Metropolitan Health Plan
Plan Name
2002
Reporting Year
General Info
Submission #
1
Last Refreshed:
7
9/23/2003 1:42:32 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
Metropolitan Health Plan
Childhood Immunization Rate
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Childhood Immunization Rate
Data Last Refreshed:
Sep 23, 2003 1:42 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Combo 1
Combo 2
410
40.84%
481
47.91%
785
78.19%
541
53.88%
508
50.60%
709
70.62%
257
25.60%
230
22.91%
185
40.84%
218
48.12%
350
77.26%
244
53.86%
235
51.88%
316
69.76%
118
26.05%
107
23.62%
171
140
75.67%
71.40%
79.94%
204
164
89.54%
86.46%
92.62%
317
37
86.13%
82.67%
89.59%
229
141
90.02%
87.01%
93.04%
218
138
86.62%
83.20%
90.03%
296
27
78.59%
74.50%
82.68%
113
154
64.96%
60.23%
69.70%
104
140
59.37%
54.50%
64.24%
453
0
Number of Records Excluded because of
Contraindications by Admin Data
1
Number of Records Excluded because of
Contraindications by Medical Record
Review
1
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
1
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
1004
Numerator events by admin data in eligible
population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
DTaP/DT
411
Page 4
Effectiveness of Care
Metropolitan Health Plan
Childhood Immunization Rate
Data Last Refreshed:
Sep 23, 2003 1:42 PM
MinnesotaCare
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Combo 1
Combo 2
7
43.75%
8
50.00%
12
75.00%
10
62.50%
9
56.25%
11
68.75%
5
31.25%
5
31.25%
7
43.75%
8
50.00%
12
75.00%
9
56.25%
8
50.00%
10
62.50%
4
25.00%
4
25.00%
7
0
NA
NA
NA
8
6
NA
NA
NA
12
0
NA
NA
NA
9
6
NA
NA
NA
8
4
NA
NA
NA
10
1
NA
NA
NA
4
2
NA
NA
NA
4
2
NA
NA
NA
16
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
16
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
16
Page 5
Effectiveness of Care
Metropolitan Health Plan
Adolescent Immunization Status
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Adolescent Immunization Status
Data Last Refreshed:
Sep 23, 2003 1:42 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Combo 1
Combo 2
166
46.37%
60
16.76%
46
12.85%
40
11.17%
8
2.23%
165
46.09%
60
16.76%
46
12.85%
39
10.89%
7
1.96%
164
137
84.55%
80.66%
88.45%
60
184
68.54%
63.58%
73.50%
46
104
42.13%
36.87%
47.40%
39
196
66.01%
60.95%
71.07%
7
109
32.58%
27.58%
37.59%
358
0
Number of Records Excluded because of
Contraindications by Admin Data
1
Number of Records Excluded because of
Contraindications by Medical Record
Review
2
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
2
HEDIS 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
358
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
356
Page 7
Effectiveness of Care
Metropolitan Health Plan
Adolescent Immunization Status
Data Last Refreshed:
Sep 23, 2003 1:42 PM
MinnesotaCare
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Combo 1
Combo 2
20
44.44%
4
8.89%
4
8.89%
3
6.67%
0
0.00%
20
44.44%
4
8.89%
4
8.89%
3
6.67%
0
0.00%
20
19
86.67%
75.62%
97.71%
4
27
68.89%
54.25%
83.53%
4
13
37.78%
22.50%
53.05%
3
27
66.67%
51.78%
81.55%
0
15
33.33%
18.45%
48.22%
45
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
45
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
45
Page 8
Effectiveness of Care
Metropolitan Health Plan
Breast Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Cervical Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Commercial
PMAP
HO
S
1490
MNCare
HO
S
442
GAMC
HO
S
298
876
263
121
58.79%
411
20.00%
494
286
83.20%
0
59.50%
411
20.00%
442
253
92.99%
0
40.60%
411
20.00%
298
121
93.29%
0
Records Excluded because of contraindications
through Admin data
1
0
1
Records Excluded because of contraindications
through Medical Record Review
4
13
20
Number of employee/dependent medical records
excluded
0
0
0
4
411
247
56
73.72%
69.35%
78.10%
13
411
253
65
77.37%
73.21%
81.54%
20
278
121
41
58.27%
52.30%
64.25%
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
