Health Insurance in Virginia

UnitedHealthcare Plan of the River Valley, Inc.

Company Information

  • Company Providing Plan:United Healthcare Plan of the River Valley, Inc.
  • Address:9800 Health Care Lane, MN006-W500
    Minnetonka, MN 55343
  • Telephone :309-736-4600
  • Website:www.uhcrivervalley.com
2018
Number of Enrollees: *3,954
PMPM: *$503
Number of Physicians: *135,644
NCQA Accreditation: Commendable

*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

Bedford, Bland, Botetourt, Buchanan, Carroll, Craig, Dickenson, Floyd, Franklin, Giles, Grayson, Henry, Lee, Montgomery, Pulaski, Roanoke, Rockbridge, Russell, Scott, Smyth, Tazewell, Washington, Wise, Wythe


Cities

Bedford, Bristol, Buena Vista, Galax, Lexington, Martinsville, Norton, Radford, Roanoke, Salem

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

Administrative Data

2018 2017 2016 2015 2014
*Number of Enrollees 3,954 3,120 2,075 12,735 12,570
PMPM $503 $445 $458 $722 $726
*Medical Cost Ratio 89% 84% 81% 78% 77%
*Administrative Ratio 12% 13% 16% 16% 14%
*Profit/Loss Ratio -1% 2% 5% 5% 9%
*Number of Physicians 135,644 126,348 104,855 96,584 75,990

*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 $22,821,362 $12,975,673 $13,908,052 $111,592,310 $120,037,173
*Income ($29,958,562) $66,112,321 $125,998,557 $62,453,637 $236,985,815
*Net Worth $462,998,137 $446,288,192 $434,309,068 $423,305,536 $600,328,649

