Health Insurance in Virginia

HMO Profile

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MD-Individual Practice Association, Inc.

Company Information

  • Company Providing Plan:UnitedHealth Group
  • Address:
  • Telephone :
2021
Number of Enrollees: N/A
PMPM: N/A
Number of Physicians: N/A
NCQA Accreditation:

*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

Cities

District of Columbia

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

Administrative Data

2021 2020 2019 2018 2017
*Number of Enrollees NA NA NA NA NA
PMPM NA NA NA NA NA
*Medical Cost Ratio NA 76% 86% 81% 79%
*Administrative Ratio NA 7% 5% 8% 5%
*Profit/Loss Ratio NA 17% 9% 12% 16%
*Number of Physicians NA 6,098 55,148 55,087 52,438

*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 NA NA NA NA NA
*Income NA $29,721,094 $17,581,309 $24,777,791 $30,680,262
*Net Worth NA $53,416,220 $44,034,292 $51,942,512 $56,355,668

*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 N/A 94.34% 93.47% 96.29%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services N/A 96.22% 96.12% 97.63%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services N/A 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 N/A 93.90% 92.88% 95.71%
2019 88.55% 92.78% 92.66% 95.76%
2018 88.37% 92.43% 92.33% 95.45%
2017 89.54% 92.73% 92.45% 95.43%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 2020 N/A 96.11% 95.86% 97.54%
2019 94.63% 95.78% 95.87% 97.69%
2018 94.93% 95.50% 95.64% 97.49%
2017 95.41% 95.57% 95.61% 97.46%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 2020 N/A 96.79% 96.95% 98.30%
2019 95.89% 97.13% 97.14% 98.42%
2018 96.41% 97.15% 97.17% 98.45%
2017 97.22% 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 N/A 38.29% 34.72% 43.21%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 N/A 45.84% 41.60% 52.08%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus N/A 38.22% 34.53% 43.21%
Engagement of Alcohol and Other Drug Dependence Treatment - Total N/A 14.66% 11.91% 15.33%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 N/A 16.85% 15.29% 22.05%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus N/A 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 N/A 40.49% 36.39% 45.24%
2019 40.16% 39.13% 35.63% 41.36%
2018 35.24% 37.53% 35.68% 42.36%
2017 34.44% 36.14% 36.11% 42.01%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2020 N/A 35.48% 44.95% 59.06%
2019 0.00% 36.19% 42.41% 54.29%
2018 44.44% 49.35% 40.21% 51.02%
2017 20.00% 40.06% 39.91% 52.54%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2020 N/A 40.55% 36.18% 45.12%
2019 41.30% 39.20% 35.47% 40.96%
2018 35.00% 37.34% 35.51% 42.35%
2017 34.82% 36.00% 35.97% 41.96%
Engagement of Alcohol and Other Drug Dependence Treatment - Total 2020 N/A 15.16% 12.46% 17.48%
2019 8.27% 13.47% 12.31% 16.44%
2018 6.88% 14.69% 12.58% 17.04%
2017 10.46% 13.36% 12.65% 17.26%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2020 N/A 14.80% 17.76% 27.27%
2019 0.00% 10.34% 16.48% 27.14%
2018 22.22% 18.18% 16.91% 25.00%
2017 20.00% 14.40% 14.95% 23.85%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2020 N/A 15.15% 12.33% 17.48%
2019 8.50% 13.52% 12.20% 16.41%
2018 6.47% 14.58% 12.47% 16.97%
2017 10.21% 13.40% 12.55% 17.38%
Info
Prenatal and Postpartum Care 2021 Plan State Avg Nat Avg 90th Pctl.
Postpartum Care N/A 80.79% 81.70% 93.89%
Timeliness of Prenatal Care N/A 86.12% 83.24% 94.16%
Prenatal and Postpartum Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Postpartum Care 2020 N/A 74.05% 78.11% 92.47%
2019 62.81% 78.66% 80.52% 91.97%
2018 62.81% 75.10% 75.89% 88.80%
2017 62.90% 73.45% 75.05% 88.13%
Timeliness of Prenatal Care 2020 N/A 79.76% 81.82% 93.92%
2019 85.95% 86.76% 85.57% 95.33%
2018 85.95% 88.15% 84.75% 94.17%
2017 83.06% 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 N/A 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 N/A 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 N/A 79.35% 76.18% 83.11%
Antidepressant Medication Management - Effective Continuation Phase Treatment N/A 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 N/A 77.14% 73.70% 81.07%
2019 69.83% 73.53% 71.19% 78.79%
2018 65.98% 71.96% 68.64% 77.59%
2017 69.02% 71.12% 67.11% 75.76%
Antidepressant Medication Management - Effective Continuation Phase Treatment 2020 N/A 59.69% 57.32% 64.22%
2019 52.01% 55.44% 54.90% 62.18%
2018 48.09% 54.22% 53.01% 60.39%
2017 51.48% 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 N/A 41.24% 36.60% 48.10%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation N/A 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 N/A 45.87% 41.24% 50.34%
2019 22.58% 42.67% 40.66% 51.30%
2018 44.83% 42.91% 39.85% 50.42%
2017 38.75% 41.27% 41.13% 50.83%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 2020 N/A 56.56% 48.67% 59.32%
2019 50.00% 50.69% 47.95% 58.82%
2018 33.33% 40.32% 48.73% 60.57%
2017 45.00% 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 N/A 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 N/A 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 N/A 14.52% 13.45% 21.43%
2019 3.57% 8.56% 11.48% 18.26%
2018 10.42% 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 N/A 19.84% 18.03% 26.07%
2019 7.14% 14.74% 15.35% 24.56%
2018 16.67% 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 N/A 44.60% 50.67% 70.54%
Follow-Up After Emergency Department Visit for Mental Illness within 30 days after hospital discharge N/A 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 N/A 48.22% 47.90% 68.29%
2019 41.18% 45.64% 48.70% 70.67%
2018 30.30% 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 N/A 59.38% 62.36% 78.77%
2019 56.86% 60.35% 62.59% 77.75%
2018 48.48% 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 N/A 49.75% 48.70% 63.60%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge N/A 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 N/A 49.46% 49.62% 63.68%
2019 44.26% 49.77% 45.66% 58.20%
2018 42.05% 48.09% 44.98% 60.38%
2017 42.74% 52.18% 46.63% 62.81%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge 2020 N/A 72.67% 70.00% 79.46%
2019 73.77% 72.38% 67.81% 80.65%
2018 60.23% 69.84% 66.68% 80.29%
2017 64.10% 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 N/A 92.78% 89.65% 96.23%
Asthma Medication Ratio - Ages 12-18 N/A 85.93% 83.38% 90.21%
Asthma Medication Ratio - Ages 19-50 N/A 82.29% 78.35% 87.18%
Asthma Medication Ratio - Ages 51-64 N/A 86.60% 83.59% 90.22%
Asthma Medication Ratio - Total N/A 85.07% 81.23% 87.41%
Asthma Medication Ratio Year Plan State Avg. Natl. Avg. 90th Pctl.