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
NR
NR
Page 10
Effectiveness of Care
Metropolitan Health Plan
Chlamydia Screening in Women
Data Last Refreshed:
Sep 23, 2003 1:42 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
357
73.95%
347
87.03%
704
80.40%
Records Excluded because of contraindications
through Admin data
NR
58
57
115
Denominator
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
NR
NR
NR
NR
NR
357
264
73.95%
69.26%
78.64%
347
302
87.03%
83.35%
90.71%
704
566
80.40%
77.39%
83.40%
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
A
General
Measure Ages 16-20 Ages 21-26
Data
Total
A
6
50.00%
10
50.00%
16
50.00%
37
51.35%
42
50.00%
79
50.63%
1
10
11
1
5
6
6
3
NA
NA
NA
10
5
NA
NA
NA
16
8
NA
NA
NA
37
19
51.35%
33.89%
68.81%
42
21
50.00%
33.69%
66.31%
79
40
50.63%
38.98%
62.29%
Page 11
Effectiveness of Care
Metropolitan Health Plan
Controlling High Blood Pressure
Data Last Refreshed:
Sep 23, 2003 1:42 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
382
382
0.00%
382
0
0
Medicare + Choice
MSHO
HO
S
149
149
0.00%
149
0
0
Records Excluded because of ESRD identified by
Admin Data
0
0
Records Excluded because of ESRD identified by
Medical Record
4
0
Number of employee/dependent medical records
excluded
0
0
4
378
197
52.12%
46.95%
57.28%
0
149
64
42.95%
34.67%
51.24%
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
NR
NR
NR
Page 12
Effectiveness of Care
Metropolitan Health Plan
Beta Blocker Treatment after Heart Attack
Data Elements
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Cholesterol Management After Acute Cardiovascular Events
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:42 PM
MSHO
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure Data
LDL-C
Screening
LDL-C Level
Monitoring
for Diabetic
Nephropathy
60
84.51%
71
100.00%
48
67.61%
49
69.01%
0
0.00%
49
69.01%
60
84.51%
71
100.00%
48
67.61%
49
69.01%
0
0.00%
49
69.01%
59
5
92.75%
85.91%
99.60%
30
0
43.48%
31.06%
55.90%
46
5
73.91%
62.83%
85.00%
48
7
79.71%
69.50%
89.92%
0
29
42.03%
29.66%
54.40%
48
3
73.91%
62.83%
85.00%
71
2
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2003 (Reporting Year 2002)
Eye Exam
69
0.00%
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
71
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
69
Page 17
Effectiveness of Care
Metropolitan Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
176
66.92%
273
NR
163
61.98%
111
42.21%
0
0.00%
148
56.27%
165
59.57%
277
100.00%
164
59.21%
110
39.71%
0
0.00%
142
51.26%
161
41
82.79%
77.85%
87.73%
86
0
35.25%
29.05%
41.45%
147
1
60.66%
54.32%
66.99%
110
79
77.46%
72.01%
82.91%
0
112
45.90%
39.44%
52.36%
142
43
75.82%
70.24%
81.40%
277
10
Number of employee/dependent records
excluded
33
Additional Records Added from the
Auxiliary List
33
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
263
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
244
Page 18
Effectiveness of Care
Metropolitan Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
95
82.61%
115
100.00%
61
53.04%
75
65.22%
0
0.00%
81
70.43%
95
77.87%
122
100.00%
67
54.92%
79
64.75%
0
0.00%
82
67.21%
90
5
87.96%
81.36%
94.56%
40
0
37.04%
27.47%
46.61%
61
1
57.41%
47.62%
67.20%
72
15
80.56%
72.63%
88.48%
0
59
54.63%
44.78%
64.48%
79
9
81.48%
73.69%
89.27%
122
0
Number of employee/dependent records
excluded
14
Additional Records Added from the
Auxiliary List
14
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
115
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
108
Page 19
Effectiveness of Care
Metropolitan Health Plan
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:42 PM
MinnesotaCare
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure Data
LDL-C
Screening
LDL-C Level
Monitoring
for Diabetic
Nephropathy
59
85.51%
64
92.75%
43
62.32%
45
65.22%
0
0.00%
46
66.67%
59
85.51%
69
100.00%
43
62.32%
48
69.57%
0
0.00%
47
68.12%
58
1
90.77%
82.96%