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

Performance

  • Per NCQA, the performance data for United Health Care River Valley has been reported with United Health Care Mid-Atlantic since 2018.
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 N/A 92.43% 92.33% 95.45%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services N/A 95.50% 95.64% 97.49%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services N/A 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 N/A 92.73% 92.45% 95.43%
2016 91.42% 92.81% 92.73% 95.55%
2015 91.83% 92.25% 92.83% 95.45%
2014 91.41% 93.10% 92.91% 95.39%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 2017 N/A 95.57% 95.61% 97.46%
2016 95.07% 95.78% 95.78% 97.61%
2015 94.70% 95.61% 95.90% 97.55%
2014 95.05% 96.03% 95.85% 97.54%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 2017 N/A 97.82% 97.07% 98.47%
2016 97.65% 97.30% 97.19% 98.61%
2015 97.44% 96.84% 97.32% 96.73%
2014 97.32% 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 N/A 37.53% 35.68% 42.36%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 N/A 49.35% 40.21% 51.02%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus N/A 37.34% 35.51% 42.35%
Engagement of Alcohol and Other Drug Dependence Treatment - Total N/A 14.69% 12.58% 17.04%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 N/A 18.18% 16.91% 25.00%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus N/A 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 N/A 36.14% 36.11% 42.01%
2016 34.10% 35.69% 32.93% 40.24%
2015 35.21% 33.04% 33.42% 41.07%
2014 34.07% 32.51% 35.63% 44.19%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2017 N/A 40.06% 39.91% 52.54%
2016 54.55% 40.15% 40.47% 51.96%
2015 N/A 37.03% 39.62% 50.00%
2014 N/A 37.09% 40.79% 52.00%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2017 N/A 36.00% 35.97% 41.96%
2016 33.57% 35.55% 32.64% 40.33%
2015 34.50% 32.96% 33.20% 40.93%
2014 33.50% 32.16% 35.21% 43.92%
Engagement of Alcohol and Other Drug Dependence Treatment - Total 2017 N/A 13.36% 12.65% 17.26%
2016 13.50% 12.51% 11.46% 16.72%
2015 15.83% 11.61% 12.46% 19.23%
2014 13.72% 10.64% 13.66% 19.19%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2017 N/A 14.40% 14.95% 23.85%
2016 9.09% 11.28% 15.68% 23.73%
2015 N/A 12.06% 15.42% 22.12%
2014 N/A 13.00% 17.24% 25.29%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2017 N/A 13.40% 12.55% 17.38%
2016 13.62% 12.57% 11.32% 16.09%
2015 15.28% 11.57% 12.34% 18.67%
2014 13.04% 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 N/A 98.57% 98.19% 99.60%
25 month to 6 year old Child Access to Primary Care Practitioners N/A 94.36% 93.13% 97.39%
7-11 year old Child Access to Primary Care Practitioners N/A 95.22% 93.87% 98.50%
12-19 year old Child Access to Primary Care Practitioners N/A 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 N/A 98.09% 97.93% 99.50%
2016 96.73% 98.34% 98.09% 99.72%
2015 98.99% 98.78% 98.03% 99.48%
2014 98.53% 98.49% 97.87% 99.62%
25 month to 6 year old Child Access to Primary Care Practitioners 2017 N/A 94.63% 92.58% 96.95%
2016 91.50% 94.33% 92.60% 96.46%
2015 91.36% 94.16% 92.67% 96.64%
2014 91.84% 93.85% 92.33% 96.52%
7-11 year old Child Access to Primary Care Practitioners 2017 N/A 95.40% 93.43% 98.48%
2016 89.26% 94.38% 93.25% 98.25%
2015 90.04% 94.23% 93.23% 97.92%
2014 89.46% 93.78% 93.02% 97.87%
12-19 year old Child Access to Primary Care Practitioners 2017 N/A 92.00% 91.08% 96.99%
2016 87.94% 91.45% 90.76% 96.39%
2015 87.75% 91.30% 90.66% 96.19%
2014 88.74% 90.84% 90.44% 96.28%
Info
Prenatal and Postpartum Care 2018 Plan State Avg Nat Avg 90th Pctl.
Postpartum Care N/A 75.10% 75.89% 88.80%
Timeliness of Prenatal Care N/A 88.15% 84.75% 94.17%
Prenatal and Postpartum Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Postpartum Care 2017 N/A 73.45% 75.05% 88.13%
2016 80.57% 74.50% 73.95% 88.85%
2015 80.53% 73.91% 73.72% 87.50%
2014 78.42% 77.29% 77.64% 88.65%
Timeliness of Prenatal Care 2017 N/A 86.37% 84.34% 94.89%
2016 67.84% 86.71% 85.57% 96.28%
2015 81.19% 86.80% 84.28% 94.56%
2014 82.57% 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 N/A 71.96% 68.64% 77.59%
Antidepressant Medication Management - Effective Continuation Phase Treatment N/A 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 N/A 71.12% 67.11% 75.76%
2016 65.92% 70.29% 66.56% 74.77%
2015 64.76% 67.61% 65.82% 74.06%
2014 65.53% 68.52% 65.88% 75.35%
Antidepressant Medication Management - Effective Continuation Phase Treatment 2017 N/A 54.87% 51.53% 60.24%
2016 48.42% 53.51% 50.69% 58.60%
2015 47.30% 49.81% 50.15% 57.56%
2014 47.65% 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 N/A 42.91% 39.85% 50.42%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation N/A 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 N/A 41.27% 41.13% 50.83%
2016 37.33% 41.91% 38.93% 48.61%
2015 40.59% 41.43% 38.13% 50.00%
