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AETNA HEALTH INC.

Company Information

  • Company Providing Plan:CVS Group
  • Address:151 FARMINGTON AVENUE, RT21
    HARTFORD CT 06156
  • Telephone :800-872-3862
  • Website:WWW.AETNA.COM
2021
Number of Enrollees: 25,053
PMPM: $723
Number of Physicians: *1,043,977
NCQA Accreditation: Accredited

*The data elements noted with an asterisk (*) contain regional-specific values whereas those not noted with an asterisk (*) contain Virginia specific values.

Coverage Areas

Counties

THE COMPANY IS LICENSED IN ALL COUNTIES AND CITIES IN THE COMMONWEALTH OF VIRGINIA.

Cities

All Cities in the Commonwealth of Virginia

Information provided by HMOs to State Corporation Commission Bureau of Insurance.

Administrative Data

2021 2020 2019 2018 2017
Number of Enrollees 25,053 23,402 20,671 22,748 50,391
PMPM $723 $713 $569 $645 $430
*Medical Cost Ratio 84% 78% 83% 80% 81%
*Administrative Ratio 11% 14% 13% 17% 15%
*Profit/Loss Ratio 5% 8% 4% 4% 5%
*Number of Physicians 1,043,977 923,132 795,989 554,080 426,906

*The data elements noted with an asterisk (*) contain regional-specific values whereas those not noted with an asterisk (*) contain Virginia specific values.

Financial Data

2021 2020 2019 2018 2017
Premiums Earned $217,435,092 $192,038,222 $141,061,312 $183,812,024 $341,947,599
*Income $150,992,976 $201,700,456 $126,982,751 $96,319,039 $129,475,325
*Net Worth $660,149,080 $562,202,243 $509,963,757 $489,511,836 $525,277,678

*The data elements noted with an asterisk (*) contain regional-specific values whereas those not noted with an asterisk (*) contain Virginia specific values.

