Health Insurance in Virginia

UnitedHealthcare of the Mid-Atlantic, Inc.

Company Information

  • Company Providing Plan:United Healthcare
  • Address:9800 Health Care Lane MN006-W500
    Minnetonka, MN 55343
  • Telephone :866-297-9264
  • Website:www.uhc.com
2017
Number of Enrollees: *83,174
PMPM: *$337
Number of Physicians: *68,443
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

All in Commonwealth of Virginia


Cities

All in Commonwealth of Virginia

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

Administrative Data

2017 2016 2015 2014 2013
*Number of Enrollees 83,174 16,756 1,672 1,648 3,525
PMPM $337 $321 $559 $496 $440
*Medical Cost Ratio 81% 79% 95% 86% 89%
*Administrative Ratio 12% 13% 13% 10% 12%
*Profit/Loss Ratio 7% 10% -9% 3% -0%
*Number of Physicians 68,443 43,435 40,524 34,031 45,153

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

Financial Data

2017 2016 2015 2014 2013
Premiums Earned $116,588,510 $58,634,436 $10,879,176 $11,802,662 $23,606,360
*Income $39,162,340 $62,387,299 ($64,214,843) $12,554,182 ($126,044)
*Net Worth $104,478,161 $139,848,163 $128,725,933 $135,936,985 $114,398,406

