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2019 HMO HEDIS® Quality Measures Data based on the 2018 measurement year.
PrimeWest Health Report Generated: 4/30/2020
Table of Contents
Code General Information / Disclaimers Page
INFO General Information / Disclaimers 3
Code Effectiveness of Care (Prevention and Screening) Page
ABA Adult BMI Assessment 4
WCC Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents 5
CIS Childhood Immunization Status 8
IMA Immunizations for Adolescents 14
BCS Breast Cancer Screening 17
CCS Cervical Cancer Screening 21
COL Colorectal Cancer Screening 22
CHL Chlamydia Screening in Women 26
COA Care for Older Adults 29
Code Effectiveness of Care (Respiratory Condition) Page
SPR Use of Spirometry Testing in the Assessment and Diagnosis of COPD 30
PCE Pharmacotherapy Management of COPD Exacerbation 31
MMA Medication Management for People with Asthma 35
AMR Asthma Medication Ratio 38
Code Effectiveness of Care (Medication Management and Care Coordination) Page
MPM Annual Monitoring for Patients on Persistent Medications 86
MRP Medication Reconciliation Post Discharge 89
TRC Transitions of Care 90
Code Effectiveness of Care (Overuse/Appropriateness) Page
DDE Potentially Harmful Drug-Disease Interactions in the Elderly 93
DAE Use of High Risk Medications in the Elderly 95
UOD Use of Opioids at High Dosage 97
UOP Use of Opioids from Multiple Providers 98
Code Access / Availability of Care Page
AAP Adult's Access to Preventive/Ambulatory Health Services 105
CAP Children's and Adolescents' Access to Primary Care Practitioners 112
ADV Annual Dental Visit 115
IET Initiation/Engagement of Alcohol & Other Drug Dependence Treatment 117
PPC Prenatal and Postpartum Care 135
Code Effectiveness of Care (Cardiovascular Conditions) Page
CBP Controlling High Blood Pressure 41
PBH Persistence of Beta Blocker Treatment After Heart Attack 42
Code Effectiveness of Care (Diabetes) Page
CDC Comprehensive Diabetes Care 43
Code Effectiveness of Care (Musculoskeletal Conditions) Page
ART Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis 53
OMW Osteoporosis Management in Women Who had a Fracture 54
Code Effectiveness of Care (Behavioral Health) Page
AMM Antidepressant Medication Management 55
ADD Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder Medication 62
FUH Follow-up After Hospitalization for Mental Illness 65
FUM Follow-up After Emergecy Visit for Mental Illness 72
FUA Follow-up After Emergecy Visit for Alcohol and Other Drug Abuse 79
Code Utilization and Risk Adjusted Utilization Page
W15 Well Child Visits in the First 15 Months of Life 138
W34 Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life 141
AWC Adolescent Well-Care Visits 142
IAD Identification of Alcohol and Other Drug Services 143
MPT Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services 171
PCR Plan All-Cause Readmissions 178
Code Health Plan Descriptive Information Page
BCR Board Certification 182
ENP Enrollment by Product Line (Age & Sex) 185
PrimeWest Health HEDIS® 2019 Page 2
General Information / Disclaimers
• Special Needs Basic Care Special Needs Basic Care (SNBC) is a voluntary managed care program for people with disabilities who are 18-64 years old and have Medical Assistance
• Special Needs Plan (SNP) - The plan integrates and provides both Medicaid and Medicare services. • Non-Special Needs Plan (Non-SNP) - The plan provides Medicaid services only and Medicare is provided fee for service.
• Audit Designation & Rate Status HEDIS Compliance Audits result in audited rates or calculations at the measure and indicator level, and indicate if the measures can be publicly reported. All measures selected for public reporting must have a final, audited result. The auditor approves the rate or report status of each measure and survey included in the audit, as shown below.
Rate/ Result Comment
R Reportable. A reportable rate was submitted for the measure.
NA
Small Denominator. The organization followed the specifications, but the denominator was too small (<30) to report a valid rate. a. For EOC and EOC-like measures, when the denominator is fewer than 30; and for HAI, when Total Inpatient Discharges is fewer than 30. b. For utilization measures that count member months, when the denominator is fewer than 360 member months.
c. For all risk-adjusted utilization measures, except PCR and HPC, when the denominator is fewer than 150.
NB No Benefit . The organization did not offer the health benefit required by the measure (e.g., mental health, chemical dependency).
NR Not Reported . The organization chose not to report the measure.
NQ Not Required. The organization was not required to report the measure.
BR Biased Rate. The calculated rate was materially biased.
UN Unaudited. The organization chose to report a measure that is not required to be audited. This result applies only to a limited set of measures (e.g., Board Certification, ECDS measures).
• Disclaimers
• NCQA removed the "Lower 95% Confidence Interval" and "Upper 95% Confidence Interval" data elements from the Data Elements for Reporting tables in all measures.
PrimeWest Health HEDIS® 2019 Page 3
Effectiveness of Care Adult BMI Assessment
Data Elements Commercial Medicare Advantage
MHCP-MC (F&C)
MHCP-MC (MN Care)
SNBC SNP
SNBC Non-SNP
Audit Designation Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 Data Collection Methodology H H H H Eligible Member Population 5613 1166 174 483 Numerator Events by Admin Data on Eligible Population (before exclusions) 2313 516 128 313
Current Year's Admin Rate 41.21% 44.25% 73.56% 64.80% Minimum Required Sample Size 411 411 174 411 Oversampling Rate 5.00% 5.00% 0.00% 5.00% Number of Oversample Records 21 21 21 Number of numerator events by administrative data in MRSS 208 219 141 292
Administrative rate on MRSS 50.61% 53.28% 81.03% 71.05% Number of Records Excluded because of Valid Data Errors 0 0 0 0
Number of Optional Administrative Data Records Excluded 0 0 0 0
Number of Optional Medical Record Data Records Excluded 0 0 0 0
Number of Employee/Dependent Medical Records Excluded 0 0 0 0
Records Added from the Oversample List 0 0 0 0 Denominator 411 411 174 411 Numerator Events by Admin Data 105 109 117 205 Numerator Events by Medical Record 173 146 28 88 Numerator Events by Supplemental Data 103 110 24 87 Rate Status R R R R Reported Rate 92.70% 88.81% 97.13% 92.46%
PrimeWest Health HEDIS® 2019 Page 4
Effectiveness of Care Weight Assessment/Counseling for Nutrition/Physical Activity for Children/Adolescents
Commercial Data Elements
BMI Percentage Counseling for Nutrition Counseling for Physical Activity Ages 3-11 Ages 12-17 Total Ages 3-11 Ages 12-17 Total Ages 3-11 Ages 12-17 Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator events by admin data in eligible population Current Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Number of oversample records Number of numerator events by admin data in MRSS Administrative rate on MRSS Number of Records Excluded Because of Valid Data Errors Number of optional administrative data records excluded Number of optional medical records excluded Number of employee/dependent records excluded Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 5
Effectiveness of Care Weight Assessment/Counseling for Nutrition/Physical Activity for Children/Adolescents
Minnesota Health Care Programs - Managed Care (Families and Children) Data Elements
BMI Percentage Counseling for Nutrition Counseling for Physical Activity Ages 3-11 Ages 12-17 Total Ages 3-11 Ages 12-17 Total Ages 3-11 Ages 12-17 Total
Audit Designation Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H H H Eligible Member Population 5698 3102 8800 5698 3102 8800 5698 3102 8800 Numerator events by admin data in eligible population 197 161 358 59 50 109 44 159 203
Current Year's Administrative Rate 3.46% 5.19% 4.07% 1.04% 1.61% 1.24% 0.77% 5.13% 2.31% Minimum Required Sample Size 411 411 411 411 411 411 411 411 411 Oversampling Rate 5.00% 5.00% 5.00% Number of oversample records 21 21 21 21 21 21 21 21 21 Number of numerator events by admin data in MRSS 27 11 38 17 5 22 15 7 22
Administrative rate on MRSS 6.57% 2.68% 9.25% 4.14% 1.22% 5.35% 3.65% 1.70% 5.35% Number of Records Excluded Because of Valid Data Errors 0 0 0
Number of optional administrative data records excluded 0 0 0
Number of optional medical records excluded 0 0 0
Number of employee/dependent records excluded 0 0 0
Records Added from the Oversample List 0 0 0 Denominator 259 152 411 259 152 411 259 152 411 Numerator Events by Admin Data 10 7 17 3 2 5 1 4 5 Numerator Events by Medical Record 148 88 236 136 66 202 115 63 178 Numerator Events by Supplemental Data 17 4 21 14 3 17 14 3 17 Rate Status R R R R R R R R R Reported Rate 67.57% 65.13% 66.67% 59.07% 46.71% 54.50% 50.19% 46.05% 48.66%
PrimeWest Health HEDIS® 2019 Page 6
Effectiveness of Care Weight Assessment/Counseling for Nutrition/Physical Activity for Children/Adolescents
Minnesota Health Care Programs - Managed Care (MN Care) Data Elements
BMI Percentage Counseling for Nutrition Counseling for Physical Activity Ages 3-11 Ages 12-17 Total Ages 3-11 Ages 12-17 Total Ages 3-11 Ages 12-17 Total
Audit Designation Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H H H Eligible Member Population 23 9 32 23 9 32 23 9 32 Numerator events by admin data in eligible population 1 1 2 0 0 0 0 0 0
Current Year's Administrative Rate 4.35% 11.11% 6.25% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% Minimum Required Sample Size 32 32 32 32 32 32 32 32 32 Oversampling Rate 0.00% 0.00% 0.00% Number of oversample records Number of numerator events by admin data in MRSS 3 1 4 1 0 1 1 0 1
Administrative rate on MRSS 9.38% 3.13% 12.50% 3.13% 0.00% 3.13% 3.13% 0.00% 3.13% Number of Records Excluded Because of Valid Data Errors 0 0 0
Number of optional administrative data records excluded 0 0 0
Number of optional medical records excluded 0 0 0
Number of employee/dependent records excluded 0 0 0
Records Added from the Oversample List 0 0 0 Denominator 23 9 32 23 9 32 23 9 32 Numerator Events by Admin Data 1 1 2 0 0 0 0 0 0 Numerator Events by Medical Record 12 3 15 11 5 16 10 7 17 Numerator Events by Supplemental Data 2 0 2 1 0 1 1 0 1 Rate Status NA NA R NA NA R NA NA R Reported Rate 65.22% 44.44% 59.38% 52.17% 55.56% 53.13% 47.83% 77.78% 56.25%
PrimeWest Health HEDIS® 2019 Page 7
Effectiveness of Care Childhood Immunization Status
Commercial (1 of 2)
Data Elements DTaP IPV MMR HiB Hepatitis B VZV Pneumo-
coccal Conjugate
Hepatitis A Rotavirus Influenza
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator events by admin data in eligible population Current Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Number of oversample records
Numerator events by admin data in MRSS
Admin rate on MRSS Number of Records Excluded Because of Valid Data Errors Number of administrative data records excluded
Number of medical data records excluded
Number of employee/dependent records excluded Records Added from the Oversample List Denominator Numerator Events by administrative Data Numerator Events by Medical Record Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 8
Effectiveness of Care Childhood Immunization Status
Commercial (2 of 2)
Data Elements Combo 2 Combo 3 Combo 4 Combo 5 Combo 6 Combo 7 Combo 8 Combo 9 Combo10
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator events by admin data in eligible population Current Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Number of oversample records
Numerator events by admin data in MRSS
Admin rate on MRSS Number of Records Excluded Because of Valid Data Errors Number of administrative data records excluded
Number of medical data records excluded
Number of employee/dependent records excluded Records Added from the Oversample List Denominator Numerator Events by administrative Data Numerator Events by Medical Record Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 9
Effectiveness of Care Childhood Immunization Status
Minnesota Health Care Programs - Managed Care (Families and Children) (1 of 2)
Data Elements DTaP IPV MMR HiB Hepatitis B VZV Pneumo-
coccal Conjugate
Hepatitis A Rotavirus Influenza
Audit Designation Reportable Reportable Reportable Reportable Reportable Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H H H H Eligible Member Population 752 752 752 752 752 752 752 752 752 752 Numerator events by admin data in eligible population 564 658 651 635 657 641 579 607 525 324
Current Year's Administrative Rate 75.00% 87.50% 86.57% 84.44% 87.37% 85.24% 76.99% 80.72% 69.81% 43.09% Minimum Required Sample Size 411 411 411 411 411 411 411 411 411 411 Oversampling Rate 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% Number of oversample records 21 21 21 21 21 21 21 21 21 21
Numerator events by admin data in MRSS 298 353 355 344 352 348 305 331 281 177
Admin rate on MRSS 72.51% 85.89% 86.37% 83.70% 85.64% 84.67% 74.21% 80.54% 68.37% 43.07% Number of Records Excluded Because of Valid Data Errors 0 0 0 0 0 0 0 0 0 0
Number of administrative data records excluded 0 0 0 0 0 0 0 0 0 0
Number of medical data records excluded 0 0 0 0 0 0 0 0 0 0
Number of employee/dependent records excluded 0 0 0 0 0 0 0 0 0 0
Records Added from the Oversample List 0 0 0 0 0 0 0 0 0 0 Denominator 411 411 411 411 411 411 411 411 411 411 Numerator Events by administrative Data 165 207 292 229 142 287 175 290 166 145 Numerator Events by Medical Record 7 9 0 7 9 0 8 2 6 3 Numerator Events by Supplemental Data 133 146 63 115 210 61 130 41 115 32 Rate Status R R R R R R R R R R Reported Rate 74.21% 88.08% 86.37% 85.40% 87.83% 84.67% 76.16% 81.02% 69.83% 43.80%
PrimeWest Health HEDIS® 2019 Page 10
Effectiveness of Care Childhood Immunization Status
Minnesota Health Care Programs - Managed Care (Families and Children) (2 of 2)
Data Elements Combo 2 Combo 3 Combo 4 Combo 5 Combo 6 Combo 7 Combo 8 Combo 9 Combo10
Audit Designation Reportable Reportable Reportable Reportable Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H H H Eligible Member Population 752 752 752 752 752 752 752 752 752 Numerator events by admin data in eligible population 531 510 500 451 284 445 278 265 261
Current Year's Administrative Rate 70.61% 67.82% 66.49% 59.97% 37.77% 59.18% 36.97% 35.24% 34.71% Minimum Required Sample Size 411 411 411 411 411 411 411 411 411 Oversampling Rate 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% Number of oversample records 21 21 21 21 21 21 21 21 21
Numerator events by admin data in MRSS 287 273 270 242 155 240 154 143 143
Admin rate on MRSS 69.83% 66.42% 65.69% 58.88% 37.71% 58.39% 37.47% 34.79% 34.79% Number of Records Excluded Because of Valid Data Errors 0 0 0 0 0 0 0 0 0
Number of administrative data records excluded 0 0 0 0 0 0 0 0 0
Number of medical data records excluded 0 0 0 0 0 0 0 0 0
Number of employee/dependent records excluded 0 0 0 0 0 0 0 0 0
Records Added from the Oversample List 0 0 0 0 0 0 0 0 0 Denominator 411 411 411 411 411 411 411 411 411 Numerator Events by administrative Data 105 103 103 90 54 90 54 50 50 Numerator Events by Medical Record 4 4 4 3 2 3 2 1 1 Numerator Events by Supplemental Data 182 170 167 152 101 150 100 93 93 Rate Status R R R R R R R R R Reported Rate 70.80% 67.40% 66.67% 59.61% 38.20% 59.12% 37.96% 35.04% 35.04%
PrimeWest Health HEDIS® 2019 Page 11
Effectiveness of Care Childhood Immunization Status
Minnesota Health Care Programs - Managed Care (MN Care) (1 of 2)
Data Elements DTaP IPV MMR HiB Hepatitis B VZV Pneumo-
coccal Conjugate
Hepatitis A Rotavirus Influenza
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H H H H Eligible Member Population 7 7 7 7 7 7 7 7 7 7 Numerator events by admin data in eligible population 7 7 7 7 7 7 7 7 7 4
Current Year's Administrative Rate 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 57.14% Minimum Required Sample Size 7 7 7 7 7 7 7 7 7 7 Oversampling Rate 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% Number of oversample records
Numerator events by admin data in MRSS 7 7 7 7 7 7 7 7 7 4
Admin rate on MRSS 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 57.14% Number of Records Excluded Because of Valid Data Errors 0 0 0 0 0 0 0 0 0 0
Number of administrative data records excluded 0 0 0 0 0 0 0 0 0 0
Number of medical data records excluded 0 0 0 0 0 0 0 0 0 0
Number of employee/dependent records excluded 0 0 0 0 0 0 0 0 0 0
Records Added from the Oversample List 0 0 0 0 0 0 0 0 0 0 Denominator 7 7 7 7 7 7 7 7 7 7 Numerator Events by administrative Data 4 4 7 4 3 7 4 7 4 4 Numerator Events by Medical Record 0 0 0 0 0 0 0 0 0 0 Numerator Events by Supplemental Data 3 3 0 3 4 0 3 0 3 0 Rate Status NA NA NA NA NA NA NA NA NA NA Reported Rate 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 57.14%
PrimeWest Health HEDIS® 2019 Page 12
Effectiveness of Care Childhood Immunization Status
Minnesota Health Care Programs - Managed Care (MN Care) (2 of 2)
Data Elements Combo 2 Combo 3 Combo 4 Combo 5 Combo 6 Combo 7 Combo 8 Combo 9 Combo10
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H H H Eligible Member Population 7 7 7 7 7 7 7 7 7 Numerator events by admin data in eligible population 7 7 7 7 4 7 4 4 4
Current Year's Administrative Rate 100.00% 100.00% 100.00% 100.00% 57.14% 100.00% 57.14% 57.14% 57.14% Minimum Required Sample Size 7 7 7 7 7 7 7 7 7 Oversampling Rate 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% Number of oversample records
Numerator events by admin data in MRSS 7 7 7 7 4 7 4 4 4
Admin rate on MRSS 100.00% 100.00% 100.00% 100.00% 57.14% 100.00% 57.14% 57.14% 57.14% Number of Records Excluded Because of Valid Data Errors 0 0 0 0 0 0 0 0 0
Number of administrative data records excluded 0 0 0 0 0 0 0 0 0
Number of medical data records excluded 0 0 0 0 0 0 0 0 0
Number of employee/dependent records excluded 0 0 0 0 0 0 0 0 0
Records Added from the Oversample List 0 0 0 0 0 0 0 0 0 Denominator 7 7 7 7 7 7 7 7 7 Numerator Events by administrative Data 3 3 3 3 1 3 1 1 1 Numerator Events by Medical Record 0 0 0 0 0 0 0 0 0 Numerator Events by Supplemental Data 4 4 4 4 3 4 3 3 3 Rate Status NA NA NA NA NA NA NA NA NA Reported Rate 100.00% 100.00% 100.00% 100.00% 57.14% 100.00% 57.14% 57.14% 57.14%
PrimeWest Health HEDIS® 2019 Page 13
Effectiveness of Care Immunizations for Adolescents
Commercial Data Elements Meningococcal Tdap Combo 1 Combo 2 HPV
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data on Eligible Population (before exclusions) Current Year's Admin Rate Minimum Required Sample Size Oversampling Rate Number of oversample records
Numerator events by admin data in MRSS
Admin Rate on MRSS Records Excluded because of Valid Data Errors Number of administrative data records excluded
Number of medical data records excluded
Number of employee/dependent medical records excluded Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 14
Effectiveness of Care Immunizations for Adolescents
Minnesota Health Care Programs - Managed Care (Families and Children) Data Elements Meningococcal Tdap Combo 1 Combo 2 HPV
Audit Designation Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H Eligible Member Population 745 745 745 745 745 Numerator Events by Admin Data on Eligible Population (before exclusions) 610 624 603 196 202
Current Year's Admin Rate 81.88% 83.76% 80.94% 26.31% 27.11% Minimum Required Sample Size 411 411 411 411 411 Oversampling Rate 5.00% 5.00% 5.00% 5.00% 5.00% Number of oversample records 21 21 21 21 21
Numerator events by admin data in MRSS 335 345 334 109 111
Admin Rate on MRSS 81.51% 83.94% 81.27% 26.52% 27.01% Records Excluded because of Valid Data Errors 0 0 0 0 0
Number of administrative data records excluded 0 0 0 0 0
Number of medical data records excluded 0 0 0 0 0
Number of employee/dependent medical records excluded 0 0 0 0 0
Records Added from the Oversample List 0 0 0 0 0 Denominator 411 411 411 411 411 Numerator Events by Admin Data 288 292 280 80 83 Numerator Events by Medical Record 1 0 1 0 0 Numerator Events by Supplemental Data 47 53 54 29 28 Rate Status R R R R R Reported Rate 81.75% 83.94% 81.51% 26.52% 27.01%
PrimeWest Health HEDIS® 2019 Page 15
Effectiveness of Care Immunizations for Adolescents
Minnesota Health Care Programs - Managed Care (MN Care) Data Elements Meningococcal Tdap Combo 1 Combo 2 HPV
