South Country Health Alliance
Plan Name
2002
Reporting Year
General Info
Submission #
1
Last Refreshed:
34
9/23/2003 1:44:04 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
62
Adolescent Immunization Rate
6
Children's Access to Primary Care Practitioners
68
Breast Cancer Screening
9
Prenatal and Postpartum Care
71
Cervical Cancer Screening
10
Availability of Language Interpretation Services
74
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
75
Appropriate Medications for People with Asthma
21
Years in Business / Total Membership
77
Follow-up After Hospitalization For Mental Illness
25
Antidepressant Medication Management
26
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
32
Board Certification / Residency Completion
79
Well-Child Visits In The Third, Fourth, Fifth And Sixth Year of Life
34
Total Enrollment by Percentage
80
Adolescent Well-Care Visits
35
Enrollment by Product Line (Age & Sex)
81
Inpatient Utilization - General Hospital/Acute Care
36
Ambulatory Care
42
Inpatient Utilization - Nonacute Care
45
Mental Health Utilization - Inpatient Discharges and Average Length of Stay
48
Mental Health Utilization - Percentage of Members Receiving Inpatient and Ambulatory Services
51
Chemical Dependency Utilization - Inpatient Discharges and Average Length of Stay
54
Chemical Dependency Utilization - Percentage of Members Receiving Inpatient and Ambulatory Services
57
Outpatient Drug Utilization
60
HEDIS 2003 (Reporting Year 2002)
DISCLAIMERS
-1
( this page left blank intentionally )
0. Disclaimer Query located below
HEDIS 2003 (Reporting Year 2002)
Page 2
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Rate
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Data Elements
General
Measure
Data
DTaP/DT
IPV/OPV
MMR
HiB
Hepatitis B
VZV
Combo 1
Combo 2
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of Records Excluded because of
Contraindications by Admin Data
Number of Records Excluded because of
Contraindications by Medical Record
Review
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2003 (Reporting Year 2002)
Page 3
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Rate
Data Last Refreshed:
Sep 23, 2003 1:44 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Combo 1
Combo 2
1
1.01%
1
1.01%
57
57.58%
1
1.01%
1
1.01%
48
48.48%
1
1.01%
1
1.01%
1
1.01%
1
1.01%
57
57.58%
1
1.01%
1
1.01%
48
48.48%
1
1.01%
1
1.01%
1
82
83.84%
76.08%
91.59%
1
93
94.95%
90.13%
99.77%
57
35
92.93%
87.37%
98.48%
1
86
87.88%
80.94%
94.81%
1
88
89.90%
83.46%
96.34%
48
29
77.78%
69.08%
86.47%
1
68
69.70%
60.14%
79.25%
1
58
59.60%
49.42%
69.77%
99
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 2003 (Reporting Year 2002)
MMR
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
IPV/OPV
HO
S
99
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
99
Page 4
Effectiveness of Care
South Country Health Alliance
Childhood Immunization Rate
Data Last Refreshed:
Sep 23, 2003 1:44 PM
MinnesotaCare
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 2003 (Reporting Year 2002)
Page 5
Effectiveness of Care
South Country Health Alliance
Adolescent Immunization Status
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Data Elements
General
Measure
Data
MMR
Hepatitis B
VZV
Combo 1
Combo 2
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of Records Excluded because of
Contraindications by Admin Data
Number of Records Excluded because of
Contraindications by Medical Record
Review
Number of employee/dependent records
excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2003 (Reporting Year 2002)
Page 6
Effectiveness of Care
South Country Health Alliance
Adolescent Immunization Status
Data Last Refreshed:
Sep 23, 2003 1:44 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Combo 1
Combo 2
10
47.62%
4
19.05%
0
0.00%
4
19.05%
0
0.00%
10
47.62%
4
19.05%
0
0.00%
4
19.05%
0
0.00%
10
5
NA
NA
NA
4
6
NA
NA
NA
0
4
NA
NA
NA
4
6
NA
NA
NA
0
3
NA
NA
NA
21
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 2003 (Reporting Year 2002)
VZV
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
Hepatitis B
HO
S
21
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
21
Page 7
Effectiveness of Care
South Country Health Alliance
Adolescent Immunization Status
Data Last Refreshed:
Sep 23, 2003 1:44 PM
MinnesotaCare
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 2003 (Reporting Year 2002)
Page 8
Effectiveness of Care
South Country Health Alliance
Breast Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Medicare + Choice
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Numerator Events by Admin Data on Eligible
Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