Asthma Medication Ratio - Ages 5-11 2020 N/A 93.70% 89.98% 95.00%
2019 73.91% 86.54% 85.94% 93.20%
2018 84.85% 85.26% 87.15% 93.97%
2017 91.07% 86.06% 86.90% 93.55%
Asthma Medication Ratio - Ages 12-18 2020 N/A 84.76% 81.90% 89.30%
2019 88.10% 84.88% 77.43% 86.25%
2018 82.61% 84.71% 78.77% 84.72%
2017 87.69% 84.80% 76.69% 85.94%
Asthma Medication Ratio - Ages 19-50 2020 N/A 78.90% 75.62% 84.47%
2019 85.29% 80.50% 74.07% 81.27%
2018 87.18% 82.69% 75.11% 82.84%
2017 80.99% 78.94% 74.23% 81.70%
Asthma Medication Ratio - Ages 51-64 2020 N/A 85.69% 82.47% 89.38%
2019 89.31% 86.85% 81.27% 88.51%
2018 93.09% 86.11% 82.81% 89.49%
2017 91.58% 89.17% 82.83% 89.28%
Asthma Medication Ratio - Total 2020 N/A 83.04% 79.76% 85.85%
2019 86.81% 83.92% 78.10% 84.69%
2018 89.32% 84.32% 79.34% 85.18%
2017 87.64% 84.01% 79.04% 85.85%
Info
Cardiovascular Disease Management 2021 Plan State Avg Nat Avg 90th Pctl.
Controlling High Blood Pressure N/A 60.64% 59.95% 73.24%
Persistence of Beta-Blockers N/A 88.98% 86.08% 93.62%
Cardiovascular Disease Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Controlling High Blood Pressure 2020 N/A 43.15% 53.49% 69.10%
2019 63.02% 60.96% 61.02% 74.21%
2018 63.02% 60.55% N/A N/A
2017 N/A N/A N/A N/A
Persistence of Beta-Blockers 2020 N/A 87.06% 87.38% 94.19%
2019 88.24% 88.62% 85.16% 92.47%
2018 82.76% 83.54% 82.37% 89.29%
2017 77.78% 85.80% 85.18% 93.41%
Info
Cervical Cancer Screening 2021 Plan State Avg Nat Avg 90th Pctl.
Cervical Cancer Screening N/A 76.66% 75.48% 81.94%
Cervical Cancer Screening Year Plan State Avg. Natl. Avg. 90th Pctl.
Cervical Cancer Screening 2020 N/A 75.44% 75.50% 81.71%
2019 74.44% 78.50% 77.40% 83.91%
2018 74.44% 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 N/A 82.09% 79.49% 89.15%
Common Childhood Illnesses Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Testing for Children With Pharyngitis 2020 N/A 90.05% 84.77% 92.62%
2019 92.07% 90.44% 86.62% 93.98%
2018 89.94% 92.74% 87.97% 94.94%
2017 92.60% 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) N/A 59.77% 62.09% 75.43%
Comprehensive Diabetes Care-HbA1c control (<8.0%) N/A 61.24% 59.64% 67.11%
Comprehensive Diabetes Care-Rate of Eye Exams N/A 57.17% 52.65% 64.30%
Comprehensive Diabetes Care-Rate of Poor HbA1c control N/A 28.15% 29.94% 21.90%
Comprehensive Diabetes Care-Testing for HbA1c N/A 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 N/A 44.59% 55.85% 73.48%
2019 53.56% 62.53% 63.23% 77.86%
2018 60.34% 63.70% 62.59% 77.37%
2017 60.98% 63.40% 60.82% 76.41%
Comprehensive Diabetes Care-HbA1c control (<8.0%) 2020 N/A 55.20% 55.37% 65.50%
2019 66.34% 63.81% 58.07% 66.33%
2018 61.31% 62.46% 57.79% 66.33%
2017 67.41% 62.51% 57.48% 67.15%
Comprehensive Diabetes Care-Rate of Eye Exams 2020 N/A 53.44% 50.27% 64.23%
2019 59.71% 58.32% 55.45% 69.32%
2018 55.72% 56.58% 54.40% 69.68%
2017 60.70% 56.95% 54.06% 70.69%
Comprehensive Diabetes Care-Rate of Poor HbA1c control 2020 N/A 36.05% 34.87% 23.45%
2019 23.83% 26.09% 30.80% 20.82%
2018 28.22% 27.18% 30.85% 20.62%
2017 23.78% 27.63% 31.91% 21.41%
Comprehensive Diabetes Care-Testing for HbA1c 2020 N/A 86.71% 87.74% 91.73%
2019 92.87% 92.45% 91.60% 94.71%
2018 91.24% 92.11% 91.29% 94.71%
2017 91.61% 91.52% 90.96% 94.18%
Info
Immunizations 2021 Plan State Avg Nat Avg 90th Pctl.