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H Eligible Member Population 2 2 2 2 2 Numerator Events by Admin Data on Eligible Population (before exclusions) 2 2 2 0 0
Current Year's Admin Rate 100.00% 100.00% 100.00% 0.00% 0.00% Minimum Required Sample Size 2 2 2 2 2 Oversampling Rate 0.00% 0.00% 0.00% 0.00% 0.00% Number of oversample records
Numerator events by admin data in MRSS 2 2 2 0 0
Admin Rate on MRSS 100.00% 100.00% 100.00% 0.00% 0.00% Records Excluded because of Valid Data Errors 0 0 0 0 0
Number of administrative data records excluded 0 0 0 0 0
Number of medical data records excluded 0 0 0 0 0
Number of employee/dependent medical records excluded 0 0 0 0 0
Records Added from the Oversample List 0 0 0 0 0 Denominator 2 2 2 2 2 Numerator Events by Admin Data 1 1 1 0 0 Numerator Events by Medical Record 0 0 0 0 0 Numerator Events by Supplemental Data 1 1 1 0 0 Rate Status NA NA NA NA NA Reported Rate 100.00% 100.00% 100.00% 0.00% 0.00%
PrimeWest Health HEDIS® 2019 Page 16
Effectiveness of Care Breast Cancer Screening
Data Elements Commercial MHCP-MC (F&C)
MHCP-MC (MN Care)
SNBC Non-SNP
Audit Designation Reportable Reportable Reportable
Measurement Year 2018 2018 2018 Data Collection Methodology A A A Eligible Member Population 677 196 121 Number of Optional Admin Data Records Excluded 4 2 0
Numerator Events by Admin Data 458 143 72 Numerator Events by Supplemental Data 0 0 0 Rate Status R R R Reported Rate 67.65% 72.96% 59.50%
PrimeWest Health HEDIS® 2019 Page 17
Effectiveness of Care Breast Cancer Screening
Medicare Advantage Data Elements Non-LIS/DE,
Nondisability LIS/DE Disability LIS/DE and Disability Other Unknown Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Number of Optional Admin Data Records Excluded Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 18
Effectiveness of Care Breast Cancer Screening
Minnesota Senior Health Options Data Elements Non-LIS/DE,
Nondisability LIS/DE Disability LIS/DE and Disability Other Unknown Total
Audit Designation Small Denominator Reportable Small
Denominator Reportable Small Denominator
Small Denominator Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A Eligible Member Population 1 113 1 85 0 0 200 Number of Optional Admin Data Records Excluded 0 0 0 2 0 0 2
Numerator Events by Admin Data 1 69 1 57 0 0 128 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 Rate Status NA R NA R NA NA R Reported Rate 100.00% 61.06% 100.00% 67.06% 64.00%
PrimeWest Health HEDIS® 2019 Page 19
Effectiveness of Care Breast Cancer Screening
Special Needs Basic Care - Special Needs Plan Data Elements Non-LIS/DE,
Nondisability LIS/DE Disability LIS/DE and Disability Other Unknown Total
Audit Designation Small Denominator
Small Denominator
Small Denominator Reportable Small
Denominator Small
Denominator Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A Eligible Member Population 0 0 0 61 0 0 61 Number of Optional Admin Data Records Excluded 0 0 0 1 0 0 1
Numerator Events by Admin Data 0 0 0 51 0 0 51 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 Rate Status NA NA NA R NA NA R Reported Rate 83.61% 83.61%
PrimeWest Health HEDIS® 2019 Page 20
Effectiveness of Care Cervical Cancer Screening
Data Elements Commercial MHCP-MC (F&C)
MHCP-MC (MN Care)
SNBC Non-SNP
Audit Designation Reportable Reportable Reportable
Measurement Year 2018 2018 2018 Data Collection Methodology H H H Eligible Member Population 5154 1185 305 Numerator Events by Admin Data on Eligible Population (before exclusions) 2650 616 139
Current Year's Admin Rate 51.42% 51.98% 45.57% Minimum Required Sample Size 411 411 265 Oversampling Rate 10.00% 10.00% 0.00% Number of Oversample Records 42 42 Numerator events by admin data in MRSS 223 237 140 Admin Rate on MRSS 54.26% 57.66% 52.83% Records Excluded because of Valid Data Errors 0 0 0
Number of administrative data records excluded 4 2 4
Number of medical record data records excluded 10 16 6
Number of employee/dependent medical records excluded 0 0 0
Records Added from the Oversample List 14 18 0
Denominator 411 411 255 Numerator Events by Admin Data 207 228 128 Numerator Events by Medical Record 28 37 5 Numerator Events by Supplemental Data 16 9 12 Rate Status R R R Reported Rate 61.07% 66.67% 56.86%
PrimeWest Health HEDIS® 2019 Page 21
Effectiveness of Care Colorectal Cancer Screening
Commercial Data Elements General
Measure Data Disability LIS/DE LIS/DE Non-LIS/DE Nondisability Other Unknown
Audit Designation
Measurement Year Data collection methodology (administrative or hybrid) Eligible population 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 Number of oversample records Number of numerator events by administrative data in MRSS Administrative rate on MRSS Number of original sample records excluded because of valid data errors Number of optional administrative data records excluded Number of medical record data records excluded Number of employee/dependent medical records excluded Records added from the oversample list Denominator Numerator events by administrative data Numerator events by medical records Numerator Events by Supplemental Data Rate Status Reported rate
PrimeWest Health HEDIS® 2019 Page 22
Effectiveness of Care Colorectal Cancer Screening
Medicare Advantage Data Elements General
Measure Data Disability LIS/DE LIS/DE Non-LIS/DE Nondisability Other Unknown
Audit Designation
Measurement Year Data collection methodology (administrative or hybrid) Eligible population 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 Number of oversample records Number of numerator events by administrative data in MRSS Administrative rate on MRSS Number of original sample records excluded because of valid data errors Number of optional administrative data records excluded Number of medical record data records excluded Number of employee/dependent medical records excluded Records added from the oversample list Denominator Numerator events by administrative data Numerator events by medical records Numerator Events by Supplemental Data Rate Status Reported rate
PrimeWest Health HEDIS® 2019 Page 23
Effectiveness of Care Colorectal Cancer Screening
Minnesota Senior Health Options Data Elements General
Measure Data Disability LIS/DE LIS/DE Non-LIS/DE Nondisability Other Unknown
Audit Designation Reportable Small Denominator Reportable Reportable Small
Denominator Small
Denominator Small
Denominator Measurement Year 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (administrative or hybrid) H H H H H H H
Eligible population 373 2 201 169 1 0 0 Number of numerator events by administrative data in eligible population (before exclusions)
207
Current year's administrative rate (before exclusions) 55.50%
Minimum required sample size (MRSS) or other sample size 372
Oversampling rate 0.00% Number of oversample records Number of numerator events by administrative data in MRSS 228
Administrative rate on MRSS 61.29% Number of original sample records excluded because of valid data errors 1
Number of optional administrative data records excluded 0
Number of medical record data records excluded 0
Number of employee/dependent medical records excluded 0
Records added from the oversample list 0 Denominator 371 2 200 168 1 0 0 Numerator events by administrative data 215 2 111 101 1 0 0 Numerator events by medical records 14 0 9 5 0 0 0 Numerator Events by Supplemental Data 13 0 5 8 0 0 0 Rate Status R NA R R NA NA NA Reported rate 65.23% 100.00% 62.50% 67.86% 100.00%
PrimeWest Health HEDIS® 2019 Page 24
Effectiveness of Care Colorectal Cancer Screening
Special Needs Basic Care - Special Needs Plan Data Elements General
Measure Data Disability LIS/DE LIS/DE Non-LIS/DE Nondisability Other Unknown
Audit Designation Reportable Small Denominator
Small Denominator Reportable Small
Denominator Small
Denominator Small
Denominator Measurement Year 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (administrative or hybrid) H H H H H H H
Eligible population 104 0 0 104 0 0 0 Number of numerator events by administrative data in eligible population (before exclusions)
72
Current year's administrative rate (before exclusions) 69.23%
Minimum required sample size (MRSS) or other sample size 104
Oversampling rate 0.00% Number of oversample records Number of numerator events by administrative data in MRSS 84
Administrative rate on MRSS 80.77% Number of original sample records excluded because of valid data errors 0
Number of optional administrative data records excluded 0
Number of medical record data records excluded 0
Number of employee/dependent medical records excluded 0
Records added from the oversample list 0 Denominator 104 0 0 104 0 0 0 Numerator events by administrative data 82 0 0 82 0 0 0 Numerator events by medical records 0 0 0 0 0 0 0 Numerator Events by Supplemental Data 2 0 0 2 0 0 0 Rate Status R NA NA R NA NA NA Reported rate 80.77% 80.77%
PrimeWest Health HEDIS® 2019 Page 25
Effectiveness of Care Chlamydia Screening in Women
Commercial Data Elements Ages 16-20 Ages 21-24 Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Number of optional administrative data records excluded Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 26
Effectiveness of Care Chlamydia Screening in Women
Minnesota Health Care Programs - Managed Care (Families and Children) Data Elements Ages 16-20 Ages 21-24 Total
Audit Designation Reportable Reportable Reportable
Measurement Year 2018 2018 2018 Data Collection Methodology A A A Eligible Member Population 688 490 1178 Number of optional administrative data records excluded 31 13 44
Numerator Events by Admin Data 259 230 489 Numerator Events by Supplemental Data 0 1 1 Rate Status R R R Reported Rate 37.65% 47.14% 41.60%
PrimeWest Health HEDIS® 2019 Page 27
Effectiveness of Care Chlamydia Screening in Women
Minnesota Health Care Programs - Managed Care (MN Care) Data Elements Ages 16-20 Ages 21-24 Total
Audit Designation Reportable Reportable Reportable
Measurement Year 2018 2018 2018 Data Collection Methodology A A A Eligible Member Population 55 66 121 Number of optional administrative data records excluded 0 0 0
Numerator Events by Admin Data 23 29 52 Numerator Events by Supplemental Data 0 0 0 Rate Status R R R Reported Rate 41.82% 43.94% 42.98%
PrimeWest Health HEDIS® 2019 Page 28
Effectiveness of Care Care for Older Adults
Minnesota Senior Health Options
Data Elements Advance Care Planning
Medication Review
Functional Status
Assessment Pain Screening
Audit Designation Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 Data Collection Methodology H H H H Eligible Member Population 1495 1495 1495 1495 Numerator Events by Admin Data on Eligible Population (before exclusions) 895 23 860 793
Current Year's Admin Rate 59.87% 1.54% 57.53% 53.04% Minimum Required Sample Size 411 411 411 411 Oversampling Rate 5.00% 5.00% 5.00% 5.00% Number of oversample records 21 21 21 21 Numerator events by admin data in MRSS 223 8 221 192 Admin Rate on MRSS 54.26% 1.95% 53.77% 46.72% Records Excluded because of Valid Data Errors 0 0 0 0
Number of employee/dependent medical records excluded 0 0 0 0
Records Added from the Oversample List 0 0 0 0 Denominator 411 411 411 411 Numerator Events by Admin Data 52 5 65 2 Numerator Events by Medical Record 146 374 159 206 Numerator Events by Supplemental Data 171 3 156 190 Rate Status R R R R Reported Rate 89.78% 92.94% 92.46% 96.84%
PrimeWest Health HEDIS® 2019 Page 29
Effectiveness of Care Use of Spirometry Testing in the Assessment and Diagnosis of COPD
Data Elements Medicare Advantage MSHO SNBC
SNP SNBC
Non-SNP
Audit Designation Reportable Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 Data Collection Methodology A A A Eligible Member Population 57 8 13 Numerator Events by Admin Data 11 2 3 Numerator Events by Supplemental Data 0 0 0 Rate Status R NA NA Reported Rate 19.30% 25.00% 23.08%
PrimeWest Health HEDIS® 2019 Page 30
Effectiveness of Care Pharmacotherapy Management of COPD Exacerbation
Medicare Advantage Data Elements Systemic
Corticosteroid Bronchodilator
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 31
Effectiveness of Care Pharmacotherapy Management of COPD Exacerbation
Minnesota Senior Health Options Data Elements Systemic
Corticosteroid Bronchodilator
Audit Designation Reportable Reportable
Measurement Year 2018 2018 Data Collection Methodology A A Eligible Member Population 59 59 Numerator Events by Admin Data 38 51 Numerator Events by Supplemental Data 0 0 Rate Status R R Reported Rate 64.41% 86.44%
PrimeWest Health HEDIS® 2019 Page 32
Effectiveness of Care Pharmacotherapy Management of COPD Exacerbation
Special Needs Basic Care - Special Needs Plan Data Elements Systemic
Corticosteroid Bronchodilator
Audit Designation Small Denominator
Small Denominator
Measurement Year 2018 2018 Data Collection Methodology A A Eligible Member Population 19 19 Numerator Events by Admin Data 16 18 Numerator Events by Supplemental Data 0 0 Rate Status NA NA Reported Rate 84.21% 94.74%
PrimeWest Health HEDIS® 2019 Page 33
Effectiveness of Care Pharmacotherapy Management of COPD Exacerbation
Special Needs Basic Care - Non-Special Needs Plan Data Elements Systemic
Corticosteroid Bronchodilator
Audit Designation Small Denominator Small Denominator
Measurement Year 2018 2018 Data Collection Methodology A A Eligible Member Population 14 14 Numerator Events by Admin Data 11 12 Numerator Events by Supplemental Data 0 0 Rate Status NA NA Reported Rate 78.57% 85.71%
PrimeWest Health HEDIS® 2019 Page 34
Effectiveness of Care Medication Management for People with Asthma
Commercial
Data Elements Medication Compliance 50% Medication Compliance 75%
Ages 5-11
Ages 12-18
Ages 19-50
Ages 51-64 Total Ages 5-11 Ages 12-18 Ages 19-50 Ages 51-64 Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Number of required exclusions Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 35
Effectiveness of Care Medication Management for People with Asthma
Minnesota Health Care Programs - Managed Care (Families and Children)
Data Elements Medication Compliance 50% Medication Compliance 75%
Ages 5-11
Ages 12-18
Ages 19-50
Ages 51-64 Total Ages 5-11 Ages 12-18 Ages 19-50 Ages 51-64 Total
Audit Designation Reportable Reportable Reportable Reportable Reportable Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A A A A Eligible Member Population 66 66 105 30 267 66 66 105 30 267 Number of required exclusions 7 7 48 76 138 7 7 48 76 138 Numerator Events by Admin Data 46 46 70 28 190 24 28 51 20 123 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 0 0 0 Rate Status R R R R R R R R R R Reported Rate 69.70% 69.70% 66.67% 93.33% 71.16% 36.36% 42.42% 48.57% 66.67% 46.07%
PrimeWest Health HEDIS® 2019 Page 36
Effectiveness of Care Medication Management for People with Asthma
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements Medication Compliance 50% Medication Compliance 75%
Ages 5-11
Ages 12-18
Ages 19-50
Ages 51-64 Total Ages 5-11 Ages 12-18 Ages 19-50 Ages 51-64 Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator Reportable Small
Denominator Small
Denominator Small
Denominator Small
Denominator Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A A A A Eligible Member Population 0 0 22 9 31 0 0 22 9 31 Number of required exclusions 0 0 3 8 11 0 0 3 8 11 Numerator Events by Admin Data 0 0 15 8 23 0 0 12 6 18 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 0 0 0 Rate Status NA NA NA NA R NA NA NA NA R Reported Rate 68.18% 88.89% 74.19% 54.55% 66.67% 58.06%
PrimeWest Health HEDIS® 2019 Page 37
Effectiveness of Care Asthma Medication Ratio
Commercial Data Elements Ages 5-11 Ages 12-18 Ages 19-50 Ages 51-64 Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Number of required exclusions Numerator Events by Admin Data Numerator events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 38
Effectiveness of Care Asthma Medication Ratio
Minnesota Health Care Programs - Managed Care (Families and Children) Data Elements Ages 5-11 Ages 12-18 Ages 19-50 Ages 51-64 Total
Audit Designation Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A Eligible Member Population 69 71 128 40 308 Number of required exclusions 4 2 25 66 97 Numerator Events by Admin Data 58 51 83 24 216 Numerator events by Supplemental Data 0 0 0 0 0 Rate Status R R R R R Reported Rate 84.06% 71.83% 64.84% 60.00% 70.13%
PrimeWest Health HEDIS® 2019 Page 39
Effectiveness of Care Asthma Medication Ratio
Minnesota Health Care Programs - Managed Care (MN Care) Data Elements Ages 5-11 Ages 12-18 Ages 19-50 Ages 51-64 Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator Reportable
Measurement Year 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A Eligible Member Population 0 0 25 9 34 Number of required exclusions 0 0 0 8 8 Numerator Events by Admin Data 0 0 18 9 27 Numerator events by Supplemental Data 0 0 0 0 0 Rate Status NA NA NA NA R Reported Rate 72.00% 100.00% 79.41%
PrimeWest Health HEDIS® 2019 Page 40
Effectiveness of Care Controlling High Blood Pressure
Data Elements Commercial Medicare Advantage
MHCP-MC (F&C)
MHCP-MC (MN Care) MSHO SNBC
SNP SNBC
Non-SNP
Audit Designation Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 Data Collection Methodology (Hybrid) H H H H H Eligible Member Population 1079 312 300 58 143 Numerator Events by Admin Data on Eligible Population (before exclusions) 256 67 61 7 42
Minimum Required Sample Size 411 306 285 57 130 Number of oversample records 42 Numerator events by admin data in MRSS 128 98 86 17 52 Records Excluded because of Valid Data Errors 0 0 1 0 0
Number of administrative data records excluded - Optional 0 0 0 1 1
Number of medical record data records excluded 0 0 0 0 0
Number of employee/dependent medical records excluded 0 0 0 0 0
Records Added from the OverSample List 0 0 0 0 0 Denominator 411 306 284 56 129 Numerator Events by Admin Data 0 0 0 0 0 Numerator Events by Medical Record 161 133 128 28 44 Numerator Events by Supplemental Data 128 98 86 17 52 Rate Status R R R R R Reported Rate 70.32% 75.49% 75.35% 80.36% 74.42%
PrimeWest Health HEDIS® 2019 Page 41
Effectiveness of Care Persistence of Beta Blocker Treatment After Heart Attack
Data Elements Commercial Medicare Advantage
MHCP-MC (F&C)
MHCP-MC (MN Care) MSHO SNBC
SNP SNBC
Non-SNP
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A Eligible Member Population 19 5 1 0 4 Number of optional exclusions 7 0 1 0 1 Numerator Events by Admin Data on Eligible Population 16 1 1 0 4
Numerator events by Supplemental Data 0 0 0 0 0 Rate Status NA NA NA NA NA Reported Rate 84.21% 20.00% 100.00% 100.00%
PrimeWest Health HEDIS® 2019 Page 42
Effectiveness of Care Comprehensive Diabetes Care
Commercial
Data Elements HbA1c Testing Poor HbA1c Control (>9.0%)
Good HbA1c Control (<7.0%)
Adequate HbA1c Control
(<8.0%) Eye Exam
Monitoring for Diabetic
Nephropathy
Blood Pressure <140/90 mm Hg
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator events by admin data in eligible population Current Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Number of oversample records
Numerator events by admin data in MRSS
Admin rate on MRSS Number of Records Excluded Because of Valid Data Errors Number of optional administrative data records excluded -Number of medical record data records excluded Number of employee/dependent medical records excluded Number of HbA1c < 7 required administrative data records excluded Number of HbA1c < 7 required medical records excluded Additional Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 43
Effectiveness of Care Comprehensive Diabetes Care
Medicare Advantage (1 of 2)
Data Elements HbA1c Testing Poor HbA1c Control (>9.0%)
Good HbA1c Control (<7.0%)
Adequate HbA1c Control
(<8.0%) Eye Exam
Monitoring for Diabetic
Nephropathy
Blood Pressure <140/90 mm Hg
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator events by admin data in eligible population Current Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Number of oversample records
Numerator events by admin data in MRSS
Admin rate on MRSS Number of Records Excluded Because of Valid Data Errors Number of optional administrative data records excluded -Number of medical record data records excluded Number of employee/dependent medical records excluded Number of HbA1c < 7 required administrative data records excluded Number of HbA1c < 7 required medical records excluded Additional Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 44
