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Aetna Health Inc. (a Pennsylvania Corporation)

Company Information

  • Company Providing Plan:Aetna Health, Inc. (a Pennsylvania Corporation)
  • Address:980 Jolly Rd, U11S
    Blue Bell, PA 19422-1904
  • Telephone :215-775-6508
  • Website:www.aetna.com
2016
Number of Enrollees: 37,605
PMPM: $378
Number of Physicians: *370,968
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

Accomack, Albemarle, Alleghany, Amelia, Amherst, Appomattox, Arlington, Augusta, Bath, Bedford, Bland, Botetourt, Brunswick, Buckingham, Campbell, Caroline, Carroll, Charles City, Charlotte, Chesterfield, Craig, Cumberland, Dinwiddie, Essex, Fairfax, Fauquier, Floyd, Fluvana, Franklin, Giles, Goochland, Grayson, Greene, Greensville, Halifax, Hanover, Henrico, Henry, Highland,Isle of Wight, James City, King and Queen, King George, King William, Lancaster, Lee, Loudoun, Louisa, Lunenburg, Madison, Mathews, Mecklenberg, Middlesex, Montgomery, Nelson, New Kent, Northampton, Northumberland, Nottaway, Orange, Patrick, Pittsylvania, Powhatan, Prince Edward, Prince George, Prince William, Pulaski, Rappahannock, Roanoke, Rockbridge, Russell, Smyth, Spotsylvania, Stafford, Surry, Sussex, Tazewell, Westmoreland, Wise, Wythe, York


Cities

Alexandria, Buena Vista, Charlottesville, Colonial Heights, Covington, Danville, Fairfax, Falls Church, Fredericksburg, Galax, Hampton, Hopewell, Lexington, Lynchburg, Manassas, Manassas Park, Martinsville, Newport News, Norton, Petersburg, Poquoson, Radford, Richmond, Roanoke, Salem, Staunton, Suffolk, Waynesboro, Williamsburg, Winchester

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

Administrative Data

2016 2015 2014 2013 2012
Number of Enrollees 37,605 34,836 12,362 29,163 31,934
PMPM $378 $386 $346 $321 $339
*Medical Cost Ratio 82% 78% 81% 84% 84%
*Administrative Ratio 16% 15% 13% 13% 11%
*Profit/Loss Ratio 3% 7% 6% 4% 6%
*Number of Physicians 370,968 407,130 377,078 345,738 324,207

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

Financial Data

2016 2015 2014 2013 2012
Premiums Earned $174,415,257 $77,438,195 $85,755,116 $121,382,668 $119,247,829
*Income $83,382,290 $113,752,294 $117,023,153 $101,022,703 $159,328,662
*Net Worth $458,205,847 $421,403,811 $446,755,219 $329,348,905 $360,216,786

*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 2016 Plan State Avg Nat Avg 90th Pctl.
Adult Access (Age 20-44) To Preventive/Ambulatory Health Services 92.05% 92.81% 92.73% 95.55%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 95.97% 95.78% 95.78% 97.61%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 97.13% 97.30% 97.19% 98.61%
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 2015 92.62% 92.25% 92.83% 95.45%
2014 92.31% 93.10% 92.91% 95.39%
2013 92.30% 93.27% 93.13% 95.56%
2012 92.81% 93.53% 93.40% 95.86%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 2015 95.97% 95.61% 95.90% 97.55%
2014 95.95% 96.03% 95.85% 97.54%
2013 95.61% 95.97% 95.93% 97.60%
2012 95.34% 95.88% 95.84% 97.42%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 2015 97.11% 96.84% 97.32% 96.73%
2014 96.83% 97.56% 97.50% 98.68%
2013 96.88% 97.45% 97.36% 98.63%
2012 97.00% 97.38% 97.27% 98.74%
Info
Alcohol and Other Drug Dependence Treatment 2016 Plan State Avg Nat Avg 90th Pctl.
Initiation of Alcohol and Other Drug Dependence Treatment - Total 33.37% 35.69% 32.93% 40.24%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 33.33% 40.15% 40.47% 51.96%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 33.37% 35.55% 32.64% 40.33%
Engagement of Alcohol and Other Drug Dependence Treatment - Total 11.16% 12.51% 11.46% 16.72%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 10.42% 11.28% 15.68% 23.73%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 11.18% 12.57% 11.32% 16.09%
Alcohol and Other Drug Dependence Treatment Year Plan State Avg. Natl. Avg. 90th Pctl.