*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 2017 Plan State Avg Nat Avg 90th Pctl.
Adult Access (Age 20-44) To Preventive/Ambulatory Health Services 94.12% 92.73% 92.45% 95.43%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 95.87% 95.57% 95.61% 97.46%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 98.84% 97.82% 97.07% 98.47%
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 2016 93.37% 92.81% 92.73% 95.55%
2015 92.89% 92.25% 92.83% 95.45%
2014 93.68% 93.10% 92.91% 95.39%
2013 93.15% 93.27% 93.13% 95.56%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 2016 94.81% 95.78% 95.78% 97.61%
2015 94.60% 95.61% 95.90% 97.55%
2014 95.16% 96.03% 95.85% 97.54%
2013 95.01% 95.97% 95.93% 97.60%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 2016 96.00% 97.30% 97.19% 98.61%
2015 95.96% 96.84% 97.32% 96.73%
2014 98.68% 97.56% 97.50% 98.68%
2013 96.55% 97.45% 97.36% 98.63%
Info
Alcohol and Other Drug Dependence Treatment 2017 Plan State Avg Nat Avg 90th Pctl.
Initiation of Alcohol and Other Drug Dependence Treatment - Total 35.94% 36.14% 36.11% 42.01%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 33.33% 40.06% 39.91% 52.54%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 36.21% 36.00% 35.97% 41.96%
Engagement of Alcohol and Other Drug Dependence Treatment - Total 10.94% 13.36% 12.65% 17.26%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 0.00% 14.40% 14.95% 23.85%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 12.07% 13.40% 12.55% 17.38%
Alcohol and Other Drug Dependence Treatment Year Plan State Avg. Natl. Avg. 90th Pctl.
Initiation of Alcohol and Other Drug Dependence Treatment - Total 2016 35.56% 35.69% 32.93% 40.24%
2015 21.57% 33.04% 33.42% 41.07%
2014 34.62% 32.51% 35.63% 44.19%
2013 31.39% 35.00% 39.01% 50.93%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2016 50.00% 40.15% 40.47% 51.96%
2015 N/A 37.03% 39.62% 50.00%
2014 N/A 37.09% 40.79% 52.00%
2013 N/A 39.67% 41.13% 53.51%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2016 34.88% 35.55% 32.64% 40.33%
2015 22.00% 32.96% 33.20% 40.93%
2014 33.33% 32.16% 35.21% 43.92%
2013 30.08% 34.74% 38.83% 51.61%
Engagement of Alcohol and Other Drug Dependence Treatment - Total 2016 11.11% 12.51% 11.46% 16.72%
2015 7.84% 11.61% 12.46% 19.23%
2014 12.82% 10.64% 13.66% 19.19%
2013 12.41% 12.12% 14.64% 21.16%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2016 0.00% 11.28% 15.68% 23.73%
2015 N/A 12.06% 15.42% 22.12%
2014 N/A 13.00% 17.24% 25.29%
2013 N/A 18.05% 18.23% 27.05%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2016 11.63% 12.57% 11.32% 16.09%
2015 8.00% 11.57% 12.34% 18.67%
2014 11.11% 10.33% 13.45% 18.68%
2013 11.28% 11.84% 14.47% 21.31%
Info
Child Access to Primary Care Practitioners 2017 Plan State Avg Nat Avg 90th Pctl.
Child Access to Primary Care Practitioners Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Prenatal and Postpartum Care 2017 Plan State Avg Nat Avg 90th Pctl.
Timeliness of Prenatal Care 80.65% 87.01% N/A N/A
Prenatal and Postpartum Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Timeliness of Prenatal Care 2016 88.24% 86.52% N/A N/A
2015 86.30% 86.91% N/A N/A
2014 82.64% 85.85% N/A N/A
2013 93.23% 91.58% N/A N/A
Effectiveness of Care
Info
Asthma Medication Management 2017 Plan State Avg Nat Avg 90th Pctl.
Medication Management for People With Asthma at least 50% Compliance - Total 84.62% 76.58% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 5-11 71.43% 66.50% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 12-18 83.33% 68.06% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 19-50 81.82% 75.34% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 51-64 94.12% 84.54% N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Total 57.69% 54.32% 50.48% 57.69%
Medication Management for People With Asthma at least 75% Compliance - Ages 5-11 42.86% 42.35% 40.22% 52.99%
Medication Management for People With Asthma at least 75% Compliance - Ages 12-18 50.00% 41.76% 37.80% 47.11%