Effectiveness of Care Comprehensive Diabetes Care
Medicare Advantage (2 of 2)
Data Elements Eye Exam Breakout
Non-LIS/DE, Nondisability LIS/DE Disability LIS/DE and
Disability Other Unknown Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Denominator Numerator Events by Admin Data Numerator Events by Medical Record Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 45
Effectiveness of Care Comprehensive Diabetes Care
Minnesota Health Care Programs - Managed Care (Families and Children)
Data Elements HbA1c Testing Poor HbA1c Control (>9.0%)
Good HbA1c Control (<7.0%)
Adequate HbA1c Control
(<8.0%) Eye Exam
Monitoring for Diabetic
Nephropathy
Blood Pressure <140/90 mm Hg
Audit Designation Reportable Reportable Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H Eligible Member Population 691 691 555 691 691 691 691 Numerator events by admin data in eligible population 608 547 53 103 448 605 231
Current Year's Administrative Rate 87.99% 79.16% 9.55% 14.91% 64.83% 87.55% 33.43% Minimum Required Sample Size 548 548 548 548 548 548 548 Oversampling Rate 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% Number of oversample records 55 55 55 55 55 55 55
Numerator events by admin data in MRSS 527 111 59 90 395 529 117
Admin rate on MRSS 96.17% 20.26% 10.77% 16.42% 72.08% 96.53% 21.35% Number of Records Excluded Because of Valid Data Errors 0 0 0 0 0 0 0
Number of optional administrative data records excluded - 0 0 0 0 0 0 0
Number of medical record data records excluded 1 1 1 1 1 1 1
Number of employee/dependent medical records excluded 0 0 0 0 0 0 0
Number of HbA1c < 7 required administrative data records excluded 120
Number of HbA1c < 7 required medical records excluded 3
Additional Records Added from the Oversample List 55 55 55 55 55 55 55
Denominator 602 602 479 602 602 602 602 Numerator Events by Admin Data 526 94 2 2 395 529 0 Numerator Events by Medical Record 17 108 105 216 33 16 369 Numerator Events by Supplemental Data 1 17 57 88 0 0 117 Rate Status R R R R R R R Reported Rate 90.37% 36.38% 34.24% 50.83% 71.10% 90.53% 80.73%
PrimeWest Health HEDIS® 2019 Page 46
Effectiveness of Care Comprehensive Diabetes Care
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements HbA1c Testing Poor HbA1c Control (>9.0%)
Good HbA1c Control (<7.0%)
Adequate HbA1c Control
(<8.0%) Eye Exam
Monitoring for Diabetic
Nephropathy
Blood Pressure <140/90 mm Hg
Audit Designation Reportable Reportable Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H Eligible Member Population 172 172 147 172 172 172 172 Numerator events by admin data in eligible population 156 142 8 23 116 159 42
Current Year's Administrative Rate 90.70% 82.56% 5.44% 13.37% 67.44% 92.44% 24.42% Minimum Required Sample Size 170 170 170 170 170 170 170 Oversampling Rate 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% Number of oversample records
Numerator events by admin data in MRSS 154 23 9 16 117 157 28
Admin rate on MRSS 90.59% 13.53% 5.29% 9.41% 68.82% 92.35% 16.47% Number of Records Excluded Because of Valid Data Errors 0 0 0 0 0 0 0
Number of optional administrative data records excluded - 0 0 0 0 0 0 0
Number of medical record data records excluded 0 0 0 0 0 0 0
Number of employee/dependent medical records excluded 0 0 0 0 0 0 0
Number of HbA1c < 7 required administrative data records excluded 26
Number of HbA1c < 7 required medical records excluded 2
Additional Records Added from the Oversample List 0 0 0 0 0 0 0
Denominator 170 170 142 170 170 170 170 Numerator Events by Admin Data 154 22 0 0 117 157 0 Numerator Events by Medical Record 3 27 38 83 12 2 114 Numerator Events by Supplemental Data 0 1 9 16 0 0 28 Rate Status R R R R R R R Reported Rate 92.35% 29.41% 33.10% 58.24% 75.88% 93.53% 83.53%
PrimeWest Health HEDIS® 2019 Page 47
Effectiveness of Care Comprehensive Diabetes Care
Minnesota Senior Health Options (1 of 2)
Data Elements HbA1c Testing Poor HbA1c Control (>9.0%)
Good HbA1c Control (<7.0%)
Adequate HbA1c Control
(<8.0%) Eye Exam
Monitoring for Diabetic
Nephropathy
Blood Pressure <140/90 mm Hg
Audit Designation Reportable Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H Eligible Member Population 134 134 134 134 134 134 Numerator events by admin data in eligible population 125 108 24 105 128 26
Current Year's Administrative Rate 93.28% 80.60% 17.91% 78.36% 95.52% 19.40% Minimum Required Sample Size 134 134 134 134 134 134 Oversampling Rate 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% Number of oversample records
Numerator events by admin data in MRSS 124 17 25 104 127 25
Admin rate on MRSS 92.54% 12.69% 18.66% 77.61% 94.78% 18.66% Number of Records Excluded Because of Valid Data Errors 2 2 2 2 2 2
Number of optional administrative data records excluded - 0 0 0 0 0 0
Number of medical record data records excluded 0 0 0 0 0 0
Number of employee/dependent medical records excluded 0 0 0 0 0 0
Number of HbA1c < 7 required administrative data records excluded Number of HbA1c < 7 required medical records excluded Additional Records Added from the Oversample List 0 0 0 0 0 0
Denominator 132 132 132 132 132 132 Numerator Events by Admin Data 124 17 0 104 127 0 Numerator Events by Medical Record 1 8 70 10 2 81 Numerator Events by Supplemental Data 0 0 25 0 0 25 Rate Status R R R R R R Reported Rate 94.70% 18.94% 71.97% 86.36% 97.73% 80.30%
PrimeWest Health HEDIS® 2019 Page 48
Effectiveness of Care Comprehensive Diabetes Care
Minnesota Senior Health Options (2 of 2)
Data Elements Eye Exam Breakout
Non-LIS/DE, Nondisability LIS/DE Disability LIS/DE and
Disability Other Unknown Total
Audit Designation Small Denominator Reportable Small
Denominator Reportable Small Denominator
Small Denominator Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H Eligible Member Population 0 64 1 69 0 0 134 Denominator 0 64 1 67 0 0 132 Numerator Events by Admin Data 0 47 1 56 0 0 104 Numerator Events by Medical Record 0 5 0 5 0 0 10 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 Rate Status NA R NA R NA NA R Reported Rate 81.25% 100.00% 91.04% 86.36%
PrimeWest Health HEDIS® 2019 Page 49
Effectiveness of Care Comprehensive Diabetes Care
Special Needs Basic Care - Special Needs Plan (1 of 2)
Data Elements HbA1c Testing Poor HbA1c Control (>9.0%)
Good HbA1c Control (<7.0%)
Adequate HbA1c Control
(<8.0%) Eye Exam
Monitoring for Diabetic
Nephropathy
Blood Pressure <140/90 mm Hg
Audit Designation Reportable Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H Eligible Member Population 47 47 47 47 47 47 Numerator events by admin data in eligible population 44 41 6 44 46 6
Current Year's Administrative Rate 93.62% 87.23% 12.77% 93.62% 97.87% 12.77% Minimum Required Sample Size 47 47 47 47 47 47 Oversampling Rate 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% Number of oversample records
Numerator events by admin data in MRSS 45 4 10 44 46 12
Admin rate on MRSS 95.74% 8.51% 21.28% 93.62% 97.87% 25.53% Number of Records Excluded Because of Valid Data Errors 0 0 0 0 0 0
Number of optional administrative data records excluded - 0 0 0 0 0 0
Number of medical record data records excluded 0 0 0 0 0 0
Number of employee/dependent medical records excluded 0 0 0 0 0 0
Number of HbA1c < 7 required administrative data records excluded Number of HbA1c < 7 required medical records excluded Additional Records Added from the Oversample List 0 0 0 0 0 0
Denominator 47 47 47 47 47 47 Numerator Events by Admin Data 45 4 1 44 46 0 Numerator Events by Medical Record 0 1 26 2 0 25 Numerator Events by Supplemental Data 0 0 9 0 0 12 Rate Status R R R R R R Reported Rate 95.74% 10.64% 76.60% 97.87% 97.87% 78.72%
PrimeWest Health HEDIS® 2019 Page 50
Effectiveness of Care Comprehensive Diabetes Care
Special Needs Basic Care - Special Needs Plan (2 of 2)
Data Elements Eye Exam Breakout
Non-LIS/DE, Nondisability LIS/DE Disability LIS/DE and
Disability Other Unknown Total
Audit Designation Small Denominator
Small Denominator
Small Denominator Reportable Small
Denominator Small
Denominator Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H Eligible Member Population 0 0 0 47 0 0 47 Denominator 0 0 0 47 0 0 47 Numerator Events by Admin Data 0 0 0 44 0 0 44 Numerator Events by Medical Record 0 0 0 2 0 0 2 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 Rate Status NA NA NA R NA NA R Reported Rate 97.87% 97.87%
PrimeWest Health HEDIS® 2019 Page 51
Effectiveness of Care Comprehensive Diabetes Care
Special Needs Basic Care - Non-Special Needs Plan
Data Elements HbA1c Testing Poor HbA1c Control (>9.0%)
Good HbA1c Control (<7.0%)
Adequate HbA1c Control
(<8.0%) Eye Exam
Monitoring for Diabetic
Nephropathy
Blood Pressure <140/90 mm Hg
Audit Designation Reportable Reportable Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H Eligible Member Population 140 140 71 140 140 140 140 Numerator events by admin data in eligible population 122 110 9 23 90 123 48
Current Year's Administrative Rate 87.14% 78.57% 12.68% 16.43% 64.29% 87.86% 34.29% Minimum Required Sample Size 140 140 140 140 140 140 140 Oversampling Rate 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% Number of oversample records
Numerator events by admin data in MRSS 121 29 6 17 90 123 29
Admin rate on MRSS 86.43% 20.71% 4.29% 12.14% 64.29% 87.86% 20.71% Number of Records Excluded Because of Valid Data Errors 0 0 0 0 0 0 0
Number of optional administrative data records excluded - 0 0 0 0 0 0 0
Number of medical record data records excluded 0 0 0 0 0 0 0
Number of employee/dependent medical records excluded 0 0 0 0 0 0 0
Number of HbA1c < 7 required administrative data records excluded 69
Number of HbA1c < 7 required medical records excluded 0
Additional Records Added from the Oversample List 0 0 0 0 0 0 0
Denominator 140 140 71 140 140 140 140 Numerator Events by Admin Data 121 26 0 0 90 123 0 Numerator Events by Medical Record 4 24 20 53 6 2 79 Numerator Events by Supplemental Data 0 3 6 17 0 0 29 Rate Status R R R R R R R Reported Rate 89.29% 37.86% 36.62% 50.00% 68.57% 89.29% 77.14%
PrimeWest Health HEDIS® 2019 Page 52
Effectiveness of Care Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
Medicare Advantage Data Elements Medicare
Advantage MSHO
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Number of optional exclusions Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 53
Effectiveness of Care Osteoporosis Management in Women Who had a Fracture
Data Elements Medicare Advantage MSHO
Audit Designation mall Denominator
Measurement Year 2018 Data Collection Methodology A Eligible Member Population 10 Number of required exclusions 10 Numerator Events by Admin Data 3 Numerator Events by Supplemental Data 0 Rate Status NA Reported Rate 30.00%
PrimeWest Health HEDIS® 2019 Page 54
Effectiveness of Care Antidepressant Medication Management
Commercial
Data Elements Effective Acute
Phase Treatment
Effective Continuation
Phase Treatment
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Number of required exclusions Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 55
Effectiveness of Care Antidepressant Medication Management
Medicare Advantage
Data Elements Effective Acute
Phase Treatment
Effective Continuation
Phase Treatment
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Number of required exclusions Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 56
Effectiveness of Care Antidepressant Medication Management
Minnesota Senior Health Options
Data Elements Effective Acute
Phase Treatment
Effective Continuation
Phase Treatment
Audit Designation Reportable Reportable
Measurement Year 2018 2018 Data Collection Methodology A A Eligible Member Population 38 38 Number of required exclusions 798 798 Numerator Events by Admin Data 35 35 Numerator Events by Supplemental Data 0 0 Rate Status R R Reported Rate 92.11% 92.11%
PrimeWest Health HEDIS® 2019 Page 57
Effectiveness of Care Antidepressant Medication Management
Special Needs Basic Care - Special Needs Plan
Data Elements Effective Acute
Phase Treatment
Effective Continuation
Phase Treatment
Audit Designation Small Denominator
Small Denominator
Measurement Year 2018 2018 Data Collection Methodology A A Eligible Member Population 3 3 Number of required exclusions 81 81 Numerator Events by Admin Data 2 2 Numerator Events by Supplemental Data 0 0 Rate Status NA NA Reported Rate 66.67% 66.67%
PrimeWest Health HEDIS® 2019 Page 58
Effectiveness of Care Antidepressant Medication Management
Special Needs Basic Care - Non-Special Needs Plan
Data Elements Effective Acute
Phase Treatment
Effective Continuation
Phase Treatment
Audit Designation Small Denominator
Small Denominator
Measurement Year 2018 2018 Data Collection Methodology A A Eligible Member Population 29 29 Number of required exclusions 284 284 Numerator Events by Admin Data 15 11 Numerator Events by Supplemental Data 0 0 Rate Status NA NA Reported Rate 51.72% 37.93%
PrimeWest Health HEDIS® 2019 Page 59
Effectiveness of Care Antidepressant Medication Management
Minnesota Health Care Programs - Managed Care (Families and Children)
Data Elements Effective Acute
Phase Treatment
Effective Continuation
Phase Treatment
Audit Designation Reportable Reportable
Measurement Year 2018 2018 Data Collection Methodology A A Eligible Member Population 621 621 Number of required exclusions 3466 3466 Numerator Events by Admin Data 339 214 Numerator Events by Supplemental Data 0 0 Rate Status R R Reported Rate 54.59% 34.46%
PrimeWest Health HEDIS® 2019 Page 60
Effectiveness of Care Antidepressant Medication Management
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements Effective Acute
Phase Treatment
Effective Continuation
Phase Treatment
Audit Designation Reportable Reportable
Measurement Year 2018 2018 Data Collection Methodology A A Eligible Member Population 65 65 Number of required exclusions 733 733 Numerator Events by Admin Data 40 28 Numerator Events by Supplemental Data 0 0 Rate Status R R Reported Rate 61.54% 43.08%
PrimeWest Health HEDIS® 2019 Page 61
Effectiveness of Care Follow-Up Care for Children
Commercial
Data Elements Initiation Phase
Continuation and
Maintenance Phase
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Number of optional exclusions Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 62
Effectiveness of Care Follow-Up Care for Children
Minnesota Health Care Programs - Managed Care (Families and Children)
Data Elements Initiation Phase
Continuation and
Maintenance Phase
Audit Designation Reportable Reportable
Measurement Year 2018 2018 Data Collection Methodology A A Eligible Member Population 211 54 Number of optional exclusions 0 0 Numerator Events by Admin Data 85 23 Numerator Events by Supplemental Data 0 0 Rate Status R R Reported Rate 40.28% 42.59%
PrimeWest Health HEDIS® 2019 Page 63
Effectiveness of Care Follow-Up Care for Children
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements Initiation Phase
Continuation and
Maintenance Phase
Audit Designation Small Denominator
Small Denominator
Measurement Year 2018 2018 Data Collection Methodology A A Eligible Member Population 1 0 Number of optional exclusions 0 0 Numerator Events by Admin Data 0 0 Numerator Events by Supplemental Data 0 0 Rate Status NA NA Reported Rate 0.00%
PrimeWest Health HEDIS® 2019 Page 64
Effectiveness of Care Follow-up After Hospitalization for Mental Illness
Commercial Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 65
Effectiveness of Care Follow-up After Hospitalization for Mental Illness
Medicare Advantage Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 66
Effectiveness of Care Follow-up After Hospitalization for Mental Illness
Minnesota Health Care Programs - Managed Care (Families and Children) Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation Reportable Reportable Small Denominator Reportable Reportable Reportable Small
Denominator Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A A Eligible Member Population 108 210 0 318 108 210 0 318 Numerator Events by Admin Data 43 82 0 125 80 135 0 215 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 0 Rate Status R R NA R R R NA R Reported Rate 39.81% 39.05% 39.31% 74.07% 64.29% 67.61%
PrimeWest Health HEDIS® 2019 Page 67
Effectiveness of Care Follow-up After Hospitalization for Mental Illness
Minnesota Health Care Programs - Managed Care (MN Care) Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A A Eligible Member Population 0 19 0 19 0 19 0 19 Numerator Events by Admin Data 0 10 0 10 0 15 0 15 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA NA NA Reported Rate 52.63% 52.63% 78.95% 78.95%
PrimeWest Health HEDIS® 2019 Page 68
Effectiveness of Care Follow-up After Hospitalization for Mental Illness
Minnesota Senior Health Options Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A A Eligible Member Population 0 0 3 3 0 0 3 3 Numerator Events by Admin Data 0 0 1 1 0 0 1 1 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA NA NA Reported Rate 33.33% 33.33% 33.33% 33.33%
PrimeWest Health HEDIS® 2019 Page 69
Effectiveness of Care Follow-up After Hospitalization for Mental Illness
Special Needs Basic Care - Special Needs Plan Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A A Eligible Member Population 0 3 0 3 0 3 0 3 Numerator Events by Admin Data 0 3 0 3 0 3 0 3 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA NA NA Reported Rate 100.00% 100.00% 100.00% 100.00%
PrimeWest Health HEDIS® 2019 Page 70
Effectiveness of Care Follow-up After Hospitalization for Mental Illness
Special Needs Basic Care - Non-Special Needs Plan Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A A Eligible Member Population 0 26 0 26 0 26 0 26 Numerator Events by Admin Data 0 7 0 7 0 16 0 16 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA NA NA Reported Rate 26.92% 26.92% 61.54% 61.54%
PrimeWest Health HEDIS® 2019 Page 71
Effectiveness of Care Follow-up After Emergecy Visit for Mental Illness
Commercial Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 72
Effectiveness of Care Follow-up After Emergecy Visit for Mental Illness
Medicare Advantage Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 73
Effectiveness of Care Follow-up After Emergecy Visit for Mental Illness
Minnesota Health Care Programs - Managed Care (Families and Children) Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation Reportable Reportable Small Denominator Reportable Reportable Reportable Small
Denominator Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A A Eligible Member Population 78 135 0 213 78 135 0 213 Numerator Events by Admin Data 55 75 0 130 64 95 0 159 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 0 Rate Status R R NA R R R NA R Reported Rate 70.51% 55.56% 61.03% 82.05% 70.37% 74.65%
PrimeWest Health HEDIS® 2019 Page 74
Effectiveness of Care Follow-up After Emergecy Visit for Mental Illness
Minnesota Health Care Programs - Managed Care (MN Care) Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A A Eligible Member Population 0 8 0 8 0 8 0 8 Numerator Events by Admin Data 0 4 0 4 0 5 0 5 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA NA NA Reported Rate 50.00% 50.00% 62.50% 62.50%
PrimeWest Health HEDIS® 2019 Page 75
Effectiveness of Care Follow-up After Emergecy Visit for Mental Illness
Minnesota Senior Health Options Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A A Eligible Member Population 0 0 2 2 0 0 2 2 Numerator Events by Admin Data 0 0 1 1 0 0 1 1 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA NA NA Reported Rate 50.00% 50.00% 50.00% 50.00%
PrimeWest Health HEDIS® 2019 Page 76
Effectiveness of Care Follow-up After Emergecy Visit for Mental Illness
Special Needs Basic Care - Special Needs Plan Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A A Eligible Member Population 0 2 0 2 0 2 0 2 Numerator Events by Admin Data 0 2 0 2 0 2 0 2 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA NA NA Reported Rate 100.00% 100.00% 100.00% 100.00%
PrimeWest Health HEDIS® 2019 Page 77
Effectiveness of Care Follow-up After Emergecy Visit for Mental Illness