Initiation of Alcohol and Other Drug Dependence Treatment - Total 2015 32.68% 33.04% 33.42% 41.07%
2014 36.19% 32.51% 35.63% 44.19%
2013 49.47% 35.00% 39.01% 50.93%
2012 51.65% 37.48% 40.13% 51.23%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2015 41.54% 37.03% 39.62% 50.00%
2014 47.54% 37.09% 40.79% 52.00%
2013 42.31% 39.67% 41.13% 53.51%
2012 N/A N/A N/A N/A
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2015 32.33% 32.96% 33.20% 40.93%
2014 35.71% 32.16% 35.21% 43.92%
2013 49.74% 34.74% 38.83% 51.61%
2012 N/A N/A N/A N/A
Engagement of Alcohol and Other Drug Dependence Treatment - Total 2015 11.29% 11.61% 12.46% 19.23%
2014 13.31% 10.64% 13.66% 19.19%
2013 13.43% 12.12% 14.64% 21.16%
2012 14.54% 11.95% 14.33% 20.35%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2015 13.85% 12.06% 15.42% 22.12%
2014 21.31% 13.00% 17.24% 25.29%
2013 28.85% 18.05% 18.23% 27.05%
2012 N/A N/A N/A N/A
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2015 11.19% 11.57% 12.34% 18.67%
2014 12.97% 10.33% 13.45% 18.68%
2013 12.84% 11.84% 14.47% 21.31%
2012 N/A N/A N/A N/A
Info
Child Access to Primary Care Practitioners 2016 Plan State Avg Nat Avg 90th Pctl.
12-24 month old Child Access to Primary Care Practitioners 98.70% 98.34% 98.09% 99.72%
25 month to 6 year old Child Access to Primary Care Practitioners 94.03% 94.33% 92.60% 96.46%
7-11 year old Child Access to Primary Care Practitioners 94.47% 94.38% 93.25% 98.25%
12-19 year old Child Access to Primary Care Practitioners 90.83% 91.45% 90.76% 96.39%
Child Access to Primary Care Practitioners Year Plan State Avg. Natl. Avg. 90th Pctl.
12-24 month old Child Access to Primary Care Practitioners 2015 98.97% 98.78% 98.03% 99.48%
2014 98.34% 98.49% 97.87% 99.62%
2013 98.39% 97.92% 97.99% 99.48%
2012 98.21% 97.87% 97.94% 99.58%
25 month to 6 year old Child Access to Primary Care Practitioners 2015 93.21% 94.16% 92.67% 96.64%
2014 93.83% 93.85% 92.33% 96.52%
2013 93.41% 93.53% 92.38% 96.50%
2012 93.33% 93.16% 92.31% 96.13%
7-11 year old Child Access to Primary Care Practitioners 2015 94.41% 94.23% 93.23% 97.92%
2014 94.05% 93.78% 93.02% 97.87%
2013 93.90% 93.78% 93.11% 97.89%
2012 93.58% 93.54% 92.93% 97.72%
12-19 year old Child Access to Primary Care Practitioners 2015 90.08% 91.30% 90.66% 96.19%
2014 89.48% 90.84% 90.44% 96.28%
2013 89.14% 90.58% 90.31% 96.28%
2012 88.47% 90.02% 90.01% 95.97%
Info
Prenatal and Postpartum Care 2016 Plan State Avg Nat Avg 90th Pctl.
Postpartum Care 71.68% 74.50% 73.95% 88.85%
Timeliness of Prenatal Care 88.27% 86.71% 85.57% 96.28%
Prenatal and Postpartum Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Postpartum Care 2015 61.70% 73.91% 73.72% 87.50%
2014 71.96% 77.29% 77.64% 88.65%
2013 74.19% 81.38% 91.35% 97.14%
2012 74.19% 81.20% 80.22% 90.25%
Timeliness of Prenatal Care 2015 80.99% 86.80% 84.28% 94.56%
2014 89.72% 86.83% 88.00% 96.23%
2013 89.92% 91.63% 81.00% 90.48%
2012 89.92% 91.51% 89.70% 96.97%
Effectiveness of Care
Info
Asthma Medication Management 2016 Plan State Avg Nat Avg 90th Pctl.