98.58%
13
0
20.00%
9.51%
30.49%
42
1
66.15%
53.88%
78.43%
46
14
92.31%
85.06%
99.56%
0
40
61.54%
48.94%
74.14%
46
10
86.15%
76.99%
95.32%
69
4
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2003 (Reporting Year 2002)
Eye Exam
69
0.00%
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
69
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
65
Page 20
Effectiveness of Care
Metropolitan Health Plan
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 23, 2003 1:42 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
73
51
69.86%
58.65%
81.07%
130
83
63.85%
55.20%
72.49%
76
46
60.53%
48.88%
72.17%
279
180
64.52%
58.72%
70.31%
A
Page 22
Effectiveness of Care
Metropolitan Health Plan
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 23, 2003 1:42 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
1
0
NA
NA
NA
1
1
NA
NA
NA
19
13
NA
NA
NA
21
14
NA
NA
NA
A
Page 23
Effectiveness of Care
Metropolitan Health Plan
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 23, 2003 1:42 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
Ages 10-17
Ages 18-56
Total
4
2
NA
NA
NA
10
6
NA
NA
NA
21
14
NA
NA
NA
35
22
62.86%
45.42%
80.29%
A
Page 24
Effectiveness of Care
Metropolitan Health Plan
Follow-Up After Hospitalization for Mental Illness
Data Last Refreshed:
Sep 23, 2003 1:42 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
MSHO
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
2
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
2
NA
NA
NA
2
NA
NA
NA
Page 25
Effectiveness of Care
Metropolitan Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:42 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
0
NA
NA
NA
8
NA
NA
NA
6
NA
NA
NA
A
10
Page 28
Effectiveness of Care
Metropolitan Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:42 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
11
16.18%
6.69%
25.66%
36
52.94%
40.34%
65.54%
26
38.24%
25.95%
50.52%
A
68
Page 29
Effectiveness of Care
Metropolitan Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:42 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
8
NA
NA
NA
13
NA
NA
NA
17
NA
NA
NA
A
26
Page 30
Effectiveness of Care
Metropolitan Health Plan
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:42 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
3
NA
NA
NA
11
NA
NA
NA
11
NA
NA
NA
A
13
Page 31
Use of Services
Metropolitan Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 23, 2003 1:42 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
137
14.92%
80
8.71%
41
4.47%
77
8.39%
109
11.87%
167
18.19%
307
33.44%
74
16.34%
39
8.61%
17
3.75%
31
6.84%
54
11.92%
82
18.10%
156
34.44%
4
0
0.97%
0.00%
2.04%
4
1
1.22%
0.04%
2.40%
5
7
2.92%
1.17%
4.67%
11
13
5.84%
3.45%
8.23%
25
16
9.98%
6.96%
12.99%
49
35
20.44%
16.42%
24.46%
146
95
58.64%
53.75%
63.52%
411
10.00%
453
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
918
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
411
Page 32
Use of Services
Metropolitan Health Plan
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 23, 2003 1:42 PM
MinnesotaCare
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
1
6.67%
0
0.00%
1
6.67%
1
6.67%
1
6.67%
5
33.33%
6
40.00%
1
6.67%
0
0.00%
1
6.67%
1
6.67%
1
6.67%
5
33.33%
6
40.00%
0
0
NA
NA
NA
0
0
NA
NA
NA
0
0
NA
NA
NA
1
0
NA
NA
NA
0
1
NA
NA
NA
3
1
NA
NA
NA
6
3
NA
NA
NA
411
10.00%
15
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
15
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
15
Page 33
Use of Services
Metropolitan Health Plan
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)
Data Last Refreshed:
Sep 23, 2003 1:42 PM
PMAP
HO
S
1569
MNCare
HO
S
132
709
68
45.19%
411
10.00%
453
200
51.52%
411
10.00%
132
67
44.15%
0
50.76%
0
1
0
1
411
183
76
63.02%
58.23%
67.81%
0
132
67
30
73.48%
65.58%
81.39%
Page 34
Use of Services
Metropolitan Health Plan
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 1:42 PM
PMAP
HO
S
2525
MNCare
HO
S
320