Special Needs Basic Care - Non-Special Needs Plan Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 18-64 65+ Total 6-17 18-64 65+ Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A A A Eligible Member Population 0 18 0 18 0 18 0 18 Numerator Events by Admin Data 0 10 0 10 0 13 0 13 Numerator Events by Supplemental Data 0 0 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA NA NA Reported Rate 55.56% 55.56% 72.22% 72.22%
PrimeWest Health HEDIS® 2019 Page 78
Effectiveness of Care Follow-up After Emergecy Visit for Alcohol and Other Drug Abuse
Commercial Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 65+ Total 6-17 65+ Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 79
Effectiveness of Care Follow-up After Emergecy Visit for Alcohol and Other Drug Abuse
Medicare Advantage Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 65+ Total 6-17 65+ Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 80
Effectiveness of Care Follow-up After Emergecy Visit for Alcohol and Other Drug Abuse
Minnesota Health Care Programs - Managed Care (Families and Children) Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 65+ Total 6-17 65+ Total
Audit Designation Small Denominator Reportable Reportable Small
Denominator Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A Eligible Member Population 11 228 239 11 228 239 Numerator Events by Admin Data 1 26 27 2 45 47 Numerator Events by Supplemental Data 0 0 0 0 0 0 Rate Status NA R R NA R R Reported Rate 9.09% 11.40% 11.30% 18.18% 19.74% 19.67%
PrimeWest Health HEDIS® 2019 Page 81
Effectiveness of Care Follow-up After Emergecy Visit for Alcohol and Other Drug Abuse
Minnesota Health Care Programs - Managed Care (MN Care) Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 65+ Total 6-17 65+ Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A Eligible Member Population 0 9 9 0 9 9 Numerator Events by Admin Data 0 0 0 0 0 0 Numerator Events by Supplemental Data 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA Reported Rate 0.00% 0.00% 0.00% 0.00%
PrimeWest Health HEDIS® 2019 Page 82
Effectiveness of Care Follow-up After Emergecy Visit for Alcohol and Other Drug Abuse
Minnesota Senior Health Options Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 65+ Total 6-17 65+ Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A Eligible Member Population 0 2 2 0 2 2 Numerator Events by Admin Data 0 0 0 0 0 0 Numerator Events by Supplemental Data 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA Reported Rate 0.00% 0.00% 0.00% 0.00%
PrimeWest Health HEDIS® 2019 Page 83
Effectiveness of Care Follow-up After Emergecy Visit for Alcohol and Other Drug Abuse
Special Needs Basic Care - Special Needs Plan Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 65+ Total 6-17 65+ Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A Eligible Member Population 0 1 1 0 1 1 Numerator Events by Admin Data 0 0 0 0 0 0 Numerator Events by Supplemental Data 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA Reported Rate 0.00% 0.00% 0.00% 0.00%
PrimeWest Health HEDIS® 2019 Page 84
Effectiveness of Care Follow-up After Emergecy Visit for Alcohol and Other Drug Abuse
Special Needs Basic Care - Non-Special Needs Plan Data Elements
Within 7 Days of Discharge Within 30 Days of Discharge 6-17 65+ Total 6-17 65+ Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A A Eligible Member Population 0 21 21 0 21 21 Numerator Events by Admin Data 0 1 1 0 2 2 Numerator Events by Supplemental Data 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA Reported Rate 4.76% 4.76% 9.52% 9.52%
PrimeWest Health HEDIS® 2019 Page 85
Effectiveness of Care Annual Monitoring for Patients on Persistent Medications
Commercial
Data Elements Annual Monitoring for Members on
ACE Inhibitors or ARBs Diuretics Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Number of optional exclusions Numerator Events by Admin Data Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 86
Effectiveness of Care Annual Monitoring for Patients on Persistent Medications
Minnesota Health Care Programs - Managed Care (Families and Children)
Data Elements Annual Monitoring for Members on
ACE Inhibitors or ARBs Diuretics Total
Audit Designation Reportable Reportable Reportable
Measurement Year 2018 2018 2018 Data Collection Methodology A A A Eligible Member Population 807 526 1333 Number of optional exclusions 0 0 0 Numerator Events by Admin Data 697 452 1149 Numerator Events by Supplemental Data 0 0 0 Rate Status R R R Reported Rate 86.37% 85.93% 86.20%
PrimeWest Health HEDIS® 2019 Page 87
Effectiveness of Care Annual Monitoring for Patients on Persistent Medications
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements Annual Monitoring for Members on
ACE Inhibitors or ARBs Diuretics Total
Audit Designation Reportable Reportable Reportable
Measurement Year 2018 2018 2018 Data Collection Methodology A A A Eligible Member Population 283 161 444 Number of optional exclusions 2 0 2 Numerator Events by Admin Data 251 138 389 Numerator Events by Supplemental Data 0 0 0 Rate Status R R R Reported Rate 88.69% 85.71% 87.61%
PrimeWest Health HEDIS® 2019 Page 88
Effectiveness of Care Medication Reconciliation Post Discharge
Data Elements Medicare Advantage MSHO SNBC
SNP
Audit Designation Reportable Reportable
Measurement Year 2018 2018 Data collection methodology (Administrative or Hybrid) H H
Eligible member population 615 33 Number of numerator events by administrative data in eligible population (before exclusions)
174 9
Current Year's Admin Rate 28.29% 27.27% Minimum required sample size (MRSS) or other sample size 411 33
Oversampling rate 50.00% 0.00% Number of Oversample Records 206 Number of numerator events by administrative data in MRSS 164 9
Administrative rate on MRSS 39.90% 27.27% Number of original sample records excluded because of valid data errors 184 1
Number of employee/dependent medical records excluded 0 0
Records added from the Oversample List 132 0 Denominator 411 32 Numerator Events by Medical Record 71 9 Numerator Events by Admin Data 143 9 Numerator Events by Supplemental Data 0 0 Rate Status R R Reported rate 52.07% 56.25%
PrimeWest Health HEDIS® 2019 Page 89
Effectiveness of Care Transitions of Care
Medicare Advantage
Data Elements Notification of Inpatient Admission Receipt of Discharge Information Patient Engagement After Inpatient
Discharge Medication Reconciliation Post-
Discharge 18-64 65+ Total 18-64 65+ Total 18-64 65+ Total 18-64 65+ Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator events by admin data in eligible population Current Year's Administrative Rate Minimum Required Sample Size Oversampling Rate Number of oversample records
Numerator events by admin data in MRSS
Admin rate on MRSS Number of Records Excluded Because of Valid Data Errors Number of employee/dependent medical records excluded Additional Records Added from the Oversample List Denominator Numerator Events by Admin Data Numerator Events by Medical Record Numerator Events by Supplemental Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 90
Effectiveness of Care Transitions of Care
Minnesota Senior Health Options
Data Elements Notification of Inpatient Admission Receipt of Discharge Information Patient Engagement After Inpatient
Discharge Medication Reconciliation Post-
Discharge 18-64 65+ Total 18-64 65+ Total 18-64 65+ Total 18-64 65+ Total
Audit Designation Small Denominator Reportable Reportable Small
Denominator Reportable Reportable Small Denominator Reportable Reportable Small
Denominator Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H H H H H H Eligible Member Population 0 615 615 0 615 615 0 615 615 0 615 615 Numerator events by admin data in eligible population 0 401 401 0 174 174
Current Year's Administrative Rate 65.20% 65.20% 28.29% 28.29% Minimum Required Sample Size 411 411 411 411 411 411 411 411 411 411 411 411 Oversampling Rate 50.00% 50.00% 50.00% 50.00% 50.00% 50.00% 50.00% 50.00% 50.00% 50.00% 50.00% 50.00% Number of oversample records 206 206 206 206 206 206 206 206 206 206 206 206
Numerator events by admin data in MRSS 0 386 386 0 164 164
Admin rate on MRSS 0.00% 93.92% 93.92% 0.00% 39.90% 39.90% Number of Records Excluded Because of Valid Data Errors 184 184 184 184 184 184 184 184 184 184 184 184
Number of employee/dependent medical records excluded 0 0 0 0 0 0 0 0 0 0 0 0
Additional Records Added from the Oversample List 132 132 132 132 132 132 132 132 132 132 132 132
Denominator 0 411 411 0 411 411 0 411 411 0 411 411 Numerator Events by Admin Data 0 322 322 0 143 143 Numerator Events by Medical Record 0 69 69 0 60 60 0 17 17 0 71 71 Numerator Events by Supplemental Data 0 0 0 0 0 0 Rate Status NA R R NA R R NA R R NA R R Reported Rate 16.79% 16.79% 14.60% 14.60% 82.48% 82.48% 52.07% 52.07%
PrimeWest Health HEDIS® 2019 Page 91
Effectiveness of Care Transitions of Care
Special Needs Basic Care - Special Needs Plan
Data Elements Notification of Inpatient Admission Receipt of Discharge Information Patient Engagement After Inpatient
Discharge Medication Reconciliation Post-
Discharge 18-64 65+ Total 18-64 65+ Total 18-64 65+ Total 18-64 65+ Total
Audit Designation Reportable Small Denominator Reportable Reportable Small
Denominator Reportable Reportable Small Denominator Reportable Reportable Small
Denominator Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H H H H H H Eligible Member Population 33 0 33 33 0 33 33 0 33 33 0 33 Numerator events by admin data in eligible population 31 0 31 9 0 9
Current Year's Administrative Rate 93.94% 93.94% 27.27% 27.27% Minimum Required Sample Size 33 33 33 33 33 33 33 33 33 33 33 33 Oversampling Rate 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% Number of oversample records
Numerator events by admin data in MRSS 31 0 31 9 0 9
Admin rate on MRSS 93.94% 0.00% 93.94% 27.27% 0.00% 27.27% Number of Records Excluded Because of Valid Data Errors 1 1 1 1 1 1 1 1 1 1 1 1
Number of employee/dependent medical records excluded 0 0 0 0 0 0 0 0 0 0 0 0
Additional Records Added from the Oversample List 0 0 0 0 0 0 0 0 0 0 0 0
Denominator 32 0 32 32 0 32 32 0 32 32 0 32 Numerator Events by Admin Data 31 0 31 9 0 9 Numerator Events by Medical Record 3 0 3 7 0 7 0 0 0 9 0 9 Numerator Events by Supplemental Data 0 0 0 0 0 0 Rate Status R NA R R NA R R NA R R NA R Reported Rate 9.38% 9.38% 21.88% 21.88% 96.88% 96.88% 56.25% 56.25%
PrimeWest Health HEDIS® 2019 Page 92
Effectiveness of Care Potentially Harmful Drug-Disease Interactions in the Elderly
Medicare Advantage
Data Elements
Drug-Disease Interactions
History of Falls + Tricyclic
Antidepressants, Antipsychotics or
Sleep Agents
Dementia + Tricyclic
Antidepressants or Anticholinergic
Agents
Chronic Renal Failure +
Nonaspirin NSAIDs or Cox-2 Selective NSAIDs
Total
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Number of required exclusions Numerator Events by Admin Data Rate Status Reported Rate
PrimeWest Health HEDIS® 2019 Page 93
Effectiveness of Care Potentially Harmful Drug-Disease Interactions in the Elderly
Minnesota Senior Health Options
Data Elements
Drug-Disease Interactions
History of Falls + Tricyclic
Antidepressants, Antipsychotics or
Sleep Agents
Dementia + Tricyclic
Antidepressants or Anticholinergic
Agents
Chronic Renal Failure +
Nonaspirin NSAIDs or Cox-2 Selective NSAIDs
Total
Audit Designation Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 Data Collection Methodology A A A A Eligible Member Population 258 270 74 602 Number of required exclusions 62 87 149 Numerator Events by Admin Data 179 144 6 329 Rate Status R R R R Reported Rate 69.38% 53.33% 8.11% 54.65%
PrimeWest Health HEDIS® 2019 Page 94
Effectiveness of Care Use of High Risk Medications in the Elderly
Medicare Advantage Data Elements At least 1
Prescription At least 2
Prescriptions
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Rate Status Reported Rate NR NR
PrimeWest Health HEDIS® 2019 Page 95
Effectiveness of Care Use of High Risk Medications in the Elderly
Minnesota Senior Health Options Data Elements At least 1
Prescription At least 2
Prescriptions
Audit Designation Reportable Reportable
Measurement Year 2018 2018 Data Collection Methodology A A Eligible Member Population 1494 1494 Numerator Events by Admin Data 236 223 Rate Status R R Reported Rate 15.80% 14.93%
PrimeWest Health HEDIS® 2019 Page 96
Effectiveness of Care Use of Opioids at High Dosage
Data Elements Commercial Medicare Advantage
MHCP-MC (F&C)
MHCP-MC (MN Care) MSHO SNBC
SNP SNBC
Non-SNP
Audit Designation Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 Data Collection Methodology A A A A A Eligible Member Population 592 70 308 32 101 Numerator Events by Admin Data on Eligible Population 12 1 16 2 10
Number of required exclusions 29 7 35 5 17 Rate Status R R R R R Reported Rate NR NR 2.03% 1.43% 5.19% 6.25% 9.90%
PrimeWest Health HEDIS® 2019 Page 97
Effectiveness of Care Use of Opioids from Multiple Providers
Commercial
Data Elements Multiple Prescribers
Multiple Pharmacies
Multiple Prescribers and
Pharmacies
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data on Eligible Population Rate Status Reported Rate NR NR NR
PrimeWest Health HEDIS® 2019 Page 98
Effectiveness of Care Use of Opioids from Multiple Providers
Medicare Advantage
Data Elements Multiple Prescribers
Multiple Pharmacies
Multiple Prescribers and
Pharmacies
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data on Eligible Population Rate Status Reported Rate NR NR NR
PrimeWest Health HEDIS® 2019 Page 99
Effectiveness of Care Use of Opioids from Multiple Providers
Minnesota Health Care Programs - Managed Care (Families and Children)
Data Elements Multiple Prescribers
Multiple Pharmacies
Multiple Prescribers and
Pharmacies
Audit Designation Reportable Reportable Reportable
Measurement Year 2018 2018 2018 Data Collection Methodology A A A Eligible Member Population 703 703 703 Numerator Events by Admin Data on Eligible Population 31 153 21
Rate Status R R R Reported Rate 4.41% 21.76% 2.99%
PrimeWest Health HEDIS® 2019 Page 100
Effectiveness of Care Use of Opioids from Multiple Providers
Minnesota Health Care Programs - Managed Care (MN Care)
Data Elements Multiple Prescribers
Multiple Pharmacies
Multiple Prescribers and
Pharmacies
Audit Designation Reportable Reportable Reportable
Measurement Year 2018 2018 2018 Data Collection Methodology A A A Eligible Member Population 114 114 114 Numerator Events by Admin Data on Eligible Population 5 22 3
Rate Status R R R Reported Rate 4.39% 19.30% 2.63%
PrimeWest Health HEDIS® 2019 Page 101
Effectiveness of Care Use of Opioids from Multiple Providers
Minnesota Senior Health Options
Data Elements Multiple Prescribers
Multiple Pharmacies
Multiple Prescribers and
Pharmacies
Audit Designation Reportable Reportable Reportable
Measurement Year 2018 2018 2018 Data Collection Methodology A A A Eligible Member Population 350 350 350 Numerator Events by Admin Data on Eligible Population 1 38 0
Rate Status R R R Reported Rate 0.29% 10.86% 0.00%
PrimeWest Health HEDIS® 2019 Page 102
Effectiveness of Care Use of Opioids from Multiple Providers
Special Needs Basic Care - Special Needs Plan
Data Elements Multiple Prescribers
Multiple Pharmacies
Multiple Prescribers and
Pharmacies
Audit Designation Reportable Reportable Reportable
Measurement Year 2018 2018 2018 Data Collection Methodology A A A Eligible Member Population 37 37 37 Numerator Events by Admin Data on Eligible Population 2 6 1
Rate Status R R R Reported Rate 5.41% 16.22% 2.70%
PrimeWest Health HEDIS® 2019 Page 103
Effectiveness of Care Use of Opioids from Multiple Providers
Special Needs Basic Care - Non-Special Needs Plan
Data Elements Multiple Prescribers
Multiple Pharmacies
Multiple Prescribers and
Pharmacies
Audit Designation Reportable Reportable Reportable
Measurement Year 2018 2018 2018 Data Collection Methodology A A A Eligible Member Population 126 126 126 Numerator Events by Admin Data on Eligible Population 8 31 6
Rate Status R R R Reported Rate 6.35% 24.60% 4.76%
PrimeWest Health HEDIS® 2019 Page 104
Access/Availability of Care Adult's Access to Preventive/Ambulatory Health Services
Commercial Data Elements Ages 20-44 Ages 45-64 Ages 65+ Total
Audit Designation
Measurement Year Data collection methodology (Administrative only) Eligible member population (i.e. members who meet all denominator criteria) Numerator events by administrative data Rate Status Reported rate
PrimeWest Health HEDIS® 2019 Page 105
Access/Availability of Care Adult's Access to Preventive/Ambulatory Health Services
Medicare Advantage Data Elements Ages 20-44 Ages 45-64 Ages 65+ Total
Audit Designation
Measurement Year Data collection methodology (Administrative only) Eligible member population (i.e. members who meet all denominator criteria) Numerator events by administrative data Rate Status Reported rate
PrimeWest Health HEDIS® 2019 Page 106
Access/Availability of Care Adult's Access to Preventive/Ambulatory Health Services
Minnesota Health Care Programs - Managed Care (Families and Children) Data Elements Ages 20-44 Ages 45-64 Ages 65+ Total
Audit Designation Reportable Reportable Small Denominator Reportable
Measurement Year 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A
Eligible member population (i.e. members who meet all denominator criteria) 6526 3151 1 9678
Numerator events by administrative data 5463 2712 1 8176 Rate Status R R NA R Reported rate 83.71% 86.07% 100.00% 84.48%
PrimeWest Health HEDIS® 2019 Page 107
Access/Availability of Care Adult's Access to Preventive/Ambulatory Health Services
Minnesota Health Care Programs - Managed Care (MN Care) Data Elements Ages 20-44 Ages 45-64 Ages 65+ Total
Audit Designation Reportable Reportable Small Denominator Reportable
Measurement Year 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A
Eligible member population (i.e. members who meet all denominator criteria) 1155 1071 17 2243
Numerator events by administrative data 980 943 14 1937 Rate Status R R NA R Reported rate 84.85% 88.05% 82.35% 86.36%
PrimeWest Health HEDIS® 2019 Page 108
Access/Availability of Care Adult's Access to Preventive/Ambulatory Health Services
Minnesota Senior Health Options Data Elements Ages 20-44 Ages 45-64 Ages 65+ Total
Audit Designation Small Denominator
Small Denominator Reportable Reportable
Measurement Year 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A
Eligible member population (i.e. members who meet all denominator criteria) 0 0 1530 1530
Numerator events by administrative data 0 0 1513 1513 Rate Status NA NA R R Reported rate 98.89% 98.89%
PrimeWest Health HEDIS® 2019 Page 109
Access/Availability of Care Adult's Access to Preventive/Ambulatory Health Services
Special Needs Basic Care - Special Needs Plan Data Elements Ages 20-44 Ages 45-64 Ages 65+ Total
Audit Designation Reportable Reportable Small Denominator Reportable
Measurement Year 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A
Eligible member population (i.e. members who meet all denominator criteria) 48 129 0 177
Numerator events by administrative data 47 128 0 175 Rate Status R R NA R Reported rate 97.92% 99.22% 98.87%
PrimeWest Health HEDIS® 2019 Page 110
Access/Availability of Care Adult's Access to Preventive/Ambulatory Health Services
Special Needs Basic Care - Non-Special Needs Plan Data Elements Ages 20-44 Ages 45-64 Ages 65+ Total
Audit Designation Reportable Reportable Small Denominator Reportable
Measurement Year 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A
Eligible member population (i.e. members who meet all denominator criteria) 270 388 0 658
Numerator events by administrative data 251 364 0 615 Rate Status R R NA R Reported rate 92.96% 93.81% 93.47%
PrimeWest Health HEDIS® 2019 Page 111
Access/Availability of Care Children's and Adolescents' Access to Primary Care Practitioners
Commercial Data Elements 12-24 months 25 months -
6 yrs. 7-11 yrs. 12-19 yrs.
Audit Designation
Measurement Year Data collection methodology (Administrative only) Eligible member population Numerator events by administrative data Rate Status Reported rate
PrimeWest Health HEDIS® 2019 Page 112
Access/Availability of Care Children's and Adolescents' Access to Primary Care Practitioners
Minnesota Health Care Programs - Managed Care (Families and Children) Data Elements 12-24 months 25 months -
6 yrs. 7-11 yrs. 12-19 yrs.
