Blue Plus (HMO Minnesota)
Plan Name
2003
Reporting Year
General Info
Submission #
1
Last Refreshed:
8
9/1/2004 3:13:08 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
Blue Plus (HMO Minnesota)
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Combo 1
Combo 2
1579
62.26%
1684
66.40%
2232
88.01%
1653
65.18%
1533
60.45%
1968
77.60%
1218
48.03%
1104
43.53%
217
61.65%
227
64.49%
308
87.50%
223
63.35%
211
59.94%
276
78.41%
162
46.02%
148
42.05%
205
84
86.27%
82.43%
90.10%
215
90
91.04%
87.84%
94.25%
294
24
94.93%
92.43%
97.42%
211
97
91.94%
88.88%
95.00%
199
95
87.76%
84.10%
91.42%
264
15
83.28%
79.14%
87.43%
153
120
81.49%
77.18%
85.80%
140
103
72.54%
67.61%
77.47%
352
1
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
1
HEDIS 2004 (Reporting Year 2003)
MMR
335
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
2536
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
335
Page 3
Effectiveness of Care
Blue Plus (HMO Minnesota)
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Childhood Immunization Rate
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Medicaid
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Combo 1
Combo 2
1752
45.28%
2018
52.16%
2932
75.78%
1948
50.35%
1805
46.65%
2465
63.71%
1201
31.04%
1022
26.42%
183
42.36%
222
51.39%
319
73.84%
216
50.00%
190
43.98%
260
60.19%
127
29.40%
109
25.23%
175
133
74.94%
70.63%
79.25%
211
142
85.89%
82.40%
89.38%
305
64
89.78%
86.73%
92.83%
207
143
85.16%
81.60%
88.72%
181
165
84.18%
80.54%
87.83%
249
36
69.34%
64.76%
73.92%
123
162
69.34%
64.76%
73.92%
105
126
56.20%
51.29%
61.12%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
0
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2004 (Reporting Year 2003)
MMR
411
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
IPV/OPV
HO
S
3869
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
DTaP/DT
411
Page 5
Effectiveness of Care
Blue Plus (HMO Minnesota)
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Combo 1
Combo 2
1807
48.60%
933
25.09%
102
2.74%
708
19.04%
23
0.62%
206
47.69%
116
26.85%
11
2.55%
84
19.44%
5
1.16%
196
157
85.89%
82.40%
89.38%
112
146
62.77%
57.98%
67.57%
11
167
43.31%
38.40%
48.22%
81
169
60.83%
55.99%
65.67%
5
123
31.14%
26.54%
35.74%
432
1
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
1
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
3718
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
Blue Plus (HMO Minnesota)
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Adolescent Immunization Status
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Medicaid
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Combo 1
Combo 2
1033
46.83%
488
22.12%
86
3.90%
374
16.95%
24
1.09%
222
51.39%
107
24.77%
12
2.78%
86
19.91%
6
1.39%
209
110
77.62%
73.46%
81.77%
103
138
58.64%
53.75%
63.52%
12
96
26.28%
21.90%
30.65%
82
143
54.74%
49.81%
59.68%
6
71
18.73%
14.84%
22.63%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
0
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2004 (Reporting Year 2003)
VZV
411
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Hepatitis B
HO
S
2206
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 8
Effectiveness of Care
Blue Plus (HMO 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 3:13 PM
Commercial
HO
S
20726
15662
75.57%
279
5.00%
293
228
77.82%
0
Records Excluded because of contraindications
through Admin data
0
Records Excluded because of contraindications