Medication Management for People With Asthma at least 75% Compliance - Ages 19-50 54.55% 52.86% 48.60% 57.87%
Medication Management for People With Asthma at least 75% Compliance - Ages 51-64 70.59% 64.50% 59.65% 67.58%
Asthma Medication Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Medication Management for People With Asthma at least 50% Compliance - Total 2016 81.82% 73.20% N/A N/A
2015 78.72% 71.52% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 5-11 2016 87.50% 67.58% N/A N/A
2015 N/A 64.34% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 12-18 2016 100.00% 65.72% N/A N/A
2015 N/A 60.17% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 19-50 2016 77.27% 71.77% N/A N/A
2015 N/A 68.82% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 51-64 2016 84.62% 79.36% N/A N/A
2015 N/A 78.55% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Total 2016 54.55% 51.17% 48.54% 56.96%
2015 51.06% 48.01% 46.20% 55.00%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Ages 5-11 2016 50.00% 39.03% 37.58% 48.84%
2015 N/A 36.59% 37.85% 49.09%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Ages 12-18 2016 0.00% 35.03% 35.83% 46.97%
2015 N/A 35.39% 34.97% 45.26%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Ages 19-50 2016 59.09% 50.18% 46.16% 55.80%
2015 N/A 45.56% 43.39% 53.13%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Ages 51-64 2016 53.85% 59.39% 57.47% 65.75%
2015 N/A 58.44% 55.49% 65.28%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Info
Asthma Medication Ratio 2017 Plan State Avg Nat Avg 90th Pctl.
Controller/Total Asthma Medication Ratio - Total 87.27% 84.01% 79.04% 85.85%
Controller/Total Asthma Medication Ratio - Ages 5-11 75.00% 86.06% 86.90% 93.55%
Controller/Total Asthma Medication Ratio - Ages 12-18 100.00% 84.80% 76.69% 85.94%
Controller/Total Asthma Medication Ratio - Ages 19-50 79.17% 78.94% 74.23% 81.70%
Controller/Total Asthma Medication Ratio - Ages 51-64 100.00% 89.17% 82.83% 89.28%
Asthma Medication Ratio Year Plan State Avg. Natl. Avg. 90th Pctl.
Controller/Total Asthma Medication Ratio - Total 2016 76.00% 80.60% 78.29% 85.46%
2015 83.02% 81.09% 77.99% 83.76%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Controller/Total Asthma Medication Ratio - Ages 5-11 2016 100.00% 91.67% 86.40% 93.97%
2015 N/A 88.49% 86.99% 92.47%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Controller/Total Asthma Medication Ratio - Ages 12-18 2016 100.00% 81.12% 78.30% 86.34%
2015 N/A 78.19% 77.09% 84.67%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Controller/Total Asthma Medication Ratio - Ages 19-50 2016 70.37% 75.24% 73.51% 81.08%
2015 N/A 75.16% 72.38% 80.79%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Controller/Total Asthma Medication Ratio - Ages 51-64 2016 71.43% 83.27% 81.70% 88.64%
2015 N/A 85.39% 81.87% 88.89%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Info
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication 2017 Plan State Avg Nat Avg 90th Pctl.
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Initiation 22.22% 41.27% 41.13% 50.83%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 100.00% 55.09% 47.07% 58.44%
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 2016 46.67% 41.91% 38.93% 48.61%
2015 N/A 41.43% 38.13% 50.00%
2014 N/A 39.00% 38.01% 46.81%
2013 38.46% 35.14% 40.10% 51.06%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 2016 25.00% 46.92% 45.82% 56.86%
2015 N/A 49.06% 46.18% 58.06%
2014 N/A 46.49% 45.70% 57.75%
2013 N/A 41.32% 46.66% 58.62%
Info
Cardiovascular Disease Management 2017 Plan State Avg Nat Avg 90th Pctl.
Controlling High Blood Pressure 53.28% 56.61% 59.90% 74.82%
Persistence of Beta-Blockers 80.00% 85.80% 85.18% 93.41%
Cardiovascular Disease Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Controlling High Blood Pressure 2016 50.78% 56.91% 60.31% 74.43%
2015 52.88% 58.35% 58.69% 73.89%
2014 51.64% 59.30% 62.63% 75.63%