Childhood Immunization for Multiple Diseases (Combo 10) N/A 66.38% 60.60% 73.21%
Childhood Immunization for Multiple Diseases Including Pneumovax N/A 82.74% 78.15% 88.27%
Flu Vaccinations for Adults Ages 18-64 N/A 59.29% 55.31% 65.85%
Immunizations for Adolescents - Combination 2 N/A 39.82% 34.09% 44.04%
Immunizations for Adolescents - HPV N/A 41.73% 35.37% 46.00%
Immunizations for Adolescents - Meningococcal N/A 86.88% 85.91% 93.19%
Immunizations for Adolescents - Tdap N/A 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 N/A 74.94% 75.84% 87.36%
2019 82.93% 81.30% 78.32% 87.99%
2018 83.33% 79.46% 77.50% 86.62%
2017 82.03% 80.09% 77.67% 87.61%
Flu Vaccinations for Adults Ages 18-64 2020 N/A 57.13% 57.41% 67.88%
2019 70.07% 59.38% 55.06% 65.24%
2018 59.52% 53.06% 51.93% 61.07%
2017 63.16% 55.21% 49.33% 59.27%
Immunizations for Adolescents - Combination 2 2020 N/A 35.09% 31.84% 39.17%
2019 33.58% 33.16% 29.59% 40.63%
2018 89.78% 79.55% 82.25% 91.52%
2017 87.35% 80.48% 80.23% 89.54%
Immunizations for Adolescents - HPV 2020 N/A 37.80% 33.38% 42.34%
2019 34.06% 35.43% 31.21% 42.46%
2018 34.06% 32.22% 28.05% 37.23%
2017 27.74% 28.29% 23.98% 32.36%
Immunizations for Adolescents - Meningococcal 2020 N/A 80.71% 85.83% 93.12%
2019 90.75% 81.83% 85.01% 92.59%
2018 90.75% 80.66% 83.69% 92.94%
2017 87.83% 82.05% 81.75% 90.27%
Immunizations for Adolescents - Tdap 2020 N/A 92.47% 90.62% 95.13%
2019 94.65% 92.23% 90.47% 95.13%
2018 94.65% 91.16% 89.95% 95.62%
2017 93.92% 91.65% 88.91% 94.65%
Info
Pharmacotherapy of COPD Exacerbation 2021 Plan State Avg Nat Avg 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator N/A 86.14% 81.56% 89.58%
Pharmacotherapy of COPD Exacerbation - Corticosteroid N/A 80.22% 74.79% 84.78%
Pharmacotherapy of COPD Exacerbation Year Plan State Avg. Natl. Avg. 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator 2020 N/A 86.03% 81.34% 88.51%
2019 83.33% 83.91% 80.32% 88.97%
2018 83.78% 85.49% 78.92% 87.88%
2017 76.06% 80.88% 79.87% 87.50%
Pharmacotherapy of COPD Exacerbation - Corticosteroid 2020 N/A 75.06% 74.31% 85.07%
2019 72.22% 81.14% 76.90% 87.69%
2018 79.73% 76.41% 74.76% 83.55%
2017 64.79% 78.84% 76.26% 84.38%
Info
Preventive Care 2021 Plan State Avg Nat Avg 90th Pctl.
Breast Cancer Screening N/A 72.93% 72.44% 79.62%
Chlamydia Screening in Women-all Age groups N/A 51.90% 48.47% 62.71%
Colorectal Cancer Screening N/A 63.99% 64.90% 76.16%
Preventive Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Breast Cancer Screening 2020 N/A 72.56% 72.44% 79.39%
2019 62.13% 72.92% 74.81% 81.58%
2018 63.34% 72.13% 73.73% 81.17%
2017 63.45% 71.85% 72.81% 80.91%
Chlamydia Screening in Women-all Age groups 2020 N/A 49.80% 48.49% 63.85%
2019 52.84% 54.77% 51.86% 67.02%
2018 53.61% 52.91% 51.41% 67.76%
2017 52.72% 51.46% 50.16% 66.08%
Colorectal Cancer Screening 2020 N/A 60.99% 63.64% 74.42%
2019 72.75% 68.10% 66.15% 77.91%
2018 72.75% 64.94% 64.37% 76.52%
2017 69.83% 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 N/A 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 N/A 37.53% 37.16% 43.86%
2019 37.50% 39.81% 42.11% 52.78%
2018 38.92% 44.14% 41.48% 50.95%
2017 42.56% 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) N/A 86.25% 84.99% 90.85%
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - 40–75 years (Female) N/A 74.86% 76.91% 83.87%
Statin Therapy for Patients with Cardiovascular Disease - Received Therapy - Total N/A 83.06% 82.86% 88.32%
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - 21-75 years (Male) N/A 78.10% 80.36% 87.04%
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - 40–75 years (Female) N/A 77.02% 76.97% 85.47%
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80% - Total N/A 77.77% 79.53% 86.44%
Statin Therapy for Patients with Diabetes - Received Therapy N/A 66.92% 66.45% 72.23%
Statin Therapy for Patients with Diabetes - Statin Adherence 80% N/A 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 N/A 85.75% 84.86% 89.67%
2019 84.11% 85.53% 84.83% 90.71%
2018 81.67% 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 N/A 77.46% 75.69% 81.94%
2019 77.55% 75.96% 74.89% 81.82%
2018 71.16% 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 N/A 83.41% 82.46% 87.85%
2019 82.13% 82.97% 82.41% 88.24%
2018 78.47% 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 N/A 81.24% 81.04% 86.60%