through Medical Record Review
2
Number of employee/dependent medical records
excluded
0
Records Added from Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
Medicare + Choice
2
279
217
5
79.57%
74.66%
84.48%
NR
NR
NR
NR
NR
Page 9
Effectiveness of Care
Blue Plus (HMO Minnesota)
Cervical Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
HO
S
60173
PMAP
HO
S
3950
47067
2807
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
78.22%
260
10.00%
286
240
83.92%
0
71.06%
296
10.00%
326
240
73.62%
0
Records Excluded because of contraindications
through Admin data
7
3
Records Excluded because of contraindications
through Medical Record Review
0
0
Number of employee/dependent medical records
excluded
0
0
7
260
224
3
87.31%
83.07%
91.55%
3
296
222
29
84.80%
80.54%
89.06%
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)
Page 10
Effectiveness of Care
Blue Plus (HMO Minnesota)
Chlamydia Screening in Women
Data Last Refreshed:
Sep 1, 2004 3:13 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
3677
20.21%
3831
19.21%
7508
19.70%
818
28.12%
1246
28.65%
2064
28.44%
0
0
0
0
0
0
3677
743
20.21%
18.90%
21.52%
3831
736
19.21%
17.95%
20.47%
7508
1479
19.70%
18.79%
20.61%
818
230
28.12%
24.98%
31.26%
1246
357
28.65%
26.10%
31.20%
2064
587
28.44%
26.47%
30.41%
Page 11
Effectiveness of Care
Blue Plus (HMO Minnesota)
Controlling High Blood Pressure
Data Last Refreshed:
Sep 1, 2004 3:13 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
8778
384
20.00%
461
0
3
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
0
Number of employee/dependent medical records
excluded
0
Records Added from Auxiliary List
Denominator
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2004 (Reporting Year 2003)
3
384
231
60.16%
55.13%
65.18%
Medicare + Choice
MSHO
NR
NR
NR
NR
NR
NR
Page 12
Effectiveness of Care
Blue Plus (HMO Minnesota)
Beta Blocker Treatment after Heart Attack
Data Elements
Data Collection Methodology
Sampling Method Used
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
HO
S
Eligible Member Population
148
Numerator Events by Admin Data on
Eligible Population
111
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
75.00%
NR
148
0.00%
148
111
75.00%
Records Excluded because of Valid Data
Errors
0
Records Excluded Contraindications/Admin Data
0
Records Excluded Contraindications/Medical Record Review
1
Number of employee/dependent medical
records excluded
0
Records Added from Auxiliary List
0
Denominator
147
Numerator Events by Admin Data
111
Numerator Events by Medical Record
22
NR
Reported Rate
90.48%
NR
Lower 95% Confidence Interval
Upper 95% Confidence Interval
85.39%
NR
95.56%
NR
HEDIS 2004 (Reporting Year 2003)
Page 13
Effectiveness of Care
Blue Plus (HMO Minnesota)
Cholesterol Management After Acute Cardiovascular Events
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
0
Number of employee/dependent medical
records excluded
0
HEDIS 2004 (Reporting Year 2003)
General
Measure
Data
LDL-C
LDL-C Level of
screening 60- <130 mg/dL 60365 Days
365 Days
366
0
72.91%
0.00%
314
0
72.69%
0.00%
300
19
0
266
77.62%
73.46%
81.77%
64.72%
59.98%
69.46%
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
411
5.00%
432
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
502
Numerator Events by Admin Data on
Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Medicare + Choice
0
411
Page 14
Effectiveness of Care
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:13 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