Records Excluded because of contraindications
through Admin data
Records Excluded because of contraindications
through Medical Record Review
Number of employee/dependent medical records
excluded
Records Added from Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2003 (Reporting Year 2002)
Page 9
Effectiveness of Care
South Country Health Alliance
Cervical Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
PMAP
A
MNCare
744
GAMC
A
91
Numerator Events by Admin Data on Eligible
Population (before exclusions)
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin Rate on FSS
Records Excluded because of Valid Data Errors
NR
38.17%
NR
28.57%
NR
NR
NR
NR
Records Excluded because of contraindications
through Admin data
0
0
744
284
91
26
Records Excluded because of contraindications
through Medical Record Review
Number of employee/dependent medical records
excluded
Records Added from Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2003 (Reporting Year 2002)
NR
NR
NR
38.17%
34.61%
41.73%
NR
NR
NR
28.57%
18.74%
38.40%
Page 10
Effectiveness of Care
South Country Health Alliance
Chlamydia Screening in Women
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Data Elements
General
Measure Ages 16-20 Ages 21-26
Data
Data Collection Methodology
Eligible Member Population
Current Year's Admin Rate
PMAP
Total
General
Measure Ages 16-20 Ages 21-26
Data
Total
A
NR
NR
143
38.46%
212
30.19%
355
33.52%
Records Excluded because of contraindications
through Admin data
NR
0
0
0
Denominator
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NR
NR
NR
NR
NR
143
55
38.46%
30.14%
46.79%
212
64
30.19%
23.77%
36.60%
355
119
33.52%
28.47%
38.57%
NR
NR
NR
NR
NR
NR
NR
NR
GAMC
Data Elements
Data Collection Methodology
Eligible Member Population
Current Year's Admin Rate
Records Excluded because of contraindications
through Admin data
Denominator
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2003 (Reporting Year 2002)
MNCare
General
Measure Ages 16-20 Ages 21-26
Data
Total
General
Measure Ages 16-20 Ages 21-26
Data
Total
A
0
NA
6
66.67%
6
66.67%
0
0
0
NR
0
0
NR
NR
NR
6
4
NA
NA
NA
6
4
NA
NA
NA
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 11
Effectiveness of Care
South Country Health Alliance
Controlling High Blood Pressure
Data Last Refreshed:
Sep 23, 2003 1:44 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
PMAP
HO
S
224
411
10.00%
228
2
0
Records Excluded because of ESRD identified by
Admin Data
4
Records Excluded because of ESRD 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 2003 (Reporting Year 2002)
NR
NR
NR
0
222
140
63.06%
56.49%
69.64%
Medicare + Choice
MSHO
NR
NR
NR
NR
NR
NR
Page 12
Effectiveness of Care
South Country Health Alliance
Beta Blocker Treatment after Heart Attack
Data Elements
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Medicare + Choice
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population
Current Year's Admin Rate
NR
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
NR
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
Reported Rate
NR
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NR
HEDIS 2003 (Reporting Year 2002)
NR
Page 13
Effectiveness of Care
South Country Health Alliance
Cholesterol Management After Acute Cardiovascular Events
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Medicare + Choice
Data Elements
General
Measure
Data
LDL-C
LDL-C Level of
screening 60- <130 mg/dL 60365 Days
365 Days
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator Events by Admin Data on
Eligible Population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
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 2003 (Reporting Year 2002)
Page 14
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Data Elements
General
Measure Data
HbA1c
Testing
Poor HbA1c
Control
Eye Exam
LDL-C
Screening
LDL-C Level
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
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 2003 (Reporting Year 2002)
Page 15
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Medicare + Choice
Data Elements
General
Measure Data
HbA1c
Testing
Poor HbA1c
Control
Eye Exam
LDL-C
Screening
LDL-C Level
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
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 2003 (Reporting Year 2002)
Page 16
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:44 PM
MSHO
Data Elements
General
Measure Data
HbA1c
Testing
Poor HbA1c
Control
Eye Exam
LDL-C
Screening
LDL-C Level
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
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 2003 (Reporting Year 2002)
Page 17
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:44 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure Data
