Health Insurance in Virginia

HealthKeepers, Inc.

Company Information

  • Company Providing Plan:Anthem
  • Address:2015 Staples Mill Road
    Richmond, VA 23230
  • Telephone :804-354-7000
  • Website:www.antheminc.com
2018
Number of Enrollees: 532,548
PMPM: $532
Number of Physicians: 29,248
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

Commonwealth of Virginia


Cities

Commonwealth of Virginia

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

Administrative Data

2018 2017 2016 2015 2014
Number of Enrollees 532,548 669,975 632,321 629,111 536,354
PMPM $532 $435 $407 $374 $354
Medical Cost Ratio 83% 82% 83% 83% 82%
Administrative Ratio 11% 10% 11% 13% 12%
Profit/Loss Ratio 6% 8% 7% 4% 6%
Number of Physicians 29,248 28,352 26,959 26,000 23,885

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

Financial Data

2018 2017 2016 2015 2014
Premiums Earned $3,496,135,978 $3,474,182,105 $3,155,311,445 $2,833,491,417 $2,095,055,319
Income $146,778,850 $183,916,865 $123,796,881 $46,167,714 $65,346,525
Net Worth $566,871,633 $595,066,070 $442,676,709 $340,724,748 $281,472,144

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

Performance

  • Healthkeepers is the product for
    HealthKeepers, Inc, Peninsula Health Care, Inc. and Priority Health Care, Inc.
Access/Availability of Care
Info
Adult Access To Preventive/Ambulatory Health Services 2018 Plan State Avg Nat Avg 90th Pctl.
Adult Access (Age 20-44) To Preventive/Ambulatory Health Services 94.45% 92.43% 92.33% 95.45%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 96.65% 95.50% 95.64% 97.49%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 97.85% 97.15% 97.17% 98.45%
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 2017 94.19% 92.73% 92.45% 95.43%
2016 94.79% 92.81% 92.73% 95.55%
2015 83.46% 92.25% 92.83% 95.45%
2014 94.87% 93.10% 92.91% 95.39%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 2017 96.37% 95.57% 95.61% 97.46%
2016 96.82% 95.78% 95.78% 97.61%
2015 91.59% 95.61% 95.90% 97.55%
2014 96.96% 96.03% 95.85% 97.54%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 2017 97.58% 97.82% 97.07% 98.47%
2016 98.09% 97.30% 97.19% 98.61%
2015 91.81% 96.84% 97.32% 96.73%
2014 97.92% 97.56% 97.50% 98.68%
Info
Alcohol and Other Drug Dependence Treatment 2018 Plan State Avg Nat Avg 90th Pctl.
Initiation of Alcohol and Other Drug Dependence Treatment - Total 38.67% 37.53% 35.68% 42.36%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 56.90% 49.35% 40.21% 51.02%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 38.17% 37.34% 35.51% 42.35%
Engagement of Alcohol and Other Drug Dependence Treatment - Total 15.08% 14.69% 12.58% 17.04%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 18.97% 18.18% 16.91% 25.00%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 14.98% 14.58% 12.47% 16.97%
Alcohol and Other Drug Dependence Treatment Year Plan State Avg. Natl. Avg. 90th Pctl.
Initiation of Alcohol and Other Drug Dependence Treatment - Total 2017 35.39% 36.14% 36.11% 42.01%
2016 32.55% 35.69% 32.93% 40.24%
2015 33.23% 33.04% 33.42% 41.07%
2014 33.47% 32.51% 35.63% 44.19%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2017 43.43% 40.06% 39.91% 52.54%
2016 39.02% 40.15% 40.47% 51.96%
2015 27.27% 37.03% 39.62% 50.00%
2014 40.48% 37.09% 40.79% 52.00%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2017 35.11% 36.00% 35.97% 41.96%
2016 32.38% 35.55% 32.64% 40.33%
2015 33.42% 32.96% 33.20% 40.93%
2014 33.16% 32.16% 35.21% 43.92%
Engagement of Alcohol and Other Drug Dependence Treatment - Total 2017 13.47% 13.36% 12.65% 17.26%
2016 11.32% 12.51% 11.46% 16.72%
2015 9.75% 11.61% 12.46% 19.23%
2014 9.43% 10.64% 13.66% 19.19%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2017 16.16% 14.40% 14.95% 23.85%
2016 13.41% 11.28% 15.68% 23.73%
2015 10.10% 12.06% 15.42% 22.12%
2014 17.86% 13.00% 17.24% 25.29%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2017 13.38% 13.40% 12.55% 17.38%
2016 11.27% 12.57% 11.32% 16.09%
2015 9.73% 11.57% 12.34% 18.67%
2014 9.06% 10.33% 13.45% 18.68%
Info
Child Access to Primary Care Practitioners 2018 Plan State Avg Nat Avg 90th Pctl.
12-24 month old Child Access to Primary Care Practitioners 99.25% 98.57% 98.19% 99.60%
25 month to 6 year old Child Access to Primary Care Practitioners 95.56% 94.36% 93.13% 97.39%
7-11 year old Child Access to Primary Care Practitioners 95.74% 95.22% 93.87% 98.50%
12-19 year old Child Access to Primary Care Practitioners 92.28% 92.36% 91.48% 97.12%
Child Access to Primary Care Practitioners Year Plan State Avg. Natl. Avg. 90th Pctl.
12-24 month old Child Access to Primary Care Practitioners 2017 99.12% 98.09% 97.93% 99.50%
2016 98.87% 98.34% 98.09% 99.72%
2015 98.63% 98.78% 98.03% 99.48%
2014 98.81% 98.49% 97.87% 99.62%
25 month to 6 year old Child Access to Primary Care Practitioners 2017 95.09% 94.63% 92.58% 96.95%
2016 95.24% 94.33% 92.60% 96.46%
2015 94.94% 94.16% 92.67% 96.64%
2014 94.76% 93.85% 92.33% 96.52%
7-11 year old Child Access to Primary Care Practitioners 2017 96.00% 95.40% 93.43% 98.48%
2016 95.33% 94.38% 93.25% 98.25%
2015 95.24% 94.23% 93.23% 97.92%
2014 94.66% 93.78% 93.02% 97.87%
12-19 year old Child Access to Primary Care Practitioners 2017 92.11% 92.00% 91.08% 96.99%
2016 91.56% 91.45% 90.76% 96.39%
2015 91.51% 91.30% 90.66% 96.19%
2014 91.56% 90.84% 90.44% 96.28%
Info
Prenatal and Postpartum Care 2018 Plan State Avg Nat Avg 90th Pctl.
Postpartum Care 75.20% 75.10% 75.89% 88.80%