5921
83.94%
0
0.00%
3816
54.10%
6055
85.84%
0
0.00%
0
0.00%
3597
50.99%
374
82.56%
0
0.00%
237
52.32%
386
85.21%
0
0.00%
0
0.00%
231
50.99%
342
20
88.08%
84.82%
91.33%
0
105
25.55%
21.21%
29.89%
216
24
58.39%
53.51%
63.28%
354
12
89.05%
85.91%
92.19%
0
245
59.61%
54.75%
64.48%
0
153
37.23%
32.43%
42.02%
214
29
59.12%
54.25%
64.00%
453
2
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
2
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
7054
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
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Medicaid
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
2067
81.15%
0
0.00%
1281
50.29%
1901
74.64%
0
0.00%
0
0.00%
1122
44.05%
381
84.11%
0
0.00%
218
48.12%
346
76.38%
0
0.00%
0
0.00%
202
44.59%
349
21
90.02%
87.01%
93.04%
0
108
26.28%
21.90%
30.65%
201
27
55.47%
50.55%
60.40%
317
14
80.54%
76.59%
84.48%
0
213
51.82%
46.87%
56.78%
0
128
31.14%
26.54%
35.74%
184
37
53.77%
48.83%
58.71%
453
1
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
1
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
2547
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 19
Effectiveness of Care
Blue Plus (HMO Minnesota)
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 1, 2004 3:13 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
305
72.13%
0
305
220
72.13%
66.94%
77.33%
634
70.66%
0
634
448
70.66%
67.04%
74.29%
2333
76.21%
0
2333
1778
76.21%
74.46%
77.96%
3272
74.76%
0
3272
2446
74.76%
73.25%
76.26%
A
Page 20
Effectiveness of Care
Blue Plus (HMO Minnesota)
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 1, 2004 3:13 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
109
63.30%
0
109
69
63.30%
53.80%
72.81%
154
60.39%
0
154
93
60.39%
52.34%
68.44%
144
65.28%
0
144
94
65.28%
57.15%
73.40%
407
62.90%
0
407
256
62.90%
58.08%
67.72%
A
Page 21
Effectiveness of Care
Blue Plus (HMO Minnesota)
Follow-Up After Hospitalization for Mental Illness
Data Last Refreshed:
Sep 1, 2004 3:13 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
466
224
48.07%
43.42%
52.71%
390
83.69%
80.23%
87.15%
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
242
NR
NR
NR
NR
NR
NR
97
40.08%
33.70%
46.46%
178
73.55%
67.79%
79.32%
Page 22
Effectiveness of Care
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Antidepressant Medication Management
Data Last Refreshed:
Sep 1, 2004 3:13 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
28
8.38%
5.26%
11.51%
181
54.19%
48.70%
59.68%
130
38.92%
33.54%
44.30%
A
334
Page 26
Use of Services
Blue Plus (HMO Minnesota)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
1.65%
0.69%
1.43%
2.51%
6.45%
21.22%
66.05%
NR
NR
NR
NR
NR
NR
NR
38
16
33
58
149
490
1525
1.65%
1.11%
2.19%
0.69%
0.33%
1.05%
1.43%
0.92%
1.93%
2.51%
1.85%
3.17%
6.45%
5.43%
7.48%
21.22%
19.53%
22.91%
66.05%
64.09%
68.00%
A
2309
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)
2309
Page 27
Use of Services
Blue Plus (HMO Minnesota)
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 1, 2004 3:13 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
2.80%
3.43%
4.70%
7.74%
15.08%
25.94%
40.31%
NR
NR
NR
NR
NR
NR
NR
71
87
119
196
382
657
1021
2.80%
2.14%
3.47%
3.43%
2.71%
4.16%
4.70%
3.85%
5.54%
7.74%
6.68%
8.80%
15.08%
13.67%
16.49%
25.94%
24.21%
27.66%
40.31%
38.38%
42.24%
A
2533
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)
2533
Page 28
Use of Services