2019 82.15% 78.19% 78.73% 85.40%
2018 82.54% 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 N/A 78.29% 77.58% 86.55%
2019 81.58% 75.98% 73.50% 82.09%
2018 77.12% 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 N/A 80.47% 80.55% 86.26%
2019 81.99% 77.63% 77.38% 84.14%
2018 81.05% 74.49% 75.95% 82.83%
2017 N/A N/A N/A N/A
Statin Therapy for Patients with Diabetes - Received Therapy 2020 N/A 66.42% 65.49% 71.27%
2019 67.39% 65.53% 64.43% 70.97%
2018 63.86% 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 N/A 73.48% 74.69% 82.04%
2019 73.25% 71.84% 71.74% 79.50%
2018 71.84% 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 N/A 77.31% 75.21% 89.14%
Children/Adolescents BMI Assessment - Ages 3-11 N/A 78.77% 76.73% 90.56%
Children/Adolescents BMI Assessment - Ages 12-17 N/A 75.37% 73.29% 87.42%
Counseling for Nutrition for Children/Adolescents - Total N/A 74.98% 69.95% 83.70%
Counseling for Nutrition for Children/Adolescents - Ages 3-11 N/A 77.08% 72.50% 86.18%
Counseling for Nutrition for Children/Adolescents - Ages 12-17 N/A 72.13% 66.75% 82.14%
Counseling for Physical Activity for Children/Adolescents - Total N/A 71.34% 66.55% 80.86%
Counseling for Physical Activity for Children/Adolescents - Ages 3-11 N/A 69.93% 66.24% 81.08%
Counseling for Physical Activity for Children/Adolescents - Ages 12-17 N/A 73.30% 66.87% 83.09%
Weight Assessment and Counseling Year Plan State Avg. Natl. Avg. 90th Pctl.
Children/Adolescents BMI Assessment - Total 2020 N/A 61.27% 70.64% 88.81%
2019 76.01% 74.97% 74.90% 90.00%
2018 76.01% 73.74% 72.87% 90.00%
2017 69.34% 70.41% 70.59% 88.08%
Children/Adolescents BMI Assessment - Ages 3-11 2020 N/A 64.54% 72.11% 88.89%
2019 81.05% 78.68% 76.00% 90.91%
2018 81.05% 76.94% 74.00% 90.91%
2017 69.01% 71.37% 71.84% 88.89%
Children/Adolescents BMI Assessment - Ages 12-17 2020 N/A 57.19% 68.80% 87.79%
2019 72.48% 70.46% 73.46% 89.29%
2018 72.48% 69.73% 71.39% 88.97%
2017 69.58% 68.96% 68.94% 87.82%
Counseling for Nutrition for Children/Adolescents - Total 2020 N/A 56.08% 65.06% 82.43%
2019 74.12% 72.58% 68.74% 85.24%
2018 74.12% 71.79% 67.72% 85.06%
2017 69.10% 69.47% 65.50% 83.21%
Counseling for Nutrition for Children/Adolescents - Ages 3-11 2020 N/A 59.21% 67.32% 84.32%
2019 77.78% 77.02% 71.33% 86.49%
2018 77.78% 75.91% 69.85% 86.21%
2017 71.93% 71.63% 68.20% 84.82%
Counseling for Nutrition for Children/Adolescents - Ages 12-17 2020 N/A 52.10% 62.24% 79.49%
2019 71.56% 66.89% 65.44% 84.29%
2018 71.56% 66.37% 64.92% 84.29%
2017 67.08% 66.54% 61.92% 80.26%
Counseling for Physical Activity for Children/Adolescents - Total 2020 N/A 52.21% 60.81% 80.29%
2019 69.27% 66.86% 64.24% 82.78%
2018 69.27% 66.42% 63.08% 81.32%
2017 66.67% 64.30% 59.96% 77.32%
Counseling for Physical Activity for Children/Adolescents - Ages 3-11 2020 N/A 52.27% 60.31% 81.14%
2019 67.32% 66.12% 63.39% 82.53%
2018 67.32% 65.48% 61.70% 80.92%
2017 61.99% 62.31% 58.84% 75.00%
Counseling for Physical Activity for Children/Adolescents - Ages 12-17 2020 N/A 51.96% 61.40% 79.85%
2019 70.64% 67.67% 65.38% 84.68%
2018 70.64% 67.51% 64.79% 84.03%
2017 70.00% 66.86% 61.40% 79.89%
Health Plan Stability/Descriptive
Info
Administrative Data 2021 Plan State Avg Nat Avg 90th Pctl.
Administrative Ratio N/A 0.12 N/A N/A
Medical Cost Ratio N/A 0.85 N/A N/A
Number of Enrollees N/A 189,570 N/A N/A
Number of Physicians N/A 144,761 N/A N/A
Premium Per Member Per Month N/A $582 N/A N/A
Profit/Loss Ratio N/A 0.04 N/A N/A
Administrative Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Administrative Ratio 2020 0.07 0.13 N/A N/A
2019 0.05 0.12 N/A N/A
2018 0.08 0.14 86.19 92.68
2017 0.05 0.12 86.39 93.13
Medical Cost Ratio 2020 0.76 0.81 N/A N/A
2019 0.86 0.84 N/A N/A
2018 0.81 0.83 92.60 95.85
2017 0.79 0.83 93.13 96.59
Number of Enrollees 2020 0 157,206 N/A N/A
2019 0 136,748 N/A N/A
2018 N/A 129,656 92 96
2017 0 133,992 92 97
Number of Physicians 2020 6,098 118,547 N/A N/A
2019 55,148 105,314 N/A N/A
2018 55,087 86,806 87 95
2017 52,438 81,926 87 95
Premium Per Member Per Month 2020 $0 $529 N/A N/A
2019 $0 $511 N/A N/A
2018 N/A $517 N/A N/A
2017 $0 $370 N/A N/A
Profit/Loss Ratio 2020 0.17 0.06 N/A N/A
2019 0.09 0.04 N/A N/A
2018 0.12 0.04 N/A N/A
2017 0.16 0.05 N/A N/A
Info
Financial Data 2021 Plan State Avg Nat Avg 90th Pctl.
