Medica
Plan Name
2002
Reporting Year
General Info
Submission #
1
Last Refreshed:
18
9/23/2003 1:41:55 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
Medica
Childhood Immunization Rate
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Combo 1
Combo 2
2144
52.63%
2290
56.21%
3417
83.87%
2291
56.23%
2117
51.96%
2916
71.58%
1670
40.99%
1465
35.96%
248
58.77%
267
63.27%
360
85.31%
262
62.09%
243
57.58%
302
71.56%
199
47.16%
167
39.57%
239
132
92.06%
89.30%
94.82%
257
128
95.53%
93.39%
97.67%
345
34
94.04%
91.61%
96.48%
251
90
84.62%
80.97%
88.26%
233
120
87.59%
84.25%
90.94%
291
40
82.13%
78.27%
86.00%
190
130
79.40%
75.33%
83.48%
160
123
70.22%
65.63%
74.81%
422
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
1
HEDIS 2003 (Reporting Year 2002)
MMR
376
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
IPV/OPV
HO
S
4074
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
403
Page 3
Effectiveness of Care
Medica
Childhood Immunization Rate
Data Last Refreshed:
Sep 23, 2003 1:41 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Combo 1
Combo 2
791
21.47%
1038
28.17%
2011
54.57%
1053
28.58%
925
25.10%
1765
47.90%
494
13.41%
428
11.61%
76
17.59%
113
26.16%
208
48.15%
100
23.15%
98
22.69%
190
43.98%
44
10.19%
40
9.26%
74
238
75.91%
71.66%
80.17%
111
239
85.16%
81.60%
88.72%
200
139
82.48%
78.69%
86.28%
98
189
69.83%
65.27%
74.39%
95
228
78.59%
74.50%
82.68%
182
111
71.29%
66.79%
75.79%
42
214
62.29%
57.48%
67.09%
38
187
54.74%
49.81%
59.68%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
0
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2003 (Reporting Year 2002)
MMR
411
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
IPV/OPV
HO
S
3685
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
Medica
Childhood Immunization Rate
Data Last Refreshed:
Sep 23, 2003 1:41 PM
MinnesotaCare
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
HiB
Hepatitis B
VZV
Combo 1
Combo 2
83
25.70%
101
31.27%
194
60.06%
110
34.06%
84
26.01%
173
53.56%
56
17.34%
49
15.17%
83
25.70%
101
31.27%
194
60.06%
110
34.06%
84
26.01%
173
53.56%
56
17.34%
49
15.17%
83
176
80.19%
75.68%
84.69%
101
184
88.24%
84.57%
91.90%
194
89
87.62%
83.87%
91.36%
110
140
77.40%
72.68%
82.12%
84
170
78.64%
74.01%
83.26%
173
60
72.14%
67.09%
77.18%
56
165
68.42%
63.20%
73.65%
49
138
57.89%
52.36%
63.43%
323
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
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
IPV/OPV
HO
S
323
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
323
Page 5
Effectiveness of Care
Medica
Adolescent Immunization Status
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Combo 1
Combo 2
2066
45.63%
897
19.81%
120
2.65%
727
16.06%
22
0.49%
219
50.69%
81
18.75%
12
2.78%
66
15.28%
3
0.69%
207
141
84.67%
81.07%
88.28%
75
158
56.69%
51.78%
61.60%
12
142
37.47%
32.67%
42.27%
61
164
54.74%
49.81%
59.68%
3
122
30.41%
25.84%
34.98%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
0
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
1
HEDIS 2003 (Reporting Year 2002)
VZV
411
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Hepatitis B
HO
S
4528
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
MMR
411
Page 6
Effectiveness of Care
Medica
Adolescent Immunization Status
Data Last Refreshed:
Sep 23, 2003 1:41 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Combo 1
Combo 2
378
28.57%
104
7.86%
79
5.97%
73
5.52%
11
0.83%
122
28.24%
23
5.32%
29
6.71%
17
3.94%
1
0.23%
118
201
77.62%
73.46%
81.77%
23
181
49.64%
44.68%
54.59%
27
115
34.55%
29.83%
39.27%
17
183
48.66%
43.71%
53.62%
1
96
23.60%
19.37%
27.83%
432
0
Number of Records Excluded because of
Contraindications by Admin Data
0
Number of Records Excluded because of
Contraindications by Medical Record
Review
0
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
1
HEDIS 2003 (Reporting Year 2002)
VZV
411
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Hepatitis B
HO
S
1323
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
MMR
411
Page 7
Effectiveness of Care
Medica
Adolescent Immunization Status
Data Last Refreshed:
Sep 23, 2003 1:41 PM
MinnesotaCare
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Combo 1
Combo 2
144
35.04%
55
13.38%
19
4.62%
37
9.00%
4
0.97%
144
35.04%
55
13.38%
19
4.62%
37
9.00%
4
0.97%
144
193
82.00%
78.16%
85.83%
55
174
55.72%
50.79%
60.64%
19
132
36.74%
31.96%
41.52%
37
186
54.26%
49.32%
59.20%
4
105
26.52%
22.13%
30.91%
411
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
5.00%
Number of Records Excluded Because of
Valid Data Errors
Denominator
Numerator Events by Admin Data
Numerator Events by Medical Record
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
Hepatitis B
HO
S
411
Numerator events by admin data in eligible
population
Currect Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
MMR
411
Page 8
Effectiveness of Care
Medica
Breast Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
A
Medicare + Choice
19289
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
NR
NR
NR
NR
0
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)
19289
14836
76.91%
76.32%
77.51%
NR
NR
NR
Page 9
Effectiveness of Care
Medica
Cervical Cancer Screening
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
A
PMAP
HO
S
8505
MNCare
HO
S
5948
GAMC
HO
S
1195
5726
3995
591
67.33%
411
10.00%
453
303
90.73%
0
67.17%
411
10.00%
453
316
90.73%
0
49.46%
411
10.00%
453
239
90.73%
0
0
0
0
Records Excluded because of contraindications
through Medical Record Review
0
0
0
Number of employee/dependent medical records
excluded
0
0
0
2
411
275
47
78.35%
74.24%
82.45%
10
411
291
35
79.32%
75.28%
83.36%
13
411
223
42
64.48%
59.73%