Blue Plus (HMO 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
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
A
PMAP
A
11648
4449
54.81%
48.93%
NR
NR
11648
6384
4449
2177
54.81%
53.90%
55.72%
48.93%
47.45%
50.41%
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 29
Use of Services
Blue Plus (HMO Minnesota)
Adolescent Well-Care Visits
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
A
PMAP
A
36326
6163
29.24%
26.09%
NR
NR
36326
10623
6163
1608
29.24%
28.77%
29.71%
26.09%
24.99%
27.20%
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
Blue Plus (HMO Minnesota)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 3:13 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
36383
359579
507200
1062419
968391
22482
1434
180
12
2958080
Discharges
Discharges /
1,000 Member
Months
533
661
862
6796
7358
343
46
4
0
16603
14.65
1.84
1.70
6.40
7.60
15.26
32.08
22.22
424
494
376
1389
3555
189
31
3
0
6461
11.65
1.37
0.74
1.31
3.67
8.41
21.62
16.67
109
167
360
1949
3801
154
15
1
0
6556
3.00
0.46
0.71
1.83
3.93
6.85
10.46
5.56
126
3458
2
0
0
3586
0.25
3.25
0.00
0.00
HEDIS 2004 (Reporting Year 2003)
5.61
2.18
2.22
1.40
Days
Days / 1,000
Member
Months
4407
1946
3034
19562
27033
1558
217
11
0
57768
121.13
5.41
5.98
18.41
27.92
69.30
151.32
61.11
3242
1217
1179
3917
11418
843
137
7
0
21960
89.11
3.38
2.32
3.69
11.79
37.50
95.54
38.89
1165
729
1489
6356
15607
715
80
4
0
26145
32.02
2.03
2.94
5.98
16.12
31.80
55.79
22.22
366
9289
8
0
0
9663
0.72
8.74
0.01
0.00
19.53
7.42
8.84
3.77
Average Length
of Stay
8.27
2.94
3.52
2.88
3.67
4.54
4.72
2.75
NA
3.48
7.65
2.46
3.14
2.82
3.21
4.46
4.42
2.33
NA
3.40
10.69
4.37
4.14
3.26
4.11
4.64
5.33
4.00
NA
3.99
2.90
2.69
4.00
NA
NA
2.69
Page 31
Use of Services
Blue Plus (HMO Minnesota)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 1, 2004 3:13 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
51128
225401
147384
148021
11617
33587
41857
45316
0
704311
Discharges
702
672
872
4187
142
1097
1784
1571
0
11027
Discharges /
1,000 Member
Months
13.73
2.98
5.92
28.29
12.22
32.66
42.62
34.67
15.66
607
540
174
521
83
761
1324
1265
0
5275
11.87
2.40
1.18
3.52
7.14
22.66
31.63
27.92
95
132
104
439
56
336
460
306
0
1928
1.86
0.59
0.71
2.97
4.82
10.00
10.99
6.75
594
3227
3
0
0
3824
4.03
21.80
0.26
0.00
HEDIS 2004 (Reporting Year 2003)
7.49
2.74
8.94
Days
Days / 1,000
Member
Months
3872
1675
2227
10789
600
5574
8331
7195
0
40263
75.73
7.43
15.11
72.89
51.65
165.96
199.03
158.77
2732
1123
464
1363
325
3176
5520
5297
0
20000
53.43
4.98
3.15
9.21
27.98
94.56
131.88
116.89
1140
552
315
1341
268
2398
2811
1898
0
10723
22.30
2.45
2.14
9.06
23.07
71.40
67.16
41.88
1448
8085
7
0
0
9540
57.17
28.40
15.22
9.82
54.62
0.60
0.00
22.30
Average Length
of Stay
5.52
2.49
2.55
2.58
4.23
5.08
4.67
4.58
NA
3.65
4.50
2.08
2.67
2.62
3.92
4.17
4.17
4.19
NA
3.79
12.00
4.18
3.03
3.05
4.79
7.14
6.11
6.20
NA
5.56
2.44
2.51
2.33
NA
NA
2.49
Page 34
Use of Services
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
36383
359579
507200
1062419
968391
22482
1434
180
12
2958080
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
34096
108289
112451
269752
335586
11119
866
55
2
872216
HEDIS 2004 (Reporting Year 2003)
Visits/ 1,000
Member
Months
937.14
301.15
221.71
253.90
346.54
494.57
603.91
305.56
294.86
Emergency Room Visits
Visits
1348
6432
6591
13171
9789
286
35
5
0
37657
Visits/ 1,000
Member
Months
37.05
17.89
12.99
12.40
10.11
12.72
24.41
27.78
12.73
Ambulatory