Timeliness of Prenatal Care 86.40% 88.15% 84.75% 94.17%
Prenatal and Postpartum Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Postpartum Care 2017 82.29% 73.45% 75.05% 88.13%
2016 78.00% 74.50% 73.95% 88.85%
2015 82.50% 73.91% 73.72% 87.50%
2014 83.09% 77.29% 77.64% 88.65%
Timeliness of Prenatal Care 2017 85.76% 86.37% 84.34% 94.89%
2016 88.80% 86.71% 85.57% 96.28%
2015 89.17% 86.80% 84.28% 94.56%
2014 91.79% 86.83% 88.00% 96.23%
Behavioral Health
Info
Antidepressant Medication Management 2018 Plan State Avg Nat Avg 90th Pctl.
Antidepressant Medication Management - Effective Acute Phase Treatment 66.62% 71.96% 68.64% 77.59%
Antidepressant Medication Management - Effective Continuation Phase Treatment 50.70% 54.22% 53.01% 60.39%
Antidepressant Medication Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Antidepressant Medication Management - Effective Acute Phase Treatment 2017 66.05% 71.12% 67.11% 75.76%
2016 62.66% 70.29% 66.56% 74.77%
2015 61.96% 67.61% 65.82% 74.06%
2014 60.79% 68.52% 65.88% 75.35%
Antidepressant Medication Management - Effective Continuation Phase Treatment 2017 49.17% 54.87% 51.53% 60.24%
2016 47.37% 53.51% 50.69% 58.60%
2015 46.48% 49.81% 50.15% 57.56%
2014 45.55% 50.31% 49.83% 59.11%
Info
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication 2018 Plan State Avg Nat Avg 90th Pctl.
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Initiation 35.77% 42.91% 39.85% 50.42%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 46.26% 40.32% 48.73% 60.57%
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 2017 37.48% 41.27% 41.13% 50.83%
2016 34.49% 41.91% 38.93% 48.61%
2015 33.84% 41.43% 38.13% 50.00%
2014 37.42% 39.00% 38.01% 46.81%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 2017 49.47% 55.09% 47.07% 58.44%
2016 42.25% 46.92% 45.82% 56.86%
2015 37.93% 49.06% 46.18% 58.06%
2014 41.30% 46.49% 45.70% 57.75%
Info
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence 2018 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 13.82% 9.96% 10.81% 17.07%
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence within 30 days after hospital discharge 18.29% 13.52% 14.98% 23.11%
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 2017 N/A N/A N/A N/A
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
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence within 30 days after hospital discharge 2017 N/A N/A N/A N/A
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
Info
Follow-Up After Emergency Department Visit for Mental Illness 2018 Plan State Avg Nat Avg 90th Pctl.
Follow-Up After Emergency Department Visit for Mental Illness within 7 days after hospital discharge 42.03% 38.46% 46.62% 66.57%
Follow-Up After Emergency Department Visit for Mental Illness within 30 days after hospital discharge 60.58% 53.38% 60.75% 77.57%
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 2017 N/A N/A N/A N/A
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
Follow-Up After Emergency Department Visit for Mental Illness within 30 days after hospital discharge 2017 N/A N/A N/A N/A
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
Info
Follow-up After Hospitalization For Mental Illness 2018 Plan State Avg Nat Avg 90th Pctl.
Follow-up After Hospitalization For Mental Illness within 7 days after hospital discharge 47.21% 48.09% 44.98% 60.38%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge 71.52% 69.84% 66.68% 80.29%
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 2017 49.52% 52.18% 46.63% 62.81%
2016 47.15% 52.99% 52.06% 67.31%
2015 48.51% 47.66% 50.57% 67.57%
2014 46.28% 51.82% 52.21% 70.33%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge 2017 72.74% 69.80% 68.66% 82.58%
2016 70.60% 73.85% 71.36% 84.17%
2015 71.98% 71.58% 69.72% 83.80%
2014 70.74% 72.52% 70.72% 85.71%
Effectiveness of Care
Info
Asthma Medication Management 2018 Plan State Avg Nat Avg 90th Pctl.
Medication Management for People With Asthma at least 50% Compliance - Total 77.78% 77.42% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 5-11 68.42% 63.81% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 12-18 68.00% 71.44% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 19-50 78.12% 77.64% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 51-64 83.73% 83.35% N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Total 53.28% 55.48% 51.74% 59.67%
Medication Management for People With Asthma at least 75% Compliance - Ages 5-11 39.68% 37.21% 38.94% 47.83%
Medication Management for People With Asthma at least 75% Compliance - Ages 12-18 43.00% 46.61% 38.67% 47.44%
Medication Management for People With Asthma at least 75% Compliance - Ages 19-50 51.90% 55.33% 50.37% 60.00%
Medication Management for People With Asthma at least 75% Compliance - Ages 51-64 63.40% 64.47% 61.41% 69.42%
Asthma Medication Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Medication Management for People With Asthma at least 50% Compliance - Total 2017 75.43% 76.58% N/A N/A
2016 74.80% 73.20% N/A N/A
2015 70.54% 71.52% N/A N/A
2014 N/A N/A N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 5-11 2017 66.11% 66.50% N/A N/A
2016 67.96% 67.58% N/A N/A
2015 62.68% 64.34% N/A N/A
2014 N/A N/A N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 12-18 2017 67.33% 68.06% N/A N/A
2016 64.38% 65.72% N/A N/A
2015 60.41% 60.17% N/A N/A
2014 N/A N/A N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 19-50 2017 75.32% 75.34% N/A N/A
2016 74.15% 71.77% N/A N/A
2015 69.04% 68.82% N/A N/A