682
101
27.01%
411
10.00%
453
141
31.56%
411
10.00%
320
101
31.13%
0
31.56%
0
0
1
0
411
124
48
41.85%
36.96%
46.74%
1
319
101
40
44.20%
38.59%
49.81%
Page 35
Use of Services
Metropolitan Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
0
0
0
0
0
2477
1718
576
0
4771
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
119
89
37
0
245
NA
NA
NA
NA
NA
48.04
51.80
64.24
0
0
0
0
0
94
74
30
0
198
NA
NA
NA
NA
NA
37.95
43.07
52.08
0
0
0
0
0
25
15
7
0
47
HEDIS 2003 (Reporting Year 2002)
51.35
41.50
NA
NA
NA
NA
NA
10.09
8.73
12.15
9.85
Days
0
0
0
0
0
625
418
128
0
1171
0
0
0
0
0
389
337
87
0
813
0
0
0
0
0
236
81
41
0
358
Days / 1,000
Member
Months
NA
NA
NA
NA
NA
252.32
243.31
222.22
245.44
NA
NA
NA
NA
NA
157.04
196.16
151.04
170.40
NA
NA
NA
NA
NA
95.28
47.15
71.18
75.04
Average Length
of Stay
NA
NA
NA
NA
NA
5.25
4.70
3.46
NA
4.78
NA
NA
NA
NA
NA
4.14
4.55
2.90
NA
4.11
NA
NA
NA
NA
NA
9.44
5.40
5.86
NA
7.62
Page 38
Use of Services
Metropolitan Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
14586
70085
50542
37149
4201
7579
3429
1208
0
188779
Discharges
284
266
332
1092
46
191
106
39
0
2356
Discharges /
1,000 Member
Months
19.47
3.80
6.57
29.40
10.95
25.20
30.91
32.28
12.48
257
228
79
103
35
145
77
31
0
955
17.62
3.25
1.56
2.77
8.33
19.13
22.46
25.66
27
38
36
64
9
45
28
8
0
255
1.85
0.54
0.71
1.72
2.14
5.94
8.17
6.62
0
0
217
925
2
2
0
1146
HEDIS 2003 (Reporting Year 2002)
5.06
1.35
0.00
0.00
4.29
24.90
0.48
0.16
6.07
Days
Days / 1,000
Member
Months
1058
680
874
2822
113
754
505
196
0
7002
72.54
9.70
17.29
75.96
26.90
99.49
147.27
162.25
817
552
233
263
80
455
329
135
0
2864
56.01
7.88
4.61
7.08
19.04
60.03
95.95
111.75
241
128
91
196
29
296
169
61
0
1211
16.52
1.83
1.80
5.28
6.90
39.06
49.29
50.50
0
0
550
2363
4
10
0
2927
0.00
0.00
10.88
63.61
0.95
0.82
37.09
15.17
6.41
15.50
Average Length
of Stay
3.73
2.56
2.63
2.58
2.46
3.95
4.76
5.03
NA
2.97
3.18
2.42
2.95
2.55
2.29
3.14
4.27
4.35
NA
3.00
8.93
3.37
2.53
3.06
3.22
6.58
6.04
7.63
NA
4.75
NA
NA
2.53
2.55
2.00
5.00
NA
2.55
Page 39
Use of Services
Metropolitan Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
10
1942
1953
13906
10855
171
43
12
0
28892
Discharges
Discharges /
1,000 Member
Months
0
1
3
202
227
8
1
5
0
447
0.00
0.51
1.54
14.53
20.91
46.78
23.26
416.67
0
0
1
128
163
5
1
4
0
302
0.00
0.00
0.51
9.20
15.02
29.24
23.26
333.33
0
1
2
65
63
3
0
1
0
135
0.00
0.51
1.02
4.67
5.80
17.54
0.00
83.33
0
0
0
9
1
0
0
10
0.00
0.00
0.00
0.65
0.09
0.00
HEDIS 2003 (Reporting Year 2002)
15.47
10.45
4.67
0.35
Days
Days / 1,000
Member
Months
0
1
5
673
941
41
1
25
0
1687
0.00
0.51
2.56
48.40
86.69
239.77
23.26
2083.33
0
0
2
333
539
9
1
19
0
903
0.00
0.00
1.02
23.95
49.65
52.63
23.26
1583.33
0
1
3
310
398
32
0
6
0
750
0.00
0.51
1.54
22.29
36.67
187.13
0.00
500.00
0
0
0
30
4
0
0
34
0.00
0.00
0.00
2.16
0.37
0.00
58.39
31.25
25.96
1.18
Average Length
of Stay
NA
1.00
1.67
3.33
4.15
5.13
1.00
5.00
NA
3.77
NA
NA
2.00
2.60
3.31
1.80
1.00
4.75
NA
2.99
NA
1.00
1.50
4.77
6.32
10.67
NA
6.00
NA
5.56
NA
NA
NA
3.33
4.00
NA
NA
3.40
Page 40
Use of Services
Metropolitan Health Plan
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
370
5738
6872
10284
4946
104
1
0
0
28315
Discharges
Discharges /
1,000 Member
Months
4
13
18
81
44
0
0
0
0
160
10.81
2.27
2.62
7.88
8.90
0.00
0.00
NA
4
11
8
21
26
0
0
0
0
70
10.81
1.92
1.16
2.04
5.26
0.00
0.00
NA
0
2
4
20
18
0
0
0
0
44
0.00
0.35
0.58
1.94
3.64
0.00
0.00
NA
0
0
6
40
0
0
0
46
HEDIS 2003 (Reporting Year 2002)
5.65
2.47
1.55
0.00
0.00
0.87
3.89
0.00
0.00
1.62
Days
7
28
56
180
155
0
0
0
0
426
Days / 1,000
Member
Months
18.92
4.88
8.15
17.50
31.34
0.00
0.00
NA
15.05
7
25
29
35
68
0
0
0
0
164
18.92
4.36
4.22
3.40
13.75
0.00
0.00
NA
0
3
16
48
87
0
0
0
0
154
0.00
0.52
2.33
4.67
17.59
0.00
0.00
NA
0
0
11
97
0
0
0
108
0.00
0.00
1.60
9.43
0.00
0.00
5.79
5.44
3.81
Average Length
of Stay
1.75
2.15
3.11
2.22
3.52
NA
NA
NA
NA
2.66
1.75
2.27
3.63
1.67
2.62
NA
NA
NA
NA
2.34