Surgery/Procedures
Procedures
235
1601
1449
6642
14629
476
33
2
0
25067
Procedures/
1,000 Member
Months
6.46
4.45
2.86
6.25
15.11
21.17
23.01
11.11
8.47
Observation Room Stays
Resulting in Discharge
Stays
70
151
196
1275
788
46
1
0
0
2527
Stays/ 1,000
Member
Months
1.92
0.42
0.39
1.20
0.81
2.05
0.70
0.00
0.85
Page 35
Use of Services
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Ambulatory Care
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
Member
Months
Age
<1
36383
1-9
359579
10-19
507200
20-44
1062419
45-64
968391
65-74
22482
75-84
1434
85+
180
Unknown
12
2958080
Total
Days
Days / 1,000
Member
Months
Average Length
of Stay
0.00
0
0.00
NA
3
0.01
28
0.08
9.33
16
0.03
271
0.53
16.94
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
10-19
Age
20-44
40
0.04
477
0.45
11.93
45-64
419
0.43
5826
6.02
13.90
65-74
58
2.58
823
36.61
14.19
75-84
11
7.67
152
106.00
13.82
85+
3
16.67
22
122.22
7.33
0
550
0.19
0
7599
2.57
NA
13.82
Unknown
Total
HEDIS 2004 (Reporting Year 2003)
Page 38
Use of Services
Blue Plus (HMO Minnesota)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
Total
275130
137169
1013377
14910
12
1440598
263594
128710
1115992
9186
0
1517482
538724
265879
2129369
24096
12
2958080
Discharges
Discharges /
1,000 Member
Months
Age
0-12
Days*
Average Length
of Stay
M
37
0.13
355
9.59
F
5
0.02
38
7.60
Total
42
0.08
393
9.36
13-17
M
163
1.19
2820
17.30
F
210
1.63
2563
12.20
Total
373
1.40
5383
14.43
18-64
M
202
0.20
1472
7.29
F
336
0.30
2794
8.32
Total
538
0.25
4266
7.93
65+
M
1
0.07
13
13.00
F
2
0.22
15
7.50
Total
3
0.12
28
9.33
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
M
Total
403
0.28
4660
11.56
F
553
0.36
5410
9.78
TOTAL
956
0.32
10070
10.53
* 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
Blue Plus (HMO Minnesota)
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:13 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
275130
137169
1013377
14910
12
1440598
Female
263594
128710
1115992
9186
0
1517482
Member Months (Inpatient)
Total
538724
265879
2129369
24096
12
2958080
Male
275130
137169
1013377
14910
12
1440598
Female
263594
128710
1115992
9186
0
1517482
Total
538724
265879
2129369
24096
12
2958080
Member Months (Day/Night)
Male
275130
137169
1013377
14910
12
1440598
Female
263594
128710
1115992
9186
0
1517482
Total
538724
265879
2129369
24096
12
2958080
Member Months (Ambulatory)
Male
275130
137169
1013377
14910
12
1440598
Female
263594
128710
1115992
9186
0
1517482
Total
538724
265879
2129369
24096
12
2958080
Any Mental Health Services
Inpatient Mental Health Services
Day/Night Mental Health Services
Ambulatory Mental Health Services
Number
1345
781
2126
1409
1373
2782
5076
9827
14903
36
30
66
0
0
0
7866
12011
19877
Number
23
4
27
76
118
194
164
266
430
1
2
3
0
0
0
264
390
654
Number
24
4
28
47
53
100
46
124
170
0
0
0
0
0
0
117
181
298
Number
1339
781
2120
1393
1361
2754
5042
9792
14834
36
29
65
0
0
0
7810
11963
19773
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
5.87%
3.56%
4.74%
12.33%
12.80%
12.56%
6.01%
10.57%
8.40%
2.90%
3.92%
3.29%
0.00%
NA
0.00%
6.55%
9.50%
8.06%
Percent
0.10%
0.02%
0.06%
0.66%
1.10%
0.88%
0.19%
0.29%
0.24%
0.08%
0.26%
0.15%
0.00%
NA
0.00%
0.22%
0.31%
0.27%
Percent
0.10%
0.02%
0.06%
0.41%
0.49%
0.45%
0.05%
0.13%
0.10%
0.00%
0.00%
0.00%
0.00%
NA
0.00%
0.10%
0.14%
0.12%
Percent
5.84%
3.56%
4.72%
12.19%
12.69%
12.43%
5.97%
10.53%
8.36%
2.90%
3.79%
3.24%
0.00%
NA
0.00%
6.51%
9.46%
8.02%
Page 44