69.23%
60002
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 Excluded because of contraindications
through Admin data
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)
76.29%
NR
0
60002
45777
76.29%
75.95%
76.63%
Page 10
Effectiveness of Care
Medica
Chlamydia Screening in Women
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
Data Elements
Data Collection Methodology
Eligible Member Population
Current Year's Admin Rate
General
Measure Ages 16-20 Ages 21-26
Data
PMAP
Total
A
Records Excluded because of contraindications
through Admin data
Denominator
Numerator Events by Admin Data
Reported Rate
Lower 95% Confidence Interval
Upper 95% Confidence Interval
General
Measure Ages 16-20 Ages 21-26
Data
A
3952
18.27%
8312
15.93%
12264
16.68%
1499
36.56%
2516
31.24%
4015
33.23%
0
0
0
0
0
0
3952
722
18.27%
17.05%
19.49%
8312
1324
15.93%
15.14%
16.72%
12264
2046
16.68%
16.02%
17.35%
1499
548
36.56%
34.09%
39.03%
2516
786
31.24%
29.41%
33.07%
4015
1334
33.23%
31.76%
34.69%
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)
Total
MNCare
General
Measure Ages 16-20 Ages 21-26
Data
Total
A
General
Measure Ages 16-20 Ages 21-26
Data
Total
A
2
50.00%
101
30.69%
103
31.07%
478
31.38%
809
24.97%
1287
27.35%
0
0
0
0
0
0
2
1
NA
NA
NA
101
31
30.69%
21.20%
40.18%
103
32
31.07%
21.65%
40.49%
478
150
31.38%
27.12%
35.65%
809
202
24.97%
21.92%
28.01%
1287
352
27.35%
24.88%
29.82%
Page 11
Effectiveness of Care
Medica
Controlling High Blood Pressure
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Data Elements
Data Collection Methodology (Hybrid)
Sampling Method Used
Eligible Member Population
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Records Excluded because of Valid Data Errors
Records Excluded - False positive diagnosis
Commercial
HO
S
9895
411
20.00%
493
0
0
PMAP
HO
S
2213
411
20.00%
493
0
0
Records Excluded because of ESRD identified by
Admin Data
0
0
0
Records Excluded because of ESRD identified by
Medical Record
0
0
8
Number of employee/dependent medical records
excluded
0
0
0
20
411
198
48.18%
43.22%
53.13%
13
411
206
50.12%
45.17%
55.08%
0
155
64
41.29%
33.22%
49.36%
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)
Medicare + Choice
NR
NR
NR
MSHO
HO
S
171
171
0.00%
171
0
8
Page 12
Effectiveness of Care
Medica
Beta Blocker Treatment after Heart Attack
Data Elements
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Cholesterol Management After Acute Cardiovascular Events
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure Data
LDL-C
Screening
LDL-C Level
Monitoring
for Diabetic
Nephropathy
5702
69.26%
8233
100.00%
4210
51.14%
5798
70.42%
0
0.00%
3684
44.75%
310
68.74%
0
0.00%
228
50.55%
324
71.84%
0
0.00%
209
46.34%
284
48
80.78%
76.85%
84.71%
0
154
37.47%
32.67%
42.27%
205
6
51.34%
46.38%
56.29%
292
35
79.56%
75.54%
83.58%
0
208
50.61%
45.65%
55.56%
190
5
47.45%
42.50%
52.39%
451
0
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
5
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
8233
Numerator events by admin data in
eligible population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
HbA1c
Testing
411
Page 15
Effectiveness of Care
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
36
26.09%
138
100.00%
88
63.77%
49
35.51%
16
11.59%
70
50.72%
36
26.28%
0
0.00%
86
62.77%
40
29.20%
0
0.00%
54
39.42%
36
33
50.36%
41.63%
59.10%
0
75
54.74%
46.04%
63.44%
86
1
63.50%
55.08%
71.93%
40
28
49.64%
40.90%
58.37%
0
44
32.12%
23.93%
40.30%
54
16
51.09%
42.36%
59.83%
137
0
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
0
HEDIS 2003 (Reporting Year 2002)
Eye Exam
137
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
138
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
137
Page 17
Effectiveness of Care
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
548
41.61%
1317
100.00%
718
54.52%
485
36.83%
0
0.00%
418
31.74%
193
42.60%
0
0.00%
259
57.17%
172
37.97%
0
0.00%
146
32.23%
178
137
76.64%
72.43%
80.85%
0
156
37.96%
33.14%
42.77%
238
10
60.34%
55.49%
65.19%
159
101
63.26%
58.48%
68.04%
0
181
44.04%
39.12%
48.96%
133
25
38.44%
33.62%
43.27%
453
0
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
6
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
1317
Numerator events by admin data in
eligible population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
HbA1c
Testing
411
Page 18
Effectiveness of Care
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
147
60.74%
242
100.00%
129
53.31%
141
58.26%
0
0.00%
90
37.19%
145
60.92%
0
0.00%
126
52.94%
140
58.82%
0
0.00%
90
37.82%
145
36
76.05%
70.42%
81.68%
0
95
39.92%
33.48%
46.35%
126
5
55.04%
48.51%
61.57%
140
27
70.17%
64.15%
76.19%
0
93
39.08%
32.67%
45.48%
90
25
48.32%
41.76%
54.88%
238
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
242
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
238
Page 19
Effectiveness of Care
Medica
Comprehensive Diabetes Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
391
70.71%
553
100.00%
282
50.99%
364
65.82%
0
0.00%
222
40.14%
321
70.86%
0
0.00%
226
49.89%
304
67.11%
0
0.00%
180
39.74%
302
52
86.13%
82.67%
89.59%
0
134
32.60%
27.95%
37.26%
204
12
52.55%
47.61%
57.50%
280
42
78.35%
74.24%
82.45%
0
196
47.69%
42.74%
52.64%
170
50
53.53%
48.58%
58.47%
453
0
Number of employee/dependent records
excluded
0
Additional Records Added from the
Auxiliary List
12
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
553
Numerator events by admin data in
eligible population
Current Year's Administrative Rate
Minimum Required Sample Size
Oversampling Rate
Final Sample Size (FSS)
Numerator events by admin data in FSS
Admin rate on FSS
HbA1c
Testing
411
Page 20
Effectiveness of Care