NA
1.50
4.00
2.40
4.83
NA
NA
NA
NA
3.50
NA
NA
1.83
2.43
NA
NA
NA
2.35
Page 41
Use of Services
Metropolitan Health Plan
Ambulatory Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Ambulatory Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Ambulatory Care
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Senior Health Options
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
0
0
0
0
0
2477
1718
576
0
4771
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
0
0
0
0
0
2166
1603
514
0
4283
HEDIS 2003 (Reporting Year 2002)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
874.44
933.06
892.36
897.72
Emergency Room Visits
Visits
0
0
0
0
0
120
63
16
0
199
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
48.45
36.67
27.78
41.71
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
0
74
29
6
0
109
Procedures/
1,000 Member
Months
NA
NA
NA
NA
NA
29.87
16.88
10.42
22.85
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
4
2
0
0
6
Stays/ 1,000
Member
Months
NA
NA
NA
NA
NA
1.61
1.16
0.00
1.26
Page 44
Use of Services
Metropolitan Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Senior Health Options
Member
Months
Age
<1
0
1-9
0
10-19
0
20-44
0
45-64
0
65-74
2477
75-84
1718
85+
576
Unknown
0
4771
Total
Days
Days / 1,000
Member
Months
Average Length
of Stay
NA
0
NA
NA
0
NA
0
NA
NA
10-19
0
NA
0
NA
NA
20-44
0
NA
0
NA
NA
45-64
0
NA
0
NA
NA
65-74
156
62.98
1500
605.57
9.62
75-84
63
36.67
768
447.03
12.19
85+
22
38.19
222
385.42
10.09
Unknown
0
241
50.51
0
2490
521.90
NA
10.33
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
Age
Total
HEDIS 2003 (Reporting Year 2002)
Page 47
Use of Services
Metropolitan Health Plan
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Senior Health Options
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Male
Female
Total
0
0
0
1535
0
1535
0
0
0
3236
0
3236
0
0
0
4771
0
4771
Discharges
Discharges /
1,000 Member
Months
Days*
Average Length
of Stay
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
13-17
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
18-64
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
65+
M
17
11.07
236
13.88
F
40
12.36
472
11.80
Total
57
11.95
708
12.42
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
17
11.07
236
13.88
F
40
12.36
472
11.80
TOTAL
57
11.95
708
12.42
* 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
Metropolitan Health Plan
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:42 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
0
0
0
1535
0
1535
Female
0
0
0
3236
0
3236
Member Months (Inpatient)
Total
0
0
0
4771
0
4771
Male
0
0
0
1535
0
1535
Female
0
0
0
3236
0
3236
Member Months (Day/Night)
Total
0
0
0
4771
0
4771
Male
0
0
0
1535
0
1535
Female
0
0
0
3236
0
3236
Member Months (Ambulatory)
Total
0
0
0
4771
0
4771
Male
0
0
0
1535
0
1535
Female
0
0
0
3236
0
3236
Total
0
0
0
4771
0
4771
Any Mental Health Services
Inpatient Mental Health Services
Day/Night Mental Health Services
Ambulatory Mental Health Services
Number
0
0
0
0
0
0
0
0
0
28
73
101
0
0
0
28
73
101
Number
0
0
0
0
0
0
0
0
0
8
20
28
0
0
0
8
20
28
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
0
0
0
0
0
0
0
0
0
27
67
94
0
0
0
27
67
94
Sex
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
M
F
Total
HEDIS 2003 (Reporting Year 2002)
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
21.89%
27.07%
25.40%
NA
NA
NA
21.89%
27.07%
25.40%
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
6.25%
7.42%
7.04%
NA
NA
NA
6.25%
7.42%
7.04%
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
21.11%
24.85%
23.64%
NA
NA
NA
21.11%
24.85%
23.64%
Page 53
Use of Services
Metropolitan Health Plan
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Senior Health Options
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Male
Female
Total
0
0
0
1535
0
1535
0
0
0
3236
0
3236
0
0
0
4771
0
4771
Discharges
Discharges /
1,000 Member
Months
Days
Average Length