2014 32.45% 39.00% 38.01% 46.81%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 2017 N/A 55.09% 47.07% 58.44%
2016 52.63% 46.92% 45.82% 56.86%
2015 47.83% 49.06% 46.18% 58.06%
2014 N/A 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 Year Plan State Avg. Natl. Avg. 90th Pctl.
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 Year Plan State Avg. Natl. Avg. 90th Pctl.
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 N/A 48.09% 44.98% 60.38%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge N/A 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 N/A 52.18% 46.63% 62.81%
2016 49.50% 52.99% 52.06% 67.31%
2015 38.71% 47.66% 50.57% 67.57%
2014 46.26% 51.82% 52.21% 70.33%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge 2017 N/A 69.80% 68.66% 82.58%
2016 72.28% 73.85% 71.36% 84.17%
2015 70.16% 71.58% 69.72% 83.80%
2014 77.55% 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 N/A 77.42% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 5-11 N/A 63.81% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 12-18 N/A 71.44% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 19-50 N/A 77.64% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 51-64 N/A 83.35% N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Total N/A 55.48% 51.74% 59.67%
Medication Management for People With Asthma at least 75% Compliance - Ages 5-11 N/A 37.21% 38.94% 47.83%
Medication Management for People With Asthma at least 75% Compliance - Ages 12-18 N/A 46.61% 38.67% 47.44%
Medication Management for People With Asthma at least 75% Compliance - Ages 19-50 N/A 55.33% 50.37% 60.00%
Medication Management for People With Asthma at least 75% Compliance - Ages 51-64 N/A 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 N/A 76.58% N/A N/A
2016 70.38% 73.20% N/A N/A
2015 67.11% 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 N/A 66.50% N/A N/A
2016 68.18% 67.58% N/A N/A
2015 63.33% 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 N/A 68.06% N/A N/A
2016 67.74% 65.72% N/A N/A
2015 69.70% 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 N/A 75.34% N/A N/A
2016 67.77% 71.77% N/A N/A
2015 58.11% 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 N/A 84.54% N/A N/A
2016 72.41% 79.36% N/A N/A
2015 72.93% 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 N/A 54.32% 50.48% 57.69%
2016 46.18% 51.17% 48.54% 56.96%
2015 44.30% 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 N/A 42.35% 40.22% 52.99%
2016 31.82% 39.03% 37.58% 48.84%
2015 30.00% 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 N/A 41.76% 37.80% 47.11%
2016 41.94% 35.03% 35.83% 46.97%
2015 51.52% 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 N/A 52.86% 48.60% 57.87%
2016 44.63% 50.18% 46.16% 55.80%
2015 39.86% 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 N/A 64.50% 59.65% 67.58%
2016 49.14% 59.39% 57.47% 65.75%
2015 45.86% 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 N/A 60.55% N/A N/A
Persistence of Beta-Blockers N/A 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 N/A 85.80% 85.18% 93.41%
2016 97.50% 90.70% 83.61% 90.83%
2015 86.84% 88.70% 84.68% 91.00%
2014 74.07% 84.03% 83.50% 91.43%
Info
Common Childhood Illnesses 2018 Plan State Avg Nat Avg 90th Pctl.
Appropriate Testing for Children With Pharyngitis N/A 92.74% 87.97% 94.94%
Common Childhood Illnesses Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Testing for Children With Pharyngitis 2017 N/A 92.30% 87.45% 94.64%
2016 78.69% 90.38% 84.50% 93.75%
2015 79.16% 90.13% 83.12% 93.11%
2014 73.74% 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) N/A 63.70% 62.59% 77.37%
Comprehensive Diabetes Care-HbA1c control (<8.0%) N/A 62.46% 57.79% 66.33%
Comprehensive Diabetes Care-Medical Attention for Nephropathy N/A 90.73% 90.33% 93.43%
Comprehensive Diabetes Care-Rate of Eye Exams N/A 56.58% 54.40% 69.68%
Comprehensive Diabetes Care-Rate of Poor HbA1c control N/A 27.18% 30.85% 20.62%
Comprehensive Diabetes Care-Testing for HbA1c N/A 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 N/A 63.40% 60.82% 76.41%
2016 67.91% 60.88% 61.06% 78.35%
2015 71.99% 61.03% 58.80% 75.68%
2014 71.99% 63.33% 63.85% 76.00%
Comprehensive Diabetes Care-HbA1c control (<8.0%) 2017 N/A 62.51% 57.48% 67.15%
2016 51.86% 58.36% 56.62% 66.39%
2015 56.71% 57.59% 55.81% 66.67%
2014 50.23% 59.12% 58.53% 68.61%
Comprehensive Diabetes Care-Medical Attention for Nephropathy 2017 N/A 90.80% 90.38% 93.61%
2016 91.16% 90.56% 90.03% 92.71%
2015 91.44% 91.11% 90.10% 93.40%
2014 84.49% 86.26% 84.72% 89.60%
Comprehensive Diabetes Care-Rate of Eye Exams 2017 N/A 56.95% 54.06% 70.69%
2016 54.88% 58.46% 52.96% 72.04%
2015 52.55% 57.15% 52.47% 70.44%
2014 54.40% 57.54% 54.98% 71.93%
Comprehensive Diabetes Care-Rate of Poor HbA1c control 2017 N/A 27.63% 31.91% 21.41%
2016 37.21% 30.47% 32.15% 20.98%
2015 32.41% 30.83% 33.90% 20.20%
2014 40.51% 31.37% 30.48% 19.33%
Comprehensive Diabetes Care-Testing for HbA1c 2017 N/A 91.52% 90.96% 94.18%