2013 55.50% 60.92% 63.30% 74.65%
Persistence of Beta-Blockers 2016 100.00% 90.70% 83.61% 90.83%
2015 100.00% 88.70% 84.68% 91.00%
2014 N/A 84.03% 83.50% 91.43%
2013 N/A 83.43% 83.39% 91.72%
Info
Common Childhood Illnesses 2017 Plan State Avg Nat Avg 90th Pctl.
Appropriate Testing for Children With Pharyngitis 91.73% 92.01% 87.45% 94.64%
Common Childhood Illnesses Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Testing for Children With Pharyngitis 2016 93.75% 91.84% 84.50% 93.75%
2015 95.56% 91.35% 83.12% 93.11%
2014 87.25% 90.30% 83.29% 91.40%
2013 85.71% 89.15% 81.45% 91.30%
Info
Diabetes Care and Management 2017 Plan State Avg Nat Avg 90th Pctl.
Diabetes Care and Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Drug Therapy in Rheumatoid Arthritis 2017 Plan State Avg Nat Avg 90th Pctl.
Drug Therapy in Rheumatoid Arthritis Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Immunizations 2017 Plan State Avg Nat Avg 90th Pctl.
Immunizations for Adolescents - Combination 83.78% 82.98% N/A N/A
Immunizations for Adolescents - Meningococcal 89.19% 81.29% 81.75% 90.27%
Immunizations Year Plan State Avg. Natl. Avg. 90th Pctl.
Immunizations for Adolescents - Combination 2016 78.87% 79.09% N/A N/A
2015 72.29% 66.99% N/A N/A
2014 69.79% 66.20% N/A N/A
2013 N/A 51.54% N/A N/A
Immunizations for Adolescents - Meningococcal 2016 80.28% 79.81% 79.20% 90.02%
2015 0.75% 0.73% 76.12% 89.29%
2014 0.70% 0.70% 72.59% 88.27%
2013 N/A 0.66% 68.70% 85.25%
Info
Mental Health: Care and Follow-up 2017 Plan State Avg Nat Avg 90th Pctl.
Mental Health: Care and Follow-up Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Persistent Medications 2017 Plan State Avg Nat Avg 90th Pctl.
Persistent Medications Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Pharmacotherapy of COPD Exacerbation 2017 Plan State Avg Nat Avg 90th Pctl.
Pharmacotherapy of COPD Exacerbation Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Preventive Care 2017 Plan State Avg Nat Avg 90th Pctl.
Breast Cancer Screening 71.76% 71.85% 72.81% 80.91%
Chlamydia Screening in Women-all Age groups 50.44% 51.46% 50.16% 66.08%
Preventive Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Breast Cancer Screening 2016 72.76% 71.80% 72.90% 80.63%
2015 71.90% 72.07% 73.08% 81.53%
2014 69.34% 72.22% 73.52% 81.91%
2013 70.63% 72.82% 73.71% 80.78%
Chlamydia Screening in Women-all Age groups 2016 48.86% 49.79% 48.98% 63.50%
2015 49.03% 47.89% 52.32% 64.06%
2014 46.63% 48.07% 51.65% 63.48%
2013 47.00% 47.46% 46.20% 59.63%
Info
Spirometry Testing 2017 Plan State Avg Nat Avg 90th Pctl.
Spirometry Testing Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Weight Assessment and Counseling 2017 Plan State Avg Nat Avg 90th Pctl.
Counseling for Physical Activity for Children/Adolescents - Total 60.58% 59.44% N/A N/A
Weight Assessment and Counseling Year Plan State Avg. Natl. Avg. 90th Pctl.
Counseling for Physical Activity for Children/Adolescents - Total 2016 54.86% 54.14% N/A N/A
2015 60.42% 54.38% N/A N/A
2014 58.33% 58.06% N/A N/A
2013 56.94% 52.85% N/A N/A
Health Plan Stability/Descriptive
Info
Administrative Data 2017 Plan State Avg Nat Avg 90th Pctl.
Administrative Ratio 0.12 0.12 86.39 93.13
Medical Cost Ratio 0.81 0.83 93.13 96.59
Number of Enrollees 83,174 133,992 92 97
Number of Physicians 68,443 81,926 87 95
Premium Per Member Per Month $337 $370 N/A N/A
Profit/Loss Ratio 0.07 0.05 79.44 89.14
Administrative Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Administrative Ratio 2016 0.13 0.15 N/A N/A
2015 0.13 0.14 N/A N/A
2014 0.10 0.14 N/A N/A
2013 0.12 0.14 N/A N/A
Medical Cost Ratio 2016 0.79 0.83 N/A N/A
2015 0.95 0.82 N/A N/A
2014 0.86 0.81 N/A N/A
2013 0.89 0.83 N/A N/A
Number of Enrollees 2016 16,756 136,796 N/A N/A
2015 1,672 124,097 N/A N/A
2014 1,648 115,428 N/A N/A
2013 3,525 98,253 N/A N/A
Number of Physicians 2016 43,435 73,426 N/A N/A
2015 40,524 90,027 N/A N/A
2014 34,031 63,157 N/A N/A
2013 45,153 64,207 N/A N/A