Performance

Access/Availability of Care
Info
Adult Access To Preventive/Ambulatory Health Services 2021 Plan State Avg Nat Avg 90th Pctl.
Adult Access (Age 20-44) To Preventive/Ambulatory Health Services 93.14% 94.34% 93.47% 96.29%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 96.15% 96.22% 96.12% 97.63%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 97.57% 96.96% 96.96% 98.35%
Adult Access To Preventive/Ambulatory Health Services Year Plan State Avg. Natl. Avg. 90th Pctl.
Adult Access (Age 20-44) To Preventive/Ambulatory Health Services 2020 92.40% 93.90% 92.88% 95.71%
2019 92.42% 92.78% 92.66% 95.76%
2018 92.21% 92.43% 92.33% 95.45%
2017 92.23% 92.73% 92.45% 95.43%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 2020 96.05% 96.11% 95.86% 97.54%
2019 96.14% 95.78% 95.87% 97.69%
2018 96.16% 95.50% 95.64% 97.49%
2017 96.03% 95.57% 95.61% 97.46%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 2020 97.28% 96.79% 96.95% 98.30%
2019 97.57% 97.13% 97.14% 98.42%
2018 97.35% 97.15% 97.17% 98.45%
2017 97.35% 97.82% 97.07% 98.47%
Info
Alcohol and Other Drug Dependence Treatment 2021 Plan State Avg Nat Avg 90th Pctl.
Initiation of Alcohol and Other Drug Dependence Treatment - Total 30.93% 38.29% 34.72% 43.21%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 18.75% 45.84% 41.60% 52.08%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 31.12% 38.22% 34.53% 43.21%
Engagement of Alcohol and Other Drug Dependence Treatment - Total 10.37% 14.66% 11.91% 15.33%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 6.25% 16.85% 15.29% 22.05%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 10.44% 14.60% 11.85% 15.56%
Alcohol and Other Drug Dependence Treatment Year Plan State Avg. Natl. Avg. 90th Pctl.
Initiation of Alcohol and Other Drug Dependence Treatment - Total 2020 34.64% 40.49% 36.39% 45.24%
2019 32.43% 39.13% 35.63% 41.36%
2018 32.55% 37.53% 35.68% 42.36%
2017 36.49% 36.14% 36.11% 42.01%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2020 42.86% 35.48% 44.95% 59.06%
2019 27.27% 36.19% 42.41% 54.29%
2018 50.00% 49.35% 40.21% 51.02%
2017 36.54% 40.06% 39.91% 52.54%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2020 34.48% 40.55% 36.18% 45.12%
2019 32.56% 39.20% 35.47% 40.96%
2018 32.20% 37.34% 35.51% 42.35%
2017 36.49% 36.00% 35.97% 41.96%
Engagement of Alcohol and Other Drug Dependence Treatment - Total 2020 12.73% 15.16% 12.46% 17.48%
2019 12.64% 13.47% 12.31% 16.44%
2018 12.99% 14.69% 12.58% 17.04%
2017 13.57% 13.36% 12.65% 17.26%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2020 14.29% 14.80% 17.76% 27.27%
2019 12.12% 10.34% 16.48% 27.14%
2018 36.67% 18.18% 16.91% 25.00%
2017 13.46% 14.40% 14.95% 23.85%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2020 12.70% 15.15% 12.33% 17.48%
2019 12.65% 13.52% 12.20% 16.41%
2018 12.52% 14.58% 12.47% 16.97%
2017 13.57% 13.40% 12.55% 17.38%
Info
Prenatal and Postpartum Care 2021 Plan State Avg Nat Avg 90th Pctl.
Postpartum Care 66.09% 80.79% 81.70% 93.89%
Timeliness of Prenatal Care 71.84% 86.12% 83.24% 94.16%
Prenatal and Postpartum Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Postpartum Care 2020 70.32% 74.05% 78.11% 92.47%
2019 73.24% 78.66% 80.52% 91.97%
2018 62.50% 75.10% 75.89% 88.80%
2017 68.71% 73.45% 75.05% 88.13%
Timeliness of Prenatal Care 2020 79.08% 79.76% 81.82% 93.92%
2019 80.05% 86.76% 85.57% 95.33%
2018 83.06% 88.15% 84.75% 94.17%
2017 81.29% 86.37% 84.34% 94.89%
Behavioral Health
Info
Adherence to Antipsychotic Medications for Individuals with Schizophrenia 2021 Plan State Avg Nat Avg 90th Pctl.
Adherence to Antipsychotic Medications for Individuals With Schizophrenia 75.21% 67.45% 68.64% 79.03%
Adherence to Antipsychotic Medications for Individuals with Schizophrenia Year Plan State Avg. Natl. Avg. 90th Pctl.
Adherence to Antipsychotic Medications for Individuals With Schizophrenia 2020 83.33% 70.63% 69.41% 79.41%
2019 N/A N/A N/A N/A
2018 N/A N/A N/A N/A
2017 N/A N/A N/A N/A
Info
Antidepressant Medication Management 2021 Plan State Avg Nat Avg 90th Pctl.
Antidepressant Medication Management - Effective Acute Phase Treatment 79.44% 79.35% 76.18% 83.11%
Antidepressant Medication Management - Effective Continuation Phase Treatment 64.47% 61.51% 59.75% 67.55%
Antidepressant Medication Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Antidepressant Medication Management - Effective Acute Phase Treatment 2020 79.16% 77.14% 73.70% 81.07%
2019 76.04% 73.53% 71.19% 78.79%
2018 74.81% 71.96% 68.64% 77.59%
2017 73.35% 71.12% 67.11% 75.76%
Antidepressant Medication Management - Effective Continuation Phase Treatment 2020 64.95% 59.69% 57.32% 64.22%
2019 60.45% 55.44% 54.90% 62.18%
2018 60.99% 54.22% 53.01% 60.39%
2017 58.79% 54.87% 51.53% 60.24%
Info
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication 2021 Plan State Avg Nat Avg 90th Pctl.
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Initiation 38.86% 41.24% 36.60% 48.10%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 44.00% 45.63% 45.94% 60.34%
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication Year Plan State Avg. Natl. Avg. 90th Pctl.
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Initiation 2020 44.10% 45.87% 41.24% 50.34%
2019 38.85% 42.67% 40.66% 51.30%
2018 36.42% 42.91% 39.85% 50.42%
2017 33.90% 41.27% 41.13% 50.83%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 2020 62.07% 56.56% 48.67% 59.32%
2019 44.05% 50.69% 47.95% 58.82%
2018 43.21% 40.32% 48.73% 60.57%
2017 40.85% 55.09% 47.07% 58.44%
Info
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence 2021 Plan State Avg Nat Avg 90th Pctl.
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence within 7 days after hospital discharge 11.36% 12.52% 12.71% 21.05%
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence within 30 days after hospital discharge 12.88% 16.65% 17.10% 27.59%
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence Year Plan State Avg. Natl. Avg. 90th Pctl.
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence within 7 days after hospital discharge 2020 5.83% 14.52% 13.45% 21.43%