2016 91.63% 90.38% 90.32% 94.83%
2015 92.13% 91.13% 90.54% 94.69%
2014 87.73% 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 N/A 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 N/A 90.16% 88.62% 93.75%
2016 85.09% 89.05% 87.87% 93.92%
2015 87.31% 89.72% 87.84% 92.86%
2014 N/A 88.05% 87.86% 93.59%
Info
Immunizations 2018 Plan State Avg Nat Avg 90th Pctl.
Childhood Immunization for Multiple Diseases Including Chicken Pox N/A 80.96% 79.32% 88.06%
Childhood Immunization for Multiple Diseases Including Pneumovax N/A 79.46% 77.50% 86.62%
Flu Vaccinations for Adults Ages 65 and Older N/A 53.53% 51.93% 61.07%
Immunizations for Adolescents - Combination N/A 79.55% 82.25% 91.52%
Immunizations for Adolescents - HPV N/A 32.22% 28.05% 37.23%
Immunizations for Adolescents - Meningococcal N/A 80.66% 83.69% 92.94%
Immunizations for Adolescents - Tdap N/A 91.16% 89.95% 95.62%
Immunizations Year Plan State Avg. Natl. Avg. 90th Pctl.
Childhood Immunization for Multiple Diseases Including Chicken Pox 2017 N/A 73.55% 79.44% 89.14%
2016 85.07% 75.86% 78.93% 89.03%
2015 80.85% 74.15% 78.59% 88.08%
2014 83.56% 72.96% 80.18% 88.07%
Childhood Immunization for Multiple Diseases Including Pneumovax 2017 N/A 80.09% 77.67% 87.61%
2016 84.18% 82.08% 77.04% 87.50%
2015 79.15% 79.45% 76.49% 87.10%
2014 81.25% 78.11% 78.13% 86.26%
Flu Vaccinations for Adults Ages 65 and Older 2017 N/A 0.53% 49.33% 59.27%
2016 40.15% 47.13% 47.47% 58.70%
2015 0.46% 0.50% 47.85% 58.01%
2014 0.48% 0.52% 49.45% 59.73%
Immunizations for Adolescents - Combination 2017 N/A 80.48% 80.23% 89.54%
2016 68.98% 77.95% 77.63% 88.81%
2015 52.59% 69.50% 74.25% 88.47%
2014 56.94% 67.04% 70.73% 87.34%
Immunizations for Adolescents - HPV 2017 N/A 28.29% 23.98% 32.36%
2016 68.98% 77.95% 77.63% 88.81%
2015 52.59% 69.50% 74.25% 88.47%
2014 56.94% 67.04% 70.73% 87.34%
Immunizations for Adolescents - Meningococcal 2017 N/A 82.05% 81.75% 90.27%
2016 69.68% 79.65% 79.20% 90.02%
2015 0.56% 0.72% 76.12% 89.29%
2014 0.58% 0.69% 72.59% 88.27%
Immunizations for Adolescents - Tdap 2017 N/A 91.65% 88.91% 94.65%
2016 85.65% 91.29% 87.77% 95.38%
2015 0.71% 0.85% 86.03% 94.39%
2014 0.85% 0.85% 84.49% 95.15%
Info
Persistent Medications 2018 Plan State Avg Nat Avg 90th Pctl.
Annual Monitoring for Patients on Persistent Medications N/A 86.50% 84.47% 88.08%
Persistent Medications Year Plan State Avg. Natl. Avg. 90th Pctl.
Annual Monitoring for Patients on Persistent Medications 2017 N/A 85.73% 83.71% 87.04%
2016 82.09% 84.90% 83.34% 87.04%
2015 80.00% 83.34% 82.94% 86.72%
2014 78.54% 83.28% 82.33% 86.25%
Info
Pharmacotherapy of COPD Exacerbation 2018 Plan State Avg Nat Avg 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator N/A 85.49% 78.92% 87.88%
Pharmacotherapy of COPD Exacerbation - Corticosteroid N/A 76.41% 74.76% 83.55%
Pharmacotherapy of COPD Exacerbation Year Plan State Avg. Natl. Avg. 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator 2017 N/A 80.88% 79.87% 87.50%
2016 76.92% 84.12% 76.30% 85.98%
2015 68.97% 78.48% 79.09% 87.10%
2014 83.05% 80.03% 80.14% 86.90%
Pharmacotherapy of COPD Exacerbation - Corticosteroid 2017 N/A 78.84% 76.26% 84.38%
2016 71.79% 79.54% 70.70% 81.82%
2015 67.24% 72.98% 75.30% 84.56%
2014 83.05% 75.53% 75.28% 83.54%
Info
Preventive Care 2018 Plan State Avg Nat Avg 90th Pctl.
Breast Cancer Screening N/A 72.13% 73.73% 81.17%
Chlamydia Screening in Women-all Age groups N/A 52.91% 51.41% 67.76%
Colorectal Cancer Screening N/A 64.94% 64.37% 76.52%
Preventive Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Breast Cancer Screening 2017 N/A 71.85% 72.81% 80.91%
2016 69.07% 71.80% 72.90% 80.63%
2015 67.84% 72.07% 73.08% 81.53%
2014 68.36% 72.22% 73.52% 81.91%
Chlamydia Screening in Women-all Age groups 2017 N/A 51.46% 50.16% 66.08%
2016 37.20% 49.79% 48.98% 63.50%
2015 37.26% 47.89% 52.32% 64.06%
2014 37.55% 48.07% 51.65% 63.48%
Colorectal Cancer Screening 2017 N/A 65.16% 62.43% 74.72%
2016 55.45% 64.67% 61.71% 74.09%
2015 53.26% 63.31% 62.32% 73.84%
2014 N/A 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 N/A 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 N/A 43.12% 41.90% 50.52%
2016 35.43% 42.48% 42.55% 51.02%
2015 46.53% 46.31% 42.44% 51.66%
2014 43.35% 42.48% 42.16% 51.85%
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Statin Therapy 2018 Plan State Avg Nat Avg 90th Pctl.
Statin Therapy Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Weight Assessment and Counseling 2018 Plan State Avg Nat Avg 90th Pctl.
Adult BMI Assessment N/A 82.61% 81.07% 93.61%
Children/Adolescents BMI Assessment - Total N/A 73.74% 72.87% 90.00%
Children/Adolescents BMI Assessment - Ages 3-11 N/A 76.94% 74.00% 90.91%
Children/Adolescents BMI Assessment - Ages 12-17 N/A 69.73% 71.39% 88.97%
Counseling for Nutrition for Children/Adolescents - Total N/A 71.79% 67.72% 85.06%
Counseling for Nutrition for Children/Adolescents - Ages 3-11 N/A 75.91% 69.85% 86.21%