Medica
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 23, 2003 1:41 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
Ages 10-17
Ages 18-56
Total
513
389
75.83%
72.03%
79.63%
807
568
70.38%
67.17%
73.60%
3397
2493
73.39%
71.89%
74.89%
4717
3450
73.14%
71.86%
74.42%
A
Page 21
Effectiveness of Care
Medica
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 23, 2003 1:41 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
261
151
57.85%
51.67%
64.04%
357
222
62.18%
57.01%
67.36%
354
205
57.91%
52.63%
63.19%
972
578
59.47%
56.33%
62.60%
A
Page 22
Effectiveness of Care
Medica
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 23, 2003 1:41 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
73
55
75.34%
64.77%
85.91%
73
55
75.34%
64.77%
85.91%
A
Page 23
Effectiveness of Care
Medica
Appropriate Medications for People with Asthma
Data Last Refreshed:
Sep 23, 2003 1:41 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
57
39
68.42%
55.48%
81.37%
103
64
62.14%
52.28%
71.99%
195
125
64.10%
57.11%
71.09%
355
228
64.23%
59.10%
69.35%
A
Page 24
Effectiveness of Care
Medica
Follow-Up After Hospitalization for Mental Illness
Data Last Refreshed:
Sep 23, 2003 1:41 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
A
814
W/in 7 Days of W/in 30 Days of
Discharge
Discharge
A
14
372
45.70%
42.22%
49.18%
607
74.57%
71.52%
77.62%
NR
NR
NR
NR
NR
NR
9
NA
NA
NA
10
NA
NA
NA
Page 25
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:41 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
271
14.76%
13.11%
16.41%
1249
68.03%
65.87%
70.19%
963
52.45%
50.14%
54.76%
A
1836
Page 26
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:41 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
18
NA
NA
NA
17
NA
NA
NA
A
24
Page 28
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:41 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
60
12.20%
9.20%
15.19%
255
51.83%
47.31%
56.35%
165
33.54%
29.26%
37.81%
A
492
Page 29
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:41 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
16
22.54%
12.11%
32.96%
37
52.11%
39.79%
64.44%
31
43.66%
31.42%
55.90%
A
71
Page 30
Effectiveness of Care
Medica
Antidepressant Medication Management
Data Last Refreshed:
Sep 23, 2003 1:41 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
26
14.44%
9.03%
19.86%
110
61.11%
53.71%
68.51%
78
43.33%
35.82%
50.85%
A
180
Page 31
Use of Services
Medica
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 23, 2003 1:41 PM
PMAP
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
4.19%
4.22%
5.89%
9.76%
17.17%
26.68%
32.08%
NR
NR
NR
NR
NR
NR
NR
146
147
205
340
598
929
1117
4.19%
3.51%
4.87%
4.22%
3.54%
4.90%
5.89%
5.09%
6.68%
9.76%
8.76%
10.76%
17.17%
15.91%
18.44%
26.68%
25.20%
28.16%
32.08%
30.51%
33.64%
A
3482
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)
3482
Page 32
Use of Services
Medica
Well Child Visits in the First 15 Months of Life
Data Last Refreshed:
Sep 23, 2003 1:41 PM
MinnesotaCare
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
General
Measure
Data
Zero Visits
1 visit
2 visits
3 visits
4 visits
5 visits
6 or more
visits
3.46%
4.15%
3.46%
9.34%
13.15%
23.88%
42.56%
NR
NR
NR
NR
NR
NR
NR
10
12
10
27
38
69
123
3.46%
1.18%
5.74%
4.15%
1.68%
6.63%
3.46%
1.18%
5.74%
9.34%
5.81%
12.87%
13.15%
9.08%
17.22%
23.88%
18.79%
28.96%
42.56%
36.69%
48.43%
A
289
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)
289
Page 33
Use of Services
Medica
Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 23, 2003 1:41 PM
PMAP
A
MNCare
A
7413
1721
56.10%
56.77%
NR
NR
7413
4159
1721
977
56.10%
54.97%
57.24%
56.77%
54.40%
59.14%
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)
Page 34
Use of Services
Medica
Adolescent Well-Care Visits
Data Elements
Data Collection Methodology
Sampling Method Used
Eligible Member Population
Data Last Refreshed:
Sep 23, 2003 1:41 PM
PMAP
A
MNCare
A
10341
3917
31.62%
30.10%
NR
NR
10341
3270
3917
1179
31.62%
30.72%
32.52%
30.10%
28.65%
31.55%
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)
Page 35
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
64509
606521
681961
2019147
1160487
47033
8323
1194
0
4589175
Discharges
Discharges /
1,000 Member
Months
983
904
1118
10989
7423
610
166
27
0
22220
15.24
1.49
1.64
5.44
6.40
12.97
19.94
22.61
502
660
507
2167
3398
298
106
25
0
7663
7.78
1.09
0.74
1.07
2.93
6.34
12.74
20.94
92
229
402
2720
3954
306
57
2
0
7762
1.43
0.38
0.59
1.35
3.41
6.51
6.85
1.68
0
1
196
5989
11
0
0
6197
HEDIS 2003 (Reporting Year 2002)
4.84
1.67
1.69
0.00
0.00
0.29
2.97
0.01
0.00
1.35
Days
Days / 1,000
Member
Months
9207
3085
4379
32913
29240
2596
821
112
0
82353
142.72
5.09
6.42
16.30
25.20
55.20
98.64
93.80
3279
1925
1828
7170
13020
1106
481
103
0
28912
50.83
3.17
2.68
3.55
11.22
23.52
57.79
86.26
1353
1084
1823
9035
15863
1465
326
9
0
30958
20.97
1.79
2.67
4.47
13.67
31.15
39.17
7.54
0
6
582
16309
33
0
0
16930
0.00
0.01
0.85
8.08
0.03
0.00
17.95
6.30
6.75
3.69
Average Length
of Stay
9.37
3.41
3.92
3.00
3.94
4.26
4.95
4.15
NA
3.71
6.53
2.92
3.61
3.31
3.83
3.71
4.54
4.12
NA
3.77
14.71
4.73
4.53
3.32
4.01
4.79
5.72
4.50
NA
3.99
NA
6.00
2.97
2.72
3.00
NA
NA
2.73
Page 36
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
5262
9400
14309
0
28971
Discharges
Discharges /
1,000 Member
Months
0
0
0
0
0
196
232
213
0
641
NA
NA
NA
NA
NA
37.25
24.68
14.89
0
0
0
0
0
143
161
155
0
459
NA
NA
NA
NA
NA
27.18
17.13
10.83
0
0
0
0
0
46
66
51
0
163
NA
NA
NA
NA
NA
8.74
7.02
3.56
HEDIS 2003 (Reporting Year 2002)
22.13
15.84
5.63
Days
Days / 1,000
Member
Months
0
0
0
0
0
944
1324
978
0
3246
NA
NA
NA
NA
NA
179.40
140.85
68.35
0
0
0
0