2019 10.30% 8.56% 11.48% 18.26%
2018 8.06% 9.96% 10.81% 17.07%
2017 N/A N/A N/A N/A
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence within 30 days after hospital discharge 2020 8.74% 19.84% 18.03% 26.07%
2019 13.94% 14.74% 15.35% 24.56%
2018 11.37% 13.52% 14.98% 23.11%
2017 N/A N/A N/A N/A
Info
Follow-Up After Emergency Department Visit for Mental Illness 2021 Plan State Avg Nat Avg 90th Pctl.
Follow-Up After Emergency Department Visit for Mental Illness within 7 days after hospital discharge 45.03% 44.60% 50.67% 70.54%
Follow-Up After Emergency Department Visit for Mental Illness within 30 days after hospital discharge 56.14% 61.91% 64.91% 82.58%
Follow-Up After Emergency Department Visit for Mental Illness Year Plan State Avg. Natl. Avg. 90th Pctl.
Follow-Up After Emergency Department Visit for Mental Illness within 7 days after hospital discharge 2020 50.70% 48.22% 47.90% 68.29%
2019 44.62% 45.64% 48.70% 70.67%
2018 37.73% 38.46% 46.62% 66.57%
2017 N/A N/A N/A N/A
Follow-Up After Emergency Department Visit for Mental Illness within 30 days after hospital discharge 2020 61.97% 59.38% 62.36% 78.77%
2019 55.38% 60.35% 62.59% 77.75%
2018 52.01% 53.38% 60.75% 77.57%
2017 N/A N/A N/A N/A
Info
Follow-up After Hospitalization For Mental Illness 2021 Plan State Avg Nat Avg 90th Pctl.
Follow-up After Hospitalization For Mental Illness within 7 days after hospital discharge 46.08% 49.75% 48.70% 63.60%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge 65.69% 73.29% 71.44% 82.61%
Follow-up After Hospitalization For Mental Illness Year Plan State Avg. Natl. Avg. 90th Pctl.
Follow-up After Hospitalization For Mental Illness within 7 days after hospital discharge 2020 41.92% 49.46% 49.62% 63.68%
2019 48.88% 49.77% 45.66% 58.20%
2018 39.52% 48.09% 44.98% 60.38%
2017 46.78% 52.18% 46.63% 62.81%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge 2020 62.69% 72.67% 70.00% 79.46%
2019 69.38% 72.38% 67.81% 80.65%
2018 62.14% 69.84% 66.68% 80.29%
2017 68.96% 69.80% 68.66% 82.58%
Effectiveness of Care
Info
Asthma Medication Ratio 2021 Plan State Avg Nat Avg 90th Pctl.
Asthma Medication Ratio - Ages 5-11 82.20% 92.78% 89.65% 96.23%
Asthma Medication Ratio - Ages 12-18 85.23% 85.93% 83.38% 90.21%
Asthma Medication Ratio - Ages 19-50 82.34% 82.29% 78.35% 87.18%
Asthma Medication Ratio - Ages 51-64 86.10% 86.60% 83.59% 90.22%
Asthma Medication Ratio - Total 84.10% 85.07% 81.23% 87.41%
Asthma Medication Ratio Year Plan State Avg. Natl. Avg. 90th Pctl.
Asthma Medication Ratio - Ages 5-11 2020 86.74% 93.70% 89.98% 95.00%
2019 82.85% 86.54% 85.94% 93.20%
2018 85.10% 85.26% 87.15% 93.97%
2017 85.00% 86.06% 86.90% 93.55%
Asthma Medication Ratio - Ages 12-18 2020 80.42% 84.76% 81.90% 89.30%
2019 75.00% 84.88% 77.43% 86.25%
2018 81.25% 84.71% 78.77% 84.72%
2017 77.36% 84.80% 76.69% 85.94%
Asthma Medication Ratio - Ages 19-50 2020 81.79% 78.90% 75.62% 84.47%
2019 79.37% 80.50% 74.07% 81.27%
2018 81.91% 82.69% 75.11% 82.84%
2017 77.97% 78.94% 74.23% 81.70%
Asthma Medication Ratio - Ages 51-64 2020 84.22% 85.69% 82.47% 89.38%
2019 83.46% 86.85% 81.27% 88.51%
2018 87.21% 86.11% 82.81% 89.49%
2017 86.96% 89.17% 82.83% 89.28%
Asthma Medication Ratio - Total 2020 83.05% 83.04% 79.76% 85.85%
2019 80.59% 83.92% 78.10% 84.69%
2018 84.04% 84.32% 79.34% 85.18%
2017 81.88% 84.01% 79.04% 85.85%
Info
Cardiovascular Disease Management 2021 Plan State Avg Nat Avg 90th Pctl.
Controlling High Blood Pressure 43.55% 60.64% 59.95% 73.24%
Persistence of Beta-Blockers 91.30% 88.98% 86.08% 93.62%
Cardiovascular Disease Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Controlling High Blood Pressure 2020 33.33% 43.15% 53.49% 69.10%
2019 41.61% 60.96% 61.02% 74.21%
2018 41.61% 60.55% N/A N/A
2017 N/A N/A N/A N/A
Persistence of Beta-Blockers 2020 93.48% 87.06% 87.38% 94.19%
2019 92.47% 88.62% 85.16% 92.47%
2018 88.79% 83.54% 82.37% 89.29%
2017 90.85% 85.80% 85.18% 93.41%
Info
Cervical Cancer Screening 2021 Plan State Avg Nat Avg 90th Pctl.
Cervical Cancer Screening 75.36% 76.66% 75.48% 81.94%
Cervical Cancer Screening Year Plan State Avg. Natl. Avg. 90th Pctl.
Cervical Cancer Screening 2020 76.69% 75.44% 75.50% 81.71%
2019 77.86% 78.50% 77.40% 83.91%
2018 77.14% 77.90% 76.08% 83.21%
2017 N/A N/A N/A N/A
Info
Common Childhood Illnesses 2021 Plan State Avg Nat Avg 90th Pctl.
Appropriate Testing for Children With Pharyngitis 80.73% 82.09% 79.49% 89.15%
Common Childhood Illnesses Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Testing for Children With Pharyngitis 2020 81.78% 90.05% 84.77% 92.62%
2019 81.31% 90.44% 86.62% 93.98%
2018 92.97% 92.74% 87.97% 94.94%
2017 91.53% 92.30% 87.45% 94.64%
Info
Diabetes Care and Management 2021 Plan State Avg Nat Avg 90th Pctl.
Comprehensive Diabetes Care-Blood Pressure Control (<140/90 mm Hg) 34.06% 59.77% 62.09% 75.43%
Comprehensive Diabetes Care-HbA1c control (<8.0%) 52.80% 61.24% 59.64% 67.11%
Comprehensive Diabetes Care-Rate of Eye Exams 54.50% 57.17% 52.65% 64.30%
Comprehensive Diabetes Care-Rate of Poor HbA1c control 36.98% 28.15% 29.94% 21.90%
Comprehensive Diabetes Care-Testing for HbA1c 87.35% 91.18% 90.81% 93.92%
Diabetes Care and Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Comprehensive Diabetes Care-Blood Pressure Control (<140/90 mm Hg) 2020 42.09% 44.59% 55.85% 73.48%
2019 51.58% 62.53% 63.23% 77.86%
2018 51.58% 63.70% 62.59% 77.37%
2017 47.45% 63.40% 60.82% 76.41%
Comprehensive Diabetes Care-HbA1c control (<8.0%) 2020 53.28% 55.20% 55.37% 65.50%
2019 65.21% 63.81% 58.07% 66.33%
2018 65.21% 62.46% 57.79% 66.33%
2017 55.96% 62.51% 57.48% 67.15%
Comprehensive Diabetes Care-Rate of Eye Exams 2020 56.20% 53.44% 50.27% 64.23%
2019 60.10% 58.32% 55.45% 69.32%
2018 60.10% 56.58% 54.40% 69.68%
2017 59.85% 56.95% 54.06% 70.69%
Comprehensive Diabetes Care-Rate of Poor HbA1c control 2020 39.90% 36.05% 34.87% 23.45%
2019 25.55% 26.09% 30.80% 20.82%
2018 25.55% 27.18% 30.85% 20.62%
2017 34.55% 27.63% 31.91% 21.41%
Comprehensive Diabetes Care-Testing for HbA1c 2020 82.97% 86.71% 87.74% 91.73%
2019 91.73% 92.45% 91.60% 94.71%
2018 91.73% 92.11% 91.29% 94.71%