Counseling for Nutrition for Children/Adolescents - Ages 12-17 N/A 66.37% 64.92% 84.29%
Counseling for Physical Activity for Children/Adolescents - Total N/A 66.42% 63.08% 81.32%
Counseling for Physical Activity for Children/Adolescents - Ages 3-11 N/A 65.48% 61.70% 80.92%
Counseling for Physical Activity for Children/Adolescents - Ages 12-17 N/A 67.51% 64.79% 84.03%
Weight Assessment and Counseling Year Plan State Avg. Natl. Avg. 90th Pctl.
Adult BMI Assessment 2017 N/A 79.49% 79.78% 93.20%
2016 79.23% 77.87% 76.17% 91.85%
2015 80.83% 75.90% 74.19% 91.76%
2014 71.43% 76.28% 75.36% 91.20%
Children/Adolescents BMI Assessment - Total 2017 N/A 70.41% 70.59% 88.08%
2016 58.56% 69.07% 65.62% 88.08%
2015 59.86% 60.49% 60.37% 83.78%
2014 64.35% 61.63% 61.08% 85.37%
Children/Adolescents BMI Assessment - Ages 3-11 2017 N/A 71.37% 71.84% 88.89%
2016 59.75% 70.86% 67.11% 88.19%
2015 60.76% 63.37% 61.61% 84.69%
2014 60.61% 60.91% 60.86% 86.64%
Children/Adolescents BMI Assessment - Ages 12-17 2017 N/A 68.96% 68.94% 87.82%
2016 57.14% 66.72% 64.28% 87.29%
2015 58.76% 56.47% 58.77% 83.62%
2014 68.66% 62.60% 61.34% 85.47%
Counseling for Nutrition for Children/Adolescents - Total 2017 N/A 69.47% 65.50% 83.21%
2016 48.15% 66.76% 61.76% 83.68%
2015 52.44% 63.88% 58.94% 80.79%
2014 53.24% 65.02% 60.64% 80.05%
Counseling for Nutrition for Children/Adolescents - Ages 3-11 2017 N/A 71.63% 68.20% 84.82%
2016 49.15% 69.25% 64.59% 85.48%
2015 56.96% 67.34% 61.49% 82.89%
2014 58.01% 68.39% 63.58% 84.21%
Counseling for Nutrition for Children/Adolescents - Ages 12-17 2017 N/A 66.54% 61.92% 80.26%
2016 46.94% 63.42% 58.79% 81.87%
2015 46.91% 59.10% 55.64% 77.85%
2014 47.76% 60.63% 56.75% 76.92%
Counseling for Physical Activity for Children/Adolescents - Total 2017 N/A 64.30% 59.96% 77.32%
2016 40.97% 60.41% 55.96% 79.44%
2015 49.65% 59.53% 54.50% 78.85%
2014 53.94% 62.13% 57.09% 77.30%
Counseling for Physical Activity for Children/Adolescents - Ages 3-11 2017 N/A 62.31% 58.84% 75.00%
2016 38.56% 58.91% 54.72% 76.52%
2015 44.73% 58.85% 53.14% 76.08%
2014 51.08% 60.95% 55.78% 76.72%
Counseling for Physical Activity for Children/Adolescents - Ages 12-17 2017 N/A 66.86% 61.40% 79.89%
2016 43.88% 62.44% 58.47% 83.05%
2015 55.67% 60.35% 56.39% 80.86%
2014 57.21% 63.65% 58.73% 78.07%
Health Plan Stability/Descriptive
Info
Administrative Data 2018 Plan State Avg Nat Avg 90th Pctl.
Administrative Ratio 0.12 0.13 86.19 92.68
Medical Cost Ratio 0.89 0.83 92.60 95.85
Number of Enrollees 3,954 140,630 92 96
Number of Physicians 135,644 94,540 87 95
Premium Per Member Per Month $503 $499 N/A N/A
Profit/Loss Ratio -0.01 0.05 N/A N/A
Administrative Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Administrative Ratio 2017 0.13 0.12 86.39 93.13
2016 0.16 0.15 N/A N/A
2015 0.16 0.14 N/A N/A
2014 0.14 0.14 N/A N/A
Medical Cost Ratio 2017 0.84 0.83 93.13 96.59
2016 0.81 0.83 N/A N/A
2015 0.78 0.82 N/A N/A
2014 0.77 0.81 N/A N/A
Number of Enrollees 2017 3,120 133,992 92 97
2016 2,075 136,796 N/A N/A
2015 12,735 124,097 N/A N/A
2014 12,570 115,428 N/A N/A
Number of Physicians 2017 126,348 81,926 87 95
2016 104,855 73,426 N/A N/A
2015 96,584 90,027 N/A N/A
2014 75,990 63,157 N/A N/A
Premium Per Member Per Month 2017 $445 $370 N/A N/A
2016 $458 $370 N/A N/A
2015 $722 $375 N/A N/A
2014 $726 $412 N/A N/A
Profit/Loss Ratio 2017 0.02 0.05 N/A N/A
2016 0.05 0.03 N/A N/A
2015 0.05 0.03 N/A N/A
2014 0.09 0.06 N/A N/A
Info
Board Certification Rates for Providers 2018 Plan State Avg Nat Avg 90th Pctl.
Board Certification for Geriatricians N/A 69.82% N/A N/A
Board Certification for Pediatricians N/A 86.24% N/A N/A
Board Certification Rate for Family Medicine Physicians N/A 83.01% N/A N/A
Board Certification Rate for Internal Medicine Physicians N/A 79.67% N/A N/A
Board Certification Rate for OB/GYN Providers N/A 84.25% N/A N/A
Board Certification Rate for Other Specialists N/A 81.57% N/A N/A
Board Certification Rates for Providers Year Plan State Avg. Natl. Avg. 90th Pctl.
Board Certification for Geriatricians 2017 N/A 71.38% N/A N/A
2016 61.66% 73.44% N/A N/A
2015 59.38% 71.06% N/A N/A
2014 69.52% 74.73% N/A N/A
Board Certification for Pediatricians 2017 N/A 85.50% N/A N/A
2016 82.04% 87.02% N/A N/A
2015 79.18% 88.14% N/A N/A
2014 79.05% 88.13% N/A N/A
Board Certification Rate for Family Medicine Physicians 2017 N/A 81.38% N/A N/A
2016 71.70% 80.32% N/A N/A
2015 69.20% 82.53% N/A N/A
2014 69.44% 82.93% N/A N/A
Board Certification Rate for Internal Medicine Physicians 2017 N/A 81.00% N/A N/A
2016 75.84% 81.15% N/A N/A
2015 75.67% 82.59% N/A N/A
2014 78.40% 83.98% N/A N/A
Board Certification Rate for OB/GYN Providers 2017 N/A 83.00% N/A N/A
2016 84.47% 83.36% N/A N/A
2015 82.90% 83.51% N/A N/A
2014 84.58% 83.71% N/A N/A
Board Certification Rate for Other Specialists 2017 N/A 81.88% N/A N/A
2016 81.29% 83.25% N/A N/A
2015 79.56% 82.88% N/A N/A
2014 79.78% 84.44% N/A N/A
Info