0
617
919
684
0
2220
NA
NA
NA
NA
NA
117.26
97.77
47.80
0
0
0
0
0
300
391
276
0
967
NA
NA
NA
NA
NA
57.01
41.60
19.29
112.04
76.63
33.38
Average Length
of Stay
NA
NA
NA
NA
NA
4.82
5.71
4.59
NA
5.06
NA
NA
NA
NA
NA
4.31
5.71
4.41
NA
4.84
NA
NA
NA
NA
NA
6.52
5.92
5.41
NA
5.93
Page 38
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
60943
315496
216891
207941
17265
42334
40597
32856
0
934323
Discharges
993
805
1201
5273
214
1127
1264
948
0
11825
Discharges /
1,000 Member
Months
16.29
2.55
5.54
25.36
12.40
26.62
31.14
28.85
12.66
679
681
270
660
116
815
997
796
0
5014
11.14
2.16
1.24
3.17
6.72
19.25
24.56
24.23
95
118
142
509
90
305
258
149
0
1666
1.56
0.37
0.65
2.45
5.21
7.20
6.36
4.53
0
0
759
3961
7
0
0
4727
HEDIS 2003 (Reporting Year 2002)
5.37
1.78
0.00
0.00
3.50
19.05
0.41
0.00
5.06
Days
Days / 1,000
Member
Months
6734
2688
3750
14558
857
5605
6337
4691
0
45220
110.50
8.52
17.29
70.01
49.64
132.40
156.10
142.77
2969
2029
880
1975
408
3600
4569
3700
0
20130
48.72
6.43
4.06
9.50
23.63
85.04
112.55
112.61
513
625
784
1538
417
1975
1740
953
0
8545
8.42
1.98
3.61
7.40
24.15
46.65
42.86
29.01
0
0
2007
10607
29
0
0
12643
0.00
0.00
9.25
51.01
1.68
0.00
48.40
21.55
9.15
13.53
Average Length
of Stay
6.78
3.34
3.12
2.76
4.00
4.97
5.01
4.95
NA
3.82
4.37
2.98
3.26
2.99
3.52
4.42
4.58
4.65
NA
4.01
5.40
5.30
5.52
3.02
4.63
6.48
6.74
6.40
NA
5.13
NA
NA
2.64
2.68
4.14
NA
NA
2.67
Page 39
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
26
1766
1217
42384
27696
324
59
2
0
73474
Discharges
0
2
3
638
554
3
0
0
0
1200
Discharges /
1,000 Member
Months
0.00
1.13
2.47
15.05
20.00
9.26
0.00
0.00
16.33
0
2
0
424
338
2
0
0
0
766
0.00
1.13
0.00
10.00
12.20
6.17
0.00
0.00
0
0
1
186
210
1
0
0
0
398
0.00
0.00
0.82
4.39
7.58
3.09
0.00
0.00
0
0
2
16
0
0
0
18
0.00
0.00
1.64
0.38
0.00
0.00
HEDIS 2003 (Reporting Year 2002)
10.43
5.42
0.24
Days
0
4
6
2269
2585
11
0
0
0
4875
Days / 1,000
Member
Months
0.00
2.27
4.93
53.53
93.33
33.95
0.00
0.00
66.35
0
4
0
1428
1519
6
0
0
0
2957
0.00
2.27
0.00
33.69
54.85
18.52
0.00
0.00
0
0
2
729
1046
5
0
0
0
1782
0.00
0.00
1.64
17.20
37.77
15.43
0.00
0.00
0
0
4
76
0
0
0
80
0.00
0.00
3.29
1.79
0.00
0.00
40.25
24.25
1.09
Average Length
of Stay
NA
2.00
2.00
3.56
4.67
3.67
NA
NA
NA
4.06
NA
2.00
NA
3.37
4.49
3.00
NA
NA
NA
3.86
NA
NA
2.00
3.92
4.98
5.00
NA
NA
NA
4.48
NA
NA
2.00
4.75
NA
NA
NA
4.44
Page 40
Use of Services
Medica
Inpatient Utilization - General Hospital/Acute Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
5522
69222
74226
131221
53626
493
44
0
0
334354
Discharges
Discharges /
1,000 Member
Months
79
117
206
1039
561
2
3
0
0
2007
14.31
1.69
2.78
7.92
10.46
4.06
68.18
NA
49
88
86
263
305
1
2
0
0
794
8.87
1.27
1.16
2.00
5.69
2.03
45.45
NA
9
29
48
295
249
1
1
0
0
632
1.63
0.42
0.65
2.25
4.64
2.03
22.73
NA
0
0
69
464
2
0
0
535
0.00
0.00
0.93
3.54
0.04
0.00
HEDIS 2003 (Reporting Year 2002)
6.00
2.37
1.89
1.60
Days
Days / 1,000
Member
Months
714
294
654
2929
2299
7
22
0
0
6919
129.30
4.25
8.81
22.32
42.87
14.20
500.00
NA
168
218
245
864
1196
5
10
0
0
2706
30.42
3.15
3.30
6.58
22.30
10.14
227.27
NA
67
76
185
881
1073
2
12
0
0
2296
12.13
1.10
2.49
6.71
20.01
4.06
272.73
NA
0
0
214
1130
8
0
0
1352
0.00
0.00
2.88
8.61
0.15
0.00
20.69
8.09
6.87
4.04
Average Length
of Stay
9.04
2.51
3.17
2.82
4.10
3.50
7.33
NA
NA
3.45
3.43
2.48
2.85
3.29
3.92
5.00
5.00
NA
NA
3.41
7.44
2.62
3.85
2.99
4.31
2.00
12.00
NA
NA
3.63
NA
NA
3.10
2.44
4.00
NA
NA
2.53
Page 41
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Member
Months
64509
606521
681961
2019147
1160487
47033
8323
1194
0
4589175
Outpatient Visits
(Excludes MH/CD)
Age
<1
1-9
10-19
20-44
45-64
65-74
75-84
85+
Unknown
Total
Visits
58771
188818
147094
484059
374125
20393
4408
547
0
1278215
HEDIS 2003 (Reporting Year 2002)
Visits/ 1,000
Member
Months
911.05
311.31
215.69
239.73
322.39
433.59
529.62
458.12
278.53
Emergency Room Visits
Visits
2168
9867
8332
24507
11809
728
169
31
0
57611
Visits/ 1,000
Member
Months
33.61
16.27
12.22
12.14
10.18
15.48
20.31
25.96
12.55
Ambulatory
Surgery/Procedures
Procedures
508
3159
2216
15218
19334
1368
279
25
0
42107
Procedures/
1,000 Member
Months
7.87
5.21
3.25
7.54
16.66
29.09
33.52
20.94
9.18
Observation Room Stays
Resulting in Discharge
Stays
37
109
160
1743
288
16
8
0
0
2361
Stays/ 1,000
Member
Months
0.57
0.18
0.23
0.86
0.25
0.34
0.96
0.00
0.51
Page 42
Use of Services
Medica
Ambulatory Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Ambulatory Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
5262
9400
14309
0
28971
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
3547
6830
10176
0
20553
HEDIS 2003 (Reporting Year 2002)
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
674.08
726.60
711.16
709.43
Emergency Room Visits
Visits
0
0
0
0
0
148
181
184
0
513
Visits/ 1,000
Member
Months
NA
NA
NA
NA
NA
28.13
19.26
12.86
17.71
Ambulatory
Surgery/Procedures
Procedures
0
0
0
0
0
168
142
114
0
424
Procedures/
1,000 Member
Months
NA
NA
NA
NA
NA
31.93
15.11
7.97
14.64
Observation Room Stays
Resulting in Discharge
Stays
0
0
0
0
0
4
6
5
0
15
Stays/ 1,000
Member
Months
NA
NA
NA
NA
NA
0.76
0.64
0.35
0.52
Page 44
Use of Services
Medica
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
Member
Months
Age
<1
64509
1-9
606521
10-19
681961
20-44
2019147
45-64
1160487
65-74
47033
75-84
8323
85+
1194
Unknown
0
4589175
Total
Days
Days / 1,000
Member
Months
Average Length
of Stay
0.00
0
0.00
NA
1
0.00
32
0.05
32.00
10-19
6
0.01
114
0.17
19.00
20-44
38
0.02
1090
0.54
28.68
45-64
89
0.08
1682
1.45
18.90
65-74
9
0.19
168
3.57
18.67
75-84
6
0.72
224
26.91
37.33
85+
2
1.68
49
41.04
24.50
0
151
0.03
0
3359
0.73
NA
22.25