LDL-C
Screening
LDL-C Level
Monitoring
for Diabetic
Nephropathy
83
50.92%
0
0.00%
96
58.90%
49
30.06%
0
0.00%
40
24.54%
83
50.92%
0
0.00%
96
58.90%
49
30.06%
0
0.00%
40
24.54%
83
56
85.80%
80.12%
91.49%
0
41
25.31%
18.30%
32.31%
96
2
60.49%
52.66%
68.33%
49
70
73.46%
66.35%
80.57%
0
84
51.85%
43.85%
59.85%
40
54
58.02%
50.12%
65.93%
163
1
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2003 (Reporting Year 2002)
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
163
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
162
Page 18
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:44 PM
GAMC
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure Data
LDL-C
Screening
LDL-C Level
Monitoring
for Diabetic
Nephropathy
22
88.00%
0
0.00%
11
44.00%
16
64.00%
0
0.00%
8
32.00%
22
88.00%
0
0.00%
11
44.00%
16
64.00%
0
0.00%
8
32.00%
22
0
NA
NA
NA
0
6
NA
NA
NA
11
0
NA
NA
NA
16
2
NA
NA
NA
0
13
NA
NA
NA
8
1
NA
NA
NA
25
0
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2003 (Reporting Year 2002)
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
25
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
25
Page 19
Effectiveness of Care
South Country Health Alliance
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:44 PM
MinnesotaCare
Data Elements
General
Measure Data
HbA1c
Testing
Poor HbA1c
Control
Eye Exam
LDL-C
Screening
LDL-C Level
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
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 2003 (Reporting Year 2002)
Page 20
Effectiveness of Care
South Country Health Alliance
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
General
Measure Data
Ages 5-9
NR
NR
NR
Ages 10-17
NR
NR
NR
Ages 18-56
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 21
Effectiveness of Care
South Country Health Alliance
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
Total
1
0
NA
NA
NA
1
1
NA
NA
NA
1
1
NA
NA
NA
3
2
NA
NA
NA
A
Page 22
Effectiveness of Care
South Country Health Alliance
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 23, 2003 1:44 PM
GAMC
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2003 (Reporting Year 2002)
General
Measure Data
Ages 5-9
Ages 10-17
Ages 18-56
Total
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
A
Page 23
Effectiveness of Care
South Country Health Alliance
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 23, 2003 1:44 PM
MNCare
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2003 (Reporting Year 2002)
General
Measure Data
Ages 5-9
NR
NR
NR
Ages 10-17
NR
NR
NR
Ages 18-56
Total
NR
NR
NR
NR
NR
NR
NR
NR
Page 24
Effectiveness of Care
South Country Health Alliance
Follow-Up After Hospitalization for Mental Illness
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
General
Measure
Data
Medicare + Choice
General
W/in 7 Days of W/in 30 Days of
Measure
Discharge
Discharge
Data
NR
NR
NR
NR
NR
NR
MSHO
General
W/in 7 Days of W/in 30 Days of
Measure
Discharge
Discharge
Data
NR
NR
NR
NR
NR
NR
W/in 7 Days of W/in 30 Days of
Discharge
Discharge
NR
NR
NR
NR
NR
NR
Page 25
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 26
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
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 27
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
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 28
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
4
NA
NA
NA
11
NA
NA
NA
10
NA
NA
NA
A
16
Page 29
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:44 PM
GAMC
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2003 (Reporting Year 2002)
General
Measure
Data
Optimal
Practitioner
Contacts for
Medication
Management
Effective Acute
Phase
Treatment
Effective
Continuation
Phase
Treatment
1
NA
NA
NA
1
NA
NA
NA
1
NA
NA
NA
A
4
Page 30
Effectiveness of Care
South Country Health Alliance
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:44 PM
MNCare
Data Elements
Data Collection Methodology
Eligible Member Population
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2003 (Reporting Year 2002)
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 31
Use of Services
South Country Health Alliance
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 23, 2003 1:44 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
0
Number of employee/dependent medical
records excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2003 (Reporting Year 2002)
2 visits
3 visits
4 visits
5 visits
6 or more
visits
4
16.00%
5
20.00%
2
8.00%
2
8.00%
6
24.00%
6
24.00%
0
0.00%
4
16.00%
5
20.00%
2
8.00%
2
8.00%
6
24.00%
6
24.00%
0
0.00%
1
0
NA
NA
NA
1
2
NA
NA
NA
0
1
NA
NA
NA
1
2
NA
NA
NA
0
0
NA
NA
NA
4
5
NA