Income N/A $84,171,275 N/A N/A
Net Worth N/A $444,659,972 N/A N/A
Premiums Earned N/A $1,315,605,350 N/A N/A
Financial Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Income 2020 $29,721,094 $108,797,768 N/A N/A
2019 $17,581,309 $81,234,487 N/A N/A
2018 $24,777,791 $44,046,244 N/A N/A
2017 $30,680,262 $34,422,501 N/A N/A
Net Worth 2020 $53,416,220 $381,868,187 N/A N/A
2019 $44,034,292 $340,553,480 N/A N/A
2018 $51,942,512 $279,558,644 N/A N/A
2017 $56,355,668 $263,890,874 N/A N/A
Premiums Earned 2020 $0 $1,079,933,473 N/A N/A
2019 $0 $936,529,722 N/A N/A
2018 N/A $815,577,345 N/A N/A
2017 $0 $645,600,589 N/A N/A
Info
Years in Business 2021 Plan State Avg Nat Avg 90th Pctl.
Years in Business N/A 39 N/A N/A
Years in Business Year Plan State Avg. Natl. Avg. 90th Pctl.
Years in Business 2020 N/A 38 N/A N/A
2019 40 37 N/A N/A
2018 39 36 N/A N/A
2017 38 35 N/A N/A
Member Satisfaction
Info
Member Satisfaction 2021 Plan State Avg Nat Avg 90th Pctl.
Getting Care Quickly N/A 83.79% 83.12% 89.04%
Getting Needed Care N/A 85.63% 84.05% 89.10%
How Well Doctors Communicate N/A 94.61% 95.28% 97.41%
Members highly rating their HMO (8 to 10 on a 0-10 scale) N/A 66.71% 67.27% 78.31%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) N/A 83.98% 84.85% 88.79%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) N/A 78.88% 77.89% 84.07%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) N/A 83.94% 85.47% 90.41%
Member Satisfaction Year Plan State Avg. Natl. Avg. 90th Pctl.
Getting Care Quickly 2020 N/A 85.38% 86.32% 91.51%
2019 88.98% 87.14% 86.32% 90.57%
2018 90.41% 85.27% 85.23% 89.89%
2017 89.94% 87.22% 85.34% 89.83%
Getting Needed Care 2020 N/A 87.88% 88.01% 92.51%
2019 90.53% 87.88% 87.38% 91.22%
2018 89.27% 85.53% 86.33% 90.45%
2017 90.34% 87.44% 86.71% 90.37%
How Well Doctors Communicate 2020 N/A 95.93% 95.93% 97.98%
2019 96.12% 94.99% 95.85% 97.38%
2018 95.83% 94.70% 95.31% 97.22%
2017 95.62% 94.74% 95.10% 96.91%
Members highly rating their HMO (8 to 10 on a 0-10 scale) 2020 N/A 65.21% 69.04% 80.59%
2019 78.71% 69.24% 67.91% 78.57%
2018 75.00% 64.78% 64.53% 76.79%
2017 76.43% 61.26% 62.44% 75.00%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 2020 N/A 86.67% 87.14% 91.18%
2019 89.90% 88.18% 86.27% 90.20%
2018 84.30% 84.82% 84.41% 88.57%
2017 87.39% 83.86% 84.62% 88.77%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) 2020 N/A 79.32% 80.71% 87.04%
2019 86.49% 79.81% 80.27% 86.36%
2018 82.35% 76.02% 78.17% 83.95%
2017 79.10% 76.98% 77.27% 82.99%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) 2020 N/A 85.69% 86.56% 91.30%
2019 92.24% 87.91% 87.34% 90.94%
2018 87.50% 84.08% 85.14% 89.78%
2017 87.94% 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 N/A 45.59% 35.85% 48.30%
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics - Ages 1-17 N/A 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 N/A 38.77% 31.82% 42.98%
2019 41.18% 42.62% 37.50% 49.28%
2018 46.34% 44.74% 36.17% 47.41%
2017 57.14% 50.55% 36.07% 48.57%
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics - Ages 1-17 2020 N/A 60.42% 62.97% 76.39%
2019 71.43% 63.47% 61.05% 78.36%
2018 52.38% 57.96% 56.00% 70.54%
2017 54.55% 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 N/A 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 N/A 0.46% 0.67% 0.19%
2019 0.79% 0.58% 0.85% 0.24%
2018 1.12% 0.71% 1.05% 0.33%
2017 1.39% 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 N/A 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 N/A 77.22% 78.53% 85.60%
2019 84.51% 77.01% 76.69% 83.47%
2018 80.20% 74.77% 75.11% 82.95%
2017 80.51% 73.85% 75.16% 82.29%
Info
Respiratory 2021 Plan State Avg Nat Avg 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection N/A 95.68% 94.48% 98.12%
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis N/A 44.79% 46.61% 61.68%
Respiratory Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection 2020 N/A 93.12% 91.57% 95.67%
2019 91.53% 91.87% 90.76% 95.51%
2018 90.00% 92.50% 91.22% 95.48%
2017 90.48% 90.92% 89.19% 94.59%
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis 2020 N/A 41.88% 43.24% 59.45%
2019 27.06% 38.42% 39.91% 54.09%
2018 21.92% 33.60% 33.16% 48.28%
2017 21.52% 30.67% 30.99% 49.52%
Info
Use of Opiods 2021 Plan State Avg Nat Avg 90th Pctl.