of Stay
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
13-17
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
18-64
M
0
NA
0
NA
F
0
NA
0
NA
Total
0
NA
0
NA
65+
M
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
0
0.00
0
NA
F
0
0.00
0
NA
TOTAL
0
0.00
0
NA
* 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
Metropolitan Health Plan
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Senior Health Options
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
0
1535
0
1535
Female
0
0
0
3236
0
3236
Member Months (Inpatient)
Total
0
0
0
4771
0
4771
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
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
1
0
1
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.78%
0.00%
0.25%
NA
NA
NA
0.78%
0.00%
0.25%
Male
0
0
0
1535
0
1535
Female
0
0
0
3236
0
3236
Member Months (Day/Night)
Total
0
0
0
4771
0
4771
Male
0
0
0
1535
0
1535
Female
0
0
0
3236
0
3236
Member Months (Ambulatory)
Total
0
0
0
4771
0
4771
Male
0
0
0
1535
0
1535
Female
0
0
0
3236
0
3236
Total
0
0
0
4771
0
4771
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
1
0
1
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.78%
0.00%
0.25%
NA
NA
NA
0.78%
0.00%
0.25%
Page 59
Use of Services
Metropolitan Health Plan
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 1:42 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
Metropolitan Health Plan
Outpatient Drug Utilization
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Senior Health Options
Age
Member Months
0-9
0
10-19
0
20-44
0
45-64
0
65-74
2477
75-84
1718
85+
576
Unknown
0
Total
4771
Specification Documentation:
Prescription is defined as (Enter "A"
or "B"):
Age
0-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Total Cost of
Prescriptions
$0.00
$0.00
$0.00
$0.00
$651,506.80
$469,263.10
$148,405.30
$0.00
$1,269,175.20
HEDIS 2003 (Reporting Year 2002)
A
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
NA
NA
$263.02
$273.14
$257.65
$266.02
Total Number of
Prescriptions
0
0
0
0
16749
12470
4739
0
33958
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
NA
NA
81.14
87.10
98.73
85.41
Page 61
Access/Availability of Care
Metropolitan Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Senior Health Options
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+
0
0
302
0
0
294
NA
NA
NA
NA
NA
NA
97.35%
95.37%
99.33%
A
Page 64
Access/Availability of Care
Metropolitan Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:42 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+
1617
246
792
1388
200
725
85.84%
84.11%
87.57%
81.30%
76.23%
86.38%
91.54%
89.54%
93.54%
A
Page 65
Access/Availability of Care
Metropolitan Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:42 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+
279
475
14
228
415
14
81.72%
77.01%
86.43%
87.37%
84.28%
90.46%
NA
NA
NA
A
Page 66
Access/Availability of Care
Metropolitan Health Plan
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Care
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+
449
294
7
365
260
6
81.29%
77.57%
85.01%
88.44%
84.61%
92.26%
NA
NA
NA
A
Page 67
Access/Availability of Care
Metropolitan Health Plan
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 23, 2003 1:42 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.
1123
2194
1318
1023
1710
964
91.10%
89.38%
92.81%
77.94%
76.18%
79.70%
73.14%
70.71%
75.57%
A
Page 69
Access/Availability of Care
Metropolitan Health Plan
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Care
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.
14
146
111
14
120
92
NA
NA
NA
82.19%
75.64%
88.74%
82.88%
75.43%
90.34%
A
Page 70
Access/Availability of Care
Metropolitan Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 23, 2003 1:42 PM
PMAP
General Measure
Data
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)
573
492
65.19%
55.97%
343
258
75.72%
56.95%
316
54
238
18
90.02%
87.01%
93.04%
62.29%
57.48%