Financial Data 2018 Plan State Avg Nat Avg 90th Pctl.
Income $-29,958,562 $47,837,732 N/A N/A
Net Worth $462,998,137 $303,649,748 N/A N/A
Premiums Earned $22,821,362 $879,518,893 N/A N/A
Financial Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Income 2017 $66,112,321 $34,422,501 N/A N/A
2016 $125,998,557 $38,212,136 N/A N/A
2015 $62,453,637 $19,029,685 N/A N/A
2014 $236,985,815 $50,732,622 N/A N/A
Net Worth 2017 $446,288,192 $263,890,874 N/A N/A
2016 $434,309,068 $267,217,323 N/A N/A
2015 $423,305,536 $237,291,717 N/A N/A
2014 $600,328,649 $250,764,247 N/A N/A
Premiums Earned 2017 $12,975,673 $645,600,589 N/A N/A
2016 $13,908,052 $644,862,921 N/A N/A
2015 $111,592,310 $552,705,214 N/A N/A
2014 $120,037,173 $470,221,984 N/A N/A
Info
Years in Business 2018 Plan State Avg Nat Avg 90th Pctl.
Years in Business 33 36 N/A N/A
Years in Business Year Plan State Avg. Natl. Avg. 90th Pctl.
Years in Business 2017 32 35 N/A N/A
2016 31 34 N/A N/A
2015 30 33 N/A N/A
2014 29 32 N/A N/A
Member Satisfaction
Info
Member Satisfaction 2018 Plan State Avg Nat Avg 90th Pctl.
Getting Care Quickly N/A 85.27% 85.23% 89.89%
Getting Needed Care N/A 85.53% 86.33% 90.45%
How Well Doctors Communicate N/A 94.70% 95.31% 97.22%
Members highly rating their HMO (8 to 10 on a 0-10 scale) N/A 64.78% 64.53% 76.79%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) N/A 84.82% 84.41% 88.57%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) N/A 76.02% 78.17% 83.95%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) N/A 84.08% 85.14% 89.78%
Member Satisfaction Year Plan State Avg. Natl. Avg. 90th Pctl.
Getting Care Quickly 2017 N/A 87.22% 85.34% 89.83%
2016 87.26% 85.81% 85.14% 90.00%
2015 87.44% 85.61% 85.00% 89.71%
2014 86.49% 86.12% 85.79% 90.17%
Getting Needed Care 2017 N/A 87.44% 86.71% 90.37%
2016 87.93% 86.38% 87.25% 91.54%
2015 88.03% 86.51% 86.79% 91.23%
2014 89.86% 88.34% 87.95% 92.13%
How Well Doctors Communicate 2017 N/A 94.74% 95.10% 96.91%
2016 97.63% 95.22% 95.39% 97.21%
2015 96.65% 94.90% 95.20% 97.10%
2014 97.39% 95.30% 95.26% 97.16%
Members highly rating their HMO (8 to 10 on a 0-10 scale) 2017 N/A 61.26% 62.44% 75.00%
2016 60.62% 62.47% 62.27% 74.92%
2015 60.71% 62.71% 62.65% 74.57%
2014 50.00% 58.77% 64.71% 76.75%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 2017 N/A 83.86% 84.62% 88.77%
2016 83.69% 83.44% 84.72% 88.74%
2015 82.03% 83.49% 83.85% 89.05%
2014 85.96% 85.38% 84.24% 88.27%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) 2017 N/A 76.98% 77.27% 82.99%
2016 79.32% 77.49% 77.19% 83.29%
2015 81.60% 76.25% 76.99% 82.76%
2014 77.70% 79.49% 78.26% 83.66%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) 2017 N/A 83.95% 84.60% 89.86%
2016 86.72% 84.65% 84.57% 88.37%
2015 88.47% 83.85% 84.24% 88.77%
2014 88.58% 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 N/A 44.74% 36.17% 47.41%
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics - Ages 1-17 N/A 57.96% 56.00% 70.54%
Use of Multiple Concurrent Antipsychotics in Children and Adolescents - Ages 1-17 N/A 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 N/A 50.55% 36.07% 48.57%
2016 19.35% 34.87% 35.80% 45.93%
2015 37.50% 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 N/A 58.14% 54.52% 68.67%
2016 78.57% 61.93% 58.30% 75.00%
2015 N/A 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 N/A 2.39% N/A N/A
2016 3.85% 2.06% N/A N/A
2015 0.00% 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.
Cervical Cancer Screening in Adolescent Females Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Lower Back Pain 2018 Plan State Avg Nat Avg 90th Pctl.
Use of Imaging for Low Back Pain N/A 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 N/A 73.85% 75.16% 82.29%
2016 80.18% 73.58% 72.67% 80.11%
2015 76.93% 74.11% 74.57% 81.25%
2014 76.73% 72.44% 74.82% 81.95%
Info
Respiratory 2018 Plan State Avg Nat Avg 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection N/A 92.50% 91.22% 95.48%
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis N/A 33.60% 33.16% 48.28%
Respiratory Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection 2017 N/A 90.92% 89.19% 94.59%
2016 78.95% 88.81% 88.51% 94.80%
2015 79.83% 87.71% 88.11% 94.26%
2014 78.27% 87.19% 87.39% 94.57%
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis 2017 N/A 30.67% 30.99% 49.52%
2016 22.84% 27.03% 28.19% 41.72%
2015 18.30% 25.68% 26.11% 38.04%
2014 17.24% 25.67% 25.79% 36.11%
Info
Use of Opiods 2018 Plan State Avg Nat Avg 90th Pctl.
Use of Opiods Year Plan State Avg. Natl. Avg. 90th Pctl.
Utilization
Info
Antibiotic Utilization 2018 Plan State Avg Nat Avg 90th Pctl.
Average number of antibiotic prescriptions per member per year - Total N/A 0.74 0.71 0.88