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
Age
Unknown
Total
HEDIS 2003 (Reporting Year 2002)
Page 45
Use of Services
Medica
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Inpatient Utilization - Nonacute Care
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Minnesota Senior Health Options
Member
Months
Age
<1
0
1-9
0
10-19
0
20-44
0
45-64
0
65-74
5262
75-84
9400
85+
14309
Unknown
0
28971
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
4
0.76
22
4.18
5.50
75-84
5
0.53
30
3.19
6.00
85+
12
0.84
56
3.91
4.67
Unknown
0
21
0.72
0
108
3.73
NA
5.14
Discharges
Discharges /
1,000 Member
Months
<1
0
1-9
Age
Total
HEDIS 2003 (Reporting Year 2002)
Page 47
Use of Services
Medica
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
Female
Total
436063
160926
1494772
24889
0
2116650
416965
155846
1555222
21950
0
2149983
853028
316772
3049994
46839
0
4266633
Discharges
Discharges /
1,000 Member
Months
Age
0-12
Days*
Average Length
of Stay
M
52
0.12
1369
26.33
F
25
0.06
879
35.16
Total
77
0.09
2248
29.19
13-17
M
93
0.58
1721
18.51
F
169
1.08
1590
9.41
Total
262
0.83
3311
12.64
18-64
M
310
0.21
2005
6.47
F
510
0.33
3517
6.90
Total
820
0.27
5522
6.73
65+
M
2
0.08
5
2.50
F
8
0.36
124
15.50
Total
10
0.21
129
12.90
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
M
Total
457
0.22
5100
11.16
F
712
0.33
6110
8.58
TOTAL
1169
0.27
11210
9.59
* 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
Medica
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Mental Health Utilization Inpatient Discharges and Average Length of Stay, by Age and Sex
Data Last Refreshed:
Sep 23, 2003 1:41 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
4902
0
4902
0
0
0
20395
0
20395
0
0
0
25297
0
25297
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
5
1.02
36
7.20
F
28
1.37
242
8.64
Total
33
1.30
278
8.42
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
5
1.02
36
7.20
F
28
1.37
242
8.64
TOTAL
33
1.30
278
8.42
* 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
Medica
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:41 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
436063
160926
1494772
24889
0
2116650
Female
416965
155846
1555222
21950
0
2149983
Member Months (Inpatient)
Total
853028
316772
3049994
46839
0
4266633
Male
436063
160926
1494772
24889
0
2116650
Female
416965
155846
1555222
21950
0
2149983
Total
853028
316772
3049994
46839
0
4266633
Member Months (Day/Night)
Male
436063
160926
1494772
24889
0
2116650
Female
416965
155846
1555222
21950
0
2149983
Total
853028
316772
3049994
46839
0
4266633
Member Months (Ambulatory)
Male
436063
160926
1494772
24889
0
2116650
Female
416965
155846
1555222
21950
0
2149983
Total
853028
316772
3049994
46839
0
4266633
Any Mental Health Services
Inpatient Mental Health Services
Day/Night Mental Health Services
Ambulatory Mental Health Services
Number
1868
1145
3013
1415
1627
3042
7325
13869
21194
38
50
88
0
0
0
10646
16691
27337
Number
33
20
53
59
127
186
267
398
665
2
5
7
0
0
0
361
550
911
Number
1
0
1
2
7
9
5
10
15
0
0
0
0
0
0
8
17
25
Number
1860
1136
2996
1402
1599
3001
7239
13786
21025
36
47
83
0
0
0
10537
16568
27105
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
5.14%
3.30%
4.24%
10.55%
12.53%
11.52%
5.88%
10.70%
8.34%
1.83%
2.73%
2.25%
NA
NA
NA
6.04%
9.32%
7.69%
Percent
0.09%
0.06%
0.07%
0.44%
0.98%
0.70%
0.21%
0.31%
0.26%
0.10%
0.27%
0.18%
NA
NA
NA
0.20%
0.31%
0.26%
Percent
0.00%
0.00%
0.00%
0.01%
0.05%
0.03%
0.00%
0.01%
0.01%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.01%
0.01%
Percent
5.12%
3.27%
4.21%
10.45%
12.31%
11.37%
5.81%
10.64%
8.27%
1.74%
2.57%
2.13%
NA
NA
NA
5.97%
9.25%
7.62%
Page 51
Use of Services
Medica
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Mental Health Utilization -Percent of Members Receiving Inpatient, Day/Night and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:41 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
4902
0
4902
Female
0
0
0
20395
0
20395
Member Months (Inpatient)
Total
0
0
0
25297
0
25297
Male
0
0
0
4902
0
4902
Female
0
0
0
20395
0
20395
Member Months (Day/Night)
Total
0
0
0
25297
0
25297
Male
0
0
0
4902
0
4902
Female
0
0
0
20395
0
20395
Total
0
0
0
25297
0
25297
Member Months (Ambulatory)
Male
0
0
0
4902
0
4902
Female
0
0
0
20395
0
20395
Total
0
0
0
25297
0
25297
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
16
76
92
0
0
0
16
76
92
Number
0
0
0
0
0
0
0
0
0
5
20
25
0
0
0
5
20
25
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
14
62
76
0
0
0
14
62
76
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
3.92%
4.47%
4.36%
NA
NA
NA
3.92%
4.47%
4.36%
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
1.22%
1.18%
1.19%
NA
NA
NA
1.22%
1.18%
1.19%
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
3.43%
3.65%
3.61%
NA
NA
NA
3.43%
3.65%
3.61%
Page 53
Use of Services
Medica
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
Member Months
Age
0-12
13-17
18-64
65+
Unknown
Total
Age
0-12
Male
Female
Total
436063
160926
1494772
24889
0
2116650
416965
155846
1555222
21950
0
2149983
853028
316772
3049994
46839
0
4266633
Discharges
Discharges /
1,000 Member
Months
Days
Average Length
of Stay
M
0
0.00
0
NA
F
0
0.00
0
NA
Total
0
0.00
0
NA
M
13-17
43
0.27
637
14.81
F
34
0.22
618
18.18
Total
77
0.24
1255
16.30
M
18-64
339
0.23
2050
6.05
F
192
0.12
1249
6.51
Total
531
0.17
3299
6.21
M
65+
2
0.08
6
3.00
F
2
0.09
21
10.50
Total
4
0.09
27
6.75
M
Unknown
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
384
0.18
2693
7.01
F
228
0.11
1888
8.28
TOTAL
612
0.14
4581
7.49
* 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
Medica
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Chemical Dependency Utilization Inpatient Discharges and Average Length of Stay