Audit Designation Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A
Eligible member population 847 3964 2863 3507 Numerator events by administrative data 778 3331 2535 3190 Rate Status R R R R Reported rate 91.85% 84.03% 88.54% 90.96%
PrimeWest Health HEDIS® 2019 Page 113
Access/Availability of Care Children's and Adolescents' Access to Primary Care Practitioners
Minnesota Health Care Programs - Managed Care (MA MN Care) Data Elements 12-24 months 25 months -
6 yrs. 7-11 yrs. 12-19 yrs.
Audit Designation Small Denominator
Small Denominator
Small Denominator Reportable
Measurement Year 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A
Eligible member population 6 29 6 60 Numerator events by administrative data 6 28 5 55 Rate Status NA NA NA R Reported rate 100.00% 96.55% 83.33% 91.67%
PrimeWest Health HEDIS® 2019 Page 114
Access/Availability of Care Annual Dental Visit
Minnesota Health Care Programs - Managed Care (Families and Children) Data Elements 2-3 Years 4-6 Years 7-10 Years 11-14 Years 15-18 Years 19-20 Years Total
Audit Designation Reportable Reportable Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A
Eligible member population 1602 2420 3323 3036 2419 661 13461 Numerator events by administrative data 592 1453 2049 1791 1309 252 7446 Rate Status R R R R R R R Reported rate 36.95% 60.04% 61.66% 58.99% 54.11% 38.12% 55.32%
PrimeWest Health HEDIS® 2019 Page 115
Access/Availability of Care Annual Dental Visit
Minnesota Health Care Programs - Managed Care (MN Care) Data Elements 2-3 Years 4-6 Years 7-10 Years 11-14 Years 15-18 Years 19-20 Years Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A
Eligible member population 21 8 9 9 10 125 182 Numerator events by administrative data 4 3 6 3 6 56 78 Rate Status NA NA NA NA NA R R Reported rate 19.05% 37.50% 66.67% 33.33% 60.00% 44.80% 42.86%
PrimeWest Health HEDIS® 2019 Page 116
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Commercial (1 of 3) - 13 - 17 Year Olds
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation
Measurement Year Data collection methodology (Administrative only) Eligible member population Numerator events by administrative data Rate Status Reported rate
PrimeWest Health HEDIS® 2019 Page 117
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Commercial (2 of 3) - 18+ Year Olds
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation
Measurement Year Data collection methodology (Administrative only) Eligible member population Numerator events by administrative data Rate Status Reported rate
PrimeWest Health HEDIS® 2019 Page 118
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Commercial (3 of 3) - Total
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation
Measurement Year Data collection methodology (Administrative only) Eligible member population Numerator events by administrative data Rate Status Reported rate
PrimeWest Health HEDIS® 2019 Page 119
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Medicare Advantage (1 of 3) - 13 - 17 Year Olds
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation
Measurement Year Data collection methodology (Administrative only) Eligible member population Numerator events by administrative data Rate Status Reported rate
PrimeWest Health HEDIS® 2019 Page 120
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Medicare Advantage (2 of 3) - 18+ Year Olds
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation
Measurement Year Data collection methodology (Administrative only) Eligible member population Numerator events by administrative data Rate Status Reported rate
PrimeWest Health HEDIS® 2019 Page 121
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Medicare Advantage (3 of 3) - Total
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation
Measurement Year Data collection methodology (Administrative only) Eligible member population Numerator events by administrative data Rate Status Reported rate
PrimeWest Health HEDIS® 2019 Page 122
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Minnesota Health Care Programs - Managed Care (F&C) (1 of 3) - 13 - 17 Year Olds
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation Small Denominator
Small Denominator Reportable Reportable Small
Denominator Small
Denominator Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A A
Eligible member population 21 0 55 66 21 0 55 66 Numerator events by administrative data 12 0 29 33 5 0 11 12 Rate Status NA NA R R NA NA R R Reported rate 57.14% 52.73% 50.00% 23.81% 20.00% 18.18%
PrimeWest Health HEDIS® 2019 Page 123
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Minnesota Health Care Programs - Managed Care (F&C) (2 of 3) - 18+ Year Olds
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation Reportable Reportable Reportable Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A A
Eligible member population 439 107 532 1011 439 107 532 1011 Numerator events by administrative data 183 52 251 448 55 24 65 139 Rate Status R R R R R R R R Reported rate 41.69% 48.60% 47.18% 44.31% 12.53% 22.43% 12.22% 13.75%
PrimeWest Health HEDIS® 2019 Page 124
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Minnesota Health Care Programs - Managed Care (F&C) (3 of 3) - Total
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation Reportable Reportable Reportable Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A A
Eligible member population 460 107 587 1077 460 107 587 1077 Numerator events by administrative data 195 52 280 481 60 24 76 151 Rate Status R R R R R R R R Reported rate 42.39% 48.60% 47.70% 44.66% 13.04% 22.43% 12.95% 14.02%
PrimeWest Health HEDIS® 2019 Page 125
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Minnesota Health Care Programs - Managed Care (MN Care) (1 of 3) - 13 - 17 Year Olds
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A A
Eligible member population 0 0 0 0 0 0 0 0 Numerator events by administrative data 0 0 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA NA NA Reported rate
PrimeWest Health HEDIS® 2019 Page 126
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Minnesota Health Care Programs - Managed Care (MN Care) (2 of 3) - 18+ Year Olds
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation Reportable Small Denominator
Small Denominator Reportable Reportable Small
Denominator Small
Denominator Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A A
Eligible member population 46 6 18 67 46 6 18 67 Numerator events by administrative data 25 2 9 35 6 1 1 8 Rate Status R NA NA R R NA NA R Reported rate 54.35% 33.33% 50.00% 52.24% 13.04% 16.67% 5.56% 11.94%
PrimeWest Health HEDIS® 2019 Page 127
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Minnesota Health Care Programs - Managed Care (MN Care) (3 of 3) - Total
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation Reportable Small Denominator
Small Denominator Reportable Reportable Small
Denominator Small
Denominator Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A A
Eligible member population 46 6 18 67 46 6 18 67 Numerator events by administrative data 25 2 9 35 6 1 1 8 Rate Status R NA NA R R NA NA R Reported rate 54.35% 33.33% 50.00% 52.24% 13.04% 16.67% 5.56% 11.94%
PrimeWest Health HEDIS® 2019 Page 128
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Minnesota Senior Health Options (1 of 3) - 13 - 17 Year Olds
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A A
Eligible member population 0 0 0 0 0 0 0 0 Numerator events by administrative data 0 0 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA NA NA Reported rate
PrimeWest Health HEDIS® 2019 Page 129
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Minnesota Senior Health Options (2 of 3) - 18+ Year Olds
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A A
Eligible member population 14 9 2 25 14 9 2 25 Numerator events by administrative data 3 4 1 8 1 1 0 2 Rate Status NA NA NA NA NA NA NA NA Reported rate 21.43% 44.44% 50.00% 32.00% 7.14% 11.11% 0.00% 8.00%
PrimeWest Health HEDIS® 2019 Page 130
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Minnesota Senior Health Options (3 of 3) - Total
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A A
Eligible member population 14 9 2 25 14 9 2 25 Numerator events by administrative data 3 4 1 8 1 1 0 2 Rate Status NA NA NA NA NA NA NA NA Reported rate 21.43% 44.44% 50.00% 32.00% 7.14% 11.11% 0.00% 8.00%
PrimeWest Health HEDIS® 2019 Page 131
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Special Needs Basic Care - Special Needs Plan (1 of 3) - 13 - 17 Year Olds
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A A
Eligible member population 0 0 0 0 0 0 0 0 Numerator events by administrative data 0 0 0 0 0 0 0 0 Rate Status NA NA NA NA NA NA NA NA Reported rate
PrimeWest Health HEDIS® 2019 Page 132
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Special Needs Basic Care - Special Needs Plan (2 of 3) - 18+ Year Olds
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A A
Eligible member population 4 7 4 14 4 7 4 14 Numerator events by administrative data 2 2 1 5 0 0 0 0 Rate Status NA NA NA NA NA NA NA NA Reported rate 50.00% 28.57% 25.00% 35.71% 0.00% 0.00% 0.00% 0.00%
PrimeWest Health HEDIS® 2019 Page 133
Access/Availability of Care Initiation/Engagement of Alcohol Other Drug Dependence Treatment
Special Needs Basic Care - Special Needs Plan (3 of 3) - Total
Data Elements Initiation AOD Tx Engagement
Alcohol Abuse Opiod Use Other Drug Total Alcohol
Abuse Opiod Use Other Drug Total
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 2018 Data collection methodology (Administrative only) A A A A A A A A
Eligible member population 4 7 4 14 4 7 4 14 Numerator events by administrative data 2 2 1 5 0 0 0 0 Rate Status NA NA NA NA NA NA NA NA Reported rate 50.00% 28.57% 25.00% 35.71% 0.00% 0.00% 0.00% 0.00%
PrimeWest Health HEDIS® 2019 Page 134
Access/Availability of Care Prenatal and Postpartum Care
Commercial Data Elements Timeliness of
Prenatal Care Postpartum
Care
Audit Designation
Measurement Year Data collection methodology (Administrative or Hybrid) Eligible member population 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 Number of oversample records Number of numerator events by administrative data in FSS Administrative rate on MRSS Number of original sample records excluded because of valid data errors Number of employee/dependent medical records excluded Records added from the oversample list Denominator Numerator events by administrative data Numerator events by medical record Rate Status Reported rate
PrimeWest Health HEDIS® 2019 Page 135
Access/Availability of Care Prenatal and Postpartum Care
Minnesota Health Care Programs - Managed Care (Families and Children) Data Elements Timeliness of
Prenatal Care Postpartum
Care
Audit Designation Reportable Reportable
Measurement Year 2018 2018 Data collection methodology (Administrative or Hybrid) H H
Eligible member population 819 819 Number of numerator events by administrative data in eligible population (before exclusions)
417 369
Current year's administrative rate (before exclusions) 50.92% 45.05%
Minimum required sample size (MRSS) or other sample size 411 411
Oversampling rate 10.00% 10.00% Number of oversample records 42 42 Number of numerator events by administrative data in FSS 225 195
Administrative rate on MRSS 54.74% 47.45% Number of original sample records excluded because of valid data errors 2 2
Number of employee/dependent medical records excluded 0 0
Records added from the oversample list 2 2 Denominator 411 411 Numerator events by administrative data 226 195 Numerator events by medical record 119 78 Rate Status R R Reported rate 83.94% 66.42%
PrimeWest Health HEDIS® 2019 Page 136
Access/Availability of Care Prenatal and Postpartum Care
Minnesota Health Care Programs - Managed Care (MN Care) Data Elements Timeliness of
Prenatal Care Postpartum
Care
Audit Designation Small Denominator
Small Denominator
Measurement Year 2018 2018 Data collection methodology (Administrative or Hybrid) H H
Eligible member population 6 6 Number of numerator events by administrative data in eligible population (before exclusions)
5 2
Current year's administrative rate (before exclusions) 83.33% 33.33%
Minimum required sample size (MRSS) or other sample size 6 6
Oversampling rate 0 0 Number of oversample records Number of numerator events by administrative data in FSS 5 2
Administrative rate on MRSS 83.33% 33.33% Number of original sample records excluded because of valid data errors 0 0
Number of employee/dependent medical records excluded 0 0
Records added from the oversample list 0 0 Denominator 6 6 Numerator events by administrative data 5 2 Numerator events by medical record 0 0 Rate Status NA NA Reported rate 83.33% 33.33%
PrimeWest Health HEDIS® 2019 Page 137
Utilization Well Child Visits in the First 15 Months of Life
Commercial Data Elements Zero Visits 1 visit 2 visits 3 visits 4 visits 5 visits 6 or more
visits
Audit Designation
Measurement Year Data Collection Methodology Eligible Member Population Numerator Events by Admin Data Numerator Events by Medical Record Numerator Events bySupplemental Data Rate Satus Reported Rate
PrimeWest Health HEDIS® 2019 Page 138
Utilization Well Child Visits in the First 15 Months of Life
Minnesota Health Care Programs - Managed Care (Families and Children) Data Elements Zero Visits 1 visit 2 visits 3 visits 4 visits 5 visits 6 or more
visits
Audit Designation Reportable Reportable Reportable Reportable Reportable Reportable Reportable
Measurement Year 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H Eligible Member Population 692 692 692 692 692 692 692 Numerator events by admin data in eligible population 42 26 27 42 77 135 343
Currect Year's Administrative Rate 6.07% 3.76% 3.90% 6.07% 11.13% 19.51% 49.57% Minimum Required Sample Size 411 411 411 411 411 411 411 Oversampling Rate 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% Number of Oversample Records 21 21 21 21 21 21 21
Numerator events by admin data in MRSS 22 16 13 24 48 78 210
Administrative rate on MRSS 5.35% 3.89% 3.16% 5.84% 11.68% 18.98% 51.09% Number of Records Excluded Because of Valid Data Errors 0 0 0 0 0 0 0
Number of employee/dependent medical records excluded 0 0 0 0 0 0 0
Additional Records Added from the Oversample List 0 0 0 0 0 0 0
Denominator 411 411 411 411 411 411 411 Numerator Events by Admin Data 18 10 10 17 31 47 214 Numerator Events by Medical Record 0 0 1 4 4 9 46 Numerator Events bySupplemental Data 0 0 0 0 0 0 0 Rate Satus R R R R R R R Reported Rate 4.38% 2.43% 2.68% 5.11% 8.52% 13.63% 63.26%
PrimeWest Health HEDIS® 2019 Page 139
Utilization Well Child Visits in the First 15 Months of Life
Minnesota Health Care Programs - Managed Care (MN Care) Data Elements Zero Visits 1 visit 2 visits 3 visits 4 visits 5 visits 6 or more
visits
Audit Designation Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Small Denominator
Measurement Year 2018 2018 2018 2018 2018 2018 2018 Data Collection Methodology H H H H H H H Eligible Member Population 6 6 6 6 6 6 6 Numerator events by admin data in eligible population 0 0 0 0 1 1 4
Currect Year's Administrative Rate 0.00% 0.00% 0.00% 0.00% 16.67% 16.67% 66.67% Minimum Required Sample Size 6 6 6 6 6 6 6 Oversampling Rate 0 0 0 0 0 0 0 Number of Oversample Records
Numerator events by admin data in MRSS 0 0 0 0 1 1 4
Administrative rate on MRSS 0.00% 0.00% 0.00% 0.00% 16.67% 16.67% 66.67% Number of Records Excluded Because of Valid Data Errors 0 0 0 0 0 0 0
Number of employee/dependent medical records excluded 0 0 0 0 0 0 0
Additional Records Added from the Oversample List 0 0 0 0 0 0 0
Denominator 6 6 6 6 6 6 6 Numerator Events by Admin Data 0 0 0 0 0 1 4 Numerator Events by Medical Record 0 0 0 0 0 1 0 Numerator Events bySupplemental Data 0 0 0 0 0 0 0 Rate Satus NA NA NA NA NA NA NA Reported Rate 0.00% 0.00% 0.00% 0.00% 0.00% 33.33% 66.67%
PrimeWest Health HEDIS® 2019 Page 140
Utilization Well Child Visits in the 3rd, 4th, 5th and 6th Years of Life
Data Elements Commercial MHCP-MC (F&C)
MHCP-MC (MN Care)
Audit Designation Reportable Small Denominator
Measurement Year 2018 2018 Data Collection Methodology H H Eligible Member Population 3236 18 Numerator events by admin data in eligible population 1800 10
Current Year's Admin Rate 55.62% 55.56% Minimum Required Sample Size 411 18 Oversampling Rate 5.00% 0 Number of Oversample Records 21 Numerator events by admin data in MRSS 239 12 Administrative rate on MRSS 58.15% 66.67% Records Excluded because of Valid Data Errors 0 0
Number of employee/dependent medical records excluded 0 0
Records Added from the Oversample List 0 0 Denominator 411 18 Numerator Events by Admin Data 239 12 Numerator Events by Medical Record 7 0 Numerator Events by Supplemental Data 0 0 Rate Status R NA Reported Rate 59.85% 66.67%
PrimeWest Health HEDIS® 2019 Page 141
Utilization Adolescent Well-Care Visits
Data Elements Commercial MHCP-MC (F&C)
MHCP-MC (MN Care)
Audit Designation Reportable Reportable
Measurement Year 2018 2018 Data Collection Methodology H H Eligible Member Population 5560 193 Numerator events by admin data in eligible population 1797 30