2014 N/A N/A N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 51-64 2017 81.62% 84.54% N/A N/A
2016 80.75% 79.36% N/A N/A
2015 78.83% 78.55% N/A N/A
2014 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Total 2017 52.40% 54.32% 50.48% 57.69%
2016 51.99% 51.17% 48.54% 56.96%
2015 47.05% 48.01% 46.20% 55.00%
2014 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Ages 5-11 2017 38.06% 42.35% 40.22% 52.99%
2016 38.95% 39.03% 37.58% 48.84%
2015 39.00% 36.59% 37.85% 49.09%
2014 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Ages 12-18 2017 41.91% 41.76% 37.80% 47.11%
2016 39.38% 35.03% 35.83% 46.97%
2015 35.51% 35.39% 34.97% 45.26%
2014 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Ages 19-50 2017 51.79% 52.86% 48.60% 57.87%
2016 49.88% 50.18% 46.16% 55.80%
2015 43.27% 45.56% 43.39% 53.13%
2014 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Ages 51-64 2017 61.89% 64.50% 59.65% 67.58%
2016 62.50% 59.39% 57.47% 65.75%
2015 58.73% 58.44% 55.49% 65.28%
2014 N/A N/A N/A N/A
Info
Cardiovascular Disease Management 2018 Plan State Avg Nat Avg 90th Pctl.
Controlling High Blood Pressure 55.72% 60.55% N/A N/A
Persistence of Beta-Blockers 89.36% 83.54% 82.37% 89.29%
Cardiovascular Disease Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Controlling High Blood Pressure 2017 N/A N/A N/A N/A
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
Persistence of Beta-Blockers 2017 84.97% 85.80% 85.18% 93.41%
2016 88.21% 90.70% 83.61% 90.83%
2015 83.65% 88.70% 84.68% 91.00%
2014 85.22% 84.03% 83.50% 91.43%
Info
Common Childhood Illnesses 2018 Plan State Avg Nat Avg 90th Pctl.
Appropriate Testing for Children With Pharyngitis 93.12% 92.74% 87.97% 94.94%
Common Childhood Illnesses Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Testing for Children With Pharyngitis 2017 92.11% 92.30% 87.45% 94.64%
2016 90.43% 90.38% 84.50% 93.75%
2015 90.39% 90.13% 83.12% 93.11%
2014 90.65% 88.64% 83.29% 91.40%
Info
Diabetes Care and Management 2018 Plan State Avg Nat Avg 90th Pctl.
Comprehensive Diabetes Care-Blood Pressure Control (<140/90 mm Hg) 64.48% 63.70% 62.59% 77.37%
Comprehensive Diabetes Care-HbA1c control (<8.0%) 65.45% 62.46% 57.79% 66.33%
Comprehensive Diabetes Care-Medical Attention for Nephropathy 92.70% 90.73% 90.33% 93.43%
Comprehensive Diabetes Care-Rate of Eye Exams 60.83% 56.58% 54.40% 69.68%
Comprehensive Diabetes Care-Rate of Poor HbA1c control 21.41% 27.18% 30.85% 20.62%
Comprehensive Diabetes Care-Testing for HbA1c 93.67% 92.11% 91.29% 94.71%
Diabetes Care and Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Comprehensive Diabetes Care-Blood Pressure Control (<140/90 mm Hg) 2017 63.26% 63.40% 60.82% 76.41%
2016 67.40% 60.88% 61.06% 78.35%
2015 70.38% 61.03% 58.80% 75.68%
2014 69.10% 63.33% 63.85% 76.00%
Comprehensive Diabetes Care-HbA1c control (<8.0%) 2017 59.37% 62.51% 57.48% 67.15%
2016 63.02% 58.36% 56.62% 66.39%
2015 60.51% 57.59% 55.81% 66.67%
2014 64.96% 59.12% 58.53% 68.61%
Comprehensive Diabetes Care-Medical Attention for Nephropathy 2017 88.61% 90.80% 90.38% 93.61%
2016 90.27% 90.56% 90.03% 92.71%
2015 90.63% 91.11% 90.10% 93.40%
2014 86.13% 86.26% 84.72% 89.60%
Comprehensive Diabetes Care-Rate of Eye Exams 2017 53.53% 56.95% 54.06% 70.69%
2016 52.31% 58.46% 52.96% 72.04%
2015 53.67% 57.15% 52.47% 70.44%
2014 60.58% 57.54% 54.98% 71.93%
Comprehensive Diabetes Care-Rate of Poor HbA1c control 2017 26.28% 27.63% 31.91% 21.41%
2016 23.11% 30.47% 32.15% 20.98%
2015 27.85% 30.83% 33.90% 20.20%
2014 25.30% 31.37% 30.48% 19.33%
Comprehensive Diabetes Care-Testing for HbA1c 2017 90.27% 91.52% 90.96% 94.18%
2016 90.51% 90.38% 90.32% 94.83%
2015 90.63% 91.13% 90.54% 94.69%
2014 91.24% 89.01% 90.34% 94.86%
Info
Drug Therapy in Rheumatoid Arthritis 2018 Plan State Avg Nat Avg 90th Pctl.
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis 88.67% 88.42% 87.69% 94.27%
Drug Therapy in Rheumatoid Arthritis Year Plan State Avg. Natl. Avg. 90th Pctl.
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis 2017 89.59% 90.16% 88.62% 93.75%
2016 90.82% 89.05% 87.87% 93.92%
2015 89.41% 89.72% 87.84% 92.86%
2014 93.12% 88.05% 87.86% 93.59%
Info
Immunizations 2018 Plan State Avg Nat Avg 90th Pctl.
Childhood Immunization for Multiple Diseases Including Chicken Pox 84.95% 80.96% 79.32% 88.06%
Childhood Immunization for Multiple Diseases Including Pneumovax 82.14% 79.46% 77.50% 86.62%
Flu Vaccinations for Adults Ages 65 and Older 51.34% 53.53% 51.93% 61.07%
Immunizations for Adolescents - Combination 73.24% 79.55% 82.25% 91.52%
Immunizations for Adolescents - HPV 23.84% 32.22% 28.05% 37.23%
Immunizations for Adolescents - Meningococcal 73.48% 80.66% 83.69% 92.94%
Immunizations for Adolescents - Tdap 93.67% 91.16% 89.95% 95.62%
Immunizations Year Plan State Avg. Natl. Avg. 90th Pctl.
Childhood Immunization for Multiple Diseases Including Chicken Pox 2017 84.18% 73.55% 79.44% 89.14%
2016 83.46% 75.86% 78.93% 89.03%
2015 81.89% 74.15% 78.59% 88.08%
2014 79.61% 72.96% 80.18% 88.07%
Childhood Immunization for Multiple Diseases Including Pneumovax 2017 81.51% 80.09% 77.67% 87.61%
2016 79.01% 82.08% 77.04% 87.50%
2015 79.16% 79.45% 76.49% 87.10%
2014 77.89% 78.11% 78.13% 86.26%
Flu Vaccinations for Adults Ages 65 and Older 2017 0.46% 0.53% 49.33% 59.27%
2016 44.88% 47.13% 47.47% 58.70%
2015 0.46% 0.50% 47.85% 58.01%
2014 0.54% 0.52% 49.45% 59.73%
Immunizations for Adolescents - Combination 2017 67.40% 80.48% 80.23% 89.54%
2016 62.77% 77.95% 77.63% 88.81%
2015 59.74% 69.50% 74.25% 88.47%