Use of Services
Blue Plus (HMO Minnesota)
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Male
Female
Total
275130
137169
1013377
14910
12
1440598
263594
128710
1115992
9186
0
1517482
538724
265879
2129369
24096
12
2958080
Discharges
Discharges /
1,000 Member
Months
Days
Average Length
of Stay
M
1
0.00
5
5.00
F
0
0.00
0
NA
Total
1
0.00
5
5.00
M
13-17
99
0.72
1522
15.37
F
78
0.61
1178
15.10
Total
177
0.67
2700
15.25
M
18-64
266
0.26
2846
10.70
F
164
0.15
1847
11.26
Total
430
0.20
4693
10.91
M
65+
1
0.07
3
3.00
F
0
0.00
0
NA
Total
1
0.04
3
3.00
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
367
0.25
4376
11.92
F
242
0.16
3025
12.50
TOTAL
609
0.21
7401
12.15
* 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
Blue Plus (HMO Minnesota)
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
275130
137169
1013377
14910
12
1440598
Female
263594
128710
1115992
9186
0
1517482
Member Months (Inpatient)
Total
538724
265879
2129369
24096
12
2958080
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
1
0
1
230
126
356
826
418
1244
4
1
5
0
0
0
1061
545
1606
Percent
0.00%
0.00%
0.00%
2.01%
1.17%
1.61%
0.98%
0.45%
0.70%
0.32%
0.13%
0.25%
0.00%
NA
0.00%
0.88%
0.43%
0.65%
Male
275130
137169
1013377
14910
12
1440598
Female
263594
128710
1115992
9186
0
1517482
Total
538724
265879
2129369
24096
12
2958080
Member Months (Day/Night)
Male
275130
137169
1013377
14910
12
1440598
Female
263594
128710
1115992
9186
0
1517482
Total
538724
265879
2129369
24096
12
2958080
Member Months (Ambulatory)
Male
275130
137169
1013377
14910
12
1440598
Female
263594
128710
1115992
9186
0
1517482
Total
538724
265879
2129369
24096
12
2958080
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
1
0
1
71
56
127
214
133
347
1
0
1
0
0
0
287
189
476
Number
0
0
0
4
1
5
3
4
7
0
0
0
0
0
0
7
5
12
Number
1
0
1
204
102
306
720
356
1076
3
1
4
0
0
0
928
459
1387
Percent
0.00%
0.00%
0.00%
0.62%
0.52%
0.57%
0.25%
0.14%
0.20%
0.08%
0.00%
0.05%
0.00%
NA
0.00%
0.24%
0.15%
0.19%
Percent
0.00%
0.00%
0.00%
0.03%
0.01%
0.02%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
0.00%
0.01%
0.00%
0.00%
Percent
0.00%
0.00%
0.00%
1.78%
0.95%
1.38%
0.85%
0.38%
0.61%
0.24%
0.13%
0.20%
0.00%
NA
0.00%
0.77%
0.36%
0.56%
Page 50
Use of Services
Blue Plus (HMO Minnesota)
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO 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 3:13 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
Blue Plus (HMO Minnesota)
Outpatient Drug Utilization
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 3:13 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+
48299
61005
1814
45799
58554
1728
94.82%
94.63%
95.02%
95.98%
95.83%
96.14%
95.26%
94.25%
96.26%
A
Page 55
Access/Availability of Care
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 1, 2004 3:13 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+
5622
556
7931
4849
467
6578
86.25%
85.34%
87.16%
83.99%
80.86%
87.13%
82.94%
82.11%
83.77%
A
Page 58
Access/Availability of Care
Blue Plus (HMO Minnesota)
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 1, 2004 3:13 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.
2747
14040
13641
29551
2672
12374
12044
26318
97.27%
96.64%
97.90%
88.13%
87.60%
88.67%
88.29%
87.75%
88.84%
89.06%
88.70%
89.42%
A
Page 59
Access/Availability of Care
Blue Plus (HMO Minnesota)
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 1, 2004 3:13 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.