Current Year's Admin Rate 32.32% 15.54% Minimum Required Sample Size (MRSS) 411 193 Oversampling Rate 5.00% 0.00% Number of oversample records 21 Numerator events by admin data in MRSS 145 32 Administrative rate on MRSS 35.28% 16.58% Records Excluded because of Valid Data Errors 0 0
Number of employee/dependent medical records excluded 0 0
Records Added from the Oversample List 0 0 Denominator 411 193 Numerator Events by Admin Data 145 32 Numerator Events by Medical Record 69 77 Numerator Events by Supplemental Data 0 0 Rate Status R R Reported Rate 52.07% 56.48%
PrimeWest Health HEDIS® 2019 Page 142
Utilization Identification of Alcohol and Other Drug Services
Commercial (1 of 4) - Alcohol
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth
Number Percent
13-17 Mbr Mnth Number Percent
18-24 Mbr Mnth Number Percent
25-34 Mbr Mnth Number Percent
35-64 Mbr Mnth Number Percent
65+ Mbr Mnth Number Percent
Unknown Mbr Mnth Number
Total Mbr Mnth Number Percent
PrimeWest Health HEDIS® 2019 Page 143
Utilization Identification of Alcohol and Other Drug Services
Commercial (2 of 4) - Opioid
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth
Number Percent
13-17 Mbr Mnth Number Percent
18-24 Mbr Mnth Number Percent
25-34 Mbr Mnth Number Percent
35-64 Mbr Mnth Number Percent
65+ Mbr Mnth Number Percent
Unknown Mbr Mnth Number
Total Mbr Mnth Number Percent
PrimeWest Health HEDIS® 2019 Page 144
Utilization Identification of Alcohol and Other Drug Services
Commercial (3 of 4) - Other
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth
Number Percent
13-17 Mbr Mnth Number Percent
18-24 Mbr Mnth Number Percent
25-34 Mbr Mnth Number Percent
35-64 Mbr Mnth Number Percent
65+ Mbr Mnth Number Percent
Unknown Mbr Mnth Number
Total Mbr Mnth Number Percent
PrimeWest Health HEDIS® 2019 Page 145
Utilization Identification of Alcohol and Other Drug Services
Commercial (4 of 4) - Total
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth
Number Percent
13-17 Mbr Mnth Number Percent
18-24 Mbr Mnth Number Percent
25-34 Mbr Mnth Number Percent
35-64 Mbr Mnth Number Percent
65+ Mbr Mnth Number Percent
Unknown Mbr Mnth Number
Total Mbr Mnth Number Percent
PrimeWest Health HEDIS® 2019 Page 146
Utilization Identification of Alcohol and Other Drug Services
Medicare Advantage (1 of 4) - Alcohol
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth
Number Percent
13-17 Mbr Mnth Number Percent
18-24 Mbr Mnth Number Percent
25-34 Mbr Mnth Number Percent
35-64 Mbr Mnth Number Percent
65+ Mbr Mnth Number Percent
Unknown Mbr Mnth Number
Total Mbr Mnth Number Percent
PrimeWest Health HEDIS® 2019 Page 147
Utilization Identification of Alcohol and Other Drug Services
Medicare Advantage (2 of 4) - Opioid
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth
Number Percent
13-17 Mbr Mnth Number Percent
18-24 Mbr Mnth Number Percent
25-34 Mbr Mnth Number Percent
35-64 Mbr Mnth Number Percent
65+ Mbr Mnth Number Percent
Unknown Mbr Mnth Number
Total Mbr Mnth Number Percent
PrimeWest Health HEDIS® 2019 Page 148
Utilization Identification of Alcohol and Other Drug Services
Medicare Advantage (3 of 4) - Other
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth
Number Percent
13-17 Mbr Mnth Number Percent
18-24 Mbr Mnth Number Percent
25-34 Mbr Mnth Number Percent
35-64 Mbr Mnth Number Percent
65+ Mbr Mnth Number Percent
Unknown Mbr Mnth Number
Total Mbr Mnth Number Percent
PrimeWest Health HEDIS® 2019 Page 149
Utilization Identification of Alcohol and Other Drug Services
Medicare Advantage (4 of 4) - Total
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth
Number Percent
13-17 Mbr Mnth Number Percent
18-24 Mbr Mnth Number Percent
25-34 Mbr Mnth Number Percent
35-64 Mbr Mnth Number Percent
65+ Mbr Mnth Number Percent
Unknown Mbr Mnth Number
Total Mbr Mnth Number Percent
PrimeWest Health HEDIS® 2019 Page 150
Utilization Identification of Alcohol and Other Drug Services
Minnesota Health Care Programs - Managed Care (Families and Children) (1 of 4) - Alcohol
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095
Number 1 0 1 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0 Percent 0.01% 0.00% 0.01% 0.01% 0.00% 0.01% 0.00% 0.00% 0.00% 0.01% 0.00% 0.01% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
13-17 Mbr Mnth 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 Number 24 21 45 6 3 9 0 0 0 13 14 27 4 5 9 3 0 3 Percent 1.13% 1.00% 1.07% 0.28% 0.14% 0.21% 0.00% 0.00% 0.00% 0.61% 0.66% 0.64% 0.19% 0.24% 0.21% 0.14% 0.00% 0.07%
18-24 Mbr Mnth 16517 25653 42170 16517 25653 42170 16517 25653 42170 16517 25653 42170 16517 25653 42170 16517 25653 42170 Number 51 55 106 6 8 14 4 2 6 25 36 61 25 14 39 2 6 8 Percent 3.71% 2.57% 3.02% 0.44% 0.37% 0.40% 0.29% 0.09% 0.17% 1.82% 1.68% 1.74% 1.82% 0.65% 1.11% 0.15% 0.28% 0.23%
25-34 Mbr Mnth 19943 36789 56732 19943 36789 56732 19943 36789 56732 19943 36789 56732 19943 36789 56732 19943 36789 56732 Number 162 164 326 25 29 54 5 11 16 132 115 247 29 46 75 14 12 26 Percent 9.75% 5.35% 6.90% 1.50% 0.95% 1.14% 0.30% 0.36% 0.34% 7.94% 3.75% 5.22% 1.74% 1.50% 1.59% 0.84% 0.39% 0.55%
35-64 Mbr Mnth 40870 50618 91488 40870 50618 91488 40870 50618 91488 40870 50618 91488 40870 50618 91488 40870 50618 91488 Number 318 267 585 73 61 134 14 12 26 249 197 446 101 78 179 25 10 35 Percent 9.34% 6.33% 7.67% 2.14% 1.45% 1.76% 0.41% 0.28% 0.34% 7.31% 4.67% 5.85% 2.97% 1.85% 2.35% 0.73% 0.24% 0.46%
65+ Mbr Mnth 8 6 14 8 6 14 8 6 14 8 6 14 8 6 14 8 6 14 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 Number 556 507 1063 111 101 212 23 25 48 420 362 782 159 143 302 44 28 72 Percent 3.49% 2.74% 3.09% 0.70% 0.55% 0.62% 0.14% 0.14% 0.14% 2.63% 1.96% 2.27% 1.00% 0.77% 0.88% 0.28% 0.15% 0.21%
PrimeWest Health HEDIS® 2019 Page 151
Utilization Identification of Alcohol and Other Drug Services
Minnesota Health Care Programs - Managed Care (Families and Children) (2 of 4) - Opioid
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095
Number 2 1 3 2 1 3 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.03% 0.01% 0.02% 0.03% 0.01% 0.02% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
13-17 Mbr Mnth 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 Number 2 0 2 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 Percent 0.09% 0.00% 0.05% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.09% 0.00% 0.05% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
18-24 Mbr Mnth 16517 25653 42170 16517 25653 42170 16517 25653 42170 16517 25653 42170 16517 25653 42170 16517 25653 42170 Number 17 37 54 2 7 9 0 1 1 16 30 46 3 6 9 1 4 5 Percent 1.24% 1.73% 1.54% 0.15% 0.33% 0.26% 0.00% 0.05% 0.03% 1.16% 1.40% 1.31% 0.22% 0.28% 0.26% 0.07% 0.19% 0.14%
25-34 Mbr Mnth 19943 36789 56732 19943 36789 56732 19943 36789 56732 19943 36789 56732 19943 36789 56732 19943 36789 56732 Number 84 135 219 7 33 40 3 4 7 74 114 188 10 12 22 4 11 15 Percent 5.05% 4.40% 4.63% 0.42% 1.08% 0.85% 0.18% 0.13% 0.15% 4.45% 3.72% 3.98% 0.60% 0.39% 0.47% 0.24% 0.36% 0.32%
35-64 Mbr Mnth 40870 50618 91488 40870 50618 91488 40870 50618 91488 40870 50618 91488 40870 50618 91488 40870 50618 91488 Number 88 149 237 5 11 16 0 2 2 79 133 212 9 16 25 0 6 6 Percent 2.58% 3.53% 3.11% 0.15% 0.26% 0.21% 0.00% 0.05% 0.03% 2.32% 3.15% 2.78% 0.26% 0.38% 0.33% 0.00% 0.14% 0.08%
65+ Mbr Mnth 8 6 14 8 6 14 8 6 14 8 6 14 8 6 14 8 6 14 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 Number 193 322 515 16 52 68 3 7 10 171 277 448 22 34 56 5 21 26 Percent 1.21% 1.74% 1.50% 0.10% 0.28% 0.20% 0.02% 0.04% 0.03% 1.07% 1.50% 1.30% 0.14% 0.18% 0.16% 0.03% 0.11% 0.08%
PrimeWest Health HEDIS® 2019 Page 152
Utilization Identification of Alcohol and Other Drug Services
Minnesota Health Care Programs - Managed Care (Families and Children) (3 of 4) - Other
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095
Number 3 5 8 2 2 4 0 0 0 2 1 3 0 1 1 0 1 1 Percent 0.04% 0.07% 0.06% 0.03% 0.03% 0.03% 0.00% 0.00% 0.00% 0.03% 0.01% 0.02% 0.00% 0.01% 0.01% 0.00% 0.01% 0.01%
13-17 Mbr Mnth 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 Number 66 54 120 13 13 26 1 1 2 52 35 87 13 8 21 5 4 9 Percent 3.12% 2.56% 2.84% 0.61% 0.62% 0.62% 0.05% 0.05% 0.05% 2.46% 1.66% 2.06% 0.61% 0.38% 0.50% 0.24% 0.19% 0.21%
18-24 Mbr Mnth 16517 25653 42170 16517 25653 42170 16517 25653 42170 16517 25653 42170 16517 25653 42170 16517 25653 42170 Number 114 174 288 14 53 67 5 5 10 85 109 194 33 46 79 9 17 26 Percent 8.28% 8.14% 8.20% 1.02% 2.48% 1.91% 0.36% 0.23% 0.28% 6.18% 5.10% 5.52% 2.40% 2.15% 2.25% 0.65% 0.80% 0.74%
25-34 Mbr Mnth 19943 36789 56732 19943 36789 56732 19943 36789 56732 19943 36789 56732 19943 36789 56732 19943 36789 56732 Number 236 365 601 39 99 138 17 18 35 176 238 414 57 79 136 22 40 62 Percent 14.20% 11.91% 12.71% 2.35% 3.23% 2.92% 1.02% 0.59% 0.74% 10.59% 7.76% 8.76% 3.43% 2.58% 2.88% 1.32% 1.30% 1.31%
35-64 Mbr Mnth 40870 50618 91488 40870 50618 91488 40870 50618 91488 40870 50618 91488 40870 50618 91488 40870 50618 91488 Number 244 245 489 55 52 107 9 7 16 173 176 349 49 62 111 15 19 34 Percent 7.16% 5.81% 6.41% 1.61% 1.23% 1.40% 0.26% 0.17% 0.21% 5.08% 4.17% 4.58% 1.44% 1.47% 1.46% 0.44% 0.45% 0.45%
65+ Mbr Mnth 8 6 14 8 6 14 8 6 14 8 6 14 8 6 14 8 6 14 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 Number 663 843 1506 123 219 342 32 31 63 488 559 1047 152 196 348 51 81 132 Percent 4.16% 4.56% 4.37% 0.77% 1.19% 0.99% 0.20% 0.17% 0.18% 3.06% 3.03% 3.04% 0.95% 1.06% 1.01% 0.32% 0.44% 0.38%
PrimeWest Health HEDIS® 2019 Page 153
Utilization Identification of Alcohol and Other Drug Services
Minnesota Health Care Programs - Managed Care (Families and Children) (4 of 4) - Total
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095
Number 4 5 9 3 2 5 0 0 0 2 1 3 0 1 1 0 1 1 Percent 0.05% 0.07% 0.06% 0.04% 0.03% 0.03% 0.00% 0.00% 0.00% 0.03% 0.01% 0.02% 0.00% 0.01% 0.01% 0.00% 0.01% 0.01%
13-17 Mbr Mnth 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 Number 82 71 153 15 14 29 1 1 2 63 48 111 17 12 29 5 4 9 Percent 3.88% 3.37% 3.62% 0.71% 0.66% 0.69% 0.05% 0.05% 0.05% 2.98% 2.28% 2.63% 0.80% 0.57% 0.69% 0.24% 0.19% 0.21%
18-24 Mbr Mnth 16517 25653 42170 16517 25653 42170 16517 25653 42170 16517 25653 42170 16517 25653 42170 16517 25653 42170 Number 160 224 384 17 61 78 7 6 13 118 155 273 56 60 116 11 20 31 Percent 11.62% 10.48% 10.93% 1.24% 2.85% 2.22% 0.51% 0.28% 0.37% 8.57% 7.25% 7.77% 4.07% 2.81% 3.30% 0.80% 0.94% 0.88%
25-34 Mbr Mnth 19943 36789 56732 19943 36789 56732 19943 36789 56732 19943 36789 56732 19943 36789 56732 19943 36789 56732 Number 398 545 943 52 135 187 21 25 46 344 418 762 89 120 209 30 49 79 Percent 23.95% 17.78% 19.95% 3.13% 4.40% 3.96% 1.26% 0.82% 0.97% 20.70% 13.63% 16.12% 5.36% 3.91% 4.42% 1.81% 1.60% 1.67%
35-64 Mbr Mnth 40870 50618 91488 40870 50618 91488 40870 50618 91488 40870 50618 91488 40870 50618 91488 40870 50618 91488 Number 564 563 1127 113 108 221 20 18 38 460 452 912 146 139 285 37 32 69 Percent 16.56% 13.35% 14.78% 3.32% 2.56% 2.90% 0.59% 0.43% 0.50% 13.51% 10.72% 11.96% 4.29% 3.30% 3.74% 1.09% 0.76% 0.91%
65+ Mbr Mnth 8 6 14 8 6 14 8 6 14 8 6 14 8 6 14 8 6 14 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 Number 1208 1408 2616 200 320 520 49 50 99 987 1074 2061 308 332 640 83 106 189 Percent 7.57% 7.62% 7.60% 1.25% 1.73% 1.51% 0.31% 0.27% 0.29% 6.19% 5.81% 5.99% 1.93% 1.80% 1.86% 0.52% 0.57% 0.55%
PrimeWest Health HEDIS® 2019 Page 154
Utilization Identification of Alcohol and Other Drug Services
Minnesota Health Care Programs - MHCP-MC (MN Care) (1 of 4) - Alcohol
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 210 292 502 210 292 502 210 292 502 210 292 502 210 292 502 210 292 502
Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
13-17 Mbr Mnth 70 50 120 70 50 120 70 50 120 70 50 120 70 50 120 70 50 120 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
18-24 Mbr Mnth 1882 2529 4411 1882 2529 4411 1882 2529 4411 1882 2529 4411 1882 2529 4411 1882 2529 4411 Number 6 6 12 1 1 2 0 0 0 4 3 7 1 2 3 0 1 1 Percent 3.83% 2.85% 3.26% 0.64% 0.47% 0.54% 0.00% 0.00% 0.00% 2.55% 1.42% 1.90% 0.64% 0.95% 0.82% 0.00% 0.47% 0.27%
25-34 Mbr Mnth 3133 4668 7801 3133 4668 7801 3133 4668 7801 3133 4668 7801 3133 4668 7801 3133 4668 7801 Number 10 11 21 3 3 6 0 1 1 8 9 17 2 3 5 0 0 0 Percent 3.83% 2.83% 3.23% 1.15% 0.77% 0.92% 0.00% 0.26% 0.15% 3.06% 2.31% 2.62% 0.77% 0.77% 0.77% 0.00% 0.00% 0.00%
35-64 Mbr Mnth 10236 13198 23434 10236 13198 23434 10236 13198 23434 10236 13198 23434 10236 13198 23434 10236 13198 23434 Number 44 27 71 8 7 15 0 0 0 35 19 54 14 4 18 3 0 3 Percent 5.16% 2.45% 3.64% 0.94% 0.64% 0.77% 0.00% 0.00% 0.00% 4.10% 1.73% 2.77% 1.64% 0.36% 0.92% 0.35% 0.00% 0.15%
65+ Mbr Mnth 95 94 189 95 94 189 95 94 189 95 94 189 95 94 189 95 94 189 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 Number 60 44 104 12 11 23 0 1 1 47 31 78 17 9 26 3 1 4 Percent 4.61% 2.53% 3.42% 0.92% 0.63% 0.76% 0.00% 0.06% 0.03% 3.61% 1.79% 2.57% 1.31% 0.52% 0.86% 0.23% 0.06% 0.13%
PrimeWest Health HEDIS® 2019 Page 155
Utilization Identification of Alcohol and Other Drug Services
Minnesota Health Care Programs - MHCP-MC (MN Care) (2 of 4) - Opioid
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 210 292 502 210 292 502 210 292 502 210 292 502 210 292 502 210 292 502
Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
13-17 Mbr Mnth 70 50 120 70 50 120 70 50 120 70 50 120 70 50 120 70 50 120 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
18-24 Mbr Mnth 1882 2529 4411 1882 2529 4411 1882 2529 4411 1882 2529 4411 1882 2529 4411 1882 2529 4411 Number 0 2 2 0 0 0 0 0 0 0 2 2 0 0 0 0 0 0 Percent 0.00% 0.95% 0.54% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.95% 0.54% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
25-34 Mbr Mnth 3133 4668 7801 3133 4668 7801 3133 4668 7801 3133 4668 7801 3133 4668 7801 3133 4668 7801 Number 3 6 9 0 0 0 0 0 0 3 6 9 0 0 0 0 0 0 Percent 1.15% 1.54% 1.38% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 1.15% 1.54% 1.38% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
35-64 Mbr Mnth 10236 13198 23434 10236 13198 23434 10236 13198 23434 10236 13198 23434 10236 13198 23434 10236 13198 23434 Number 6 16 22 0 1 1 0 0 0 5 14 19 1 2 3 0 1 1 Percent 0.70% 1.45% 1.13% 0.00% 0.09% 0.05% 0.00% 0.00% 0.00% 0.59% 1.27% 0.97% 0.12% 0.18% 0.15% 0.00% 0.09% 0.05%
65+ Mbr Mnth 95 94 189 95 94 189 95 94 189 95 94 189 95 94 189 95 94 189 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 Number 9 24 33 0 1 1 0 0 0 8 22 30 1 2 3 0 1 1 Percent 0.69% 1.38% 1.09% 0.00% 0.06% 0.03% 0.00% 0.00% 0.00% 0.61% 1.27% 0.99% 0.08% 0.12% 0.10% 0.00% 0.06% 0.03%
PrimeWest Health HEDIS® 2019 Page 156
Utilization Identification of Alcohol and Other Drug Services
Minnesota Health Care Programs - MHCP-MC (MN Care) (3 of 4) - Other
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 210 292 502 210 292 502 210 292 502 210 292 502 210 292 502 210 292 502
Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
13-17 Mbr Mnth 70 50 120 70 50 120 70 50 120 70 50 120 70 50 120 70 50 120 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
18-24 Mbr Mnth 1882 2529 4411 1882 2529 4411 1882 2529 4411 1882 2529 4411 1882 2529 4411 1882 2529 4411 Number 12 6 18 1 1 2 0 0 0 10 3 13 1 3 4 3 0 3 Percent 7.65% 2.85% 4.90% 0.64% 0.47% 0.54% 0.00% 0.00% 0.00% 6.38% 1.42% 3.54% 0.64% 1.42% 1.09% 1.91% 0.00% 0.82%
25-34 Mbr Mnth 3133 4668 7801 3133 4668 7801 3133 4668 7801 3133 4668 7801 3133 4668 7801 3133 4668 7801 Number 7 6 13 1 0 1 0 1 1 7 3 10 0 2 2 0 1 1 Percent 2.68% 1.54% 2.00% 0.38% 0.00% 0.15% 0.00% 0.26% 0.15% 2.68% 0.77% 1.54% 0.00% 0.51% 0.31% 0.00% 0.26% 0.15%
35-64 Mbr Mnth 10236 13198 23434 10236 13198 23434 10236 13198 23434 10236 13198 23434 10236 13198 23434 10236 13198 23434 Number 21 19 40 8 6 14 0 0 0 12 14 26 4 1 5 1 3 4 Percent 2.46% 1.73% 2.05% 0.94% 0.55% 0.72% 0.00% 0.00% 0.00% 1.41% 1.27% 1.33% 0.47% 0.09% 0.26% 0.12% 0.27% 0.20%
65+ Mbr Mnth 95 94 189 95 94 189 95 94 189 95 94 189 95 94 189 95 94 189 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 Number 40 31 71 10 7 17 0 1 1 29 20 49 5 6 11 4 4 8 Percent 3.07% 1.79% 2.34% 0.77% 0.40% 0.56% 0.00% 0.06% 0.03% 2.23% 1.15% 1.61% 0.38% 0.35% 0.36% 0.31% 0.23% 0.26%
PrimeWest Health HEDIS® 2019 Page 157
Utilization Identification of Alcohol and Other Drug Services
Minnesota Health Care Programs - MHCP-MC (MN Care) (4 of 4) - Total
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 210 292 502 210 292 502 210 292 502 210 292 502 210 292 502 210 292 502
Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
13-17 Mbr Mnth 70 50 120 70 50 120 70 50 120 70 50 120 70 50 120 70 50 120 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
18-24 Mbr Mnth 1882 2529 4411 1882 2529 4411 1882 2529 4411 1882 2529 4411 1882 2529 4411 1882 2529 4411 Number 16 12 28 2 2 4 0 0 0 14 8 22 2 4 6 3 1 4 Percent 10.20% 5.69% 7.62% 1.28% 0.95% 1.09% 0.00% 0.00% 0.00% 8.93% 3.80% 5.99% 1.28% 1.90% 1.63% 1.91% 0.47% 1.09%
25-34 Mbr Mnth 3133 4668 7801 3133 4668 7801 3133 4668 7801 3133 4668 7801 3133 4668 7801 3133 4668 7801 Number 17 16 33 3 3 6 0 1 1 15 15 30 2 3 5 0 1 1 Percent 6.51% 4.11% 5.08% 1.15% 0.77% 0.92% 0.00% 0.26% 0.15% 5.75% 3.86% 4.61% 0.77% 0.77% 0.77% 0.00% 0.26% 0.15%