Use of Opioids at High Dosage N/A 6.26% 5.24% 1.88%
Use of Opioids From Multiple Providers - Multiple Pharmacies N/A 1.32% 1.59% 0.33%
Use of Opioids From Multiple Providers - Multiple Prescribers N/A 16.64% 13.69% 8.71%
Use of Opioids From Multiple Providers - Multiple Prescribers and Multiple Pharmacies N/A 0.70% 0.77% 0.00%
Use of Opiods Year Plan State Avg. Natl. Avg. 90th Pctl.
Use of Opioids at High Dosage 2020 N/A 6.49% 5.76% 1.88%
2019 8.32% 6.96% 6.08% 1.88%
2018 5.71% 5.32% 4.54% 1.87%
2017 N/A N/A N/A N/A
Use of Opioids From Multiple Providers - Multiple Pharmacies 2020 N/A 2.27% 1.67% 0.62%
2019 3.94% 3.75% 2.79% 0.69%
2018 3.80% 5.21% 3.80% 1.40%
2017 N/A N/A N/A N/A
Use of Opioids From Multiple Providers - Multiple Prescribers 2020 N/A 16.62% 13.32% 8.20%
2019 15.65% 17.64% 14.51% 9.79%
2018 16.06% 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 N/A 1.22% 0.76% 0.08%
2019 1.42% 1.70% 1.24% 0.00%
2018 1.90% 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 N/A 23.22% 0.78% 0.58%
Acute Hospital Utilization - Surgery N/A 11.64% N/A N/A
Acute Hospital Utilization - Total Acute N/A 34.86% 1.02% 0.79%
Acute Hospital Utilization Rate Year Plan State Avg. Natl. Avg. 90th Pctl.
Acute Hospital Utilization - Medicine 2020 N/A 21.48% 0.72% 0.53%
2019 42.50% 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 N/A 11.94% N/A N/A
2019 23.00% 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 N/A 33.42% 0.97% 0.78%
2019 65.50% 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 N/A 138.89% 0.90% 0.72%
Emergency Department Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Emergency Department Utilization 2020 N/A 124.84% N/A N/A
2019 226.95% 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) N/A 4.93% 0.60% 0.48%
Plan All-Cause Readmissions Ages 18-44 N/A 4.20% N/A N/A
Plan All-Cause Readmissions Ages 45-54 N/A 4.67% N/A N/A
Plan All-Cause Readmissions Ages 55-64 N/A 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 N/A 4.88% 0.58% 0.47%
2019 4.55% 4.32% 0.51% 0.37%
2018 10.21% 11.17% N/A N/A
2017 13.34% 12.19% N/A N/A
Plan All-Cause Readmissions Ages 18-44 2020 N/A 4.26% N/A N/A
2019 7.28% 4.54% N/A N/A
2018 9.12% 11.41% N/A N/A
2017 14.95% 12.99% N/A N/A
Plan All-Cause Readmissions Ages 45-54 2020 N/A 4.46% N/A N/A
2019 3.83% 4.35% N/A N/A
2018 8.44% 10.56% N/A N/A
2017 11.95% 11.71% N/A N/A
Plan All-Cause Readmissions Ages 55-64 2020 N/A 5.69% N/A N/A
2019 4.03% 4.26% N/A N/A
2018 11.35% 11.21% N/A N/A
2017 13.45% 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 N/A 0.55 0.57 0.73
Average number of antibiotic prescriptions per member per year - Ages 0-9 N/A 0.39 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 10-17 N/A 0.31 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 18-34 N/A 0.52 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 35-49 N/A 0.57 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 50-64 N/A 0.67 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 65-74 N/A 0.75 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 75-85 N/A 0.82 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 85 plus N/A 1.42 N/A N/A
Days suppplied per antibiotic prescription - Total N/A 10.197 10.210 11.220
Days suppplied per antibiotic prescription - Ages 0-9 N/A 10.540 N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 N/A 14.793 N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 N/A 9.754 N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 N/A 9.787 N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 N/A 10.114 N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 N/A 10.241 N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 N/A 8.940 N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus N/A 11.142 N/A N/A
Prescriptions of concern - Total N/A 0.209 0.230 0.340
Prescriptions of concern - Ages 0-9 N/A 0.14 N/A N/A
Prescriptions of concern - Ages 10-17 N/A 0.10 N/A N/A
Prescriptions of concern - Ages 18-34 N/A 0.18 N/A N/A
Prescriptions of concern - Ages 35-49 N/A 0.22 N/A N/A