2014 64.29% 67.04% 70.73% 87.34%
Immunizations for Adolescents - HPV 2017 25.79% 28.29% 23.98% 32.36%
2016 62.77% 77.95% 77.63% 88.81%
2015 59.74% 69.50% 74.25% 88.47%
2014 64.29% 67.04% 70.73% 87.34%
Immunizations for Adolescents - Meningococcal 2017 68.13% 82.05% 81.75% 90.27%
2016 63.75% 79.65% 79.20% 90.02%
2015 0.60% 0.72% 76.12% 89.29%
2014 0.65% 0.69% 72.59% 88.27%
Immunizations for Adolescents - Tdap 2017 94.65% 91.65% 88.91% 94.65%
2016 93.67% 91.29% 87.77% 95.38%
2015 0.93% 0.85% 86.03% 94.39%
2014 0.91% 0.85% 84.49% 95.15%
Info
Persistent Medications 2018 Plan State Avg Nat Avg 90th Pctl.
Annual Monitoring for Patients on Persistent Medications 85.79% 86.50% 84.47% 88.08%
Persistent Medications Year Plan State Avg. Natl. Avg. 90th Pctl.
Annual Monitoring for Patients on Persistent Medications 2017 86.22% 85.73% 83.71% 87.04%
2016 86.40% 84.90% 83.34% 87.04%
2015 86.13% 83.34% 82.94% 86.72%
2014 86.25% 83.28% 82.33% 86.25%
Info
Pharmacotherapy of COPD Exacerbation 2018 Plan State Avg Nat Avg 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator 73.96% 85.49% 78.92% 87.88%
Pharmacotherapy of COPD Exacerbation - Corticosteroid 75.15% 76.41% 74.76% 83.55%
Pharmacotherapy of COPD Exacerbation Year Plan State Avg. Natl. Avg. 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator 2017 78.76% 80.88% 79.87% 87.50%
2016 70.52% 84.12% 76.30% 85.98%
2015 77.37% 78.48% 79.09% 87.10%
2014 83.70% 80.03% 80.14% 86.90%
Pharmacotherapy of COPD Exacerbation - Corticosteroid 2017 77.61% 78.84% 76.26% 84.38%
2016 72.51% 79.54% 70.70% 81.82%
2015 74.21% 72.98% 75.30% 84.56%
2014 75.56% 75.53% 75.28% 83.54%
Info
Preventive Care 2018 Plan State Avg Nat Avg 90th Pctl.
Breast Cancer Screening 74.26% 72.13% 73.73% 81.17%
Chlamydia Screening in Women-all Age groups 46.26% 52.91% 51.41% 67.76%
Colorectal Cancer Screening 67.12% 64.94% 64.37% 76.52%
Preventive Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Breast Cancer Screening 2017 73.79% 71.85% 72.81% 80.91%
2016 73.75% 71.80% 72.90% 80.63%
2015 73.17% 72.07% 73.08% 81.53%
2014 72.07% 72.22% 73.52% 81.91%
Chlamydia Screening in Women-all Age groups 2017 44.40% 51.46% 50.16% 66.08%
2016 45.22% 49.79% 48.98% 63.50%
2015 43.40% 47.89% 52.32% 64.06%
2014 45.16% 48.07% 51.65% 63.48%
Colorectal Cancer Screening 2017 66.58% 65.16% 62.43% 74.72%
2016 66.84% 64.67% 61.71% 74.09%
2015 60.56% 63.31% 62.32% 73.84%
2014 68.06% 63.41% 64.06% 74.86%
Info
Spirometry Testing 2018 Plan State Avg Nat Avg 90th Pctl.
Use of Spirometry Testing in the Assessment and diagnosis of COPD 38.81% 44.14% 41.48% 50.95%
Spirometry Testing Year Plan State Avg. Natl. Avg. 90th Pctl.
Use of Spirometry Testing in the Assessment and diagnosis of COPD 2017 38.54% 43.12% 41.90% 50.52%
2016 36.96% 42.48% 42.55% 51.02%
2015 37.15% 46.31% 42.44% 51.66%
2014 37.90% 42.48% 42.16% 51.85%
Info
Statin Therapy 2018 Plan State Avg Nat Avg 90th Pctl.
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - 21-75 years (Male) 84.50% 84.45% 83.64% 89.14%
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - 40–75 years (Female) 74.65% 76.45% 73.26% 81.82%
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - Total 81.96% 82.21% 81.23% 87.21%
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - 21-75 years (Male) 74.71% 75.19% 77.14% 82.88%
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - 40–75 years (Female) 67.65% 72.78% 72.12% 81.10%
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - Total 73.06% 74.49% 75.95% 82.83%
Statin Therapy for Patients with Diabetes - Received Therapy 61.44% 63.94% 62.57% 70.05%
Statin Therapy for Patients with Diabetes - Statin Adherence 80% 65.57% 68.88% 69.52% 78.00%
Statin Therapy Year Plan State Avg. Natl. Avg. 90th Pctl.
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - 21-75 years (Male) 2017 N/A N/A N/A N/A
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
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - 40–75 years (Female) 2017 N/A N/A N/A N/A
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
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - Total 2017 N/A N/A N/A N/A
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
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - 21-75 years (Male) 2017 N/A N/A N/A N/A
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
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - 40–75 years (Female) 2017 N/A N/A N/A N/A
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
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - Total 2017 N/A N/A N/A N/A
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
Statin Therapy for Patients with Diabetes - Received Therapy 2017 N/A N/A N/A N/A
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
Statin Therapy for Patients with Diabetes - Statin Adherence 80% 2017 N/A N/A N/A N/A
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
Info
Weight Assessment and Counseling 2018 Plan State Avg Nat Avg 90th Pctl.
Adult BMI Assessment 87.21% 82.61% 81.07% 93.61%
Children/Adolescents BMI Assessment - Total 66.07% 73.74% 72.87% 90.00%
Children/Adolescents BMI Assessment - Ages 3-11 74.89% 76.94% 74.00% 90.91%
Children/Adolescents BMI Assessment - Ages 12-17 53.94% 69.73% 71.39% 88.97%
Counseling for Nutrition for Children/Adolescents - Total 64.54% 71.79% 67.72% 85.06%
Counseling for Nutrition for Children/Adolescents - Ages 3-11 74.01% 75.91% 69.85% 86.21%
Counseling for Nutrition for Children/Adolescents - Ages 12-17 51.52% 66.37% 64.92% 84.29%