Data Last Refreshed:
Sep 23, 2003 1:41 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
4902
0
4902
0
0
0
20395
0
20395
0
0
0
25297
0
25297
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
2
0.10
10
5.00
Total
2
0.08
10
5.00
Unknown
M
0
0
NA
F
0
0
NA
Total
0
0
NA
Total
M
0
0.00
0
NA
F
2
0.10
10
5.00
TOTAL
2
0.08
10
5.00
* 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
Medica
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
436063
160926
1494772
24889
0
2116650
Female
416965
155846
1555222
21950
0
2149983
Member Months (Inpatient)
Total
853028
316772
3049994
46839
0
4266633
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
1
0
1
109
68
177
853
349
1202
4
3
7
0
0
0
967
420
1387
Percent
0.00%
0.00%
0.00%
0.81%
0.52%
0.67%
0.68%
0.27%
0.47%
0.19%
0.16%
0.18%
NA
NA
NA
0.55%
0.23%
0.39%
Male
436063
160926
1494772
24889
0
2116650
Female
416965
155846
1555222
21950
0
2149983
Total
853028
316772
3049994
46839
0
4266633
Member Months (Day/Night)
Male
436063
160926
1494772
24889
0
2116650
Female
416965
155846
1555222
21950
0
2149983
Total
853028
316772
3049994
46839
0
4266633
Member Months (Ambulatory)
Male
436063
160926
1494772
24889
0
2116650
Female
416965
155846
1555222
21950
0
2149983
Total
853028
316772
3049994
46839
0
4266633
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
0
0
0
33
28
61
269
148
417
2
2
4
0
0
0
304
178
482
Number
0
0
0
1
1
2
0
0
0
0
0
0
0
0
0
1
1
2
Number
1
0
1
81
44
125
632
222
854
2
1
3
0
0
0
716
267
983
Percent
0.00%
0.00%
0.00%
0.25%
0.22%
0.23%
0.22%
0.11%
0.16%
0.10%
0.11%
0.10%
NA
NA
NA
0.17%
0.10%
0.14%
Percent
0.00%
0.00%
0.00%
0.01%
0.01%
0.01%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
NA
NA
NA
0.00%
0.00%
0.00%
Percent
0.00%
0.00%
0.00%
0.60%
0.34%
0.47%
0.51%
0.17%
0.34%
0.10%
0.05%
0.08%
NA
NA
NA
0.41%
0.15%
0.28%
Page 57
Use of Services
Medica
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Chemical Dependency Utilization -Percent of members Receiving inpatient, Day/Night Care, and Ambulatory Services
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Minnesota Senior Health Options
Member Months (Any)
Age
0-12
13-17
18-64
65+
Unknown
Total
Male
0
0
0
4902
0
4902
Female
0
0
0
20395
0
20395
Member Months (Inpatient)
Total
0
0
0
25297
0
25297
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
0
3
3
0
0
0
0
3
3
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.18%
0.14%
NA
NA
NA
0.00%
0.18%
0.14%
Male
0
0
0
4902
0
4902
Female
0
0
0
20395
0
20395
Member Months (Day/Night)
Total
0
0
0
25297
0
25297
Male
0
0
0
4902
0
4902
Female
0
0
0
20395
0
20395
Total
0
0
0
25297
0
25297
Member Months (Ambulatory)
Male
0
0
0
4902
0
4902
Female
0
0
0
20395
0
20395
Total
0
0
0
25297
0
25297
Inpatient Chemical Dependency
Services
Day/Night Chemical Dependency
Services
Ambulatory Chemical Dependency
Services
Number
0
0
0
0
0
0
0
0
0
0
2
2
0
0
0
0
2
2
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
1
1
0
0
0
0
1
1
Percent
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.00%
0.12%
0.09%
NA
NA
NA
0.00%
0.12%
0.09%
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%
0.06%
0.05%
NA
NA
NA
0.00%
0.06%
0.05%
Page 59
Use of Services
Medica
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 1:41 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
Medica
Outpatient Drug Utilization
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Minnesota Senior Health Options
Age
Member Months
0-9
0
10-19
0
20-44
0
45-64
0
65-74
5262
75-84
9400
85+
14309
Unknown
0
Total
28971
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
$1,600,938.00
$2,494,262.00
$2,946,386.00
$0.00
$7,041,586.00
HEDIS 2003 (Reporting Year 2002)
A
Avg. Cost of
Prescriptions /
Per Member Per
Month
NA
NA
NA
NA
$304.25
$265.35
$205.91
$243.06
Total Number of
Prescriptions
0
0
0
0
37928
73086
104422
0
215436
Avg. Num. Of
Prescriptions /
Per Member Per
Year
NA
NA
NA
NA
86.49
93.30
87.57
89.24
Page 61
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
Data Elements
Data collection methodology
(Administrative only)
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2003 (Reporting Year 2002)
General Measure
Data
Ages 20-44
Ages 45-64
Ages 65+
62946
53532
3045
60042
51668
2937
95.39%
95.22%
95.55%
96.52%
96.36%
96.67%
96.45%
95.78%
97.13%
A
Page 62
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:41 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
2105
0
0
2044
NA
NA
NA
NA
NA
NA
97.10%
96.36%
97.84%
A
Page 64
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:41 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+
9755
989
8061
8587
868
7620
88.03%
87.38%
88.68%
87.77%
85.67%
89.86%
94.53%
94.03%
95.03%
A
Page 65
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:41 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+
1113
1283
21
943
1133
19
84.73%
82.57%
86.88%
88.31%
86.51%
90.11%
NA
NA
NA
A
Page 66
Access/Availability of Care
Medica
Adult's Access to Preventive/Ambulatory Health Services
Data Last Refreshed:
Sep 23, 2003 1:41 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+
6550
3305
31
5569
2894
26
85.02%
84.15%
85.89%
87.56%
86.42%
88.70%
83.87%
69.31%
98.43%
A
Page 67
Access/Availability of Care
Medica
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
Data Elements
Data collection methodology
(Administrative only)
Eligible member population (i.e. members who
meet all denominator criteria)
Numerator events by administrative data
Reported rate
Lower 95% confidence interval
Upper 95% confidence interval
HEDIS 2003 (Reporting Year 2002)
General Measure
Data
12-24 months
25 months - 6
yrs.