35-64 Mbr Mnth 10236 13198 23434 10236 13198 23434 10236 13198 23434 10236 13198 23434 10236 13198 23434 10236 13198 23434 Number 64 50 114 14 11 25 0 0 0 49 39 88 19 7 26 3 4 7 Percent 7.50% 4.55% 5.84% 1.64% 1.00% 1.28% 0.00% 0.00% 0.00% 5.74% 3.55% 4.51% 2.23% 0.64% 1.33% 0.35% 0.36% 0.36%
65+ Mbr Mnth 95 94 189 95 94 189 95 94 189 95 94 189 95 94 189 95 94 189 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 Number 97 78 175 19 16 35 0 1 1 78 62 140 23 14 37 6 6 12 Percent 7.45% 4.49% 5.76% 1.46% 0.92% 1.15% 0.00% 0.06% 0.03% 5.99% 3.57% 4.61% 1.77% 0.81% 1.22% 0.46% 0.35% 0.39%
PrimeWest Health HEDIS® 2019 Page 158
Utilization Identification of Alcohol and Other Drug Services
Minnesota Senior Health Options (1 of 4) - Alcohol
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
13-17 Mbr Mnth 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
18-24 Mbr Mnth 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
25-34 Mbr Mnth 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
35-64 Mbr Mnth 5 7 12 5 7 12 5 7 12 5 7 12 5 7 12 5 7 12 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
65+ Mbr Mnth 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 Number 23 16 39 9 7 16 0 0 0 15 9 24 4 1 5 1 0 1 Percent 4.53% 1.27% 2.21% 1.77% 0.56% 0.91% 0.00% 0.00% 0.00% 2.96% 0.72% 1.36% 0.79% 0.08% 0.28% 0.20% 0.00% 0.06%
Unknown Mbr Mnth 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
Total Mbr Mnth 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 Number 23 16 39 9 7 16 0 0 0 15 9 24 4 1 5 1 0 1 Percent 4.53% 1.27% 2.21% 1.77% 0.56% 0.91% 0.00% 0.00% 0.00% 2.95% 0.72% 1.36% 0.79% 0.08% 0.28% 0.20% 0.00% 0.06%
PrimeWest Health HEDIS® 2019 Page 159
Utilization Identification of Alcohol and Other Drug Services
Minnesota Senior Health Options (2 of 4) - Opioid
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 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 Percent
13-17 Mbr Mnth 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 Percent
18-24 Mbr Mnth 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 Percent
25-34 Mbr Mnth 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 Percent
35-64 Mbr Mnth 5 7 12 5 7 12 5 7 12 5 7 12 5 7 12 5 7 12 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
65+ Mbr Mnth 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 Number 8 20 28 2 3 5 0 0 0 6 16 22 0 3 3 0 0 0 Percent 1.58% 1.59% 1.59% 0.39% 0.24% 0.28% 0.00% 0.00% 0.00% 1.18% 1.27% 1.25% 0.00% 0.24% 0.17% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 Number 8 20 28 2 3 5 0 0 0 6 16 22 0 3 3 0 0 0 Percent 1.58% 1.59% 1.59% 0.39% 0.24% 0.28% 0.00% 0.00% 0.00% 1.18% 1.27% 1.25% 0.00% 0.24% 0.17% 0.00% 0.00% 0.00%
PrimeWest Health HEDIS® 2019 Page 160
Utilization Identification of Alcohol and Other Drug Services
Minnesota Senior Health Options (3 of 4) - Other
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 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 Percent
13-17 Mbr Mnth 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 Percent
18-24 Mbr Mnth 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 Percent
25-34 Mbr Mnth 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 Percent
35-64 Mbr Mnth 5 7 12 5 7 12 5 7 12 5 7 12 5 7 12 5 7 12 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
65+ Mbr Mnth 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 Number 4 5 9 2 3 5 0 0 0 3 2 5 0 0 0 0 0 0 Percent 0.79% 0.40% 0.51% 0.39% 0.24% 0.28% 0.00% 0.00% 0.00% 0.59% 0.16% 0.28% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 Number 4 5 9 2 3 5 0 0 0 3 2 5 0 0 0 0 0 0 Percent 0.79% 0.40% 0.51% 0.39% 0.24% 0.28% 0.00% 0.00% 0.00% 0.59% 0.16% 0.28% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
PrimeWest Health HEDIS® 2019 Page 161
Utilization Identification of Alcohol and Other Drug Services
Minnesota Senior Health Options (4 of 4) - Total
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
13-17 Mbr Mnth 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
18-24 Mbr Mnth 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
25-34 Mbr Mnth 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
35-64 Mbr Mnth 5 7 12 5 7 12 5 7 12 5 7 12 5 7 12 5 7 12 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
65+ Mbr Mnth 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 Number 32 37 69 13 12 25 0 0 0 22 25 47 4 3 7 1 0 1 Percent 6.31% 2.94% 3.91% 2.56% 0.95% 1.42% 0.00% 0.00% 0.00% 4.34% 1.99% 2.66% 0.79% 0.24% 0.40% 0.20% 0.00% 0.06%
Unknown Mbr Mnth 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
Total Mbr Mnth 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 Number 32 37 69 13 12 25 0 0 0 22 25 47 4 3 7 1 0 1 Percent 6.30% 2.94% 3.91% 2.56% 0.95% 1.42% 0.00% 0.00% 0.00% 4.33% 1.99% 2.66% 0.79% 0.24% 0.40% 0.20% 0.00% 0.06%
PrimeWest Health HEDIS® 2019 Page 162
Utilization Identification of Alcohol and Other Drug Services
Special Needs Basic Care - Special Needs Plan (1 of 4) - Alcohol
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 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 Percent
13-17 Mbr Mnth 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 Percent
18-24 Mbr Mnth 14 12 26 14 12 26 14 12 26 14 12 26 14 12 26 14 12 26 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
25-34 Mbr Mnth 118 44 162 118 44 162 118 44 162 118 44 162 118 44 162 118 44 162 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
35-64 Mbr Mnth 841 1248 2089 841 1248 2089 841 1248 2089 841 1248 2089 841 1248 2089 841 1248 2089 Number 8 8 16 0 1 1 0 0 0 7 7 14 0 3 3 1 0 1 Percent 11.41% 7.69% 9.19% 0.00% 0.96% 0.57% 0.00% 0.00% 0.00% 9.99% 6.73% 8.04% 0.00% 2.88% 1.72% 1.43% 0.00% 0.57%
65+ Mbr Mnth 9 3 12 9 3 12 9 3 12 9 3 12 9 3 12 9 3 12 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 Number 8 8 16 0 1 1 0 0 0 7 7 14 0 3 3 1 0 1 Percent 9.78% 7.35% 8.39% 0.00% 0.92% 0.52% 0.00% 0.00% 0.00% 8.55% 6.43% 7.34% 0.00% 2.75% 1.57% 1.22% 0.00% 0.52%
PrimeWest Health HEDIS® 2019 Page 163
Utilization Identification of Alcohol and Other Drug Services
Special Needs Basic Care - Special Needs Plan (2 of 4) - Opioid
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 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 Percent
13-17 Mbr Mnth 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 Percent
18-24 Mbr Mnth 14 12 26 14 12 26 14 12 26 14 12 26 14 12 26 14 12 26 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
25-34 Mbr Mnth 118 44 162 118 44 162 118 44 162 118 44 162 118 44 162 118 44 162 Number 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 Percent 10.17% 0.00% 7.41% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 10.17% 0.00% 7.41% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
35-64 Mbr Mnth 841 1248 2089 841 1248 2089 841 1248 2089 841 1248 2089 841 1248 2089 841 1248 2089 Number 3 5 8 1 0 1 0 0 0 2 5 7 0 0 0 0 0 0 Percent 4.28% 4.81% 4.60% 1.43% 0.00% 0.57% 0.00% 0.00% 0.00% 2.85% 4.81% 4.02% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
65+ Mbr Mnth 9 3 12 9 3 12 9 3 12 9 3 12 9 3 12 9 3 12 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 Number 4 5 9 1 0 1 0 0 0 3 5 8 0 0 0 0 0 0 Percent 4.89% 4.59% 4.72% 1.22% 0.00% 0.52% 0.00% 0.00% 0.00% 3.67% 4.59% 4.19% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
PrimeWest Health HEDIS® 2019 Page 164
Utilization Identification of Alcohol and Other Drug Services
Special Needs Basic Care - Special Needs Plan (3 of 4) - Other
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 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 Percent
13-17 Mbr Mnth 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 Percent
18-24 Mbr Mnth 14 12 26 14 12 26 14 12 26 14 12 26 14 12 26 14 12 26 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
25-34 Mbr Mnth 118 44 162 118 44 162 118 44 162 118 44 162 118 44 162 118 44 162 Number 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 Percent 10.17% 0.00% 7.41% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 10.17% 0.00% 7.41% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
35-64 Mbr Mnth 841 1248 2089 841 1248 2089 841 1248 2089 841 1248 2089 841 1248 2089 841 1248 2089 Number 6 6 12 1 1 2 0 0 0 4 6 10 1 2 3 0 0 0 Percent 8.56% 5.77% 6.89% 1.43% 0.96% 1.15% 0.00% 0.00% 0.00% 5.71% 5.77% 5.74% 1.43% 1.92% 1.72% 0.00% 0.00% 0.00%
65+ Mbr Mnth 9 3 12 9 3 12 9 3 12 9 3 12 9 3 12 9 3 12 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 Number 7 6 13 1 1 2 0 0 0 5 6 11 1 2 3 0 0 0 Percent 8.55% 5.51% 6.82% 1.22% 0.92% 1.05% 0.00% 0.00% 0.00% 6.11% 5.51% 5.77% 1.22% 1.84% 1.57% 0.00% 0.00% 0.00%
PrimeWest Health HEDIS® 2019 Page 165
Utilization Identification of Alcohol and Other Drug Services
Special Needs Basic Care - Special Needs Plan (4 of 4) - Total
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 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 Percent
13-17 Mbr Mnth 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 Percent
18-24 Mbr Mnth 14 12 26 14 12 26 14 12 26 14 12 26 14 12 26 14 12 26 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
25-34 Mbr Mnth 118 44 162 118 44 162 118 44 162 118 44 162 118 44 162 118 44 162 Number 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 Percent 10.17% 0.00% 7.41% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 10.17% 0.00% 7.41% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
35-64 Mbr Mnth 841 1248 2089 841 1248 2089 841 1248 2089 841 1248 2089 841 1248 2089 841 1248 2089 Number 14 18 32 2 2 4 0 0 0 12 17 29 1 5 6 1 0 1 Percent 19.98% 17.31% 18.38% 2.85% 1.92% 2.30% 0.00% 0.00% 0.00% 17.12% 16.35% 16.66% 1.43% 4.81% 3.45% 1.43% 0.00% 0.57%
65+ Mbr Mnth 9 3 12 9 3 12 9 3 12 9 3 12 9 3 12 9 3 12 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 Number 15 18 33 2 2 4 0 0 0 13 17 30 1 5 6 1 0 1 Percent 18.33% 16.53% 17.30% 2.44% 1.84% 2.10% 0.00% 0.00% 0.00% 15.89% 15.61% 15.73% 1.22% 4.59% 3.15% 1.22% 0.00% 0.52%
PrimeWest Health HEDIS® 2019 Page 166
Utilization Identification of Alcohol and Other Drug Services
Special Needs Basic Care - Non-Special Needs Plan (1 of 4) - Alcohol
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 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 Percent
13-17 Mbr Mnth 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 Percent
18-24 Mbr Mnth 942 588 1530 942 588 1530 942 588 1530 942 588 1530 942 588 1530 942 588 1530 Number 4 1 5 0 0 0 0 0 0 4 0 4 1 1 2 0 0 0 Percent 5.10% 2.04% 3.92% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 5.10% 0.00% 3.14% 1.27% 2.04% 1.57% 0.00% 0.00% 0.00%
25-34 Mbr Mnth 810 741 1551 810 741 1551 810 741 1551 810 741 1551 810 741 1551 810 741 1551 Number 9 5 14 3 2 5 0 1 1 6 1 7 2 1 3 2 0 2 Percent 13.33% 8.10% 10.83% 4.44% 3.24% 3.87% 0.00% 1.62% 0.77% 8.89% 1.62% 5.42% 2.96% 1.62% 2.32% 2.96% 0.00% 1.55%
35-64 Mbr Mnth 3033 3660 6693 3033 3660 6693 3033 3660 6693 3033 3660 6693 3033 3660 6693 3033 3660 6693 Number 38 34 72 16 16 32 2 1 3 25 23 48 5 13 18 1 3 4 Percent 15.03% 11.15% 12.91% 6.33% 5.25% 5.74% 0.79% 0.33% 0.54% 9.89% 7.54% 8.61% 1.98% 4.26% 3.23% 0.40% 0.98% 0.72%
65+ Mbr Mnth 1 5 6 1 5 6 1 5 6 1 5 6 1 5 6 1 5 6 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 Number 51 40 91 19 18 37 2 2 4 35 24 59 8 15 23 3 3 6 Percent 12.79% 9.61% 11.17% 4.76% 4.33% 4.54% 0.50% 0.48% 0.49% 8.78% 5.77% 7.24% 2.01% 3.60% 2.82% 0.75% 0.72% 0.74%
PrimeWest Health HEDIS® 2019 Page 167
Utilization Identification of Alcohol and Other Drug Services
Special Needs Basic Care - Non-Special Needs Plan (2 of 4) - Opioid
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 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 Percent
13-17 Mbr Mnth 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 Percent
18-24 Mbr Mnth 942 588 1530 942 588 1530 942 588 1530 942 588 1530 942 588 1530 942 588 1530 Number 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 Percent 1.27% 0.00% 0.78% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 1.27% 0.00% 0.78% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
25-34 Mbr Mnth 810 741 1551 810 741 1551 810 741 1551 810 741 1551 810 741 1551 810 741 1551 Number 3 4 7 1 1 2 0 2 2 2 2 4 0 1 1 0 0 0 Percent 4.44% 6.48% 5.42% 1.48% 1.62% 1.55% 0.00% 3.24% 1.55% 2.96% 3.24% 3.09% 0.00% 1.62% 0.77% 0.00% 0.00% 0.00%
35-64 Mbr Mnth 3033 3660 6693 3033 3660 6693 3033 3660 6693 3033 3660 6693 3033 3660 6693 3033 3660 6693 Number 16 21 37 0 5 5 2 0 2 13 17 30 4 3 7 1 1 2 Percent 6.33% 6.89% 6.63% 0.00% 1.64% 0.90% 0.79% 0.00% 0.36% 5.14% 5.57% 5.38% 1.58% 0.98% 1.26% 0.40% 0.33% 0.36%
65+ Mbr Mnth 1 5 6 1 5 6 1 5 6 1 5 6 1 5 6 1 5 6 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 Number 20 25 45 1 6 7 2 2 4 16 19 35 4 4 8 1 1 2 Percent 5.01% 6.01% 5.52% 0.25% 1.44% 0.86% 0.50% 0.48% 0.49% 4.01% 4.57% 4.29% 1.00% 0.96% 0.98% 0.25% 0.24% 0.25%
PrimeWest Health HEDIS® 2019 Page 168
Utilization Identification of Alcohol and Other Drug Services
Special Needs Basic Care - Non-Special Needs Plan (3 of 4) - Other
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 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 Percent
13-17 Mbr Mnth 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 Percent
18-24 Mbr Mnth 942 588 1530 942 588 1530 942 588 1530 942 588 1530 942 588 1530 942 588 1530 Number 8 1 9 1 0 1 0 0 0 4 1 5 3 0 3 0 0 0 Percent 10.19% 2.04% 7.06% 1.27% 0.00% 0.78% 0.00% 0.00% 0.00% 5.10% 2.04% 3.92% 3.82% 0.00% 2.35% 0.00% 0.00% 0.00%
25-34 Mbr Mnth 810 741 1551 810 741 1551 810 741 1551 810 741 1551 810 741 1551 810 741 1551 Number 16 13 29 7 3 10 0 2 2 11 8 19 2 5 7 5 0 5 Percent 23.70% 21.05% 22.44% 10.37% 4.86% 7.74% 0.00% 3.24% 1.55% 16.30% 12.96% 14.70% 2.96% 8.10% 5.42% 7.41% 0.00% 3.87%
35-64 Mbr Mnth 3033 3660 6693 3033 3660 6693 3033 3660 6693 3033 3660 6693 3033 3660 6693 3033 3660 6693 Number 35 44 79 13 9 22 2 3 5 15 26 41 9 15 24 4 3 7 Percent 13.85% 14.43% 14.16% 5.14% 2.95% 3.94% 0.79% 0.98% 0.90% 5.93% 8.52% 7.35% 3.56% 4.92% 4.30% 1.58% 0.98% 1.26%
65+ Mbr Mnth 1 5 6 1 5 6 1 5 6 1 5 6 1 5 6 1 5 6 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 Number 59 58 117 21 12 33 2 5 7 30 35 65 14 20 34 9 3 12 Percent 14.79% 13.94% 14.36% 5.27% 2.88% 4.05% 0.50% 1.20% 0.86% 7.52% 8.41% 7.98% 3.51% 4.81% 4.17% 2.26% 0.72% 1.47%
PrimeWest Health HEDIS® 2019 Page 169
Utilization Identification of Alcohol and Other Drug Services
Special Needs Basic Care - Non-Special Needs Plan (4 of 4) - Total
Age Data Element
Any Services Inpatient Intensive Outpatient/Partial Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnth 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 Percent
13-17 Mbr Mnth 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 Percent
18-24 Mbr Mnth 942 588 1530 942 588 1530 942 588 1530 942 588 1530 942 588 1530 942 588 1530 Number 10 1 11 1 0 1 0 0 0 6 1 7 4 1 5 0 0 0 Percent 12.74% 2.04% 8.63% 1.27% 0.00% 0.78% 0.00% 0.00% 0.00% 7.64% 2.04% 5.49% 5.10% 2.04% 3.92% 0.00% 0.00% 0.00%
25-34 Mbr Mnth 810 741 1551 810 741 1551 810 741 1551 810 741 1551 810 741 1551 810 741 1551 Number 19 16 35 7 4 11 0 3 3 14 11 25 4 7 11 5 0 5 Percent 28.15% 25.91% 27.08% 10.37% 6.48% 8.51% 0.00% 4.86% 2.32% 20.74% 17.81% 19.34% 5.93% 11.34% 8.51% 7.41% 0.00% 3.87%
35-64 Mbr Mnth 3033 3660 6693 3033 3660 6693 3033 3660 6693 3033 3660 6693 3033 3660 6693 3033 3660 6693 Number 69 85 154 21 27 48 3 4 7 47 61 108 17 30 47 4 7 11 Percent 27.30% 27.87% 27.61% 8.31% 8.85% 8.61% 1.19% 1.31% 1.26% 18.60% 20.00% 19.36% 6.73% 9.84% 8.43% 1.58% 2.30% 1.97%
65+ Mbr Mnth 1 5 6 1 5 6 1 5 6 1 5 6 1 5 6 1 5 6 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnth 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
Total Mbr Mnth 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 Number 98 102 200 29 31 60 3 7 10 67 73 140 25 38 63 9 7 16 Percent 24.57% 24.51% 24.54% 7.27% 7.45% 7.36% 0.75% 1.68% 1.23% 16.80% 17.54% 17.18% 6.27% 9.13% 7.73% 2.26% 1.68% 1.96%
PrimeWest Health HEDIS® 2019 Page 170
Utilization Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Commercial
Age Data
Element Any Services Inpatient Intensive Outpatient/Partial
Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnths
Number Percent
13-17 Mbr Mnths Number Percent
18-24 Mbr Mnths Number Percent
65+ Mbr Mnths Number Percent
Unknown Mbr Mnths Number
Total Mbr Mnths Number Percent
PrimeWest Health HEDIS® 2019 Page 171
Utilization Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Medicare Advantage
Age Data
Element Any Services Inpatient Intensive Outpatient/Partial
Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnths
Number Percent
13-17 Mbr Mnths Number Percent
18-24 Mbr Mnths Number Percent
65+ Mbr Mnths Number Percent
Unknown Mbr Mnths Number
Total Mbr Mnths 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
PrimeWest Health HEDIS® 2019 Page 172
Utilization Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Minnesota Health Care Programs - Managed Care (Families and Children)
Age Data
Element Any Services Inpatient Intensive Outpatient/Partial
Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnths 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095 88724 83371 172095
Number 1240 993 2233 13 14 27 179 148 327 1228 987 2215 145 123 268 25 5 30 Percent 16.77% 14.29% 15.57% 0.18% 0.20% 0.19% 2.42% 2.13% 2.28% 16.61% 14.21% 15.44% 1.96% 1.77% 1.87% 0.34% 0.07% 0.21%