Medication Management for People With Asthma at least 50% Compliance - Total 74.18% 73.20% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 5-11 71.87% 67.58% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 12-18 62.30% 65.72% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 19-50 75.15% 71.77% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 51-64 79.83% 79.36% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 65-85 78.43% 82.66% N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Total 54.08% 51.17% 48.54% 56.96%
Medication Management for People With Asthma at least 75% Compliance - Ages 5-11 48.01% 39.03% 37.58% 48.84%
Medication Management for People With Asthma at least 75% Compliance - Ages 12-18 38.49% 35.03% 35.83% 46.97%
Medication Management for People With Asthma at least 75% Compliance - Ages 19-50 56.54% 50.18% 46.16% 55.80%
Medication Management for People With Asthma at least 75% Compliance - Ages 51-64 62.21% 59.39% 57.47% 65.75%
Medication Management for People With Asthma at least 75% Compliance - Ages 65-85 57.84% 62.35% 60.79% 70.92%
Asthma Medication Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Medication Management for People With Asthma at least 50% Compliance - Total 2015 75.57% 71.52% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 5-11 2015 72.30% 64.34% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 12-18 2015 65.60% 60.17% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 19-50 2015 76.34% 68.82% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 51-64 2015 80.37% 78.55% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 65-85 2015 83.18% 78.86% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Total 2015 54.58% 48.01% 46.20% 55.00%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Ages 5-11 2015 46.28% 36.59% 37.85% 49.09%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Ages 12-18 2015 41.74% 35.39% 34.97% 45.26%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Ages 19-50 2015 55.88% 45.56% 43.39% 53.13%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Ages 51-64 2015 63.61% 58.44% 55.49% 65.28%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Ages 65-85 2015 63.55% 56.41% 59.60% 70.59%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Info
Asthma Medication Ratio 2016 Plan State Avg Nat Avg 90th Pctl.
Controller/Total Asthma Medication Ratio - Total 83.93% 80.60% 78.29% 85.46%
Controller/Total Asthma Medication Ratio - Ages 5-11 90.24% 91.67% 86.40% 93.97%
Controller/Total Asthma Medication Ratio - Ages 12-18 79.92% 81.12% 78.30% 86.34%
Controller/Total Asthma Medication Ratio - Ages 19-50 80.85% 75.24% 73.51% 81.08%
Controller/Total Asthma Medication Ratio - Ages 51-64 86.59% 83.27% 81.70% 88.64%
Controller/Total Asthma Medication Ratio - Ages 65-85 82.73% 88.55% 84.66% 91.94%
Asthma Medication Ratio Year Plan State Avg. Natl. Avg. 90th Pctl.
Controller/Total Asthma Medication Ratio - Total 2015 81.01% 81.09% 77.99% 83.76%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Controller/Total Asthma Medication Ratio - Ages 5-11 2015 84.66% 88.49% 86.99% 92.47%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Controller/Total Asthma Medication Ratio - Ages 12-18 2015 74.47% 78.19% 77.09% 84.67%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Controller/Total Asthma Medication Ratio - Ages 19-50 2015 79.37% 75.16% 72.38% 80.79%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Controller/Total Asthma Medication Ratio - Ages 51-64 2015 84.34% 85.39% 81.87% 88.89%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Controller/Total Asthma Medication Ratio - Ages 65-85 2015 82.76% 87.62% 85.49% 92.31%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Info
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication 2016 Plan State Avg Nat Avg 90th Pctl.
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Initiation 37.42% 41.91% 38.93% 48.61%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 47.22% 46.92% 45.82% 56.86%
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 2015 38.71% 41.43% 38.13% 50.00%
2014 41.71% 39.00% 38.01% 46.81%
2013 38.04% 35.14% 40.10% 51.06%
2012 35.37% 36.75% 38.72% 48.58%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 2015 54.02% 49.06% 46.18% 58.06%
2014 56.38% 46.49% 45.70% 57.75%
2013 42.70% 41.32% 46.66% 58.62%
2012 38.46% 38.87% 45.07% 54.05%
Info
Cardiovascular Disease Management 2016 Plan State Avg Nat Avg 90th Pctl.
Controlling High Blood Pressure 49.02% 56.91% 60.31% 74.43%
Persistence of Beta-Blockers 90.97% 90.70% 83.61% 90.83%
Cardiovascular Disease Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Controlling High Blood Pressure 2015 52.68% 58.35% 58.69% 73.89%
2014 52.93% 59.30% 62.63% 75.63%
2013 53.77% 60.92% 63.30% 74.65%
2012 47.29% 59.78% 61.63% 72.94%
Persistence of Beta-Blockers 2015 87.21% 88.70% 84.68% 91.00%
2014 88.46% 84.03% 83.50% 91.43%
2013 88.50% 83.43% 83.39% 91.72%
2012 83.06% 82.94% 83.03% 92.98%
Info
Common Childhood Illnesses 2016 Plan State Avg Nat Avg 90th Pctl.