7-11 yrs.
4598
21234
16978
4511
18896
15012
98.11%
97.70%
98.51%
88.99%
88.57%
89.41%
88.42%
87.94%
88.90%
A
Page 68
Access/Availability of Care
Medica
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 23, 2003 1:41 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.
4515
9790
5469
4305
8312
4529
95.35%
94.72%
95.97%
84.90%
84.19%
85.62%
82.81%
81.80%
83.82%
A
Page 69
Access/Availability of Care
Medica
Children's Access to Primary Care Practitioners
Data Last Refreshed:
Sep 23, 2003 1:41 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.
360
2085
1549
350
1847
1389
97.22%
95.39%
99.06%
88.59%
87.20%
89.97%
89.67%
88.12%
91.22%
A
Page 70
Access/Availability of Care
Medica
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
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)
3915
3332
74.01%
62.99%
327
277
75.69%
64.12%
316
50
265
59
89.05%
85.91%
92.19%
78.83%
74.76%
82.90%
S
5290
Minimum required sample size (MRSS) or other sample size
411
Oversampling rate
Final sample size (FSS)
5%
432
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
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
6
411
Page 71
Access/Availability of Care
Medica
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 23, 2003 1:41 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)
1736
1922
46.06%
50.99%
190
217
44.29%
50.58%
185
147
209
43
80.78%
76.85%
84.71%
61.31%
56.48%
66.14%
S
3769
Minimum required sample size (MRSS) or other sample size
411
Oversampling rate
Final sample size (FSS)
5%
429
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
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
4
411
Page 72
Access/Availability of Care
Medica
Prenatal and Postpartum Care
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Minnesota Care
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)
271
215
62.44%
49.54%
270
215
62.50%
49.77%
261
70
208
67
80.54%
76.59%
84.48%
66.91%
62.24%
71.58%
S
434
Minimum required sample size (MRSS) or other sample size
411
Oversampling rate
Final sample size (FSS)
5%
432
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
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
4
411
Page 73
Access/Availability of Care
Medica
Availability of Language Interpretation Services
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Minnesota Senior Health Options
Language (not to exceed 25
Interpreter Services (not to exceed
Description (not to exceed 50
characters)
50 characters)
characters)
Type of Agreement (not to exceed 50 Restrictions on Availability (not
characters)
to exceed 50 characters)
Hearing impaired
Internal referral service
in person
formal written contract
Hmong
Global Interpreters, Kim Tong's,
M ltili
lW d
Accutrans
phone and in person
formal written contract
plan service area
phone and in person
formal written contract
plan service area
Accutrans, Kim Tong's, Multilingual
W d
Accutrans,
Kim Tong's, Multilingual
phone and in person
formal written contract
plan service area
phone and in person
formal written contract
plan service area
W d Interpreters, Bridge World
Global
L
Accutrans,
Kim Tong's, Multilingual
phone and in person
formal written contract
plan service area
phone and in person
formal written contract
plan service area
W d
Accutrans,
Kim Tong's, Multilingual
W d
phone and in person
formal written contract
plan service area
Hmong
Russian
Somali
Spanish
Spanish
Vietnamese
HEDIS 2003 (Reporting Year 2002)
8-5 only and plan service area
Page 74
Health Plan Stability
Medica
Practitioner Turnover
Medicare + Choice
Practitioner Types
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Practitioner Turnover
Data Last Refreshed:
Sep 23, 2003 1:41 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
1296
49
3.78%
Non-Physician Primary
Care Practitioners
222
11
4.95%
HEDIS 2003 (Reporting Year 2002)
Page 76
Health Plan Stability
Medica
Years in Business / Total Membership
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Years in Business / Total Membership
Data Last Refreshed:
Sep 23, 2003 1:41 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
28.00
28.00
28.00
3.00
0.00
0.00
Members*
184660
119471
62794
2395
0
0
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
28.00
28.00
3.00
28.00
0.00
583810
374712
20475
188623
0
768470
* Total number of members in each category as of December 31, 2002
HEDIS 2003 (Reporting Year 2002)
Page 78
Health Plan Descriptive Information
Medica
Board Certification / Residency Completion
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Minnesota Senior Health Options
Type of Practitioner
Primary Care Practitioners
Residency / Fellowship
Completion
Percent
Number
Number of
Practitioners in Each
Practice Area
Number
Percent
1818
103
1470
94
80.86%
91.26%
1512
94
83.17%
91.26%
942
806
85.56%
830
88.11%
Geriatricians
Other practitioner
Specialists
HEDIS 2003 (Reporting Year 2002)
Board Certification
Page 79
Health Plan Descriptive Information
Medica
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
39.32%
60.68%
0.00%
0.00%
39.29%
60.71%
0.00%
0.00%
31.59%
68.41%
0.00%
0.00%
31.83%
68.17%
0.00%
0.00%
24.60%
75.40%
0.00%
0.00%
24.67%
75.32%
0.00%
0.01%
21.74%