2017 86.13% 91.52% 90.96% 94.18%
Info
Immunizations 2021 Plan State Avg Nat Avg 90th Pctl.
Childhood Immunization for Multiple Diseases (Combo 10) 61.77% 66.38% 60.60% 73.21%
Childhood Immunization for Multiple Diseases Including Pneumovax 76.20% 82.74% 78.15% 88.27%
Flu Vaccinations for Adults Ages 18-64 55.56% 59.29% 55.31% 65.85%
Immunizations for Adolescents - Combination 2 36.01% 39.82% 34.09% 44.04%
Immunizations for Adolescents - HPV 38.20% 41.73% 35.37% 46.00%
Immunizations for Adolescents - Meningococcal 85.40% 86.88% 85.91% 93.19%
Immunizations for Adolescents - Tdap 92.94% 93.05% 90.13% 95.38%
Immunizations Year Plan State Avg. Natl. Avg. 90th Pctl.
Childhood Immunization for Multiple Diseases (Combo 10) 2020 N/A N/A N/A N/A
2019 N/A N/A N/A N/A
2018 N/A N/A N/A N/A
2017 N/A N/A N/A N/A
Childhood Immunization for Multiple Diseases Including Pneumovax 2020 73.71% 74.94% 75.84% 87.36%
2019 75.19% 81.30% 78.32% 87.99%
2018 75.19% 79.46% 77.50% 86.62%
2017 82.15% 80.09% 77.67% 87.61%
Flu Vaccinations for Adults Ages 18-64 2020 59.28% 57.13% 57.41% 67.88%
2019 61.17% 59.38% 55.06% 65.24%
2018 55.61% 53.06% 51.93% 61.07%
2017 50.49% 55.21% 49.33% 59.27%
Immunizations for Adolescents - Combination 2 2020 31.14% 35.09% 31.84% 39.17%
2019 31.87% 33.16% 29.59% 40.63%
2018 79.08% 79.55% 82.25% 91.52%
2017 78.83% 80.48% 80.23% 89.54%
Immunizations for Adolescents - HPV 2020 34.06% 37.80% 33.38% 42.34%
2019 34.06% 35.43% 31.21% 42.46%
2018 27.49% 32.22% 28.05% 37.23%
2017 22.87% 28.29% 23.98% 32.36%
Immunizations for Adolescents - Meningococcal 2020 84.43% 80.71% 85.83% 93.12%
2019 84.67% 81.83% 85.01% 92.59%
2018 80.05% 80.66% 83.69% 92.94%
2017 79.81% 82.05% 81.75% 90.27%
Immunizations for Adolescents - Tdap 2020 89.05% 92.47% 90.62% 95.13%
2019 89.05% 92.23% 90.47% 95.13%
2018 87.10% 91.16% 89.95% 95.62%
2017 87.83% 91.65% 88.91% 94.65%
Info
Pharmacotherapy of COPD Exacerbation 2021 Plan State Avg Nat Avg 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator 88.66% 86.14% 81.56% 89.58%
Pharmacotherapy of COPD Exacerbation - Corticosteroid 76.29% 80.22% 74.79% 84.78%
Pharmacotherapy of COPD Exacerbation Year Plan State Avg. Natl. Avg. 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator 2020 85.71% 86.03% 81.34% 88.51%
2019 93.18% 83.91% 80.32% 88.97%
2018 88.51% 85.49% 78.92% 87.88%
2017 81.67% 80.88% 79.87% 87.50%
Pharmacotherapy of COPD Exacerbation - Corticosteroid 2020 71.43% 75.06% 74.31% 85.07%
2019 73.30% 81.14% 76.90% 87.69%
2018 75.86% 76.41% 74.76% 83.55%
2017 75.42% 78.84% 76.26% 84.38%
Info
Preventive Care 2021 Plan State Avg Nat Avg 90th Pctl.
Breast Cancer Screening 70.24% 72.93% 72.44% 79.62%
Chlamydia Screening in Women-all Age groups 49.99% 51.90% 48.47% 62.71%
Colorectal Cancer Screening 67.02% 63.99% 64.90% 76.16%
Preventive Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Breast Cancer Screening 2020 68.12% 72.56% 72.44% 79.39%
2019 70.84% 72.92% 74.81% 81.58%
2018 70.34% 72.13% 73.73% 81.17%
2017 69.17% 71.85% 72.81% 80.91%
Chlamydia Screening in Women-all Age groups 2020 49.39% 49.80% 48.49% 63.85%
2019 53.99% 54.77% 51.86% 67.02%
2018 53.31% 52.91% 51.41% 67.76%
2017 52.43% 51.46% 50.16% 66.08%
Colorectal Cancer Screening 2020 65.56% 60.99% 63.64% 74.42%
2019 68.16% 68.10% 66.15% 77.91%
2018 64.42% 64.94% 64.37% 76.52%
2017 66.49% 65.16% 62.43% 74.72%
Info
Spirometry Testing 2021 Plan State Avg Nat Avg 90th Pctl.
Use of Spirometry Testing in the Assessment and diagnosis of COPD 36.90% 34.87% 36.29% 45.50%
Spirometry Testing Year Plan State Avg. Natl. Avg. 90th Pctl.
Use of Spirometry Testing in the Assessment and diagnosis of COPD 2020 38.90% 37.53% 37.16% 43.86%
2019 46.79% 39.81% 42.11% 52.78%
2018 44.40% 44.14% 41.48% 50.95%
2017 43.44% 43.12% 41.90% 50.52%
Info
Statin Therapy 2021 Plan State Avg Nat Avg 90th Pctl.
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - 21-75 years (Male) 86.63% 86.25% 84.99% 90.85%
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - 40–75 years (Female) 72.59% 74.86% 76.91% 83.87%
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - Total 81.53% 83.06% 82.86% 88.32%
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - 21-75 years (Male) 87.51% 78.10% 80.36% 87.04%
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - 40–75 years (Female) 84.32% 77.02% 76.97% 85.47%
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - Total 86.48% 77.77% 79.53% 86.44%
Statin Therapy for Patients with Diabetes - Received Therapy 68.74% 66.92% 66.45% 72.23%
Statin Therapy for Patients with Diabetes - Statin Adherence 80% 80.67% 74.32% 73.74% 81.61%
Statin Therapy Year Plan State Avg. Natl. Avg. 90th Pctl.
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - 21-75 years (Male) 2020 85.37% 85.75% 84.86% 89.67%
2019 85.33% 85.53% 84.83% 90.71%
2018 81.38% 84.45% 83.64% 89.14%
2017 N/A N/A N/A N/A
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - 40–75 years (Female) 2020 75.18% 77.46% 75.69% 81.94%
2019 73.25% 75.96% 74.89% 81.82%
2018 69.59% 76.45% 73.26% 81.82%
2017 N/A N/A N/A N/A
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - Total 2020 81.78% 83.41% 82.46% 87.85%
2019 81.18% 82.97% 82.41% 88.24%
2018 77.31% 82.21% 81.23% 87.21%
2017 N/A N/A N/A N/A
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - 21-75 years (Male) 2020 86.34% 81.24% 81.04% 86.60%
2019 85.71% 78.19% 78.73% 85.40%
2018 82.35% 75.19% 77.14% 82.88%
2017 N/A N/A N/A N/A
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - 40–75 years (Female) 2020 83.84% 78.29% 77.58% 86.55%
2019 82.34% 75.98% 73.50% 82.09%
2018 76.48% 72.78% 72.12% 81.10%
2017 N/A N/A N/A N/A
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - Total 2020 85.53% 80.47% 80.55% 86.26%
2019 84.67% 77.63% 77.38% 84.14%
2018 80.53% 74.49% 75.95% 82.83%
2017 N/A N/A N/A N/A
Statin Therapy for Patients with Diabetes - Received Therapy 2020 66.65% 66.42% 65.49% 71.27%
2019 65.25% 65.53% 64.43% 70.97%
2018 63.50% 63.94% 62.57% 70.05%
2017 N/A N/A N/A N/A
Statin Therapy for Patients with Diabetes - Statin Adherence 80% 2020 80.92% 73.48% 74.69% 82.04%
2019 79.71% 71.84% 71.74% 79.50%