NA
NA
0
8
NA
NA
NA
411
10.00%
25
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
1 visit
HO
S
25
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Zero Visits
25
Page 32
Use of Services
South Country Health Alliance
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 23, 2003 1:44 PM
MinnesotaCare
Data Elements
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Number of Records Excluded Because of
Valid Data Errors
Number of employee/dependent medical
records excluded
Additional Records Added from the
Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2003 (Reporting Year 2002)
Page 33
Use of Services
South Country Health Alliance
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 2003 (Reporting Year 2002)
PMAP
HO
S
723
Data Last Refreshed:
Sep 23, 2003 1:44 PM
MNCare
301
41.63%
411
10.00%
453
185
NR
40.84%
0
NR
0
0
411
165
51
52.55%
47.61%
57.50%
NR
NR
NR
Page 34
Use of Services
South Country Health Alliance
Adolescent Well-Care Visits
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Numerator events by admin data in eligible
population
Current Year's Admin Rate
Minimum Required Sample Size
Oversampling Rate
Final sample size (FSS)
Numerator events by admin data in FSS
Administrative rate on FSS
Records Excluded because of Valid Data Errors
Number of employee/dependent medical records
excluded
Records Added from Auxiliary List
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
HEDIS 2003 (Reporting Year 2002)
Data Last Refreshed:
Sep 23, 2003 1:44 PM
PMAP
HO
S
976
MNCare
218
22.34%
411
10.00%
453
94
NR
20.75%
0
NR
0
0
411
84
88
41.85%
36.96%
46.74%
NR
NR
NR
Page 35
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:44 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
<1
1-9
10-19
20-44
45-64
65+
Unknown
Total
Member Months
NR
Discharges
Discharges /
1,000 Member
Months
Days
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2003 (Reporting Year 2002)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Days / 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Average Length
of Stay
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 36
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
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 37
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
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 38
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:44 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
<1
1-9
10-19
20-44
45-64
65+
Unknown
Total
Member Months
8670
38785
23362
23615
1786
6113
9118
10520
0
121969
Discharges
161
111
145
672
13
135
231
191
0
1659
Discharges /
1,000 Member
Months
18.57
2.86
6.21
28.46
7.28
22.08
25.33
18.16
13.60
139
89
35
179
7
131
229
190
0
999
16.03
2.29
1.50
7.58
3.92
21.43
25.12
18.06
22
22
12
52
6
4
2
1
0
121
2.54
0.57
0.51
2.20
3.36
0.65
0.22
0.10
0
0
98
441
0
0
0
539
HEDIS 2003 (Reporting Year 2002)
8.19
0.99
0.00
0.00
4.19
18.67
0.00
0.00
4.42
Days
Days / 1,000
Member
Months
1090
270
367
1756
44
710
934
805
0
5976
125.72
6.96
15.71
74.36
24.64
116.15
102.43
76.52
850
180
99
428
22
681
921
792
0
3973
98.04
4.64
4.24
18.12
12.32
111.40
101.01
75.29
240
90
33
171
22
29
13
13
0
611
27.68
2.32
1.41
7.24
12.32
4.74
1.43
1.24
0
0
235
1157
0
0
0
1392
0.00
0.00
10.06
48.99
0.00
0.00
49.00
32.57
5.01
11.41
Average Length
of Stay
6.77
2.43
2.53
2.61
3.38
5.26
4.04
4.21
NA
3.60
6.12
2.02
2.83
2.39
3.14
5.20
4.02
4.17
NA
3.98
10.91
4.09
2.75
3.29
3.67
7.25
6.50
13.00
NA
5.05
NA
NA
2.40
2.62
NA
NA
NA
2.58
Page 39
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:44 PM
GAMC
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
<1
1-9
10-19
20-44
45-64
65+
Unknown
Total
Member Months
3
188
219
4234
2868
3
0
0
0
7515
Discharges
0
0
0
55
66
0
0
0
0
121
0
0
0
39
40
0
0
0
0
79
0
0
0
16
26
0
0
0
0
42
0
0
0
0
0
0
0
0
HEDIS 2003 (Reporting Year 2002)
Discharges /
1,000 Member
Months
0.00
0.00
0.00
12.99
23.01
0.00
NA
NA
16.10
0.00
0.00
0.00
9.21
13.95
0.00
NA
NA
10.51
0.00
0.00
0.00
3.78
9.07
0.00
NA
NA
5.59
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Days
0
0
0
224
207
0
0
0
0
431
0
0
0
155
104
0
0
0
0
259
0
0
0
69
103
0
0
0
0
172
0
0
0
0
0
0
0
0
Days / 1,000
Member
Months
0.00
0.00
0.00
52.91
72.18
0.00
NA
NA
57.35
0.00
0.00
0.00
36.61
36.26
0.00
NA
NA
34.46
0.00
0.00
0.00
16.30
35.91
0.00
NA
NA
22.89
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Average Length
of Stay
NA
NA
NA
4.07
3.14
NA
NA
NA
NA
3.56
NA
NA
NA
3.97
2.60
NA
NA
NA
NA
3.28
NA
NA
NA
4.31
3.96
NA
NA
NA
NA
4.10
NA
NA
NA
NA
NA
NA
NA
NA
Page 40
Use of Services
South Country Health Alliance
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:44 PM
MinnesotaCare