Appropriate Testing for Children With Pharyngitis 90.44% 90.38% 84.50% 93.75%
Common Childhood Illnesses Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Testing for Children With Pharyngitis 2015 91.43% 90.13% 83.12% 93.11%
2014 90.37% 88.64% 83.29% 91.40%
2013 88.28% 87.54% 81.45% 91.30%
2012 84.31% 87.53% 81.22% 91.58%
Info
Diabetes Care and Management 2016 Plan State Avg Nat Avg 90th Pctl.
Comprehensive Diabetes Care-Blood Pressure Control (<140/90 mm Hg) 49.64% 60.88% 61.06% 78.35%
Comprehensive Diabetes Care-HbA1c control (<8.0%) 55.96% 58.36% 56.62% 66.39%
Comprehensive Diabetes Care-Rate of Eye Exams 59.85% 58.46% 52.96% 72.04%
Comprehensive Diabetes Care-Rate of Medical Attention for Diabetic Nephropathy 88.56% 90.56% 90.03% 92.71%
Comprehensive Diabetes Care-Rate of Poor HbA1c control 34.79% 30.47% 32.15% 20.98%
Comprehensive Diabetes Care-Testing for HbA1c 85.64% 90.38% 90.32% 94.83%
Diabetes Care and Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Comprehensive Diabetes Care-Blood Pressure Control (<140/90 mm Hg) 2015 50.36% 61.03% 58.80% 75.68%
2014 46.81% 63.33% 63.85% 76.00%
2013 28.61% 42.35% 64.44% 76.22%
2012 N/A N/A N/A N/A
Comprehensive Diabetes Care-HbA1c control (<8.0%) 2015 54.01% 57.59% 55.81% 66.67%
2014 56.45% 59.12% 58.53% 68.61%
2013 53.90% 55.47% 58.87% 69.16%
2012 N/A N/A N/A N/A
Comprehensive Diabetes Care-Rate of Eye Exams 2015 58.15% 57.15% 52.47% 70.44%
2014 61.31% 57.54% 54.98% 71.93%
2013 55.32% 56.05% 54.65% 71.53%
2012 62.36% 57.24% 55.70% 74.09%
Comprehensive Diabetes Care-Rate of Medical Attention for Diabetic Nephropathy 2015 92.46% 91.11% 90.10% 93.40%
2014 85.16% 86.26% 84.72% 89.60%
2013 84.16% 84.97% 83.75% 89.19%
2012 85.85% 85.74% 83.70% 89.54%
Comprehensive Diabetes Care-Rate of Poor HbA1c control 2015 35.28% 30.83% 33.90% 20.20%
2014 34.31% 31.37% 30.48% 19.33%
2013 37.12% 34.40% 30.71% 19.46%
2012 30.14% 27.02% 28.85% 18.18%
Comprehensive Diabetes Care-Testing for HbA1c 2015 90.75% 91.13% 90.54% 94.69%
2014 85.40% 89.01% 90.34% 94.86%
2013 84.16% 88.32% 89.62% 94.23%
2012 87.40% 89.98% 89.76% 94.38%
Info
Drug Therapy in Rheumatoid Arthritis 2016 Plan State Avg Nat Avg 90th Pctl.
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis 83.56% 89.05% 87.87% 93.92%
Drug Therapy in Rheumatoid Arthritis Year Plan State Avg. Natl. Avg. 90th Pctl.
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis 2015 82.46% 89.72% 87.84% 92.86%
2014 85.00% 88.05% 87.86% 93.59%
2013 83.43% 88.24% 87.95% 94.49%
2012 84.43% 88.39% 87.47% 93.70%
Info
Immunizations 2016 Plan State Avg Nat Avg 90th Pctl.
Childhood Immunization for Multiple diseases including Chicken Pox 80.89% 84.29% 78.93% 89.03%
Childhood Immunization for Multiple diseases including pneumovax 78.91% 82.08% 77.04% 87.50%
Flu Vaccinations for Adults Ages 18–64 44.69% 47.13% N/A N/A
Immunizations for Adolescents - Combination 78.83% 77.95% 77.63% 88.81%
Immunizations for Adolescents - Meningococcal 81.51% 79.65% 79.20% 90.02%
Immunizations for Adolescents - Tdap 89.29% 91.29% 87.77% 95.38%
Immunizations Year Plan State Avg. Natl. Avg. 90th Pctl.