Premium Per Member Per Month 2016 $321 $370 N/A N/A
2015 $559 $375 N/A N/A
2014 $496 $412 N/A N/A
2013 $440 $544 N/A N/A
Profit/Loss Ratio 2016 0.10 0.03 N/A N/A
2015 -0.09 0.04 N/A N/A
2014 0.03 0.06 N/A N/A
2013 -0.00 0.03 N/A N/A
Info
Board Certification Rates for Providers 2017 Plan State Avg Nat Avg 90th Pctl.
Board Certification for Geriatricians 61.00% 71.38% N/A N/A
Board Certification for Pediatricians 82.00% 85.50% N/A N/A
Board Certification Rate for Family Medicine Physicians 74.00% 81.38% N/A N/A
Board Certification Rate for Internal Medicine Physicians 77.00% 81.00% N/A N/A
Board Certification Rate for OB/GYN Providers 83.00% 83.00% N/A N/A
Board Certification Rate for Other Specialists 80.00% 81.88% N/A N/A
Board Certification Rates for Providers Year Plan State Avg. Natl. Avg. 90th Pctl.
Board Certification for Geriatricians 2016 66.54% 73.44% N/A N/A
2015 65.43% 71.06% N/A N/A
2014 65.90% 74.73% 64.82% 87.50%
2013 67.08% 71.19% 63.29% 83.33%
Board Certification for Pediatricians 2016 83.65% 87.02% N/A N/A
2015 86.38% 88.14% N/A N/A
2014 87.80% 88.13% 83.89% 91.52%
2013 87.80% 86.01% 81.01% 90.29%
Board Certification Rate for Family Medicine Physicians 2016 72.97% 80.32% N/A N/A
2015 77.53% 82.53% N/A N/A
2014 79.66% 82.93% 77.41% 89.90%
2013 80.56% 81.36% 76.60% 88.80%
Board Certification Rate for Internal Medicine Physicians 2016 76.17% 81.15% N/A N/A
2015 78.38% 82.59% N/A N/A
2014 81.05% 83.98% 79.07% 88.73%
2013 80.16% 80.80% 78.18% 87.44%
Board Certification Rate for OB/GYN Providers 2016 83.10% 83.36% N/A N/A
2015 85.90% 83.51% N/A N/A
2014 85.73% 83.71% 79.30% 88.80%
2013 86.09% 80.44% 76.89% 87.80%
Board Certification Rate for Other Specialists 2016 80.80% 83.25% N/A N/A
2015 82.49% 82.88% N/A N/A
2014 83.50% 84.44% 78.09% 89.67%
2013 84.15% 79.95% 74.88% 88.36%
Info
Financial Data 2017 Plan State Avg Nat Avg 90th Pctl.
Financial Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Years in Business 2017 Plan State Avg Nat Avg 90th Pctl.
Years in Business 40 35 N/A N/A
Years in Business Year Plan State Avg. Natl. Avg. 90th Pctl.
Years in Business 2016 39 34 N/A N/A
2015 38 33 N/A N/A
2014 37 32 N/A N/A
2013 36 31 N/A N/A
Member Satisfaction
Info
Member Satisfaction 2017 Plan State Avg Nat Avg 90th Pctl.
Getting Needed Care 87.87% 88.46% N/A N/A
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 90.27% 94.34% 95.10% 96.91%
Member Satisfaction Year Plan State Avg. Natl. Avg. 90th Pctl.
Getting Needed Care 2016 85.23% 87.23% N/A N/A
2015 87.55% 87.33% N/A N/A
2014 89.39% 88.88% N/A N/A
2013 86.01% 87.29% N/A N/A
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 2016 76.70% 94.88% 95.39% 97.21%
2015 80.00% 94.63% 95.20% 97.10%
2014 85.81% 94.87% 95.26% 97.16%
2013 82.41% 93.94% 94.94% 96.97%
Overuse/Appropriateness
Info
Antipsychotics 2017 Plan State Avg Nat Avg 90th Pctl.
Metabolic Monitoring for Children and Adolescents on Antipsychotics - Ages 1-17 100.00% 50.55% 36.07% 48.57%
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics - Ages 1-17 100.00% 58.14% 54.52% 68.67%
Use of Multiple Concurrent Antipsychotics in Children and Adolescents - Ages 1-17 0.00% 2.39% N/A N/A
Antipsychotics Year Plan State Avg. Natl. Avg. 90th Pctl.
Metabolic Monitoring for Children and Adolescents on Antipsychotics - Ages 1-17 2016 0.00% 34.87% 35.80% 45.93%
2015 N/A 37.02% 33.94% 45.45%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics - Ages 1-17 2016 75.00% 61.93% 58.30% 75.00%
2015 N/A 61.38% 54.40% 70.49%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Use of Multiple Concurrent Antipsychotics in Children and Adolescents - Ages 1-17 2016 0.00% 2.06% N/A N/A
2015 0.00% 1.70% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Info
Cervical Cancer Screening in Adolescent Females 2017 Plan State Avg Nat Avg 90th Pctl.
Cervical Cancer Screening in Adolescent Females Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Lower Back Pain 2017 Plan State Avg Nat Avg 90th Pctl.