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
<1
1-9
10-19
20-44
45-64
65+
Unknown
Total
Member Months
NR
Discharges
Discharges /
1,000 Member
Months
Days
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2003 (Reporting Year 2002)
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Days / 1,000
Member
Months
NR
NR
NR
NR
NR
NR
NR
NR
NR
Average Length
of Stay
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Page 41
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
NR
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
NR
HEDIS 2003 (Reporting Year 2002)
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 42
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
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 43
Use of Services
South Country Health Alliance
Ambulatory Care
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
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 44
Use of Services
South Country Health Alliance
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Member
Months
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
NR
Total
Age
Discharges
Discharges /
1,000 Member
Months
Days
Days / 1,000
Member
Months
Average Length
of Stay
<1
NR
NR
NR
1-9
NR
NR
NR
10-19
NR
NR
NR
20-44
NR
NR
NR
45-64
NR
NR
NR
65-74
NR
NR
NR
75-84
NR
NR
NR
85+
NR
NR
NR
NR
NR
NR
Unknown
Total
HEDIS 2003 (Reporting Year 2002)
NR
NR
NR
Page 45
Use of Services
South Country Health Alliance
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
NR
NR
NR
Page 46
Use of Services
South Country Health Alliance
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
NR
NR
NR
Page 47
Use of Services
South Country Health Alliance
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
Discharges
Age
0-12
Discharges /
1,000 Member
Months
Days*
Average Length
of Stay
M
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
13-17
M
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
18-64
M
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
65+
M
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
Unknown
NR
F
NR
Total
NR
NR
NR
M
Total
NR
NR
NR
NR
F
NR
NR
NR
NR
TOTAL
NR
NR
NR
NR
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization should not be included in this table
HEDIS 2003 (Reporting Year 2002)
Page 48
Use of Services
South Country Health Alliance
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
Page 49
Use of Services
South Country Health Alliance
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
Page 50
Use of Services
South Country Health Alliance
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
NR
NR
Member Months (Inpatient)
Total
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Member Months (Day/Night)
Total
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Member Months (Ambulatory)
Total
NR
NR
NR
NR
NR
NR
Male
Female
NR
NR
Total
NR
NR
NR
NR
NR
NR
Any Mental Health Services
Inpatient Mental Health Services
Day/Night Mental Health Services
Ambulatory Mental Health Services
Number
Number
Number
Number
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2003 (Reporting Year 2002)
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 51
Use of Services
South Country Health Alliance
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
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 52
Use of Services
South Country Health Alliance
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
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 53
Use of Services
South Country Health Alliance
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
NR
Female
Total
NR
NR
NR
NR
NR
NR
NR
Discharges
Age
0-12
Discharges /
1,000 Member
Months
Days
Average Length
of Stay
M
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
13-17
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
18-64
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
65+
NR
NR
F
NR
NR
Total
NR
NR
NR
NR
M
Unknown
NR
F
NR
Total
NR
NR
NR
Total
M
NR
NR
NR
NR
F
NR
NR
NR
NR
TOTAL
NR
NR
NR
NR
* This table should reflect inpatient days only. Days associated with day/night or partial hospitalization should not be included in this table
HEDIS 2003 (Reporting Year 2002)
Page 54
Use of Services
South Country Health Alliance
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
Page 55
Use of Services
South Country Health Alliance
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
Page 56
Use of Services
South Country Health Alliance
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
NR
NR
Member Months (Inpatient)
Total
NR
NR
NR
NR
NR
NR
Any Chemical Dependency Services
Age
0-12
13-17
18-64
65+
Unknown
Total
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2003 (Reporting Year 2002)