Childhood Immunization for Multiple diseases including Chicken Pox 2015 83.94% 81.56% 78.59% 88.08%
2014 77.86% 80.25% 80.18% 88.07%
2013 74.06% 80.24% 78.39% 87.14%
2012 81.80% 82.72% 79.83% 88.00%
Childhood Immunization for Multiple diseases including pneumovax 2015 80.05% 79.45% 76.49% 87.10%
2014 75.43% 78.11% 78.13% 86.26%
2013 70.28% 78.73% 76.21% 85.40%
2012 79.43% 78.74% 77.05% 86.00%
Flu Vaccinations for Adults Ages 18–64 2015 0.46% 0.50% 47.85% 58.01%
2014 0.47% 0.52% 49.45% 59.73%
2013 0.49% 0.49% 49.06% 59.59%
2012 N/A N/A N/A N/A
Immunizations for Adolescents - Combination 2015 66.40% 69.50% 74.25% 88.47%
2014 56.05% 67.04% 70.73% 87.34%
2013 51.18% 60.89% 66.54% 84.18%
2012 N/A N/A N/A N/A
Immunizations for Adolescents - Meningococcal 2015 0.73% 0.72% 76.12% 89.29%
2014 0.63% 0.69% 72.59% 88.27%
2013 0.58% 0.64% 68.70% 85.25%
2012 N/A N/A N/A N/A
Immunizations for Adolescents - Tdap 2015 0.77% 0.85% 86.03% 94.39%
2014 0.69% 0.85% 84.49% 95.15%
2013 0.65% 0.80% 80.83% 94.73%
2012 N/A N/A N/A N/A
Info
Mental Health: Care and Follow-up 2016 Plan State Avg Nat Avg 90th Pctl.
Antidepressant Medication Management-Acute Phase Treatment 73.73% 70.29% 66.56% 74.77%
Antidepressant Medication Management-Continuation Phase Treatment 58.01% 53.51% 50.69% 58.60%
Follow-up After Hospitalization For Mental Illness within 7 days after hospital discharge 43.67% 52.99% 52.06% 67.31%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge 63.97% 73.85% 71.36% 84.17%
Mental Health: Care and Follow-up Year Plan State Avg. Natl. Avg. 90th Pctl.
Antidepressant Medication Management-Acute Phase Treatment 2015 69.69% 67.61% 65.82% 74.06%
2014 73.33% 68.52% 65.88% 75.35%
2013 73.26% 65.67% 63.60% 73.26%
2012 75.38% 69.62% 69.03% 77.57%
Antidepressant Medication Management-Continuation Phase Treatment 2015 56.22% 49.81% 50.15% 57.56%
2014 59.11% 50.31% 49.83% 59.11%
2013 61.15% 48.37% 46.58% 57.12%
2012 60.98% 52.80% 53.51% 61.69%
Follow-up After Hospitalization For Mental Illness within 7 days after hospital discharge 2015 46.44% 47.66% 50.57% 67.57%
2014 47.84% 51.82% 52.21% 70.33%
2013 49.20% 55.07% 53.70% 69.16%
2012 47.63% 61.69% 57.57% 73.88%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge 2015 66.75% 71.58% 69.72% 83.80%
2014 63.87% 72.52% 70.72% 85.71%
2013 66.58% 73.03% 72.56% 84.19%
2012 65.42% 77.74% 75.42% 86.45%
Info
Persistent Medications 2016 Plan State Avg Nat Avg 90th Pctl.
Annual Monitoring for Patients on Persistent Medications 81.30% 84.90% 83.34% 87.04%
Persistent Medications Year Plan State Avg. Natl. Avg. 90th Pctl.
Annual Monitoring for Patients on Persistent Medications 2015 81.38% 83.34% 82.94% 86.72%
2014 81.74% 83.28% 82.33% 86.25%
2013 80.41% 83.44% 82.32% 86.12%
2012 81.07% 83.30% 82.11% 86.32%
Info
Pharmacotherapy of COPD Exacerbation 2016 Plan State Avg Nat Avg 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator 79.17% 84.12% 76.30% 85.98%
Pharmacotherapy of COPD Exacerbation - Corticosteroid 70.31% 79.54% 70.70% 81.82%
Pharmacotherapy of COPD Exacerbation Year Plan State Avg. Natl. Avg. 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator 2015 76.33% 78.48% 79.09% 87.10%
2014 81.03% 80.03% 80.14% 86.90%
2013 82.35% 78.88% 79.47% 87.58%
2012 80.91% 80.97% 80.45% 87.50%
Pharmacotherapy of COPD Exacerbation - Corticosteroid 2015 70.41% 72.98% 75.30% 84.56%
2014 78.97% 75.53% 75.28% 83.54%
2013 71.57% 73.76% 75.40% 83.33%
2012 75.45% 73.69% 73.65% 81.32%
Info
Preventive Care 2016 Plan State Avg Nat Avg 90th Pctl.