2018 75.73% 68.88% 69.52% 78.00%
2017 N/A N/A N/A N/A
Info
Weight Assessment and Counseling 2021 Plan State Avg Nat Avg 90th Pctl.
Children/Adolescents BMI Assessment - Total 66.10% 77.31% 75.21% 89.14%
Children/Adolescents BMI Assessment - Ages 3-11 65.67% 78.77% 76.73% 90.56%
Children/Adolescents BMI Assessment - Ages 12-17 66.67% 75.37% 73.29% 87.42%
Counseling for Nutrition for Children/Adolescents - Total 63.90% 74.98% 69.95% 83.70%
Counseling for Nutrition for Children/Adolescents - Ages 3-11 62.23% 77.08% 72.50% 86.18%
Counseling for Nutrition for Children/Adolescents - Ages 12-17 66.10% 72.13% 66.75% 82.14%
Counseling for Physical Activity for Children/Adolescents - Total 61.71% 71.34% 66.55% 80.86%
Counseling for Physical Activity for Children/Adolescents - Ages 3-11 58.80% 69.93% 66.24% 81.08%
Counseling for Physical Activity for Children/Adolescents - Ages 12-17 65.54% 73.30% 66.87% 83.09%
Weight Assessment and Counseling Year Plan State Avg. Natl. Avg. 90th Pctl.
Children/Adolescents BMI Assessment - Total 2020 60.93% 61.27% 70.64% 88.81%
2019 63.52% 74.97% 74.90% 90.00%
2018 63.52% 73.74% 72.87% 90.00%
2017 65.51% 70.41% 70.59% 88.08%
Children/Adolescents BMI Assessment - Ages 3-11 2020 67.13% 64.54% 72.11% 88.89%
2019 68.37% 78.68% 76.00% 90.91%
2018 68.37% 76.94% 74.00% 90.91%
2017 66.09% 71.37% 71.84% 88.89%
Children/Adolescents BMI Assessment - Ages 12-17 2020 53.93% 57.19% 68.80% 87.79%
2019 57.98% 70.46% 73.46% 89.29%
2018 57.98% 69.73% 71.39% 88.97%
2017 64.71% 68.96% 68.94% 87.82%
Counseling for Nutrition for Children/Adolescents - Total 2020 57.74% 56.08% 65.06% 82.43%
2019 62.53% 72.58% 68.74% 85.24%
2018 62.53% 71.79% 67.72% 85.06%
2017 64.52% 69.47% 65.50% 83.21%
Counseling for Nutrition for Children/Adolescents - Ages 3-11 2020 62.04% 59.21% 67.32% 84.32%
2019 65.12% 77.02% 71.33% 86.49%
2018 65.12% 75.91% 69.85% 86.21%
2017 64.38% 71.63% 68.20% 84.82%
Counseling for Nutrition for Children/Adolescents - Ages 12-17 2020 52.88% 52.10% 62.24% 79.49%
2019 59.57% 66.89% 65.44% 84.29%
2018 59.57% 66.37% 64.92% 84.29%
2017 64.71% 66.54% 61.92% 80.26%
Counseling for Physical Activity for Children/Adolescents - Total 2020 54.79% 52.21% 60.81% 80.29%
2019 57.57% 66.86% 64.24% 82.78%
2018 57.57% 66.42% 63.08% 81.32%
2017 60.55% 64.30% 59.96% 77.32%
Counseling for Physical Activity for Children/Adolescents - Ages 3-11 2020 56.48% 52.27% 60.31% 81.14%
2019 55.35% 66.12% 63.39% 82.53%
2018 55.35% 65.48% 61.70% 80.92%
2017 57.51% 62.31% 58.84% 75.00%
Counseling for Physical Activity for Children/Adolescents - Ages 12-17 2020 52.88% 51.96% 61.40% 79.85%
2019 60.11% 67.67% 65.38% 84.68%
2018 60.11% 67.51% 64.79% 84.03%
2017 64.71% 66.86% 61.40% 79.89%
Health Plan Stability/Descriptive
Info
Administrative Data 2021 Plan State Avg Nat Avg 90th Pctl.
Administrative Ratio 0.11 0.12 N/A N/A
Medical Cost Ratio 0.84 0.85 N/A N/A
Number of Enrollees 25,053 189,570 N/A N/A
Number of Physicians 1,043,977 144,761 N/A N/A
Premium Per Member Per Month $723 $582 N/A N/A
Administrative Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Administrative Ratio 2020 0.14 0.13 N/A N/A
2019 0.13 0.12 N/A N/A
2018 0.17 0.14 86.19 92.68
2017 0.15 0.12 86.39 93.13
Medical Cost Ratio 2020 0.78 0.81 N/A N/A
2019 0.83 0.84 N/A N/A
2018 0.80 0.83 92.60 95.85
2017 0.81 0.83 93.13 96.59
Number of Enrollees 2020 23,402 157,206 N/A N/A
2019 20,671 136,748 N/A N/A
2018 22,748 129,656 92 96
2017 50,391 133,992 92 97
Number of Physicians 2020 923,132 118,547 N/A N/A
2019 795,989 105,314 N/A N/A
2018 554,080 86,806 87 95
2017 426,906 81,926 87 95
Premium Per Member Per Month 2020 $713 $529 N/A N/A
2019 $569 $511 N/A N/A
2018 $645 $517 N/A N/A
2017 $430 $370 N/A N/A
Info
Financial Data 2021 Plan State Avg Nat Avg 90th Pctl.
Income $150,992,976 $84,171,275 N/A N/A
Net Worth $660,149,080 $444,659,972 N/A N/A
Premiums Earned $217,435,092 $1,315,605,350 N/A N/A
Financial Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Income 2020 $201,700,456 $108,797,768 N/A N/A
2019 $126,982,751 $81,234,487 N/A N/A
2018 $96,319,039 $44,046,244 N/A N/A
2017 $129,475,325 $34,422,501 N/A N/A
Net Worth 2020 $562,202,243 $381,868,187 N/A N/A
2019 $509,963,757 $340,553,480 N/A N/A
2018 $489,511,836 $279,558,644 N/A N/A
2017 $525,277,678 $263,890,874 N/A N/A
Premiums Earned 2020 $192,038,222 $1,079,933,473 N/A N/A
2019 $141,061,312 $936,529,722 N/A N/A
2018 $183,812,024 $815,577,345 N/A N/A
2017 $341,947,599 $645,600,589 N/A N/A
Info
Years in Business 2021 Plan State Avg Nat Avg 90th Pctl.
Years in Business 43 39 N/A N/A
Years in Business Year Plan State Avg. Natl. Avg. 90th Pctl.
Years in Business 2020 42 38 N/A N/A
2019 41 37 N/A N/A
2018 40 36 N/A N/A
2017 39 35 N/A N/A
Member Satisfaction
Info
Member Satisfaction 2021 Plan State Avg Nat Avg 90th Pctl.
Getting Care Quickly 88.48% 83.79% 83.12% 89.04%
Getting Needed Care 89.21% 85.63% 84.05% 89.10%
How Well Doctors Communicate 95.62% 94.61% 95.28% 97.41%
Members highly rating their HMO (8 to 10 on a 0-10 scale) 74.66% 66.71% 67.27% 78.31%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 85.35% 83.98% 84.85% 88.79%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) 79.68% 78.88% 77.89% 84.07%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) 85.29% 83.94% 85.47% 90.41%
Member Satisfaction Year Plan State Avg. Natl. Avg. 90th Pctl.
Getting Care Quickly 2020 84.25% 85.38% 86.32% 91.51%
2019 86.96% 87.14% 86.32% 90.57%
2018 88.81% 85.27% 85.23% 89.89%
2017 91.22% 87.22% 85.34% 89.83%
Getting Needed Care 2020 89.55% 87.88% 88.01% 92.51%
2019 90.58% 87.88% 87.38% 91.22%
2018 88.23% 85.53% 86.33% 90.45%
2017 91.67% 87.44% 86.71% 90.37%
How Well Doctors Communicate 2020 98.05% 95.93% 95.93% 97.98%
2019 94.71% 94.99% 95.85% 97.38%
2018 96.57% 94.70% 95.31% 97.22%
2017 97.17% 94.74% 95.10% 96.91%
Members highly rating their HMO (8 to 10 on a 0-10 scale) 2020 73.64% 65.21% 69.04% 80.59%
2019 73.13% 69.24% 67.91% 78.57%
2018 74.12% 64.78% 64.53% 76.79%
2017 70.90% 61.26% 62.44% 75.00%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 2020 86.79% 86.67% 87.14% 91.18%