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 57
Use of Services
South Country Health Alliance
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
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 58
Use of Services
South Country Health Alliance
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
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 59
Use of Services
South Country Health Alliance
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 23, 2003 1:44 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 2003 (Reporting Year 2002)
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 60
Use of Services
South Country Health Alliance
Outpatient Drug Utilization
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
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 61
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Data Elements
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data collection methodology
(Administrative only)
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2003 (Reporting Year 2002)
Page 62
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
Page 63
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
Page 64
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
845
89
1716
753
79
1628
89.11%
86.95%
91.27%
88.76%
81.64%
95.89%
94.87%
93.80%
95.94%
A
Page 65
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:44 PM
GAMC
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 2003 (Reporting Year 2002)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
93
117
1
73
97
0
78.49%
69.61%
87.38%
82.91%
75.66%
90.15%
NA
NA
NA
A
Page 66
Access/Availability of Care
South Country Health Alliance
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Minnesota Care
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 2003 (Reporting Year 2002)
Page 67
Access/Availability of Care
South Country Health Alliance
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Data Elements
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
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 2003 (Reporting Year 2002)
Page 68
Access/Availability of Care
South Country Health Alliance
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
604
1025
5
545
838
5
90.23%
87.78%
92.68%
81.76%
79.34%
84.17%
NA
NA
NA
A
Page 69
Access/Availability of Care
South Country Health Alliance
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Minnesota Care
Data Elements
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
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 2003 (Reporting Year 2002)
Page 70
Access/Availability of Care
South Country Health Alliance
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
General Measure
Data
Timeliness of
Prenatal Care
Postpartum Care
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data collection methodology (Administrative or Hybrid)
Sampling method used (see User's Guide for entry
descriptions)
Eligible member population (i.e. members who meet all
denominator criteria)
Number of numerator events by administrative data in
eligible population (before exclusions)
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of
valid data errors
Number of employee/dependent medical records excluded
Additional records added from the auxiliary list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2003 (Reporting Year 2002)
Page 71
Access/Availability of Care
South Country Health Alliance
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 23, 2003 1:44 PM
PMAP
General Measure
Data
Data collection methodology (Administrative or Hybrid)
Timeliness of
Prenatal Care
Postpartum Care
47.79%
54.78%
NR
NR
205
235
47.79%
42.94%
52.63%
54.78%
49.95%
59.60%
A
Sampling method used (see User's Guide for entry
descriptions)
Eligible member population (i.e. members who meet all
denominator criteria)
429
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 2003 (Reporting Year 2002)
429
Page 72
Access/Availability of Care
South Country Health Alliance
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Minnesota Care
General Measure
Data
Timeliness of
Prenatal Care
Postpartum Care
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
Data collection methodology (Administrative or Hybrid)
Sampling method used (see User's Guide for entry
descriptions)
Eligible member population (i.e. members who meet all
denominator criteria)
Number of numerator events by administrative data in
eligible population (before exclusions)
Current year's administrative rate (before exclusions)
Minimum required sample size (MRSS) or other sample size
Oversampling rate
Final sample size (FSS)
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of