Breast Cancer Screening 67.74% 71.80% 72.90% 80.63%
Chlamydia Screening in Women-all Age groups 51.14% 49.79% 48.98% 63.50%
Colorectal Cancer Screening 62.23% 65.83% 61.71% 74.09%
Preventive Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Breast Cancer Screening 2015 67.66% 72.07% 73.08% 81.53%
2014 68.57% 72.22% 73.52% 81.91%
2013 69.36% 72.82% 73.71% 80.78%
2012 N/A N/A N/A N/A
Chlamydia Screening in Women-all Age groups 2015 49.47% 47.89% 52.32% 64.06%
2014 49.68% 48.07% 51.65% 63.48%
2013 50.01% 47.46% 46.20% 59.63%
2012 49.77% 46.98% 45.16% 57.69%
Colorectal Cancer Screening 2015 65.80% 64.43% 62.32% 73.84%
2014 70.21% 63.41% 64.06% 74.86%
2013 65.15% 65.36% 62.85% 72.75%
2012 64.00% 64.80% 62.63% 73.86%
Info
Spirometry Testing 2016 Plan State Avg Nat Avg 90th Pctl.
Use of Spirometry Testing in the Assessment and diagnosis of COPD 47.78% 42.48% 42.55% 51.02%
Spirometry Testing Year Plan State Avg. Natl. Avg. 90th Pctl.
Use of Spirometry Testing in the Assessment and diagnosis of COPD 2015 48.18% 46.31% 42.44% 51.66%
2014 48.58% 42.48% 42.16% 51.85%
2013 46.04% 43.20% 42.08% 50.99%
2012 43.52% 45.42% 43.34% 55.44%
Info
Weight Assessment and Counseling 2016 Plan State Avg Nat Avg 90th Pctl.
Adult BMI Assessment 68.16% 77.87% 76.17% 91.85%
Children/Adolescents BMI Assessment - Total 66.34% 69.07% 65.62% 88.08%
Counseling for Nutrition for Children/Adolescents - Total 69.02% 66.76% 61.76% 83.68%
Counseling for Physical Activity for Children/Adolescents - Total 59.02% 60.41% 55.96% 79.44%
Weight Assessment and Counseling Year Plan State Avg. Natl. Avg. 90th Pctl.
Adult BMI Assessment 2015 64.10% 75.90% 74.19% 91.76%
2014 65.16% 76.28% 75.36% 91.20%
2013 65.07% 72.78% 74.24% 90.00%
2012 56.13% 60.89% N/A N/A
Children/Adolescents BMI Assessment - Total 2015 54.55% 60.49% 60.37% 83.78%
2014 58.77% 61.63% 61.08% 85.37%
2013 58.77% 52.14% 54.90% 83.13%
2012 57.08% 43.29% 49.34% 78.51%
Counseling for Nutrition for Children/Adolescents - Total 2015 60.69% 63.88% 58.94% 80.79%
2014 61.61% 65.02% 60.64% 80.05%
2013 61.61% 61.17% 56.48% 79.32%
2012 58.49% 51.32% 54.19% 75.00%
Counseling for Physical Activity for Children/Adolescents - Total 2015 59.21% 59.53% 54.50% 78.85%
2014 59.66% 62.13% 57.09% 77.30%
2013 54.27% 56.47% 53.16% 74.70%
2012 54.01% 45.42% 49.91% 70.66%
Health Plan Stability/Descriptive
Info
Administrative Data 2016 Plan State Avg Nat Avg 90th Pctl.
Administrative Ratio 0.16 0.15 N/A N/A
Medical Cost Ratio 0.82 0.83 N/A N/A
Number of Enrollees 37,605 136,796 N/A N/A
Number of Physicians 370,968 73,426 N/A N/A
Premium Per Member Per Month $378 $370 N/A N/A
Profit/Loss Ratio 0.03 0.03 N/A N/A
Administrative Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Administrative Ratio 2015 0.15 0.14 N/A N/A
2014 0.13 0.14 N/A N/A
2013 0.13 0.14 N/A N/A
2012 0.11 0.10 N/A N/A
Medical Cost Ratio 2015 0.78 0.82 N/A N/A
2014 0.81 0.81 N/A N/A
2013 0.84 0.83 N/A N/A
2012 0.84 0.84 N/A N/A
Number of Enrollees 2015 34,836 124,097 N/A N/A
2014 12,362 115,428 N/A N/A
2013 29,163 98,253 N/A N/A
2012 31,934 111,525 N/A N/A
Number of Physicians 2015 407,130 90,027 N/A N/A
2014 377,078 63,157 N/A N/A
2013 345,738 64,207 N/A N/A
2012 324,207 62,436 N/A N/A
Premium Per Member Per Month 2015 $386 $375 N/A N/A
2014 $346 $412 N/A N/A
2013 $321 $544 N/A N/A
2012 $339 $378 N/A N/A
Profit/Loss Ratio 2015 0.07 0.04 N/A N/A
2014 0.06 0.06 N/A N/A
2013 0.04 0.03 N/A N/A
2012 0.06 0.07 N/A N/A
Info
Board Certification Rates for Providers 2016 Plan State Avg Nat Avg 90th Pctl.