2019 88.95% 88.18% 86.27% 90.20%
2018 87.71% 84.82% 84.41% 88.57%
2017 89.08% 83.86% 84.62% 88.77%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) 2020 87.82% 79.32% 80.71% 87.04%
2019 73.13% 79.81% 80.27% 86.36%
2018 79.20% 76.02% 78.17% 83.95%
2017 82.48% 76.98% 77.27% 82.99%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) 2020 91.54% 85.69% 86.56% 91.30%
2019 84.17% 87.91% 87.34% 90.94%
2018 89.45% 84.08% 85.14% 89.78%
2017 83.98% 83.95% 84.60% 89.86%
Overuse/Appropriateness
Info
Antipsychotics 2021 Plan State Avg Nat Avg 90th Pctl.
Metabolic Monitoring for Children and Adolescents on Antipsychotics - Ages 1-17 32.14% 45.59% 35.85% 48.30%
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics - Ages 1-17 52.38% 60.14% 63.65% 75.31%
Antipsychotics Year Plan State Avg. Natl. Avg. 90th Pctl.
Metabolic Monitoring for Children and Adolescents on Antipsychotics - Ages 1-17 2020 35.54% 38.77% 31.82% 42.98%
2019 34.93% 42.62% 37.50% 49.28%
2018 50.36% 44.74% 36.17% 47.41%
2017 38.13% 50.55% 36.07% 48.57%
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics - Ages 1-17 2020 62.22% 60.42% 62.97% 76.39%
2019 65.00% 63.47% 61.05% 78.36%
2018 48.98% 57.96% 56.00% 70.54%
2017 45.83% 58.14% 54.52% 68.67%
Info
Cervical Cancer Screening in Adolescent Females 2021 Plan State Avg Nat Avg 90th Pctl.
Non-Recommended Cervical Cancer Screening in Adolescent Females 0.22% 0.37% 0.59% 0.10%
Cervical Cancer Screening in Adolescent Females Year Plan State Avg. Natl. Avg. 90th Pctl.
Non-Recommended Cervical Cancer Screening in Adolescent Females 2020 0.20% 0.46% 0.67% 0.19%
2019 0.26% 0.58% 0.85% 0.24%
2018 0.33% 0.71% 1.05% 0.33%
2017 0.82% 0.94% 1.47% 0.50%
Info
Lower Back Pain 2021 Plan State Avg Nat Avg 90th Pctl.
Use of Imaging for Low Back Pain 73.14% 75.38% 77.23% 84.21%
Lower Back Pain Year Plan State Avg. Natl. Avg. 90th Pctl.
Use of Imaging for Low Back Pain 2020 75.40% 77.22% 78.53% 85.60%
2019 74.15% 77.01% 76.69% 83.47%
2018 71.32% 74.77% 75.11% 82.95%
2017 69.90% 73.85% 75.16% 82.29%
Info
Respiratory 2021 Plan State Avg Nat Avg 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection 95.60% 95.68% 94.48% 98.12%
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis 44.08% 44.79% 46.61% 61.68%
Respiratory Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection 2020 92.12% 93.12% 91.57% 95.67%
2019 92.27% 91.87% 90.76% 95.51%
2018 93.81% 92.50% 91.22% 95.48%
2017 90.02% 90.92% 89.19% 94.59%
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis 2020 40.17% 41.88% 43.24% 59.45%
2019 37.75% 38.42% 39.91% 54.09%
2018 28.31% 33.60% 33.16% 48.28%
2017 27.67% 30.67% 30.99% 49.52%
Info
Use of Opiods 2021 Plan State Avg Nat Avg 90th Pctl.
Use of Opioids at High Dosage 6.77% 6.26% 5.24% 1.88%
Use of Opioids From Multiple Providers - Multiple Pharmacies 1.32% 1.32% 1.59% 0.33%
Use of Opioids From Multiple Providers - Multiple Prescribers 14.62% 16.64% 13.69% 8.71%
Use of Opioids From Multiple Providers - Multiple Prescribers and Multiple Pharmacies 0.78% 0.70% 0.77% 0.00%
Use of Opiods Year Plan State Avg. Natl. Avg. 90th Pctl.
Use of Opioids at High Dosage 2020 7.62% 6.49% 5.76% 1.88%
2019 9.82% 6.96% 6.08% 1.88%
2018 3.87% 5.32% 4.54% 1.87%
2017 N/A N/A N/A N/A
Use of Opioids From Multiple Providers - Multiple Pharmacies 2020 3.25% 2.27% 1.67% 0.62%
2019 3.99% 3.75% 2.79% 0.69%
2018 6.65% 5.21% 3.80% 1.40%
2017 N/A N/A N/A N/A
Use of Opioids From Multiple Providers - Multiple Prescribers 2020 16.78% 16.62% 13.32% 8.20%
2019 17.97% 17.64% 14.51% 9.79%
2018 18.33% 18.32% 15.02% 9.64%
2017 N/A N/A N/A N/A
Use of Opioids From Multiple Providers - Multiple Prescribers and Multiple Pharmacies 2020 1.84% 1.22% 0.76% 0.08%
2019 2.00% 1.70% 1.24% 0.00%
2018 2.79% 2.68% 1.76% 0.47%
2017 N/A N/A N/A N/A
Risk Adjusted Utilization
Info
Acute Hospital Utilization Rate 2021 Plan State Avg Nat Avg 90th Pctl.
Acute Hospital Utilization - Medicine 30.08% 23.22% 0.78% 0.58%
Acute Hospital Utilization - Surgery 15.70% 11.64% N/A N/A
Acute Hospital Utilization - Total Acute 45.77% 34.86% 1.02% 0.79%
Acute Hospital Utilization Rate Year Plan State Avg. Natl. Avg. 90th Pctl.
Acute Hospital Utilization - Medicine 2020 28.63% 21.48% 0.72% 0.53%
2019 31.16% 26.50% 0.89% 0.68%
2018 N/A N/A N/A N/A
2017 N/A N/A N/A N/A
Acute Hospital Utilization - Surgery 2020 15.41% 11.94% N/A N/A
2019 18.31% 15.92% N/A N/A
2018 N/A N/A N/A N/A
2017 N/A N/A N/A N/A
Acute Hospital Utilization - Total Acute 2020 44.04% 33.42% 0.97% 0.78%
2019 49.47% 42.42% 1.09% 0.92%
2018 N/A N/A N/A N/A
2017 N/A N/A N/A N/A
Info
Emergency Department Utilization 2021 Plan State Avg Nat Avg 90th Pctl.
Emergency Department Utilization 164.20% 138.89% 0.90% 0.72%
Emergency Department Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Emergency Department Utilization 2020 144.07% 124.84% N/A N/A
2019 238.91% 187.39% 1.04% 0.82%
2018 N/A N/A N/A N/A
2017 N/A N/A N/A N/A
Info
Plan All-Cause Readmissions 2021 Plan State Avg Nat Avg 90th Pctl.
Plan All-Cause Readmissions Ages 18-64 (Total) 5.70% 4.93% 0.60% 0.48%
Plan All-Cause Readmissions Ages 18-44 4.21% 4.20% N/A N/A
Plan All-Cause Readmissions Ages 45-54 5.56% 4.67% N/A N/A
Plan All-Cause Readmissions Ages 55-64 6.73% 5.63% N/A N/A
Plan All-Cause Readmissions Year Plan State Avg. Natl. Avg. 90th Pctl.
Plan All-Cause Readmissions Ages 18-64 (Total) 2020 5.63% 4.88% 0.58% 0.47%
2019 4.34% 4.32% 0.51% 0.37%
2018 13.37% 11.17% N/A N/A
2017 13.26% 12.19% N/A N/A
Plan All-Cause Readmissions Ages 18-44 2020 4.77% 4.26% N/A N/A
2019 4.73% 4.54% N/A N/A
2018 13.33% 11.41% N/A N/A
2017 14.11% 12.99% N/A N/A
Plan All-Cause Readmissions Ages 45-54 2020 4.54% 4.46% N/A N/A
2019 4.40% 4.35% N/A N/A
2018 12.17% 10.56% N/A N/A
2017 12.25% 11.71% N/A N/A
Plan All-Cause Readmissions Ages 55-64 2020 6.85% 5.69% N/A N/A
2019 4.01% 4.26% N/A N/A
2018 14.24% 11.21% N/A N/A
2017 13.40% 11.93% N/A N/A
Utilization
Info
Antibiotic Utilization 2021 Plan State Avg Nat Avg 90th Pctl.
Average number of antibiotic prescriptions per member per year - Total 0.60 0.55 0.57 0.73