Lower Back Pain Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Respiratory 2017 Plan State Avg Nat Avg 90th Pctl.
Respiratory Year Plan State Avg. Natl. Avg. 90th Pctl.
Utilization
Info
Antibiotic Utilization 2017 Plan State Avg Nat Avg 90th Pctl.
Average number of antibiotic prescriptions per member per year - Total 0.71 0.77 0.76 0.90
Average number of antibiotic prescriptions per member per year - Ages 0-9 0.86 0.87 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 10-17 0.57 0.57 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 18-34 0.60 0.67 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 35-49 0.69 0.75 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 50-64 0.82 0.88 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 65-74 0.94 1.00 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 75-85 1.19 1.12 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 85 plus 0.00 1.12 N/A N/A
Days suppplied per antibiotic prescription - Total 9.52 10.02 9.88 10.83
Days suppplied per antibiotic prescription - Ages 0-9 10.06 10.05 N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 11.14 12.69 N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 8.93 9.84 N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 9.31 9.59 N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 9.72 9.86 N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 7.93 9.85 N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 8.29 10.60 N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus N/A 9.87 N/A N/A
Prescriptions of concern - Total 0.34 0.35 0.36 0.45
Prescriptions of concern - Ages 0-9 0.37 0.35 N/A N/A
Prescriptions of concern - Ages 10-17 0.23 0.22 N/A N/A
Prescriptions of concern - Ages 18-34 0.26 0.28 N/A N/A
Prescriptions of concern - Ages 35-49 0.34 0.37 N/A N/A
Prescriptions of concern - Ages 50-64 0.43 0.44 N/A N/A
Prescriptions of concern - Ages 65-74 0.56 0.50 N/A N/A
Prescriptions of concern - Ages 75-85 0.60 0.54 N/A N/A
Prescriptions of concern - Ages 85 plus 0.00 0.48 N/A N/A
Antibiotic Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Average number of antibiotic prescriptions per member per year - Total 2016 0.78 0.79 0.76 0.90
2015 0.77 0.80 0.81 0.97
2014 0.81 0.75 0.79 0.96
2013 0.84 0.83 0.81 0.98
Average number of antibiotic prescriptions per member per year - Ages 0-9 2016 1.01 0.97 N/A N/A
2015 0.90 0.94 N/A N/A
2014 1.01 0.84 N/A N/A
2013 0.91 0.93 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 10-17 2016 0.66 0.60 N/A N/A
2015 0.56 0.60 N/A N/A
2014 0.66 0.56 N/A N/A
2013 0.64 0.62 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 18-34 2016 0.69 0.69 N/A N/A
2015 0.68 0.70 N/A N/A
2014 0.72 0.67 N/A N/A
2013 0.77 0.74 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 35-49 2016 0.73 0.77 N/A N/A
2015 0.75 0.80 N/A N/A
2014 0.79 0.76 N/A N/A
2013 0.86 0.83 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 50-64 2016 0.86 0.87 N/A N/A
2015 0.91 0.90 N/A N/A
2014 0.92 0.84 N/A N/A
2013 0.93 0.92 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 65-74 2016 0.94 0.99 N/A N/A
2015 1.15 1.07 N/A N/A
2014 0.99 0.96 N/A N/A
2013 0.91 1.05 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 75-85 2016 2.18 1.23 N/A N/A
2015 0.61 1.08 N/A N/A
2014 1.34 1.09 N/A N/A
2013 0.71 1.11 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 85 plus 2016 0.00 0.73 N/A N/A
2015 1.38 1.67 N/A N/A
2014 0.50 1.37 N/A N/A
2013 2.57 1.67 N/A N/A
Days suppplied per antibiotic prescription - Total 2016 9.68 10.09 9.88 10.83
2015 9.89 10.26 10.12 11.03
2014 10.67 10.44 10.32 11.18
2013 10.44 10.44 10.45 11.35
Days suppplied per antibiotic prescription - Ages 0-9 2016 10.55 10.04 N/A N/A
2015 9.89 9.99 N/A N/A
2014 10.32 10.01 N/A N/A
2013 10.24 10.00 N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 2016 12.26 12.80 N/A N/A
2015 11.46 13.32 N/A N/A
2014 13.57 13.65 N/A N/A
2013 14.23 13.72 N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 2016 9.77 10.07 N/A N/A