Board Certification for Geriatricians 65.41% 73.44% N/A N/A
Board Certification for Pediatricians 88.37% 87.02% N/A N/A
Board Certification Rate for Family Medicine Physicians 83.07% 80.32% N/A N/A
Board Certification Rate for Internal Medicine Physicians 77.14% 81.15% N/A N/A
Board Certification Rate for OB/GYN Providers 78.53% 83.36% N/A N/A
Board Certification Rate for Other Specialists 73.68% 83.25% N/A N/A
Board Certification Rates for Providers Year Plan State Avg. Natl. Avg. 90th Pctl.
Board Certification for Geriatricians 2015 61.21% 71.06% N/A N/A
2014 64.03% 74.73% 64.82% 87.50%
2013 64.29% 71.19% 63.29% 83.33%
2012 65.93% 73.37% 65.21% 87.23%
Board Certification for Pediatricians 2015 88.81% 88.14% N/A N/A
2014 88.72% 88.13% 83.89% 91.52%
2013 84.86% 86.01% 81.01% 90.29%
2012 86.85% 86.06% 83.97% 91.65%
Board Certification Rate for Family Medicine Physicians 2015 83.88% 82.53% N/A N/A
2014 84.91% 82.93% 77.41% 89.90%
2013 82.57% 81.36% 76.60% 88.80%
2012 84.13% 81.09% 77.40% 89.19%
Board Certification Rate for Internal Medicine Physicians 2015 78.10% 82.59% N/A N/A
2014 78.37% 83.98% 79.07% 88.73%
2013 76.77% 80.80% 78.18% 87.44%
2012 79.47% 81.93% 79.29% 88.24%
Board Certification Rate for OB/GYN Providers 2015 78.29% 83.51% N/A N/A
2014 77.61% 83.71% 79.30% 88.80%
2013 74.90% 80.44% 76.89% 87.80%
2012 76.64% 80.51% 79.23% 86.38%
Board Certification Rate for Other Specialists 2015 74.57% 82.88% N/A N/A
2014 75.69% 84.44% 78.09% 89.67%
2013 71.73% 79.95% 74.88% 88.36%
2012 73.96% 79.00% 75.49% 87.62%
Info
Financial Data 2016 Plan State Avg Nat Avg 90th Pctl.
Income $83,382,290 $38,212,136 N/A N/A
Net Worth $458,205,847 $267,217,323 N/A N/A
Premiums Earned $174,415,257 $644,862,921 N/A N/A
Financial Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Income 2015 $113,752,294 $19,029,685 N/A N/A
2014 $117,023,153 $50,732,622 N/A N/A
2013 $101,022,703 $44,817,532 N/A N/A
2012 $159,328,662 $57,195,463 N/A N/A
Net Worth 2015 $421,403,811 $237,291,717 N/A N/A
2014 $446,755,219 $250,764,247 N/A N/A
2013 $329,348,905 $222,343,959 N/A N/A
2012 $360,216,786 $232,468,936 N/A N/A
Premiums Earned 2015 $77,438,195 $552,705,214 N/A N/A
2014 $85,755,116 $470,221,984 N/A N/A
2013 $121,382,668 $403,549,832 N/A N/A
2012 $119,247,829 $442,669,442 N/A N/A
Info
Years in Business 2016 Plan State Avg Nat Avg 90th Pctl.
Years in Business 38 34 N/A N/A
Years in Business Year Plan State Avg. Natl. Avg. 90th Pctl.
Years in Business 2015 37 33 N/A N/A
2014 36 32 N/A N/A
2013 35 31 N/A N/A
2012 34 30 N/A N/A
Member Satisfaction
Info
Member Satisfaction 2016 Plan State Avg Nat Avg 90th Pctl.
Getting Care Quickly 82.72% 85.81% 85.14% 90.00%
Getting Needed Care 89.93% 86.38% 87.25% 91.54%
How Well Doctors Communicate 95.15% 95.22% 95.39% 97.21%
Members highly rating their HMO (8 to 10 on a 0-10 scale) 68.07% 62.47% 62.27% 74.92%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 83.33% 83.44% 84.72% 88.74%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) 76.69% 77.49% 77.19% 83.29%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) 86.69% 84.65% 84.57% 88.37%
Member Satisfaction Year Plan State Avg. Natl. Avg. 90th Pctl.