13-17 Mbr Mnths 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 25383 25298 50681 Number 518 692 1210 31 60 91 82 118 200 510 674 1184 57 67 124 13 27 40 Percent 24.49% 32.82% 28.65% 1.47% 2.85% 2.15% 3.88% 5.60% 4.74% 24.11% 31.97% 28.03% 2.69% 3.18% 2.94% 0.61% 1.28% 0.95%
18-24 Mbr Mnths 77330 113060 190390 77330 113060 190390 77330 113060 190390 77330 113060 190390 77330 113060 190390 77330 113060 190390 Number 1232 2499 3731 84 143 227 234 413 647 1193 2438 3631 207 346 553 45 98 143 Percent 19.12% 26.52% 23.52% 1.30% 1.52% 1.43% 3.63% 4.38% 4.08% 18.51% 25.88% 22.89% 3.21% 3.67% 3.49% 0.70% 1.04% 0.90%
65+ Mbr Mnths 8 6 14 8 6 14 8 6 14 8 6 14 8 6 14 8 6 14 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnths 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
Total Mbr Mnths 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 191445 221735 413180 Number 2990 4184 7174 128 217 345 495 679 1174 2931 4099 7030 409 536 945 83 130 213 Percent 18.74% 22.64% 20.84% 0.80% 1.17% 1.00% 3.10% 3.67% 3.41% 18.37% 22.18% 20.42% 2.56% 2.90% 2.74% 0.52% 0.70% 0.62%
PrimeWest Health HEDIS® 2019 Page 173
Utilization Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Minnesota Health Care Programs - Managed Care (MN Care)
Age Data
Element Any Services Inpatient Intensive Outpatient/Partial
Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnths 210 292 502 210 292 502 210 292 502 210 292 502 210 292 502 210 292 502
Number 1 3 4 0 0 0 0 0 0 1 3 4 0 0 0 0 0 0 Percent 5.71% 12.33% 9.56% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 5.71% 12.33% 9.56% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
13-17 Mbr Mnths 70 50 120 70 50 120 70 50 120 70 50 120 70 50 120 70 50 120 Number 0 2 2 0 0 0 0 0 0 0 2 2 0 0 0 0 0 0 Percent 0.00% 48.00% 20.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 48.00% 20.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
18-24 Mbr Mnths 15251 20395 35646 15251 20395 35646 15251 20395 35646 15251 20395 35646 15251 20395 35646 15251 20395 35646 Number 117 290 407 12 14 26 16 38 54 112 286 398 14 31 45 8 12 20 Percent 9.21% 17.06% 13.70% 0.94% 0.82% 0.88% 1.26% 2.24% 1.82% 8.81% 16.83% 13.40% 1.10% 1.82% 1.51% 0.63% 0.71% 0.67%
65+ Mbr Mnths 95 94 189 95 94 189 95 94 189 95 94 189 95 94 189 95 94 189 Number 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 Percent 0.00% 12.77% 6.35% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 12.77% 6.35% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnths 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
Total Mbr Mnths 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 15626 20831 36457 Number 118 296 414 12 14 26 16 38 54 113 292 405 14 31 45 8 12 20 Percent 9.06% 17.05% 13.63% 0.92% 0.81% 0.86% 1.23% 2.19% 1.78% 8.68% 16.82% 13.33% 1.08% 1.79% 1.48% 0.61% 0.69% 0.66%
PrimeWest Health HEDIS® 2019 Page 174
Utilization Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Minnesota Senior Health Options
Age Data
Element Any Services Inpatient Intensive Outpatient/Partial
Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnths 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
13-17 Mbr Mnths 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
18-24 Mbr Mnths 5 7 12 5 7 12 5 7 12 5 7 12 5 7 12 5 7 12 Number 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 Percent 240.00% 0.00% 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 240.00% 0.00% 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
65+ Mbr Mnths 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 6089 15092 21181 Number 71 167 238 14 33 47 3 12 15 58 142 200 3 9 12 1 1 2 Percent 13.99% 13.28% 13.48% 2.76% 2.62% 2.66% 0.59% 0.95% 0.85% 11.43% 11.29% 11.33% 0.59% 0.72% 0.68% 0.20% 0.08% 0.11%
Unknown Mbr Mnths 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
Total Mbr Mnths 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 6094 15099 21193 Number 72 167 239 14 33 47 3 12 15 59 142 201 3 9 12 1 1 2 Percent 14.18% 13.27% 13.53% 2.76% 2.62% 2.66% 0.59% 0.95% 0.85% 11.62% 11.29% 11.38% 0.59% 0.72% 0.68% 0.20% 0.08% 0.11%
PrimeWest Health HEDIS® 2019 Page 175
Utilization Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Special Needs Basic Care - Special Needs Plan
Age Data
Element Any Services Inpatient Intensive Outpatient/Partial
Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnths 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
13-17 Mbr Mnths 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
18-24 Mbr Mnths 973 1304 2277 973 1304 2277 973 1304 2277 973 1304 2277 973 1304 2277 973 1304 2277 Number 37 61 98 1 4 5 6 12 18 37 61 98 5 9 14 0 0 0 Percent 45.63% 56.13% 51.65% 1.23% 3.68% 2.64% 7.40% 11.04% 9.49% 45.63% 56.13% 51.65% 6.17% 8.28% 7.38% 0.00% 0.00% 0.00%
65+ Mbr Mnths 9 3 12 9 3 12 9 3 12 9 3 12 9 3 12 9 3 12 Number 0 1 1 0 0 0 0 1 1 0 1 1 0 1 1 0 0 0 Percent 0.00% 400.00% 100.00% 0.00% 0.00% 0.00% 0.00% 400.00% 100.00% 0.00% 400.00% 100.00% 0.00% 400.00% 100.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnths 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
Total Mbr Mnths 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 982 1307 2289 Number 37 62 99 1 4 5 6 13 19 37 62 99 5 10 15 0 0 0 Percent 45.21% 56.92% 51.90% 1.22% 3.67% 2.62% 7.33% 11.94% 9.96% 45.21% 56.92% 51.90% 6.11% 9.18% 7.86% 0.00% 0.00% 0.00%
PrimeWest Health HEDIS® 2019 Page 176
Utilization Mental Health Utilization - % of Members Receiving Inpatient, Day/Night and Ambulatory Services
Special Needs Basic Care - Non-Special Needs Plan
Age Data
Element Any Services Inpatient Intensive Outpatient/Partial
Hospitalization Outpatient/MAT ED Telehealth
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total 0-12 Mbr Mnths 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
13-17 Mbr Mnths 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 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
18-24 Mbr Mnths 4785 4989 9774 4785 4989 9774 4785 4989 9774 4785 4989 9774 4785 4989 9774 4785 4989 9774 Number 152 212 364 15 12 27 23 38 61 142 208 350 19 31 50 6 14 20 Percent 38.12% 50.99% 44.69% 3.76% 2.89% 3.31% 5.77% 9.14% 7.49% 35.61% 50.03% 42.97% 4.76% 7.46% 6.14% 1.50% 3.37% 2.46%
65+ Mbr Mnths 1 5 6 1 5 6 1 5 6 1 5 6 1 5 6 1 5 6 Number 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Percent 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Unknown Mbr Mnths 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
Total Mbr Mnths 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 4786 4994 9780 Number 152 212 364 15 12 27 23 38 61 142 208 350 19 31 50 6 14 20 Percent 38.11% 50.94% 44.66% 3.76% 2.88% 3.31% 5.77% 9.13% 7.48% 35.60% 49.98% 42.94% 4.76% 7.45% 6.13% 1.50% 3.36% 2.45%
PrimeWest Health HEDIS® 2019 Page 177
Risk Adjusted Utilization Plan All-Cause Readmissions
Commercial Observed Expected - Observed/Expected
Age
Count of Index Stays (Observed)
Observed 30-Day
Re-admissions
Observed Re-
admission Rate
Count of Index Stays (Expected)
Expected 30-Day
Re-admissions
Expected Re-
admission Rate
Variance
Expected 30-Day
Re-admissions
Observed 30-Day
Re-admissions
Observed/ Expected
Ratio 18-44 45-54 55-64
Total (18-64)
PrimeWest Health HEDIS® 2019 Page 178
Risk Adjusted Utilization Plan All-Cause Readmissions
Medicare Advantage Observed Expected - Observed/Expected
Age SES
Stratification
Count of Index Stays (Observed)
Observed 30-Day
Re-admissions
Observed Re-
admission Rate
Count of Index Stays (Expected)
Expected 30-Day
Re-admissions
Expected Re-
admission Rate
Variance
Expected 30-Day
Re-admissions
Observed 30-Day
Re-admissions
Observed/ Expected
Ratio
18-64
Non-LIS/DE, Nondisability
LIS/DE Disability
LIS/DE and Disability
Other Unknown
Total Medicare
Observed Expected - Observed/Expected
Age
Count of Index Stays (Observed)
Observed 30-Day
Re-admissions
Observed Re-
admission Rate
Count of Index Stays (Expected)
Expected 30-Day
Re-admissions
Expected Re-
admission Rate
Variance
Expected 30-Day
Re-admissions
Observed 30-Day
Re-admissions
Observed/ Expected
Ratio 18-44 45-54 55-64
Total (18-64)
PrimeWest Health HEDIS® 2019 Page 179
Risk Adjusted Utilization Plan All-Cause Readmissions
Minnesota Senior Health Options Observed Expected - Observed/Expected
Age SES
Stratification
Count of Index Stays (Observed)
Observed 30-Day
Re-admissions
Observed Re-
admission Rate
Count of Index Stays (Expected)
Expected 30-Day
Re-admissions
Expected Re-
admission Rate
Variance
Expected 30-Day
Re-admissions
Observed 30-Day
Re-admissions
Observed/ Expected
Ratio
18-64
Non-LIS/DE, Nondisability 0 0 0 0 0
LIS/DE 0 0 0 0 0 Disability 0 0 0 0 0
LIS/DE and Disability 0 0 0 0 0
Other 0 0 0 0 0 Unknown 0 0 0 0 0
Total Medicare 0 0 0 0 0 0 0
Observed Expected - Observed/Expected
Age
Count of Index Stays (Observed)
Observed 30-Day
Re-admissions
Observed Re-
admission Rate
Count of Index Stays (Expected)
Expected 30-Day
Re-admissions
Expected Re-
admission Rate
Variance
Expected 30-Day
Re-admissions
Observed 30-Day
Re-admissions
Observed/ Expected
Ratio 18-44 0 0 0 0 0 0 0 45-54 0 0 0 0 0 0 0 55-64 0 0 0 0 0 0 0
Total (18-64) 0 0 0 0 0 0 0
PrimeWest Health HEDIS® 2019 Page 180
Risk Adjusted Utilization Plan All-Cause Readmissions
Special Needs Basic Care - Special Needs Plan Observed Expected - Observed/Expected
Age SES
Stratification
Count of Index Stays (Observed)
Observed 30-Day
Re-admissions
Observed Re-
admission Rate
Count of Index Stays (Expected)
Expected 30-Day
Re-admissions
Expected Re-
admission Rate
Variance
Expected 30-Day
Re-admissions
Observed 30-Day
Re-admissions
Observed/ Expected
Ratio
18-64
Non-LIS/DE, Nondisability 0 0 0 0 0
LIS/DE 0 0 0 0 0 Disability 0 0 0 0 0
LIS/DE and Disability 32 6 18.75% 32 7.2226 22.57% 4.8799
Other 0 0 0 0 0 Unknown 0 0 0 0 0
Total Medicare 32 6 18.75% 32 7.2226 22.57% 4.8799 7.2226 6 83.07%
Observed Expected - Observed/Expected
Age
Count of Index Stays (Observed)
Observed 30-Day
Re-admissions
Observed Re-
admission Rate
Count of Index Stays (Expected)
Expected 30-Day
Re-admissions
Expected Re-
admission Rate
Variance
Expected 30-Day
Re-admissions
Observed 30-Day
Re-admissions
Observed/ Expected
Ratio 18-44 8 2 25.00% 8 2.1819 27.27% 1.383 2.1819 2 91.66% 45-54 9 1 11.11% 9 1.0127 11.25% 0.8916 1.0127 1 98.75% 55-64 15 3 20.00% 15 4.028 26.85% 2.6053 4.028 3 74.48%
Total (18-64) 32 6 18.75% 32 7.2226 22.57% 4.8799 7.2226 6 83.07%
PrimeWest Health HEDIS® 2019 Page 181
Health Plan Descriptive Information Board Certification
Minnesota Senior Health Options
Type of Physician Audit Designation
Number of Physicians in Each
Practice Area
Active Board Certification
Number Rate Status Percent
Family Medicine Unaudited 854 743 UN 87.00% Internal Medicine Unaudited 933 748 UN 80.17% Pediatrician Unaudited 356 309 UN 86.80% OB/GYN Unaudited 185 155 UN 83.78% Geriatricians Unaudited 30 19 UN 63.33% Other practitioner Specialists Unaudited 2478 2034 UN 82.08%
PrimeWest Health HEDIS® 2019 Page 182
Health Plan Descriptive Information Board Certification
Special Needs Basic Care - Special Needs Plan
Type of Physician Audit Designation
Number of Physicians in Each
Practice Area
Active Board Certification
Number Rate Status Percent
Family Medicine Unaudited 854 743 UN 87.00% Internal Medicine Unaudited 933 748 UN 80.17% Pediatrician Unaudited 356 309 UN 86.80% OB/GYN Unaudited 185 155 UN 83.78% Geriatricians Unaudited 30 19 UN 63.33% Other practitioner Specialists Unaudited 2478 2034 UN 82.08%
PrimeWest Health HEDIS® 2019 Page 183
Health Plan Descriptive Information Board Certification
Special Needs Basic Care - Non-Special Needs Plan
Type of Physician Audit Designation
Number of Physicians in Each
Practice Area
Active Board Certification
Number Rate Status Percent
Family Medicine Unaudited 854 743 UN 87.00% Internal Medicine Unaudited 933 748 UN 80.17% Pediatrician Unaudited 356 309 UN 86.80% OB/GYN Unaudited 185 155 UN 83.78% Geriatricians Unaudited 30 19 UN 63.33% Other practitioner Specialists Unaudited 2478 2034 UN 82.08%
PrimeWest Health HEDIS® 2019 Page 184
Health Plan Descriptive Information Enrollment by Product Line (Age & Sex)
Commercial Age Members Member Months
Male Female Total Male Female Total <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
PrimeWest Health HEDIS® 2019 Page 185
Health Plan Descriptive Information Enrollment by Product Line (Age & Sex)
Medicare Advantage Age Members Member Months
Male Female Total Male Female Total <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
PrimeWest Health HEDIS® 2019 Page 186
Health Plan Descriptive Information Enrollment by Product Line (Age & Sex)
Minnesota Health Care Programs - Managed Care (Families and Children) Age Members
Male Female Total <1 7154 6593 13747 1-4 28596 26585 55181 5-9 33968 31619 65587 10-14 30001 29499 59500 15-17 14388 14373 28761 18-19 6799 8034 14833
0-19 Subtotal: 120906 116703 237609 0-19 Subtotal: % 63.13% 52.62% 57.49%
20-24 9718 17619 27337 25-29 9859 19390 29249 30-34 10087 17399 27486 35-39 9305 14012 23317 40-44 6993 9105 16098
20-44 Subtotal: 45962 77525 123487 20-44 Subtotal: % 24.00% 34.96% 29.88%
45-49 6087 7482 13569 50-54 6369 7209 13578 55-59 6728 7196 13924 60-64 5466 5659 11125
45-64 Subtotal: 24650 27546 52196 45-64 Subtotal: % 12.87% 12.42% 12.63%
65-69 8 6 14 70-74 0 0 0 75-79 0 0 0 80-84 0 0 0 85-89 0 0 0 >=90 0 0 0
>=65 Subtotal: 8 6 14 >=65 Subtotal: % 0.00% 0.00% 0.00%
Age Unknown 0 0 0 Total 191526 221780 413306
PrimeWest Health HEDIS® 2019 Page 187
Health Plan Descriptive Information Enrollment by Product Line (Age & Sex)
Minnesota Health Care Programs - Managed Care (MN Care) Age Members
Male Female Total <1 2 0 2 1-4 145 181 326 5-9 43 87 130 10-14 64 35 99 15-17 26 39 65 18-19 380 481 861
0-19 Subtotal: 660 823 1483 0-19 Subtotal: % 4.22% 3.95% 4.06%
20-24 1502 2048 3550 25-29 1293 2311 3604 30-34 1840 2357 4197 35-39 1824 2343 4167 40-44 1537 2039 3576
20-44 Subtotal: 7996 11098 19094 20-44 Subtotal: % 51.12% 53.25% 52.34%
45-49 1451 1989 3440 50-54 1505 1833 3338 55-59 1838 2181 4019 60-64 2096 2824 4920
45-64 Subtotal: 6890 8827 15717 45-64 Subtotal: % 44.05% 42.35% 43.08%
65-69 39 60 99 70-74 56 13 69 75-79 0 21 21 80-84 0 0 0 85-89 0 0 0 >=90 0 0 0
>=65 Subtotal: 95 94 189 >=65 Subtotal: % 0.61% 0.45% 0.52%
Age Unknown 0 0 0 Total 15641 20842 36483
PrimeWest Health HEDIS® 2019 Page 188
Health Plan Descriptive Information Enrollment by Product Line (Age & Sex)
Minnesota Senior Health Options Age Members Member Months
Male Female Total Male Female Total <1 0 0 0 0 0 0 1-4 0 0 0 0 0 0 5-9 0 0 0 0 0 0 10-14 0 0 0 0 0 0 15-17 0 0 0 0 0 0 18-19 0 0 0 0 0 0
0-19 Subtotal: 0 0 0 0 0 0 0-19 Subtotal: % 0.00% 0.00% 0.00%
20-24 0 0 0 0 0 0 25-29 0 0 0 0 0 0 30-34 0 0 0 0 0 0 35-39 0 0 0 0 0 0 40-44 0 0 0 0 0 0
20-44 Subtotal: 0 0 0 0 0 0 20-44 Subtotal: % 0.00% 0.00% 0.00%
45-49 0 0 0 0 0 0 50-54 0 0 0 0 0 0 55-59 0 0 0 0 0 0 60-64 0 1 1 5 7 12
45-64 Subtotal: 0 1 1 5 7 12 45-64 Subtotal: % 0.00% 0.07% 0.05%
65-69 128 184 312 1537 2205 3742 70-74 97 207 304 1167 2486 3653 75-79 92 198 290 1098 2375 3473 80-84 90 210 300 1078 2525 3603 85-89 68 235 303 813 2817 3630 >=90 68 355 423 821 4255 5076
>=65 Subtotal: 543 1389 1932 6514 16663 23177 >=65 Subtotal: % 100.00% 99.93% 99.95%
Age Unknown 0 0 0 0 0 0 Total 543 1390 1933
PrimeWest Health HEDIS® 2019 Page 189
Health Plan Descriptive Information Enrollment by Product Line (Age & Sex)
Special Needs Basic Care - Special Needs Plan Age Members Member Months
Male Female Total Male Female Total <1 0 0 0 0 0 0 1-4 0 0 0 0 0 0 5-9 0 0 0 0 0 0 10-14 0 0 0 0 0 0 15-17 0 0 0 0 0 0 18-19 0 0 0 0 0 0
0-19 Subtotal: 0 0 0 0 0 0 0-19 Subtotal: % 0.00% 0.00% 0.00%
20-24 1 1 2 14 12 26 25-29 3 0 3 37 0 37 30-34 7 4 11 81 44 125 35-39 4 11 15 53 132 185 40-44 9 10 19 103 120 223
20-44 Subtotal: 24 26 50 288 308 596 20-44 Subtotal: % 28.92% 23.85% 26.04%
45-49 7 11 18 80 137 217 50-54 15 19 34 185 227 412 55-59 19 28 47 231 341 572 60-64 17 25 42 201 295 496
45-64 Subtotal: 58 83 141 697 1000 1697 45-64 Subtotal: % 69.88% 76.15% 73.44%
65-69 1 0 1 9 3 12 70-74 0 0 0 0 0 0 75-79 0 0 0 0 0 0 80-84 0 0 0 0 0 0 85-89 0 0 0 0 0 0 >=90 0 0 0 0 0 0
>=65 Subtotal: 1 0 1 9 3 12 >=65 Subtotal: % 1.20% 0.00% 0.52%
Age Unknown 0 0 0 0 0 0 Total 83 109 192
PrimeWest Health HEDIS® 2019 Page 190
Health Plan Descriptive Information Enrollment by Product Line (Age & Sex)
Special Needs Basic Care - Non-Special Needs Plan Age Members
Male Female Total <1 0 0 0 1-4 0 0 0 5-9 0 0 0 10-14 0 0 0 15-17 0 0 0 18-19 346 212 558
0-19 Subtotal: 346 212 558 0-19 Subtotal: % 7.21% 4.22% 5.68%
20-24 596 376 972 25-29 415 328 743 30-34 395 413 808 35-39 296 485 781 40-44 264 240 504
20-44 Subtotal: 1966 1842 3808 20-44 Subtotal: % 40.98% 36.67% 38.78%
45-49 395 544 939 50-54 569 836 1405 55-59 709 806 1515 60-64 811 778 1589
45-64 Subtotal: 2484 2964 5448 45-64 Subtotal: % 51.78% 59.01% 55.48%
65-69 1 5 6 70-74 0 0 0 75-79 0 0 0 80-84 0 0 0 85-89 0 0 0 >=90 0 0 0
>=65 Subtotal: 1 5 6 >=65 Subtotal: % 0.02% 0.10% 0.06%
Age Unknown 0 0 0 Total 4797 5023 9820
PrimeWest Health HEDIS® 2019 Page 191
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