Prescriptions of concern - Ages 50-64 N/A 0.28 N/A N/A
Prescriptions of concern - Ages 65-74 N/A 0.29 N/A N/A
Prescriptions of concern - Ages 75-85 N/A 0.27 N/A N/A
Prescriptions of concern - Ages 85 plus N/A 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 N/A 0.57 0.57 0.71
2019 0.79 0.75 0.74 0.90
2018 0.79 0.74 0.71 0.88
2017 0.81 0.77 0.76 0.90
Average number of antibiotic prescriptions per member per year - Ages 0-9 2020 N/A 0.41 N/A N/A
2019 0.80 0.85 N/A N/A
2018 0.77 0.81 N/A N/A
2017 0.89 0.87 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 10-17 2020 N/A 0.33 N/A N/A
2019 0.54 0.52 N/A N/A
2018 0.60 0.52 N/A N/A
2017 0.63 0.57 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 18-34 2020 N/A 0.53 N/A N/A
2019 0.62 0.66 N/A N/A
2018 0.65 0.65 N/A N/A
2017 0.65 0.67 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 35-49 2020 N/A 0.59 N/A N/A
2019 0.73 0.74 N/A N/A
2018 0.76 0.73 N/A N/A
2017 0.76 0.75 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 50-64 2020 N/A 0.70 N/A N/A
2019 0.86 0.85 N/A N/A
2018 0.85 0.84 N/A N/A
2017 0.89 0.88 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 65-74 2020 N/A 0.77 N/A N/A
2019 0.95 0.95 N/A N/A
2018 0.96 0.97 N/A N/A
2017 0.99 1.00 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 75-85 2020 N/A 0.80 N/A N/A
2019 1.10 1.15 N/A N/A
2018 1.09 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 N/A 1.56 N/A N/A
2019 0.83 0.95 N/A N/A
2018 0.94 1.32 N/A N/A
2017 0.95 1.12 N/A N/A
Days suppplied per antibiotic prescription - Total 2020 N/A 10.133 10.310 11.480
2019 10.330 9.888 9.890 10.660
2018 10.220 9.950 9.910 10.890
2017 10.490 10.024 9.880 10.830
Days suppplied per antibiotic prescription - Ages 0-9 2020 N/A 10.550 N/A N/A
2019 9.740 10.025 N/A N/A
2018 9.810 9.979 N/A N/A
2017 10.300 10.050 N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 2020 N/A 14.369 N/A N/A
2019 12.550 12.591 N/A N/A
2018 12.970 12.948 N/A N/A
2017 13.670 12.689 N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 2020 N/A 9.729 N/A N/A
2019 10.870 9.695 N/A N/A
2018 10.270 9.731 N/A N/A
2017 10.520 9.836 N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 2020 N/A 9.703 N/A N/A
2019 9.390 9.488 N/A N/A
2018 9.670 9.568 N/A N/A
2017 9.710 9.591 N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 2020 N/A 10.027 N/A N/A
2019 10.260 9.756 N/A N/A
2018 9.870 9.769 N/A N/A
2017 10.070 9.856 N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 2020 N/A 9.997 N/A N/A
2019 10.310 9.766 N/A N/A
2018 10.620 9.830 N/A N/A
2017 10.640 9.850 N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 2020 N/A 10.119 N/A N/A
2019 9.940 9.645 N/A N/A
2018 9.560 9.428 N/A N/A
2017 10.690 10.604 N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus 2020 N/A 10.606 N/A N/A
2019 8.520 9.997 N/A N/A
2018 8.470 9.026 N/A N/A
2017 7.280 9.873 N/A N/A
Prescriptions of concern - Total 2020 N/A 0.227 0.240 0.320
2019 0.370 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 N/A 0.15 N/A N/A
2019 0.30 0.34 N/A N/A
2018 0.26 0.32 N/A N/A
2017 0.34 0.35 N/A N/A
Prescriptions of concern - Ages 10-17 2020 N/A 0.11 N/A N/A
2019 0.22 0.20 N/A N/A
2018 0.25 0.20 N/A N/A
2017 0.25 0.22 N/A N/A
Prescriptions of concern - Ages 18-34 2020 N/A 0.20 N/A N/A
2019 0.24 0.28 N/A N/A
2018 0.27 0.28 N/A N/A
2017 0.26 0.28 N/A N/A
Prescriptions of concern - Ages 35-49 2020 N/A 0.25 N/A N/A
2019 0.37 0.35 N/A N/A
2018 0.37 0.35 N/A N/A
2017 0.38 0.37 N/A N/A
Prescriptions of concern - Ages 50-64 2020 N/A 0.31 N/A N/A
2019 0.42 0.41 N/A N/A
2018 0.42 0.42 N/A N/A
2017 0.46 0.44 N/A N/A
Prescriptions of concern - Ages 65-74 2020 N/A 0.33 N/A N/A
2019 0.44 0.44 N/A N/A
2018 0.45 0.48 N/A N/A
2017 0.48 0.50 N/A N/A
Prescriptions of concern - Ages 75-85 2020 N/A 0.34 N/A N/A
2019 0.47 0.51 N/A N/A
2018 0.54 0.62 N/A N/A
2017 0.46 0.54 N/A N/A
Prescriptions of concern - Ages 85 plus 2020 N/A 0.41 N/A N/A
2019 0.35 0.36 N/A N/A
2018 0.45 0.45 N/A N/A
2017 0.47 0.48 N/A N/A
Info
Mental Health Utilization 2021 Plan State Avg Nat Avg 90th Pctl.