2015 10.09 10.33 N/A N/A
2014 11.28 10.65 N/A N/A
2013 10.87 10.61 N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 2016 8.99 9.62 N/A N/A
2015 9.91 9.83 N/A N/A
2014 10.21 9.95 N/A N/A
2013 10.00 9.93 N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 2016 9.24 9.82 N/A N/A
2015 9.44 9.90 N/A N/A
2014 9.87 10.04 N/A N/A
2013 9.59 10.07 N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 2016 7.66 9.93 N/A N/A
2015 9.04 10.18 N/A N/A
2014 10.60 10.43 N/A N/A
2013 8.79 10.23 N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 2016 7.22 10.59 N/A N/A
2015 5.00 9.93 N/A N/A
2014 8.16 10.54 N/A N/A
2013 6.95 10.32 N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus 2016 N/A 9.43 N/A N/A
2015 7.67 9.54 N/A N/A
2014 10.00 10.65 N/A N/A
2013 5.33 8.73 N/A N/A
Prescriptions of concern - Total 2016 0.39 0.38 0.36 0.45
2015 0.39 0.40 0.41 0.52
2014 0.41 0.37 0.39 0.49
2013 0.43 0.42 0.41 0.52
Prescriptions of concern - Ages 0-9 2016 0.48 0.43 N/A N/A
2015 0.39 0.41 N/A N/A
2014 0.45 0.38 N/A N/A
2013 0.43 0.44 N/A N/A
Prescriptions of concern - Ages 10-17 2016 0.25 0.24 N/A N/A
2015 0.24 0.25 N/A N/A
2014 0.29 0.22 N/A N/A
2013 0.25 0.25 N/A N/A
Prescriptions of concern - Ages 18-34 2016 0.31 0.31 N/A N/A
2015 0.32 0.32 N/A N/A
2014 0.32 0.30 N/A N/A
2013 0.37 0.34 N/A N/A
Prescriptions of concern - Ages 35-49 2016 0.39 0.40 N/A N/A
2015 0.40 0.42 N/A N/A
2014 0.44 0.41 N/A N/A
2013 0.47 0.45 N/A N/A
Prescriptions of concern - Ages 50-64 2016 0.48 0.46 N/A N/A
2015 0.51 0.49 N/A N/A
2014 0.50 0.45 N/A N/A
2013 0.52 0.50 N/A N/A
Prescriptions of concern - Ages 65-74 2016 0.56 0.51 N/A N/A
2015 0.62 0.57 N/A N/A
2014 0.57 0.51 N/A N/A
2013 0.54 0.56 N/A N/A
Prescriptions of concern - Ages 75-85 2016 1.45 0.65 N/A N/A
2015 0.61 0.59 N/A N/A
2014 0.43 0.51 N/A N/A
2013 0.15 0.57 N/A N/A
Prescriptions of concern - Ages 85 plus 2016 0.00 0.34 N/A N/A
2015 0.46 0.82 N/A N/A
2014 0.00 0.55 N/A N/A
2013 2.57 1.15 N/A N/A
Info
Child and Adolescent Well Child Visits 2017 Plan State Avg Nat Avg 90th Pctl.
Well Child Visits in the First 15 Months of Life 85.45% 85.55% N/A N/A
Well Child Visits in the 3rd - 6th Years 83.18% 83.18% 79.11% 91.03%
Adolescent Well-Care Visits 50.43% 53.24% 50.46% 70.44%
Child and Adolescent Well Child Visits Year Plan State Avg. Natl. Avg. 90th Pctl.
Well Child Visits in the First 15 Months of Life 2016 88.00% 82.77% N/A N/A
2015 85.45% 83.06% N/A N/A
2014 86.15% 81.95% N/A N/A
2013 82.02% 82.08% N/A N/A
Well Child Visits in the 3rd - 6th Years 2016 87.89% 82.50% 78.30% 90.11%
2015 82.33% 80.48% 77.75% 89.74%
2014 83.08% 80.03% 77.37% 88.75%
2013 80.49% 78.43% 75.89% 88.25%
Adolescent Well-Care Visits 2016 52.95% 50.35% 49.68% 67.70%
2015 58.26% 49.34% 48.26% 64.50%
2014 56.91% 48.09% 47.51% 64.76%
2013 52.72% 46.84% 46.27% 63.82%
Info
Mental Health Utilization 2017 Plan State Avg Nat Avg 90th Pctl.
Mental Health Utilization - ED - Ages 0-12 0.00% 0.01% N/A N/A
Mental Health Utilization - ED - Ages 13-17 0.00% 0.00% N/A N/A
Mental Health Utilization - Outpatient - Ages 18-64 6.49% 6.30% N/A N/A
Mental Health Utilization - Outpatient - Ages 65 plus 4.19% 2.97% N/A N/A
Mental Health Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Mental Health Utilization - ED - Ages 0-12 2016 4.71% 5.26% N/A N/A
2015 3.84% 5.07% N/A N/A
2014 4.29% 5.47% N/A N/A
2013 3.84% 5.15% N/A N/A
Mental Health Utilization - ED - Ages 13-17 2016 14.81% 14.81% N/A N/A
2015 10.33% 10.33% N/A N/A
2014 10.70% 10.70% N/A N/A
2013 10.29% 10.29% N/A N/A
Mental Health Utilization - Outpatient - Ages 18-64 2016 5.95% 6.56% N/A N/A
2015 6.12% 6.62% N/A N/A
2014 6.68% 7.64% N/A N/A
2013 5.99% 6.80% N/A N/A
Mental Health Utilization - Outpatient - Ages 65 plus 2016 N/A N/A N/A N/A
2015 N/A N/A N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
Info
Plan All-Cause Readmissions 2017 Plan State Avg Nat Avg 90th Pctl.
Plan All-Cause Readmissions Year Plan State Avg. Natl. Avg. 90th Pctl.