67.09%
S
879
Minimum required sample size (MRSS) or other sample size
411
Oversampling rate
Final sample size (FSS)
10%
453
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of
valid data errors
0
Number of employee/dependent medical records excluded
1
HEDIS 2003 (Reporting Year 2002)
Postpartum Care
HO
Number of numerator events by administrative data in
eligible population (before exclusions)
Current year's administrative rate (before exclusions)
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
Timeliness of
Prenatal Care
1
411
Page 72
Access/Availability of Care
Metropolitan Health Plan
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Care
General Measure
Data
Data collection methodology (Administrative or Hybrid)
Postpartum Care
24
14
80.00%
46.67%
25
14
83.33%
46.67%
25
3
14
2
93.33%
82.74%
100.00%
53.33%
33.81%
72.85%
HO
Sampling method used (see User's Guide for entry
descriptions)
S
Eligible member population (i.e. members who meet all
denominator criteria)
30
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
30
Oversampling rate
Final sample size (FSS)
0%
30
Number of numerator events by administrative data in FSS
Administrative rate on FSS
Number of original sample records excluded because of
valid data errors
0
Number of employee/dependent medical records excluded
0
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
0
30
HEDIS 2003 (Reporting Year 2002)
Timeliness of
Prenatal Care
Page 73
Access/Availability of Care
Metropolitan Health Plan
Availability of Language Interpretation Services
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Practitioner Turnover
Medicare + Choice
Practitioner Types
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Practitioner Turnover
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Senior Health Options
Practitioner Types
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
783
5
0.64%
Non-Physician Primary
Care Practitioners
229
2
0.87%
HEDIS 2003 (Reporting Year 2002)
Page 76
Health Plan Stability
Metropolitan Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Years in Business / Total Membership
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Senior Health Options
Product/Product Line
HMO (Total)
Medicaid
Commercial
Medicare (cost or risk)
Self-insured
Other (specify)
PPO (Total)
Commercial
Medicare (cost or risk)
Self-insured
Other (specify)
POS (Total)
Commercial
Medicare (cost or risk)
Self-insured
Other (specify)
Total
Years in Business
18.00
18.00
0.00
5.00
0.00
0.00
Members*
399
0
0
399
0
0
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
399
* Total number of members in each category as of December 31, 2002
HEDIS 2003 (Reporting Year 2002)
Page 78
Health Plan Descriptive Information
Metropolitan Health Plan
Board Certification / Residency Completion
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Total Enrollment by Percentage
Medicaid
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%
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%
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%
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%
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%
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%
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%
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%
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%
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%
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%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
100.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
100.00%
0.00%
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
Age Unknown
Total
Data Last Refreshed:
Sep 23, 2003 1:42 PM
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%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
0.00%
100.00%
Note: Row entries should add up to 100%.