Counseling for Physical Activity for Children/Adolescents - Total 58.67% 66.42% 63.08% 81.32%
Counseling for Physical Activity for Children/Adolescents - Ages 3-11 61.23% 65.48% 61.70% 80.92%
Counseling for Physical Activity for Children/Adolescents - Ages 12-17 55.15% 67.51% 64.79% 84.03%
Weight Assessment and Counseling Year Plan State Avg. Natl. Avg. 90th Pctl.
Adult BMI Assessment 2017 85.99% 79.49% 79.78% 93.20%
2016 86.90% 77.87% 76.17% 91.85%
2015 84.72% 75.90% 74.19% 91.76%
2014 84.58% 76.28% 75.36% 91.20%
Children/Adolescents BMI Assessment - Total 2017 68.84% 70.41% 70.59% 88.08%
2016 70.56% 69.07% 65.62% 88.08%
2015 53.53% 60.49% 60.37% 83.78%
2014 45.01% 61.63% 61.08% 85.37%
Children/Adolescents BMI Assessment - Ages 3-11 2017 71.14% 71.37% 71.84% 88.89%
2016 71.13% 70.86% 67.11% 88.19%
2015 56.85% 63.37% 61.61% 84.69%
2014 44.80% 60.91% 60.86% 86.64%
Children/Adolescents BMI Assessment - Ages 12-17 2017 65.13% 68.96% 68.94% 87.82%
2016 69.77% 66.72% 64.28% 87.29%
2015 48.82% 56.47% 58.77% 83.62%
2014 45.34% 62.60% 61.34% 85.47%
Counseling for Nutrition for Children/Adolescents - Total 2017 66.58% 69.47% 65.50% 83.21%
2016 68.86% 66.76% 61.76% 83.68%
2015 68.37% 63.88% 58.94% 80.79%
2014 60.58% 65.02% 60.64% 80.05%
Counseling for Nutrition for Children/Adolescents - Ages 3-11 2017 68.29% 71.63% 68.20% 84.82%
2016 72.38% 69.25% 64.59% 85.48%
2015 71.78% 67.34% 61.49% 82.89%
2014 63.79% 68.39% 63.58% 84.21%
Counseling for Nutrition for Children/Adolescents - Ages 12-17 2017 63.82% 66.54% 61.92% 80.26%
2016 63.95% 63.42% 58.79% 81.87%
2015 63.53% 59.10% 55.64% 77.85%
2014 55.95% 60.63% 56.75% 76.92%
Counseling for Physical Activity for Children/Adolescents - Total 2017 61.56% 64.30% 59.96% 77.32%
2016 59.85% 60.41% 55.96% 79.44%
2015 61.31% 59.53% 54.50% 78.85%
2014 55.72% 62.13% 57.09% 77.30%
Counseling for Physical Activity for Children/Adolescents - Ages 3-11 2017 60.57% 62.31% 58.84% 75.00%
2016 54.81% 58.91% 54.72% 76.52%
2015 57.26% 58.85% 53.14% 76.08%
2014 51.03% 60.95% 55.78% 76.72%
Counseling for Physical Activity for Children/Adolescents - Ages 12-17 2017 63.16% 66.86% 61.40% 79.89%
2016 66.86% 62.44% 58.47% 83.05%
2015 67.06% 60.35% 56.39% 80.86%
2014 62.50% 63.65% 58.73% 78.07%
Health Plan Stability/Descriptive
Info
Administrative Data 2018 Plan State Avg Nat Avg 90th Pctl.
Administrative Ratio 0.11 0.13 86.19 92.68
Medical Cost Ratio 0.83 0.83 92.60 95.85
Number of Enrollees 532,548 140,630 92 96
Number of Physicians 29,248 94,540 87 95
Premium Per Member Per Month $532 $499 N/A N/A
Profit/Loss Ratio 0.06 0.05 N/A N/A
Administrative Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Administrative Ratio 2017 0.10 0.12 86.39 93.13
2016 0.11 0.15 N/A N/A
2015 0.13 0.14 N/A N/A
2014 0.12 0.14 N/A N/A
Medical Cost Ratio 2017 0.82 0.83 93.13 96.59
2016 0.83 0.83 N/A N/A
2015 0.83 0.82 N/A N/A
2014 0.82 0.81 N/A N/A
Number of Enrollees 2017 669,975 133,992 92 97
2016 632,321 136,796 N/A N/A
2015 629,111 124,097 N/A N/A
2014 536,354 115,428 N/A N/A
Number of Physicians 2017 28,352 81,926 87 95
2016 26,959 73,426 N/A N/A
2015 26,000 90,027 N/A N/A
2014 23,885 63,157 N/A N/A
Premium Per Member Per Month 2017 $435 $370 N/A N/A
2016 $407 $370 N/A N/A
2015 $374 $375 N/A N/A
2014 $354 $412 N/A N/A
Profit/Loss Ratio 2017 0.08 0.05 N/A N/A
2016 0.07 0.03 N/A N/A
2015 0.04 0.03 N/A N/A
2014 0.06 0.06 N/A N/A
Info
Board Certification Rates for Providers 2018 Plan State Avg Nat Avg 90th Pctl.
Board Certification for Geriatricians 66.14% 69.82% N/A N/A
Board Certification for Pediatricians 84.76% 86.24% N/A N/A
Board Certification Rate for Family Medicine Physicians 80.21% 83.01% N/A N/A
Board Certification Rate for Internal Medicine Physicians 78.41% 79.67% N/A N/A
Board Certification Rate for OB/GYN Providers 81.66% 84.25% N/A N/A
Board Certification Rate for Other Specialists 85.70% 81.57% N/A N/A
Board Certification Rates for Providers Year Plan State Avg. Natl. Avg. 90th Pctl.
Board Certification for Geriatricians 2017 72.00% 71.38% N/A N/A
2016 74.17% 73.44% N/A N/A
2015 74.31% 71.06% N/A N/A
2014 73.28% 74.73% N/A N/A
Board Certification for Pediatricians 2017 85.00% 85.50% N/A N/A
2016 86.49% 87.02% N/A N/A
2015 87.84% 88.14% N/A N/A
2014 85.62% 88.13% N/A N/A
Board Certification Rate for Family Medicine Physicians 2017 85.00% 81.38% N/A N/A
2016 85.17% 80.32% N/A N/A
2015 84.59% 82.53% N/A N/A
2014 84.48% 82.93% N/A N/A
Board Certification Rate for Internal Medicine Physicians 2017 84.00% 81.00% N/A N/A
2016 83.89% 81.15% N/A N/A
2015 85.35% 82.59% N/A N/A
2014 84.46% 83.98% N/A N/A
Board Certification Rate for OB/GYN Providers 2017 80.00% 83.00% N/A N/A
2016 82.65% 83.36% N/A N/A
2015 83.46% 83.51% N/A N/A
2014 83.72% 83.71% N/A N/A
Board Certification Rate for Other Specialists 2017 85.00% 81.88% N/A N/A
2016 84.27% 83.25% N/A N/A
2015 85.35% 82.88% N/A N/A
2014 84.67% 84.44% N/A N/A
Info
Financial Data 2018 Plan State Avg Nat Avg 90th Pctl.
Income $146,778,850 $47,837,732 N/A N/A
Net Worth $566,871,633 $303,649,748 N/A N/A
Premiums Earned $3,496,135,978 $879,518,893 N/A N/A
Financial Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Income 2017 $183,916,865 $34,422,501 N/A N/A
2016 $123,796,881 $38,212,136 N/A N/A
2015 $46,167,714 $19,029,685 N/A N/A
2014 $65,346,525 $50,732,622 N/A N/A
Net Worth 2017 $595,066,070 $263,890,874 N/A N/A
2016 $442,676,709 $267,217,323 N/A N/A
2015 $340,724,748 $237,291,717 N/A N/A
2014 $281,472,144 $250,764,247 N/A N/A
