
12/31/2002
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Years in Business / Total Membership
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Board Certification / Residency Completion
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
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 3:34 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
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 3:34 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
96
600
744
1116
708
504
Member Months
Female
72
696
732
840
672
480
Total
168
1296
1476
1956
1380
984
3768
28.86%
1044
960
876
876
1272
3492
24.09%
1056
1392
1236
1368
1512
7260
26.35%
5028
38.51%
1404
1332
876
528
6564
45.28%
1548
1452
852
540
11592
42.07%
4140
31.71%
108
12
0
0
0
0
4392
30.30%
48
0
0
0
0
0
8532
30.97%
120
0.92%
0
48
0.33%
0
168
0.61%
13056
14496
HEDIS 2004 (Reporting Year 2003)
2100
2352
2112
2244
2784
2952
2784
1728
1068
156
12
0
0
0
0
0
27552
Page 69
Health Plan Descriptive Information
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 3:34 PM
Medicare + Choice
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2004 (Reporting Year 2003)
Page 70
Health Plan Descriptive Information
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 3:34 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
First Plan of Minnesota
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 3:34 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
899
4460
2723
2725
1591
698
Member Months
Female
719
3842
2954
2919
1631
1310
Total
1618
8302
5677
5644
3222
2008
13096
70.75%
910
493
505
460
507
13375
44.67%
3154
2126
1602
1168
1020
26471
54.63%
2875
15.53%
214
110
42
0
9070
30.29%
312
74
17
12
11945
24.65%
366
1.98%
568
372
364
341
270
259
415
1.39%
786
757
1003
1265
1657
1612
781
1.61%
2174
11.74%
0
7080
23.65%
0
9254
19.10%
18511
29940
HEDIS 2004 (Reporting Year 2003)
4064
2619
2107
1628
1527
526
184
59
12
1354
1129
1367
1606
1927
1871
0
48451
Page 72