HEDIS 2003 (Reporting Year 2002)
Page 80
Health Plan Descriptive Information
Metropolitan Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:42 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
Metropolitan Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Senior Health Options
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
0
0
0
0
0
0
Member Months
Female
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0
0
0
0
0
0.00%
0
0.00%
0
0
0
0
0
0.00%
0
0
0
0
0
0.00%
0
0.00%
432
492
360
156
84
12
0
0.00%
552
1008
768
444
276
204
0
0.00%
1536
100.00%
0
3252
100.00%
0
4788
100.00%
1536
3252
HEDIS 2003 (Reporting Year 2002)
0
0
0
0
0
0
0
0
0
984
1500
1128
600
360
216
0
4788
Page 83
Health Plan Descriptive Information
Metropolitan Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:42 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
7506
20185
15136
14459
6525
2919
Member Months
Female
7080
19994
14770
14374
7301
4964
Total
14586
40179
29906
28833
13826
7883
66730
85.29%
1586
854
1044
1105
986
68483
61.95%
9659
7537
6216
4683
3479
135213
71.63%
5575
7.13%
730
294
167
155
31574
28.56%
1531
875
300
149
37149
19.68%
1346
1.72%
1730
1451
733
417
157
99
2855
2.58%
2272
2126
1406
873
645
307
4201
2.23%
4587
5.86%
0
7629
6.90%
0
12216
6.47%
78238
110541
HEDIS 2003 (Reporting Year 2002)
11245
8391
7260
5788
4465
2261
1169
467
304
4002
3577
2139
1290
802
406
0
188779
Page 84
Health Plan Descriptive Information
Metropolitan Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:42 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
8
288
710
634
309
23
Member Months
Female
2
312
632
629
300
58
Total
10
600
1342
1263
609
81
1972
10.86%
1386
1301
1601
2336
2780
1933
18.01%
958
638
633
979
1294
3905
13.52%
9404
51.79%
2623
1894
1296
931
4502
41.94%
1186
1024
908
993
13906
48.13%
6744
37.14%
29
4
5
0
0
0
4111
38.30%
87
51
38
0
12
0
10855
37.57%
38
0.21%
0
188
1.75%
0
226
0.78%
18158
10734
HEDIS 2003 (Reporting Year 2002)
2344
1939
2234
3315
4074
3809
2918
2204
1924
116
55
43
0
12
0
0
28892
Page 85
Health Plan Descriptive Information
Metropolitan Health Plan
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:42 PM
Minnesota Care
<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
124
1042
1785
1902
1077
519
Member Months
Female
246
1139
1772
1773
950
651
Total
370
2181
3557
3675
2027
1170
6449
51.16%
960
748
676
751
957
6531
41.57%
1454
1179
1215
1120
1224
12980
45.84%
4092
32.46%
642
596
399
383
6192
39.42%
910
877
595
544
10284
36.32%
2020
16.02%
37
8
0
0
0
0
2926
18.63%
27
32
1
0
0
0
4946
17.47%
45
0.36%
0
60
0.38%
0
105
0.37%
12606
15709
HEDIS 2003 (Reporting Year 2002)
2414
1927
1891
1871
2181
1552
1473
994
927
64
40
1
0
0
0
0
28315
Page 86