Premiums Earned 2017 $3,474,182,105 $645,600,589 N/A N/A
2016 $3,155,311,445 $644,862,921 N/A N/A
2015 $2,833,491,417 $552,705,214 N/A N/A
2014 $2,095,055,319 $470,221,984 N/A N/A
Info
Years in Business 2018 Plan State Avg Nat Avg 90th Pctl.
Years in Business 32 36 N/A N/A
Years in Business Year Plan State Avg. Natl. Avg. 90th Pctl.
Years in Business 2017 31 35 N/A N/A
2016 30 34 N/A N/A
2015 29 33 N/A N/A
2014 28 32 N/A N/A
Member Satisfaction
Info
Member Satisfaction 2018 Plan State Avg Nat Avg 90th Pctl.
Getting Care Quickly 81.17% 85.27% 85.23% 89.89%
Getting Needed Care 84.10% 85.53% 86.33% 90.45%
How Well Doctors Communicate 93.24% 94.70% 95.31% 97.22%
Members highly rating their HMO (8 to 10 on a 0-10 scale) 62.89% 64.78% 64.53% 76.79%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 83.33% 84.82% 84.41% 88.57%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) 76.33% 76.02% 78.17% 83.95%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) 83.33% 84.08% 85.14% 89.78%
Member Satisfaction Year Plan State Avg. Natl. Avg. 90th Pctl.
Getting Care Quickly 2017 87.93% 87.22% 85.34% 89.83%
2016 85.08% 85.81% 85.14% 90.00%
2015 84.73% 85.61% 85.00% 89.71%
2014 86.41% 86.12% 85.79% 90.17%
Getting Needed Care 2017 85.45% 87.44% 86.71% 90.37%
2016 88.03% 86.38% 87.25% 91.54%
2015 86.63% 86.51% 86.79% 91.23%
2014 87.51% 88.34% 87.95% 92.13%
How Well Doctors Communicate 2017 94.15% 94.74% 95.10% 96.91%
2016 93.88% 95.22% 95.39% 97.21%
2015 94.78% 94.90% 95.20% 97.10%
2014 94.79% 95.30% 95.26% 97.16%
Members highly rating their HMO (8 to 10 on a 0-10 scale) 2017 53.18% 61.26% 62.44% 75.00%
2016 50.00% 62.47% 62.27% 74.92%
2015 56.10% 62.71% 62.65% 74.57%
2014 53.37% 58.77% 64.71% 76.75%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 2017 80.45% 83.86% 84.62% 88.77%
2016 83.94% 83.44% 84.72% 88.74%
2015 84.12% 83.49% 83.85% 89.05%
2014 79.89% 85.38% 84.24% 88.27%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) 2017 72.92% 76.98% 77.27% 82.99%
2016 74.60% 77.49% 77.19% 83.29%
2015 76.13% 76.25% 76.99% 82.76%
2014 78.68% 79.49% 78.26% 83.66%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) 2017 85.57% 83.95% 84.60% 89.86%
2016 83.06% 84.65% 84.57% 88.37%
2015 88.51% 83.85% 84.24% 88.77%
2014 84.47% 84.37% 84.70% 88.96%
Overuse/Appropriateness
Info
Antipsychotics 2018 Plan State Avg Nat Avg 90th Pctl.
Metabolic Monitoring for Children and Adolescents on Antipsychotics - Ages 1-17 24.44% 44.74% 36.17% 47.41%
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics - Ages 1-17 54.39% 57.96% 56.00% 70.54%
Use of Multiple Concurrent Antipsychotics in Children and Adolescents - Ages 1-17 1.37% 5.32% N/A N/A
Antipsychotics Year Plan State Avg. Natl. Avg. 90th Pctl.
Metabolic Monitoring for Children and Adolescents on Antipsychotics - Ages 1-17 2017 22.40% 50.55% 36.07% 48.57%
2016 24.60% 34.87% 35.80% 45.93%
2015 28.16% 37.02% 33.94% 45.45%
2014 N/A N/A N/A N/A
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics - Ages 1-17 2017 56.10% 58.14% 54.52% 68.67%
2016 62.20% 61.93% 58.30% 75.00%
2015 59.69% 61.38% 54.40% 70.49%
2014 N/A N/A N/A N/A
Use of Multiple Concurrent Antipsychotics in Children and Adolescents - Ages 1-17 2017 1.98% 2.39% N/A N/A
2016 2.33% 2.06% N/A N/A
2015 3.10% 1.70% N/A N/A
2014 N/A N/A N/A N/A
Info
Cervical Cancer Screening in Adolescent Females 2018 Plan State Avg Nat Avg 90th Pctl.
Non-Recommended Cervical Cancer Screening in Adolescent Females 75.91% 77.90% 76.08% 83.21%
Cervical Cancer Screening in Adolescent Females Year Plan State Avg. Natl. Avg. 90th Pctl.
Non-Recommended Cervical Cancer Screening in Adolescent Females 2017 N/A N/A N/A N/A
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
Info
Lower Back Pain 2018 Plan State Avg Nat Avg 90th Pctl.
Use of Imaging for Low Back Pain 68.07% 74.77% 75.11% 82.95%
Lower Back Pain Year Plan State Avg. Natl. Avg. 90th Pctl.
Use of Imaging for Low Back Pain 2017 66.25% 73.85% 75.16% 82.29%
2016 63.48% 73.58% 72.67% 80.11%
2015 65.71% 74.11% 74.57% 81.25%
2014 64.74% 72.44% 74.82% 81.95%
Info
Respiratory 2018 Plan State Avg Nat Avg 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection 91.08% 92.50% 91.22% 95.48%
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis 27.96% 33.60% 33.16% 48.28%
Respiratory Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection 2017 88.31% 90.92% 89.19% 94.59%
2016 86.21% 88.81% 88.51% 94.80%
2015 86.95% 87.71% 88.11% 94.26%
2014 81.16% 87.19% 87.39% 94.57%
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis 2017 21.79% 30.67% 30.99% 49.52%
2016 16.93% 27.03% 28.19% 41.72%
2015 15.71% 25.68% 26.11% 38.04%
2014 16.30% 25.67% 25.79% 36.11%
Info
Use of Opiods 2018 Plan State Avg Nat Avg 90th Pctl.
Use of Opioids at High Dosage 5.37% 5.32% 4.54% 1.87%
Use of Opioids From Multiple Providers - Multiple Pharmacies 5.16% 5.21% 3.80% 1.40%
Use of Opioids From Multiple Providers - Multiple Prescribers 15.44% 18.32% 15.02% 9.64%
Use of Opioids From Multiple Providers - Multiple Prescribers and Multiple Pharmacies 2.50% 2.68% 1.76% 0.47%
Use of Opiods Year Plan State Avg. Natl. Avg. 90th Pctl.
Use of Opioids at High Dosage 2017 N/A N/A N/A N/A
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
Use of Opioids From Multiple Providers - Multiple Pharmacies 2017 N/A N/A N/A N/A
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
Use of Opioids From Multiple Providers - Multiple Prescribers 2017 N/A N/A N/A N/A
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