3285
6020
2650
3370
3144
5236
2304
2983
95.71%
95.00%
96.42%
86.98%
86.12%
87.84%
86.94%
85.64%
88.25%
88.52%
87.43%
89.61%
A
Page 60
Access/Availability of Care
Blue Plus (HMO Minnesota)
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 1, 2004 3:13 PM
Commercial
Timeliness of
Prenatal Care
Postpartum
Care
HO
HO
S
S
3112
3112
1246
2017
40.04%
64.81%
Minimum required sample size (MRSS) or other sample size
288
288
Oversampling rate
Final sample size (FSS)
5%
303
5%
303
Number of numerator events by administrative data in FSS
118
195
38.94%
64.36%
Number of original sample records excluded because of
valid data errors
2
2
Number of employee/dependent medical records excluded
0
0
2
288
111
161
2
288
188
43
94.44%
91.63%
97.26%
80.21%
75.43%
84.98%
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
Blue Plus (HMO Minnesota)
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 1, 2004 3:13 PM
PMAP
Timeliness of
Prenatal Care
Postpartum
Care
HO
HO
S
S
2358
2358
484
1302
20.53%
55.22%
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
96
231
22.22%
53.47%
Number of original sample records excluded because of
valid data errors
4
4
Number of employee/dependent medical records excluded
0
0
4
411
90
279
4
411
221
51
89.78%
86.73%
92.83%
66.18%
61.48%
70.88%
Data collection methodology (Administrative or Hybrid)
Sampling method used (see User's Guide for entry
descriptions)
Eligible member population (i.e. members who meet all
denominator criteria)
Number of numerator events by administrative data in
eligible population (before exclusions)
Current year's administrative rate (before exclusions)
Administrative rate on FSS
Additional records added from the auxiliary list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2004 (Reporting Year 2003)
Page 62
Health Plan Stability
Blue Plus (HMO Minnesota)
Practitioner Turnover
Medicare + Choice
Practitioner Types
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Practitioner Turnover
Minnesota Senior Health Options
Practitioner Types
Number of
Practitioners as of
12/31/2002
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Years in Business / Total Membership
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Years in Business / Total Membership
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO Minnesota)
Board Certification / Residency Completion
Data Last Refreshed:
Sep 1, 2004 3:13 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
Blue Plus (HMO 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 3:13 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 InformationBlue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 3:13 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
18900
77532
105660
126564
83640
49152
Member Months
Female
17484
74604
101784
119712
78720
49404
Total
36384
152136
207444
246276
162360
98556
461448
32.03%
85980
69708
93456
111876
133656
441708
29.11%
96936
83544
105948
124908
156408
903156
30.53%
494676
34.34%
143124
141444
111588
73392
567744
37.41%
161892
150648
113700
72612
1062420
35.92%
469548
32.59%
11292
2520
792
192
48
72
498852
32.87%
7200
1464
324
132
12
60
968400
32.74%
14916
1.04%
12
9192
0.61%
0
24108
0.81%
1440600
1517496
HEDIS 2004 (Reporting Year 2003)
182916
153252
199404
236784
290064
305016
292092
225288
146004
18492
3984
1116
324
60
132
12
2958096
Page 69
Health Plan Descriptive InformationBlue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 3:13 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 InformationBlue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 3:13 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 InformationBlue Plus (HMO Minnesota)
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 1, 2004 3:13 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
26312
66438
49296
41979
20394
7552
Member Months
Female
24816
62149
47518
41743
21383
14333
Total
51128
128587
96814
83722
41777
21885
211971
76.48%
6508
6080
6239
5312
4513
211942
49.62%
40822
28745
22070
16299
11433
423913
60.19%
28652
10.34%
2644
1052
627
218
119369
27.94%
4766
1628
548
134
148021
21.02%
4541
1.64%
6456
5804
5293
5946
4542
3938
7076
1.66%
9780
11547
13567
17051
17068
19768
11617
1.65%
31979
11.54%
0
88781
20.78%
0
120760
17.15%
277143
427168
HEDIS 2004 (Reporting Year 2003)
47330
34825
28309
21611
15946
7410
2680
1175
352
16236
17351
18860
22997
21610
23706
0
704311
Page 72