Average number of antibiotic prescriptions per member per year - Ages 0-9 0.35 0.39 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 10-17 0.30 0.31 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 18-34 0.58 0.52 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 35-49 0.60 0.57 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 50-64 0.72 0.67 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 65-74 0.83 0.75 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 75-85 0.89 0.82 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 85 plus 0.86 1.42 N/A N/A
Days suppplied per antibiotic prescription - Total 9.980 10.197 10.210 11.220
Days suppplied per antibiotic prescription - Ages 0-9 10.240 10.540 N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 14.640 14.793 N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 9.640 9.754 N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 9.660 9.787 N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 9.800 10.114 N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 9.480 10.241 N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 9.910 8.940 N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus 9.220 11.142 N/A N/A
Prescriptions of concern - Total 0.230 0.209 0.230 0.340
Prescriptions of concern - Ages 0-9 0.12 0.14 N/A N/A
Prescriptions of concern - Ages 10-17 0.09 0.10 N/A N/A
Prescriptions of concern - Ages 18-34 0.21 0.18 N/A N/A
Prescriptions of concern - Ages 35-49 0.23 0.22 N/A N/A
Prescriptions of concern - Ages 50-64 0.30 0.28 N/A N/A
Prescriptions of concern - Ages 65-74 0.33 0.29 N/A N/A
Prescriptions of concern - Ages 75-85 0.39 0.27 N/A N/A
Prescriptions of concern - Ages 85 plus 0.39 0.32 N/A N/A
Antibiotic Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Average number of antibiotic prescriptions per member per year - Total 2020 0.61 0.57 0.57 0.71
2019 0.78 0.75 0.74 0.90
2018 0.79 0.74 0.71 0.88
2017 0.80 0.77 0.76 0.90
Average number of antibiotic prescriptions per member per year - Ages 0-9 2020 0.38 0.41 N/A N/A
2019 0.82 0.85 N/A N/A
2018 0.82 0.81 N/A N/A
2017 0.85 0.87 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 10-17 2020 0.31 0.33 N/A N/A
2019 0.49 0.52 N/A N/A
2018 0.50 0.52 N/A N/A
2017 0.55 0.57 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 18-34 2020 0.56 0.53 N/A N/A
2019 0.69 0.66 N/A N/A
2018 0.70 0.65 N/A N/A
2017 0.70 0.67 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 35-49 2020 0.63 0.59 N/A N/A
2019 0.80 0.74 N/A N/A
2018 0.79 0.73 N/A N/A
2017 0.81 0.75 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 50-64 2020 0.74 0.70 N/A N/A
2019 0.88 0.85 N/A N/A
2018 0.91 0.84 N/A N/A
2017 0.91 0.88 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 65-74 2020 0.80 0.77 N/A N/A
2019 0.98 0.95 N/A N/A
2018 0.99 0.97 N/A N/A
2017 1.03 1.00 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 75-85 2020 0.88 0.80 N/A N/A
2019 1.09 1.15 N/A N/A
2018 1.07 1.21 N/A N/A
2017 1.04 1.12 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 85 plus 2020 0.77 1.56 N/A N/A
2019 0.93 0.95 N/A N/A
2018 1.06 1.32 N/A N/A
2017 1.18 1.12 N/A N/A
Days suppplied per antibiotic prescription - Total 2020 9.800 10.133 10.310 11.480
2019 9.520 9.888 9.890 10.660
2018 9.460 9.950 9.910 10.890
2017 9.560 10.024 9.880 10.830
Days suppplied per antibiotic prescription - Ages 0-9 2020 10.110 10.550 N/A N/A
2019 9.860 10.025 N/A N/A
2018 9.850 9.979 N/A N/A
2017 9.690 10.050 N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 2020 14.060 14.369 N/A N/A
2019 12.230 12.591 N/A N/A
2018 12.530 12.948 N/A N/A
2017 12.090 12.689 N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 2020 9.490 9.729 N/A N/A
2019 9.520 9.695 N/A N/A
2018 9.380 9.731 N/A N/A
2017 9.390 9.836 N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 2020 9.550 9.703 N/A N/A
2019 9.160 9.488 N/A N/A
2018 9.140 9.568 N/A N/A
2017 9.320 9.591 N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 2020 9.520 10.027 N/A N/A
2019 9.220 9.756 N/A N/A
2018 9.070 9.769 N/A N/A
2017 9.230 9.856 N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 2020 9.490 9.997 N/A N/A
2019 9.070 9.766 N/A N/A
2018 8.930 9.830 N/A N/A
2017 9.220 9.850 N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 2020 9.850 10.119 N/A N/A
2019 9.410 9.645 N/A N/A
2018 9.410 9.428 N/A N/A
2017 9.770 10.604 N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus 2020 9.470 10.606 N/A N/A
2019 9.000 9.997 N/A N/A
2018 9.200 9.026 N/A N/A
2017 9.820 9.873 N/A N/A
Prescriptions of concern - Total 2020 0.250 0.227 0.240 0.320
2019 0.360 0.339 0.330 0.430
2018 0.370 0.338 0.330 0.430
2017 0.380 0.354 0.360 0.450
Prescriptions of concern - Ages 0-9 2020 0.14 0.15 N/A N/A
2019 0.31 0.34 N/A N/A
2018 0.33 0.32 N/A N/A
2017 0.35 0.35 N/A N/A
Prescriptions of concern - Ages 10-17 2020 0.10 0.11 N/A N/A
2019 0.19 0.20 N/A N/A
2018 0.19 0.20 N/A N/A
2017 0.22 0.22 N/A N/A
Prescriptions of concern - Ages 18-34 2020 0.21 0.20 N/A N/A
2019 0.29 0.28 N/A N/A
2018 0.30 0.28 N/A N/A
2017 0.30 0.28 N/A N/A
Prescriptions of concern - Ages 35-49 2020 0.27 0.25 N/A N/A
2019 0.38 0.35 N/A N/A
2018 0.38 0.35 N/A N/A
2017 0.39 0.37 N/A N/A
Prescriptions of concern - Ages 50-64 2020 0.34 0.31 N/A N/A
2019 0.44 0.41 N/A N/A
2018 0.46 0.42 N/A N/A
2017 0.47 0.44 N/A N/A
Prescriptions of concern - Ages 65-74 2020 0.35 0.33 N/A N/A
2019 0.47 0.44 N/A N/A
2018 0.52 0.48 N/A N/A
2017 0.52 0.50 N/A N/A
Prescriptions of concern - Ages 75-85 2020 0.41 0.34 N/A N/A
2019 0.54 0.51 N/A N/A
2018 0.53 0.62 N/A N/A
2017 0.51 0.54 N/A N/A
Prescriptions of concern - Ages 85 plus 2020 0.40 0.41 N/A N/A
2019 0.53 0.36 N/A N/A
2018 0.57 0.45 N/A N/A
2017 0.64 0.48 N/A N/A
Info
Mental Health Utilization 2021 Plan State Avg Nat Avg 90th Pctl.
Mental Health Utilization - Any Service - Total 8.19% 9.40% 9.48% 13.63%
Mental Health Utilization - Any Service - Ages 0-12 5.46% 6.00% N/A N/A
Mental Health Utilization - Any Service - Ages 13-17 13.35% 16.24% N/A N/A
Mental Health Utilization - Any Service - Ages 18-64 8.87% 9.76% N/A N/A
Mental Health Utilization - Any Service - Ages 65 plus 2.79% 3.11% N/A N/A