Use of Opioids From Multiple Providers - Multiple Prescribers and Multiple Pharmacies 2017 N/A N/A N/A N/A
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
Utilization
Info
Antibiotic Utilization 2018 Plan State Avg Nat Avg 90th Pctl.
Average number of antibiotic prescriptions per member per year - Total 0.81 0.74 0.71 0.88
Average number of antibiotic prescriptions per member per year - Ages 0-9 0.98 0.81 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 10-17 0.60 0.52 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 18-34 0.72 0.65 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 35-49 0.80 0.73 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 50-64 0.91 0.84 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 65-74 1.06 0.97 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 75-85 0.95 1.21 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 85 plus 1.80 1.32 N/A N/A
Days suppplied per antibiotic prescription - Total 10.080 9.950 9.910 10.890
Days suppplied per antibiotic prescription - Ages 0-9 9.880 9.979 N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 12.530 12.948 N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 9.650 9.731 N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 9.750 9.568 N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 10.130 9.769 N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 10.650 9.830 N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 10.040 9.428 N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus 8.410 9.026 N/A N/A
Prescriptions of concern - Total 0.360 0.338 0.330 0.430
Prescriptions of concern - Ages 0-9 0.42 0.32 N/A N/A
Prescriptions of concern - Ages 10-17 0.23 0.20 N/A N/A
Prescriptions of concern - Ages 18-34 0.30 0.28 N/A N/A
Prescriptions of concern - Ages 35-49 0.38 0.35 N/A N/A
Prescriptions of concern - Ages 50-64 0.44 0.42 N/A N/A
Prescriptions of concern - Ages 65-74 0.48 0.48 N/A N/A
Prescriptions of concern - Ages 75-85 0.46 0.62 N/A N/A
Prescriptions of concern - Ages 85 plus 0.87 0.45 N/A N/A
Antibiotic Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Average number of antibiotic prescriptions per member per year - Total 2017 0.89 0.77 0.76 0.90
2016 0.91 0.79 0.76 0.90
2015 0.88 0.80 0.81 0.97
2014 0.93 0.75 0.79 0.96
Average number of antibiotic prescriptions per member per year - Ages 0-9 2017 1.11 0.87 N/A N/A
2016 1.21 0.97 N/A N/A
2015 1.13 0.94 N/A N/A
2014 1.10 0.84 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 10-17 2017 0.70 0.57 N/A N/A
2016 0.73 0.60 N/A N/A
2015 0.73 0.60 N/A N/A
2014 0.71 0.56 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 18-34 2017 0.78 0.67 N/A N/A
2016 0.81 0.69 N/A N/A
2015 0.77 0.70 N/A N/A
2014 0.84 0.67 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 35-49 2017 0.88 0.75 N/A N/A
2016 0.88 0.77 N/A N/A
2015 0.84 0.80 N/A N/A
2014 0.92 0.76 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 50-64 2017 0.99 0.88 N/A N/A
2016 0.97 0.87 N/A N/A
2015 0.96 0.90 N/A N/A
2014 1.02 0.84 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 65-74 2017 1.18 1.00 N/A N/A
2016 1.14 0.99 N/A N/A
2015 1.12 1.07 N/A N/A
2014 1.23 0.96 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 75-85 2017 1.34 1.12 N/A N/A
2016 1.39 1.23 N/A N/A
2015 1.06 1.08 N/A N/A
2014 1.45 1.09 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 85 plus 2017 1.49 1.12 N/A N/A
2016 1.20 0.73 N/A N/A
2015 1.47 1.67 N/A N/A
2014 2.08 1.37 N/A N/A
Days suppplied per antibiotic prescription - Total 2017 10.050 10.024 9.880 10.830
2016 9.990 10.090 9.880 10.830
2015 10.113 10.259 10.120 11.030
2014 10.189 10.444 10.320 11.180
Days suppplied per antibiotic prescription - Ages 0-9 2017 9.850 10.050 N/A N/A
2016 9.700 10.041 N/A N/A
2015 9.655 9.987 N/A N/A
2014 9.654 10.008 N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 2017 12.320 12.689 N/A N/A
2016 12.430 12.799 N/A N/A
2015 13.009 13.321 N/A N/A
2014 13.046 13.648 N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 2017 9.750 9.836 N/A N/A
2016 9.780 10.074 N/A N/A
2015 9.917 10.334 N/A N/A
2014 10.061 10.650 N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 2017 9.730 9.591 N/A N/A
2016 9.660 9.620 N/A N/A
2015 9.716 9.825 N/A N/A
2014 9.782 9.954 N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 2017 10.000 9.856 N/A N/A
2016 9.860 9.816 N/A N/A
2015 9.967 9.898 N/A N/A
2014 10.052 10.043 N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 2017 10.490 9.850 N/A N/A
2016 10.380 9.929 N/A N/A
2015 10.316 10.178 N/A N/A
2014 10.379 10.427 N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 2017 10.340 10.604 N/A N/A
2016 10.330 10.594 N/A N/A
2015 9.285 9.934 N/A N/A
2014 10.892 10.543 N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus 2017 9.000 9.873 N/A N/A
2016 11.480 9.431 N/A N/A
2015 11.000 9.538 N/A N/A
2014 11.882 10.648 N/A N/A
Prescriptions of concern - Total 2017 0.410 0.354 0.360 0.450
2016 0.440 0.383 0.360 0.450
2015 0.437 0.401 0.410 0.520
2014 0.461 0.374 0.390 0.490
Prescriptions of concern - Ages 0-9 2017 0.48 0.35 N/A N/A
2016 0.56 0.43 N/A N/A
2015 0.53 0.41 N/A N/A
2014 0.53 0.38 N/A N/A
Prescriptions of concern - Ages 10-17 2017 0.27 0.22 N/A N/A
2016 0.29 0.24 N/A N/A
2015 0.29 0.25 N/A N/A
2014 0.28 0.22 N/A N/A
Prescriptions of concern - Ages 18-34 2017 0.34 0.28 N/A N/A
2016 0.37 0.31 N/A N/A
2015 0.36 0.32 N/A N/A
2014 0.39 0.30 N/A N/A
Prescriptions of concern - Ages 35-49 2017 0.43 0.37 N/A N/A
2016 0.46 0.40 N/A N/A