Average number of antibiotic prescriptions per member per year - Ages 0-9 N/A 0.81 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 10-17 N/A 0.52 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 18-34 N/A 0.65 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 35-49 N/A 0.73 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 50-64 N/A 0.84 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 65-74 N/A 0.97 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 75-85 N/A 1.21 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 85 plus N/A 1.32 N/A N/A
Days suppplied per antibiotic prescription - Total N/A 9.950 9.910 10.890
Days suppplied per antibiotic prescription - Ages 0-9 N/A 9.979 N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 N/A 12.948 N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 N/A 9.731 N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 N/A 9.568 N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 N/A 9.769 N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 N/A 9.830 N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 N/A 9.428 N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus N/A 9.026 N/A N/A
Prescriptions of concern - Total N/A 0.338 0.330 0.430
Prescriptions of concern - Ages 0-9 N/A 0.32 N/A N/A
Prescriptions of concern - Ages 10-17 N/A 0.20 N/A N/A
Prescriptions of concern - Ages 18-34 N/A 0.28 N/A N/A
Prescriptions of concern - Ages 35-49 N/A 0.35 N/A N/A
Prescriptions of concern - Ages 50-64 N/A 0.42 N/A N/A
Prescriptions of concern - Ages 65-74 N/A 0.48 N/A N/A
Prescriptions of concern - Ages 75-85 N/A 0.62 N/A N/A
Prescriptions of concern - Ages 85 plus N/A 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 N/A 0.77 0.76 0.90
2016 0.84 0.79 0.76 0.90
2015 0.89 0.80 0.81 0.97
2014 0.89 0.75 0.79 0.96
Average number of antibiotic prescriptions per member per year - Ages 0-9 2017 N/A 0.87 N/A N/A
2016 1.16 0.97 N/A N/A
2015 1.18 0.94 N/A N/A
2014 1.13 0.84 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 10-17 2017 N/A 0.57 N/A N/A
2016 0.70 0.60 N/A N/A
2015 0.72 0.60 N/A N/A
2014 0.76 0.56 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 18-34 2017 N/A 0.67 N/A N/A
2016 0.71 0.69 N/A N/A
2015 0.74 0.70 N/A N/A
2014 0.76 0.67 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 35-49 2017 N/A 0.75 N/A N/A
2016 0.79 0.77 N/A N/A
2015 0.85 0.80 N/A N/A
2014 0.88 0.76 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 50-64 2017 N/A 0.88 N/A N/A
2016 0.94 0.87 N/A N/A
2015 0.97 0.90 N/A N/A
2014 0.94 0.84 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 65-74 2017 N/A 1.00 N/A N/A
2016 1.02 0.99 N/A N/A
2015 1.08 1.07 N/A N/A
2014 1.09 0.96 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 75-85 2017 N/A 1.12 N/A N/A
2016 1.17 1.23 N/A N/A
2015 1.49 1.08 N/A N/A
2014 1.58 1.09 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 85 plus 2017 N/A 1.12 N/A N/A
2016 0.18 0.73 N/A N/A
2015 0.79 1.67 N/A N/A
2014 1.22 1.37 N/A N/A
Days suppplied per antibiotic prescription - Total 2017 N/A 10.024 9.880 10.830
2016 10.410 10.090 9.880 10.830
2015 10.244 10.259 10.120 11.030
2014 10.405 10.444 10.320 11.180
Days suppplied per antibiotic prescription - Ages 0-9 2017 N/A 10.050 N/A N/A
2016 9.610 10.041 N/A N/A
2015 9.649 9.987 N/A N/A
2014 9.516 10.008 N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 2017 N/A 12.689 N/A N/A
2016 12.610 12.799 N/A N/A
2015 12.529 13.321 N/A N/A
2014 12.825 13.648 N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 2017 N/A 9.836 N/A N/A
2016 10.770 10.074 N/A N/A
2015 10.287 10.334 N/A N/A
2014 10.698 10.650 N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 2017 N/A 9.591 N/A N/A
2016 10.150 9.620 N/A N/A
2015 9.996 9.825 N/A N/A
2014 10.001 9.954 N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 2017 N/A 9.856 N/A N/A
2016 10.120 9.816 N/A N/A
2015 9.997 9.898 N/A N/A
2014 10.115 10.043 N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 2017 N/A 9.850 N/A N/A
2016 10.110 9.929 N/A N/A
2015 10.481 10.178 N/A N/A
2014 10.541 10.427 N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 2017 N/A 10.604 N/A N/A
2016 10.950 10.594 N/A N/A
2015 10.205 9.934 N/A N/A
2014 11.154 10.543 N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus 2017 N/A 9.873 N/A N/A
2016 5.000 9.431 N/A N/A
2015 6.231 9.538 N/A N/A
2014 10.784 10.648 N/A N/A
Prescriptions of concern - Total 2017 N/A 0.354 0.360 0.450
2016 0.420 0.383 0.360 0.450
2015 0.457 0.401 0.410 0.520
2014 0.458 0.374 0.390 0.490
Prescriptions of concern - Ages 0-9 2017 N/A 0.35 N/A N/A
2016 0.54 0.43 N/A N/A
2015 0.56 0.41 N/A N/A
2014 0.56 0.38 N/A N/A
Prescriptions of concern - Ages 10-17 2017 N/A 0.22 N/A N/A
2016 0.29 0.24 N/A N/A
2015 0.31 0.25 N/A N/A
2014 0.32 0.22 N/A N/A
Prescriptions of concern - Ages 18-34 2017 N/A 0.28 N/A N/A
2016 0.33 0.31 N/A N/A
2015 0.36 0.32 N/A N/A
2014 0.37 0.30 N/A N/A
Prescriptions of concern - Ages 35-49 2017 N/A 0.37 N/A N/A
2016 0.42 0.40 N/A N/A
2015 0.48 0.42 N/A N/A
2014 0.50 0.41 N/A N/A
Prescriptions of concern - Ages 50-64 2017 N/A 0.44 N/A N/A
2016 0.51 0.46 N/A N/A
2015 0.54 0.49 N/A N/A
2014 0.51 0.45 N/A N/A