Mental Health Utilization - ED - Total 0.10% 0.05% 0.07% 0.17%
Mental Health Utilization - ED - Ages 0-12 0.05% 0.02% N/A N/A
Mental Health Utilization - ED - Ages 13-17 0.39% 0.21% N/A N/A
Mental Health Utilization - ED - Ages 18-64 0.08% 0.04% N/A N/A
Mental Health Utilization - ED - Ages 65 plus 0.05% 0.01% N/A N/A
Mental Health Utilization - Inpatient - Total 0.26% 0.24% 0.25% 0.33%
Mental Health Utilization - Inpatient - Ages 0-12 0.08% 0.08% N/A N/A
Mental Health Utilization - Inpatient - Ages 13-17 0.84% 0.88% N/A N/A
Mental Health Utilization - Inpatient - Ages 18-64 0.25% 0.22% N/A N/A
Mental Health Utilization - Inpatient - Ages 65 plus 0.11% 0.08% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Total 0.11% 0.08% 0.16% 0.31%
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 0-12 0.07% 0.03% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 13-17 0.43% 0.40% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 18-64 0.10% 0.07% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 65 plus 0.03% 0.01% N/A N/A
Mental Health Utilization - Outpatient - Total 4.50% 4.73% 5.70% 8.26%
Mental Health Utilization - Outpatient - Ages 0-12 4.03% 3.72% N/A N/A
Mental Health Utilization - Outpatient - Ages 13-17 8.98% 9.85% N/A N/A
Mental Health Utilization - Outpatient - Ages 18-64 4.50% 4.63% N/A N/A
Mental Health Utilization - Outpatient - Ages 65 plus 1.80% 1.73% N/A N/A
Mental Health Utilization - Telehealth - Total 6.01% 6.68% 6.01% 9.77%
Mental Health Utilization - Telehealth - Ages 0-12 3.48% 3.74% N/A N/A
Mental Health Utilization - Telehealth - Ages 13-17 9.27% 10.92% N/A N/A
Mental Health Utilization - Telehealth - Ages 18-64 6.69% 7.11% N/A N/A
Mental Health Utilization - Telehealth - Ages 65 plus 1.76% 1.96% N/A N/A
Mental Health Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Mental Health Utilization - Any Service - Total 2020 7.98% 9.13% 9.07% 12.95%
2019 7.54% 8.33% 8.86% 12.67%
2018 6.89% 7.63% 7.98% 11.76%
2017 N/A N/A N/A N/A
Mental Health Utilization - Any Service - Ages 0-12 2020 5.43% 6.25% N/A N/A
2019 5.35% 6.35% N/A N/A
2018 5.24% 6.12% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Any Service - Ages 13-17 2020 12.19% 15.31% N/A N/A
2019 12.51% 15.01% N/A N/A
2018 11.44% 13.96% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Any Service - Ages 18-64 2020 8.56% 9.40% N/A N/A
2019 7.99% 8.45% N/A N/A
2018 7.18% 7.62% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Any Service - Ages 65 plus 2020 3.71% 3.53% N/A N/A
2019 2.79% 3.17% N/A N/A
2018 2.53% 3.20% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - ED - Total 2020 0.09% 0.03% 0.06% 0.15%
2019 0.11% 0.04% 0.08% 0.17%
2018 0.10% 0.09% 0.10% 0.22%
2017 N/A N/A N/A N/A
Mental Health Utilization - ED - Ages 0-12 2020 0.04% 0.01% N/A N/A
2019 0.05% 0.02% N/A N/A
2018 0.07% 0.05% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - ED - Ages 13-17 2020 0.20% 0.10% N/A N/A
2019 0.44% 0.17% N/A N/A
2018 0.32% 0.28% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - ED - Ages 18-64 2020 0.09% 0.03% N/A N/A
2019 0.09% 0.03% N/A N/A
2018 0.09% 0.08% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - ED - Ages 65 plus 2020 0.05% 0.01% N/A N/A
2019 0.05% 0.07% N/A N/A
2018 0.01% 0.02% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Total 2020 0.24% 0.22% 0.24% 0.31%
2019 0.25% 0.25% 0.27% 0.34%
2018 0.29% 0.27% 0.27% 0.34%
2017 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 0-12 2020 0.05% 0.07% N/A N/A
2019 0.10% 0.12% N/A N/A
2018 0.14% 0.12% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 13-17 2020 0.77% 0.79% N/A N/A
2019 0.86% 0.85% N/A N/A
2018 0.83% 0.95% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 18-64 2020 0.23% 0.20% N/A N/A
2019 0.25% 0.24% N/A N/A
2018 0.27% 0.26% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 65 plus 2020 0.12% 0.06% N/A N/A
2019 0.08% 0.11% N/A N/A
2018 0.15% 0.06% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Total 2020 0.10% 0.07% 0.15% 0.30%
2019 0.16% 0.11% 0.20% 0.40%
2018 0.10% 0.12% 0.19% 0.38%
2017 N/A N/A N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 0-12 2020 0.05% 0.05% N/A N/A
2019 0.09% 0.10% N/A N/A
2018 0.08% 0.15% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 13-17 2020 0.35% 0.26% N/A N/A
2019 0.59% 0.35% N/A N/A
2018 0.45% 0.49% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 18-64 2020 0.09% 0.06% N/A N/A
2019 0.14% 0.09% N/A N/A
2018 0.08% 0.09% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 65 plus 2020 0.01% 0.01% N/A N/A
2019 0.04% 0.02% N/A N/A
2018 0.03% 0.02% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Outpatient - Total 2020 6.18% 7.22% 6.95% 9.99%
2019 7.45% 8.24% 8.73% 12.61%
2018 6.79% 7.53% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Outpatient - Ages 0-12 2020 4.75% 5.23% N/A N/A
2019 5.33% 6.32% N/A N/A
2018 5.22% 6.10% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Outpatient - Ages 13-17 2020 10.64% 12.84% N/A N/A
2019 12.35% 14.86% N/A N/A
2018 11.26% 13.80% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Outpatient - Ages 18-64 2020 6.44% 7.35% N/A N/A
2019 7.90% 8.36% N/A N/A
2018 7.08% 7.51% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Outpatient - Ages 65 plus 2020 2.65% 2.62% N/A N/A
2019 2.72% 3.07% N/A N/A
2018 2.42% 3.16% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Telehealth - Total 2020 4.81% 4.92% 5.19% 8.37%
2019 0.10% 0.11% 0.11% 0.22%
2018 0.07% 0.10% 0.05% 0.11%
2017 N/A N/A N/A N/A
Mental Health Utilization - Telehealth - Ages 0-12 2020 3.20% 3.07% N/A N/A
2019 0.01% 0.04% N/A N/A
2018 0.01% 0.03% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Telehealth - Ages 13-17 2020 7.32% 8.30% N/A N/A
2019 0.17% 0.15% N/A N/A
2018 0.08% 0.19% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Telehealth - Ages 18-64 2020 5.20% 5.11% N/A N/A
2019 0.12% 0.12% N/A N/A
2018 0.08% 0.11% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Telehealth - Ages 65 plus 2020 2.00% 1.80% N/A N/A
2019 0.02% 0.02% N/A N/A
2018 0.02% 0.02% N/A N/A
2017 N/A N/A N/A N/A
2021 data updated on: 07/02/2024