2015 0.45 0.42 N/A N/A
2014 0.50 0.41 N/A N/A
Prescriptions of concern - Ages 50-64 2017 0.49 0.44 N/A N/A
2016 0.50 0.46 N/A N/A
2015 0.51 0.49 N/A N/A
2014 0.54 0.45 N/A N/A
Prescriptions of concern - Ages 65-74 2017 0.55 0.50 N/A N/A
2016 0.55 0.51 N/A N/A
2015 0.57 0.57 N/A N/A
2014 0.63 0.51 N/A N/A
Prescriptions of concern - Ages 75-85 2017 0.65 0.54 N/A N/A
2016 0.64 0.65 N/A N/A
2015 0.55 0.59 N/A N/A
2014 0.76 0.51 N/A N/A
Prescriptions of concern - Ages 85 plus 2017 0.88 0.48 N/A N/A
2016 0.58 0.34 N/A N/A
2015 0.80 0.82 N/A N/A
2014 1.10 0.55 N/A N/A
Info
Child and Adolescent Well Child Visits 2018 Plan State Avg Nat Avg 90th Pctl.
Well Child Visits in the First 15 Months of Life 89.70% 85.93% 81.33% 90.72%
Well Child Visits in the 3rd - 6th Years 83.40% 83.85% 80.95% 91.86%
Adolescent Well-Care Visits 49.06% 53.54% 52.57% 71.93%
Child and Adolescent Well Child Visits Year Plan State Avg. Natl. Avg. 90th Pctl.
Well Child Visits in the First 15 Months of Life 2017 88.92% 85.68% 80.53% 90.78%
2016 86.71% 83.40% 80.76% 90.36%
2015 86.80% 84.01% 79.35% 89.12%
2014 84.36% 82.63% 79.12% 89.64%
Well Child Visits in the 3rd - 6th Years 2017 82.10% 83.18% 79.11% 91.03%
2016 81.46% 82.50% 78.30% 90.11%
2015 81.05% 80.48% 77.75% 89.74%
2014 79.71% 80.03% 77.37% 88.75%
Adolescent Well-Care Visits 2017 49.18% 53.24% 50.46% 70.44%
2016 47.50% 50.35% 49.68% 67.70%
2015 45.62% 49.34% 48.26% 64.50%
2014 44.08% 48.09% 47.51% 64.76%
Info
Mental Health Utilization 2018 Plan State Avg Nat Avg 90th Pctl.
Mental Health Utilization - Any service - Total 9.10% 7.63% 7.98% 11.76%
Mental Health Utilization - Any service - Ages 0-12 7.60% 6.12% N/A N/A
Mental Health Utilization - Any service - Ages 13-17 16.52% 13.96% N/A N/A
Mental Health Utilization - Any service - Ages 18-64 8.89% 7.62% N/A N/A
Mental Health Utilization - Any service - Ages 65 plus 3.47% 3.20% N/A N/A
Mental Health Utilization - ED - Total 0.01% 0.09% 0.10% 0.22%
Mental Health Utilization - ED - Ages 0-12 0.01% 0.05% N/A N/A
Mental Health Utilization - ED - Ages 13-17 0.03% 0.28% N/A N/A
Mental Health Utilization - ED - Ages 18-64 0.01% 0.08% N/A N/A
Mental Health Utilization - ED - Ages 65 plus 0.02% 0.02% N/A N/A
Mental Health Utilization - Inpatient - Total 0.24% 0.27% 0.27% 0.34%
Mental Health Utilization - Inpatient - Ages 0-12 0.07% 0.12% N/A N/A
Mental Health Utilization - Inpatient - Ages 13-17 0.74% 0.95% N/A N/A
Mental Health Utilization - Inpatient - Ages 18-64 0.23% 0.26% N/A N/A
Mental Health Utilization - Inpatient - Ages 65 plus 0.06% 0.06% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Total 0.10% 0.12% 0.19% 0.38%
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 0-12 0.07% 0.15% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 13-17 0.43% 0.49% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 18-64 0.08% 0.09% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 65 plus 0.02% 0.02% N/A N/A
Mental Health Utilization - Outpatient - Total 9.03% 7.53% N/A N/A
Mental Health Utilization - Outpatient - Ages 0-12 7.56% 6.10% N/A N/A
Mental Health Utilization - Outpatient - Ages 13-17 16.37% 13.80% N/A N/A
Mental Health Utilization - Outpatient - Ages 18-64 8.82% 7.51% N/A N/A
Mental Health Utilization - Outpatient - Ages 65 plus 3.43% 3.16% N/A N/A
Mental Health Utilization - Telehealth - Total 0.04% 0.10% 0.05% 0.11%
Mental Health Utilization - Telehealth - Ages 0-12 0.03% 0.03% N/A N/A
Mental Health Utilization - Telehealth - Ages 13-17 0.07% 0.19% N/A N/A
Mental Health Utilization - Telehealth - Ages 18-64 0.04% 0.11% N/A N/A
Mental Health Utilization - Telehealth - Ages 65 plus 0.00% 0.02% N/A N/A
Mental Health Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Mental Health Utilization - Any service - Total 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Any service - Ages 0-12 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Any service - Ages 13-17 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Any service - Ages 18-64 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Any service - Ages 65 plus 2017 N/A N/A N/A N/A
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
Mental Health Utilization - ED - Total 2017 N/A N/A N/A N/A
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
Mental Health Utilization - ED - Ages 0-12 2017 N/A N/A N/A N/A
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
Mental Health Utilization - ED - Ages 13-17 2017 N/A N/A N/A N/A
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
Mental Health Utilization - ED - Ages 18-64 2017 N/A N/A N/A N/A
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
Mental Health Utilization - ED - Ages 65 plus 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Inpatient - Total 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Inpatient - Ages 0-12 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Inpatient - Ages 13-17 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Inpatient - Ages 18-64 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Inpatient - Ages 65 plus 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Total 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 0-12 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 13-17 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 18-64 2017 N/A N/A N/A N/A
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
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 65 plus 2017 N/A N/A N/A N/A
2016 N/A N/A N/A N/A
2015 N/A N/A