78.25%
0.00%
0.01%
22.29%
77.69%
0.00%
0.02%
18.39%
81.58%
0.00%
0.03%
18.80%
81.16%
0.00%
0.04%
14.86%
85.13%
0.00%
0.01%
21.46%
78.51%
0.00%
0.03%
24.58%
75.41%
0.00%
0.01%
25.27%
74.72%
0.00%
0.01%
24.92%
75.07%
0.00%
0.01%
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%
M
F
M
F
M
F
M
F
M
F
M
F
Total
10.09%
89.89%
0.00%
0.02%
23.64%
76.36%
0.00%
0.00%
M
F
M
F
M
F
M
F
M
F
Total
M
F
M
F
M
F
M
F
M
F
M
F
M
F
Total
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 1:41 PM
7.39%
92.60%
0.00%
0.01%
17.96%
82.04%
0.00%
0.00%
6.46%
93.54%
0.00%
0.00%
13.32%
86.67%
0.01%
0.00%
5.95%
94.02%
0.01%
0.02%
10.20%
89.79%
0.01%
0.00%
5.50%
94.45%
0.02%
0.03%
7.89%
92.05%
0.03%
0.03%
6.83%
93.14%
0.01%
0.02%
14.05%
85.93%
0.01%
0.01%
10.75%
89.23%
0.01%
0.01%
4.95%
94.94%
0.05%
0.06%
6.05%
93.86%
0.05%
0.04%
4.19%
95.60%
0.09%
0.12%
4.72%
95.07%
0.11%
0.10%
3.93%
95.63%
0.17%
0.27%
4.72%
94.84%
0.21%
0.23%
4.33%
94.54%
0.51%
0.62%
6.69%
92.11%
0.65%
0.55%
4.43%
95.22%
0.15%
0.20%
5.46%
94.20%
0.18%
0.16%
4.98%
94.68%
0.17%
0.17%
13.58%
54.45%
17.33%
14.64%
21.23%
41.99%
20.12%
16.66%
18.36%
28.24%
24.91%
28.49%
26.69%
17.46%
27.83%
28.02%
14.94%
10.71%
50.38%
23.97%
21.01%
5.48%
52.12%
21.39%
11.88%
4.95%
61.94%
21.23%
18.81%
2.59%
60.40%
18.20%
14.27%
2.74%
62.59%
20.40%
22.24%
1.26%
59.82%
16.68%
23.77%
1.75%
59.38%
15.10%
29.12%
0.50%
59.88%
10.50%
15.07%
23.68%
40.24%
21.01%
22.64%
11.44%
47.15%
18.77%
19.95%
15.79%
44.69%
19.57%
0.00%
0.00%
0.00%
0.00%
14.74%
81.05%
2.91%
1.30%
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%
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%
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
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:41 PM
Commercial
<1
1-4
5-9
10-14
15-17
18-19
0-19 Subtotal
0-19 Subtotal: %
20-24
25-29
30-34
35-39
40-44
20-44 Subtotal
20-44 Subtotal: %
45-49
50-54
55-59
60-64
45-64 Subtotal
45-64 Subtotal: %
65-69
70-74
75-79
80-84
85-89
>=90
>=65 Subtotal
>=65 Subtotal: %
Age Unknown
Total
Male
32760
137244
172764
181668
104292
61236
Member Months
Female
31752
130512
165996
171756
103332
59688
Total
64512
267756
338760
353424
207624
120924
689964
30.32%
156120
170592
206976
226200
235788
663036
28.66%
160116
181140
212688
228180
241356
1353000
29.48%
995676
43.75%
204312
163644
117408
74664
1023480
44.24%
211740
178860
130308
79560
2019156
44.00%
560028
24.61%
18480
6720
3012
1260
408
120
600468
25.95%
15768
6072
2688
1380
552
120
1160496
25.29%
30000
1.32%
0
26580
1.15%
0
56580
1.23%
2275668
2313564
HEDIS 2003 (Reporting Year 2002)
316236
351732
419664
454380
477144
416052
342504
247716
154224
34248
12792
5700
2640
960
240
0
4589232
Page 81
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:41 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
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:41 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%
684
1008
1056
1188
900
684
0
0.00%
1476
2100
3096
4056
4704
8028
0
0.00%
5520
100.00%
0
23460
100.00%
0
28980
100.00%
5520
23460
HEDIS 2003 (Reporting Year 2002)
0
0
0
0
0
0
0
0
0
2160
3108
4152
5244
5604
8712
0
28980
Page 83
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:41 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
31071
87130
71601
62851
28535
10878
Member Months
Female
29872
86093
70672
63751
30214
20662
Total
60943
173223
142273
126602
58749
31540
292066
80.13%
8606
7099
7606
6881
5600
301264
52.87%
54957
44183
33492
23868
15649
593330
63.50%
35792
9.82%
3058
1423
720
418
172149
30.21%
7269
2906
973
498
207941
22.26%
5619
1.54%
7421
7375
6276
4404
3045
2514
11646
2.04%
13008
14530
15303
14614
13498
13799
17265
1.85%
31035
8.51%
0
84752
14.87%
0
115787
12.39%
364512
569811
HEDIS 2003 (Reporting Year 2002)
63563
51282
41098
30749
21249
10327
4329
1693
916
20429
21905
21579
19018
16543
16313
0
934323
Page 84
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:41 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
6
280
652
406
171
39
Member Months
Female
20
245
589
370
183
48
Total
26
525
1241
776
354
87
1554
3.80%
5472
4121
4282
5493
6201
1455
4.46%
4308
2968
2528
2941
4070
3009
4.10%
25569
62.59%
5568
3852
2582
1643
16815
51.55%
4424
3697
3155
2775
42384
57.69%
13645
33.40%
56
12
8
10
0
0
14051
43.07%
221
35
17
24
2
0
27696
37.69%
86
0.21%
0
299
0.92%
0
385
0.52%
40854
32620
HEDIS 2003 (Reporting Year 2002)
9780
7089
6810
8434
10271
9992
7549
5737
4418
277
47
25
34
2
0
0
73474
Page 85
Health Plan Descriptive Information
Medica
Enrollment by Product Line (Age & Sex)
Data Last Refreshed:
Sep 23, 2003 1:41 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
2876
14633
21120
20553
10757
6282
Member Months
Female
2646
13659
19810
19772
10086
6776
Total
5522
28292
40930
40325
20843
13058
76221
51.52%
11396
8703
9860
9804
9793
72749
39.03%
19618
15383
16590
15630
14444
148970
44.55%
49556
33.50%
8153
6046
4300
3406
81665
43.81%
11014
8160
6488
6059
131221
39.25%
21905
14.81%
195
44
23
0
0
0
31721
17.02%
177
77
11
10
0
0
53626
16.04%
262
0.18%
0
275
0.15%
0
537
0.16%
147944
186410
HEDIS 2003 (Reporting Year 2002)
31014
24086
26450
25434
24237
19167
14206
10788
9465
372
121
34
10
0
0
0
334354
Page 86