valid data errors
Number of employee/dependent medical records excluded
Additional records added from the auxiliary list
Denominator
Numerator events by administrative data
Numerator events by medical record
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2003 (Reporting Year 2002)
Page 73
Access/Availability of Care
South Country Health Alliance
Availability of Language Interpretation Services
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Minnesota Senior Health Options
Language (not to exceed 25
Interpreter Services (not to exceed
Description (not to exceed 50
characters)
50 characters)
characters)
HEDIS 2003 (Reporting Year 2002)
Type of Agreement (not to exceed 50 Restrictions on Availability (not
characters)
to exceed 50 characters)
Page 74
Health Plan Stability
South Country Health Alliance
Practitioner Turnover
Medicare + Choice
Practitioner Types
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Number of
Practitioners as of
12/31/2001
Number of
Practitioners who
were not affiliated
with the plan as of
12/31/2002
Practitioner
Turnover Rate
Primary Care
Physicians
NR
Non-Physician Primary
Care Practitioners
NR
HEDIS 2003 (Reporting Year 2002)
Page 75
Health Plan Stability
South Country Health Alliance
Practitioner Turnover
Minnesota Senior Health Options
Practitioner Types
Number of
Practitioners as of
12/31/2001
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Number of
Practitioners who
were not affiliated
with the plan as of
12/31/2002
Practitioner
Turnover Rate
Primary Care
Physicians
NR
Non-Physician Primary
Care Practitioners
NR
HEDIS 2003 (Reporting Year 2002)
Page 76
Health Plan Stability
South Country Health Alliance
Years in Business / Total Membership
Data Last Refreshed:
Sep 23, 2003 1:44 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, 2002
HEDIS 2003 (Reporting Year 2002)
Page 77
Health Plan Stability
South Country Health Alliance
Years in Business / Total Membership
Data Last Refreshed:
Sep 23, 2003 1:44 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, 2002
HEDIS 2003 (Reporting Year 2002)
Page 78
Health Plan Descriptive Information
South Country Health Alliance
Board Certification / Residency Completion
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Minnesota Senior Health Options
Type of Practitioner
Primary Care Practitioners
Number of
Practitioners in Each
Practice Area
Geriatricians
Other practitioner
Specialists
HEDIS 2003 (Reporting Year 2002)
Board Certification
Number
Percent
Residency / Fellowship
Completion
Percent
Number
NR
NR
NR
NR
NR
NR
Page 79
Health Plan Descriptive Information
South Country Health Alliance
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 23, 2003 1:44 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 2003 (Reporting Year 2002)
Page 80
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Commercial
Male
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Member Months
Female
Total
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
HEDIS 2003 (Reporting Year 2002)
Page 81
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
Page 82
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:44 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 2003 (Reporting Year 2002)
Page 83
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:44 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
4279
12155
7956
6755
3056
1046
Member Months
Female
4391
11111
7563
6583
3305
2617
Total
8670
23266
15519
13338
6361
3663
35247
74.93%
1045
982
886
710
619
35570
47.47%
6897
4746
3361
2601
1768
70817
58.06%
4242
9.02%
397
140
106
48
19373
25.86%
666
272
89
68
23615
19.36%
691
1.47%
1156
1180
1182
1305
1059
978
1095
1.46%
1747
2030
2775
3856
3659
4824
1786
1.46%
6860
14.58%
0
18891
25.21%
0
25751
21.11%
47040
74929
HEDIS 2003 (Reporting Year 2002)
7942
5728
4247
3311
2387
1063
412
195
116
2903
3210
3957
5161
4718
5802
0
121969
Page 84
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:44 PM
GAMC
<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
3
14
80
95
39
6
Member Months
Female
0
40
54
43
26
10
Total
3
54
134
138
65
16
237
5.34%
583
549
373
501
623
173
5.62%
459
286
234
223
403
410
5.46%
2629
59.27%
571
358
434
206
1605
52.13%
361
307
378
253
4234
56.34%
1569
35.37%
1
0
0
0
0
0
1299
42.19%
2
0
0
0
0
0
2868
38.16%
1
0.02%
0
2
0.06%
0
3
0.04%
4436
3079
HEDIS 2003 (Reporting Year 2002)
1042
835
607
724
1026
932
665
812
459
3
0
0
0
0
0
0
7515
Page 85
Health Plan Descriptive Information
South Country Health Alliance
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:44 PM
Minnesota Care
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 2003 (Reporting Year 2002)
Page 86