Prescriptions of concern - Ages 65-74 2017 N/A 0.50 N/A N/A
2016 0.49 0.51 N/A N/A
2015 0.57 0.57 N/A N/A
2014 0.56 0.51 N/A N/A
Prescriptions of concern - Ages 75-85 2017 N/A 0.54 N/A N/A
2016 0.54 0.65 N/A N/A
2015 0.65 0.59 N/A N/A
2014 0.72 0.51 N/A N/A
Prescriptions of concern - Ages 85 plus 2017 N/A 0.48 N/A N/A
2016 0.09 0.34 N/A N/A
2015 0.42 0.82 N/A N/A
2014 0.59 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 N/A 85.93% 81.33% 90.72%
Well Child Visits in the 3rd - 6th Years N/A 83.85% 80.95% 91.86%
Adolescent Well-Care Visits N/A 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 N/A 85.68% 80.53% 90.78%
2016 72.28% 83.40% 80.76% 90.36%
2015 74.35% 84.01% 79.35% 89.12%
2014 71.80% 82.63% 79.12% 89.64%
Well Child Visits in the 3rd - 6th Years 2017 N/A 83.18% 79.11% 91.03%
2016 73.02% 82.50% 78.30% 90.11%
2015 69.09% 80.48% 77.75% 89.74%
2014 71.82% 80.03% 77.37% 88.75%
Adolescent Well-Care Visits 2017 N/A 53.24% 50.46% 70.44%
2016 37.77% 50.35% 49.68% 67.70%
2015 37.89% 49.34% 48.26% 64.50%
2014 38.15% 48.09% 47.51% 64.76%
Info
Mental Health Utilization 2018 Plan State Avg Nat Avg 90th Pctl.
Mental Health Utilization - Any service - Total N/A 7.63% 7.98% 11.76%
Mental Health Utilization - Any service - Ages 0-12 N/A 6.12% N/A N/A
Mental Health Utilization - Any service - Ages 13-17 N/A 13.96% N/A N/A
Mental Health Utilization - Any service - Ages 18-64 N/A 7.62% N/A N/A
Mental Health Utilization - Any service - Ages 65 plus N/A 3.20% N/A N/A
Mental Health Utilization - ED - Total N/A 0.09% 0.10% 0.22%
Mental Health Utilization - ED - Ages 0-12 N/A 0.05% N/A N/A
Mental Health Utilization - ED - Ages 13-17 N/A 0.28% N/A N/A
Mental Health Utilization - ED - Ages 18-64 N/A 0.08% N/A N/A
Mental Health Utilization - ED - Ages 65 plus N/A 0.02% N/A N/A
Mental Health Utilization - Inpatient - Total N/A 0.27% 0.27% 0.34%
Mental Health Utilization - Inpatient - Ages 0-12 N/A 0.12% N/A N/A
Mental Health Utilization - Inpatient - Ages 13-17 N/A 0.95% N/A N/A
Mental Health Utilization - Inpatient - Ages 18-64 N/A 0.26% N/A N/A
Mental Health Utilization - Inpatient - Ages 65 plus N/A 0.06% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Total N/A 0.12% 0.19% 0.38%
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 0-12 N/A 0.15% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 13-17 N/A 0.49% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 18-64 N/A 0.09% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 65 plus N/A 0.02% N/A N/A
Mental Health Utilization - Outpatient - Total N/A 7.53% N/A N/A
Mental Health Utilization - Outpatient - Ages 0-12 N/A 6.10% N/A N/A
Mental Health Utilization - Outpatient - Ages 13-17 N/A 13.80% N/A N/A
Mental Health Utilization - Outpatient - Ages 18-64 N/A 7.51% N/A N/A
Mental Health Utilization - Outpatient - Ages 65 plus N/A 3.16% N/A N/A
Mental Health Utilization - Telehealth - Total N/A 0.10% 0.05% 0.11%
Mental Health Utilization - Telehealth - Ages 0-12 N/A 0.03% N/A N/A
Mental Health Utilization - Telehealth - Ages 13-17 N/A 0.19% N/A N/A
Mental Health Utilization - Telehealth - Ages 18-64 N/A 0.11% N/A N/A
Mental Health Utilization - Telehealth - Ages 65 plus N/A 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 N/A N/A
2014 N/A N/A N/A N/A
Mental Health Utilization - Outpatient - 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 - Outpatient - 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 - Outpatient - 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 - Outpatient - 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 - Outpatient - 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 - Telehealth - 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 - Telehealth - 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 - Telehealth - 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 - Telehealth - 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 - Telehealth - 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
Info
Plan All-Cause Readmissions 2018 Plan State Avg Nat Avg 90th Pctl.
Plan All-Cause Readmissions Ages 18-44 N/A 11.41% N/A N/A
Plan All-Cause Readmissions Ages 45-54 N/A 10.56% N/A N/A
Plan All-Cause Readmissions Ages 55-64 N/A 11.21% N/A N/A
Plan All-Cause Readmissions Total N/A 11.17% N/A N/A
Plan All-Cause Readmissions Year Plan State Avg. Natl. Avg. 90th Pctl.
Plan All-Cause Readmissions Ages 18-44 2017 N/A 12.99% N/A N/A
2016 0.12% 0.12% N/A N/A
2015 0.11% 0.12% N/A N/A
2014 N/A N/A N/A N/A
Plan All-Cause Readmissions Ages 45-54 2017 N/A 11.71% N/A N/A
2016 0.13% 0.12% N/A N/A
2015 0.12% 0.11% N/A N/A
2014 N/A N/A N/A N/A
Plan All-Cause Readmissions Ages 55-64 2017 N/A 11.93% N/A N/A
2016 0.10% 0.11% N/A N/A
2015 0.10% 0.11% N/A N/A
2014 N/A N/A N/A N/A
Plan All-Cause Readmissions Total 2017 N/A 12.19% N/A N/A
2016 0.11% 0.12% N/A N/A
2015 0.11% 0.11% N/A N/A
2014 N/A N/A N/A N/A

2018 data updated on: 11/14/2019