Mental Health Utilization - Any Service - Total N/A 9.40% 9.48% 13.63%
Mental Health Utilization - Any Service - Ages 0-12 N/A 6.00% N/A N/A
Mental Health Utilization - Any Service - Ages 13-17 N/A 16.24% N/A N/A
Mental Health Utilization - Any Service - Ages 18-64 N/A 9.76% N/A N/A
Mental Health Utilization - Any Service - Ages 65 plus N/A 3.11% N/A N/A
Mental Health Utilization - ED - Total N/A 0.05% 0.07% 0.17%
Mental Health Utilization - ED - Ages 0-12 N/A 0.02% N/A N/A
Mental Health Utilization - ED - Ages 13-17 N/A 0.21% N/A N/A
Mental Health Utilization - ED - Ages 18-64 N/A 0.04% N/A N/A
Mental Health Utilization - ED - Ages 65 plus N/A 0.01% N/A N/A
Mental Health Utilization - Inpatient - Total N/A 0.24% 0.25% 0.33%
Mental Health Utilization - Inpatient - Ages 0-12 N/A 0.08% N/A N/A
Mental Health Utilization - Inpatient - Ages 13-17 N/A 0.88% N/A N/A
Mental Health Utilization - Inpatient - Ages 18-64 N/A 0.22% N/A N/A
Mental Health Utilization - Inpatient - Ages 65 plus N/A 0.08% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Total N/A 0.08% 0.16% 0.31%
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 0-12 N/A 0.03% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 13-17 N/A 0.40% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 18-64 N/A 0.07% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 65 plus N/A 0.01% N/A N/A
Mental Health Utilization - Outpatient - Total N/A 4.73% 5.70% 8.26%
Mental Health Utilization - Outpatient - Ages 0-12 N/A 3.72% N/A N/A
Mental Health Utilization - Outpatient - Ages 13-17 N/A 9.85% N/A N/A
Mental Health Utilization - Outpatient - Ages 18-64 N/A 4.63% N/A N/A
Mental Health Utilization - Outpatient - Ages 65 plus N/A 1.73% N/A N/A
Mental Health Utilization - Telehealth - Total N/A 6.68% 6.01% 9.77%
Mental Health Utilization - Telehealth - Ages 0-12 N/A 3.74% N/A N/A
Mental Health Utilization - Telehealth - Ages 13-17 N/A 10.92% N/A N/A
Mental Health Utilization - Telehealth - Ages 18-64 N/A 7.11% N/A N/A
Mental Health Utilization - Telehealth - Ages 65 plus N/A 1.96% N/A N/A
Mental Health Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Mental Health Utilization - Any Service - Total 2020 N/A 9.13% 9.07% 12.95%
2019 6.67% 8.33% 8.86% 12.67%
2018 6.50% 7.63% 7.98% 11.76%
2017 N/A N/A N/A N/A
Mental Health Utilization - Any Service - Ages 0-12 2020 N/A 6.25% N/A N/A
2019 6.84% 6.35% N/A N/A
2018 6.25% 6.12% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Any Service - Ages 13-17 2020 N/A 15.31% N/A N/A
2019 13.96% 15.01% N/A N/A
2018 12.52% 13.96% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Any Service - Ages 18-64 2020 N/A 9.40% N/A N/A
2019 6.77% 8.45% N/A N/A
2018 6.53% 7.62% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Any Service - Ages 65 plus 2020 N/A 3.53% N/A N/A
2019 3.18% 3.17% N/A N/A
2018 3.45% 3.20% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - ED - Total 2020 N/A 0.03% 0.06% 0.15%
2019 0.04% 0.04% 0.08% 0.17%
2018 0.07% 0.09% 0.10% 0.22%
2017 N/A N/A N/A N/A
Mental Health Utilization - ED - Ages 0-12 2020 N/A 0.01% N/A N/A
2019 0.00% 0.02% N/A N/A
2018 0.04% 0.05% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - ED - Ages 13-17 2020 N/A 0.10% N/A N/A
2019 0.11% 0.17% N/A N/A
2018 0.25% 0.28% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - ED - Ages 18-64 2020 N/A 0.03% N/A N/A
2019 0.04% 0.03% N/A N/A
2018 0.06% 0.08% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - ED - Ages 65 plus 2020 N/A 0.01% N/A N/A
2019 0.02% 0.07% N/A N/A
2018 0.04% 0.02% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Total 2020 N/A 0.22% 0.24% 0.31%
2019 0.23% 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 N/A 0.07% N/A N/A
2019 0.11% 0.12% N/A N/A
2018 0.19% 0.12% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 13-17 2020 N/A 0.79% N/A N/A
2019 0.65% 0.85% N/A N/A
2018 0.72% 0.95% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 18-64 2020 N/A 0.20% N/A N/A
2019 0.23% 0.24% N/A N/A
2018 0.30% 0.26% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 65 plus 2020 N/A 0.06% N/A N/A
2019 0.09% 0.11% N/A N/A
2018 0.07% 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 N/A 0.07% 0.15% 0.30%
2019 0.10% 0.11% 0.20% 0.40%
2018 0.15% 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 N/A 0.05% N/A N/A
2019 0.05% 0.10% N/A N/A
2018 0.23% 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 N/A 0.26% N/A N/A
2019 0.33% 0.35% N/A N/A
2018 0.59% 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 N/A 0.06% N/A N/A
2019 0.11% 0.09% N/A N/A
2018 0.11% 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 N/A 0.01% N/A N/A
2019 0.00% 0.02% N/A N/A
2018 0.04% 0.02% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Outpatient - Total 2020 N/A 7.22% 6.95% 9.99%
2019 6.59% 8.24% 8.73% 12.61%
2018 6.41% 7.53% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Outpatient - Ages 0-12 2020 N/A 5.23% N/A N/A
2019 6.78% 6.32% N/A N/A
2018 6.18% 6.10% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Outpatient - Ages 13-17 2020 N/A 12.84% N/A N/A
2019 13.79% 14.86% N/A N/A
2018 12.35% 13.80% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Outpatient - Ages 18-64 2020 N/A 7.35% N/A N/A
2019 6.69% 8.36% N/A N/A
2018 6.43% 7.51% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Outpatient - Ages 65 plus 2020 N/A 2.62% N/A N/A
2019 3.16% 3.07% N/A N/A
2018 3.40% 3.16% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Telehealth - Total 2020 N/A 4.92% 5.19% 8.37%
2019 0.09% 0.11% 0.11% 0.22%
2018 0.05% 0.10% 0.05% 0.11%
2017 N/A N/A N/A N/A
Mental Health Utilization - Telehealth - Ages 0-12 2020 N/A 3.07% N/A N/A
2019 0.11% 0.04% N/A N/A
2018 0.04% 0.03% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Telehealth - Ages 13-17 2020 N/A 8.30% N/A N/A
2019 0.27% 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 N/A 5.11% N/A N/A
2019 0.08% 0.12% N/A N/A
2018 0.05% 0.11% N/A N/A
2017 N/A N/A N/A N/A
Mental Health Utilization - Telehealth - Ages 65 plus 2020 N/A 1.80% N/A N/A
2019 0.04% 0.02% N/A N/A
2018 0.04% 0.02% N/A N/A
2017 N/A N/A N/A N/A
2021 data updated on: 07/05/2023