Getting Care Quickly 2015 84.16% 85.61% 85.00% 89.71%
2014 88.17% 86.12% 85.79% 90.17%
2013 88.06% 86.65% 86.84% 90.75%
2012 87.17% 85.74% 85.81% 90.18%
Getting Needed Care 2015 86.79% 86.51% 86.79% 91.23%
2014 92.63% 88.34% 87.95% 92.13%
2013 87.43% 87.20% 88.05% 92.37%
2012 84.39% 86.83% 87.88% 91.65%
How Well Doctors Communicate 2015 93.79% 94.90% 95.20% 97.10%
2014 95.67% 95.30% 95.26% 97.16%
2013 93.01% 94.13% 94.94% 96.97%
2012 94.22% 94.08% 94.39% 96.44%
Members highly rating their HMO (8 to 10 on a 0-10 scale) 2015 61.84% 62.71% 62.65% 74.57%
2014 64.05% 58.77% 64.71% 76.75%
2013 68.61% 65.03% 66.21% 78.29%
2012 68.97% 64.01% 63.16% 74.19%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 2015 85.79% 83.49% 83.85% 89.05%
2014 81.37% 85.38% 84.24% 88.27%
2013 80.92% 83.04% 84.52% 89.47%
2012 83.44% 84.35% 83.55% 88.27%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) 2015 69.73% 76.25% 76.99% 82.76%
2014 74.37% 79.49% 78.26% 83.66%
2013 72.10% 76.64% 78.14% 84.28%
2012 69.06% 75.50% 76.51% 82.08%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) 2015 80.88% 83.85% 84.24% 88.77%
2014 78.10% 84.37% 84.70% 88.96%
2013 80.28% 83.92% 84.96% 89.71%
2012 81.57% 84.23% 83.62% 87.92%
Overuse/Appropriateness
Info
Antipsychotics 2016 Plan State Avg Nat Avg 90th Pctl.
Metabolic Monitoring for Children and Adolescents on Antipsychotics - Ages 1-17 33.78% 34.87% 35.80% 45.93%
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics - Ages 1-17 50.00% 61.93% 58.30% 75.00%
Use of Multiple Concurrent Antipsychotics in Children and Adolescents - Ages 1-17 0.00% 2.06% N/A N/A
Antipsychotics Year Plan State Avg. Natl. Avg. 90th Pctl.
Metabolic Monitoring for Children and Adolescents on Antipsychotics - Ages 1-17 2015 35.66% 37.02% 33.94% 45.45%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics - Ages 1-17 2015 62.12% 61.38% 54.40% 70.49%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Use of Multiple Concurrent Antipsychotics in Children and Adolescents - Ages 1-17 2015 3.77% 1.70% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Info
Cervical Cancer Screening in Adolescent Females 2016 Plan State Avg Nat Avg 90th Pctl.
Non-Recommended Cervical Cancer Screening in Adolescent Females 1.22% 1.60% 1.84% 0.62%
Cervical Cancer Screening in Adolescent Females Year Plan State Avg. Natl. Avg. 90th Pctl.
Non-Recommended Cervical Cancer Screening in Adolescent Females 2015 0.02% 0.02% 2.40% 0.93%
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Info
Lower Back Pain 2016 Plan State Avg Nat Avg 90th Pctl.
Use of Imaging for Low Back Pain 68.56% 73.58% 72.67% 80.11%
Lower Back Pain Year Plan State Avg. Natl. Avg. 90th Pctl.
Use of Imaging for Low Back Pain 2015 69.59% 74.11% 74.57% 81.25%
2014 69.80% 72.44% 74.82% 81.95%
2013 71.50% 73.66% 74.48% 81.27%
2012 73.71% 72.73% 74.28% 81.82%
Info
Respiratory 2016 Plan State Avg Nat Avg 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection 92.02% 88.81% 88.51% 94.80%
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis 22.07% 27.03% 28.19% 41.72%
Respiratory Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection 2015 89.82% 87.71% 88.11% 94.26%
2014 88.67% 87.19% 87.39% 94.57%
2013 83.44% 82.80% 85.30% 92.63%
2012 85.39% 81.66% 84.23% 92.25%
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis 2015 20.62% 25.68% 26.11% 38.04%
2014 21.09% 25.67% 25.79% 36.11%
2013 19.32% 22.74% 23.86% 30.84%
2012 19.48% 20.78% 22.26% 32.00%
Utilization
Info
Antibiotic Utilization 2016 Plan State Avg Nat Avg 90th Pctl.
Average number of antibiotic prescriptions per member per year - Total 0.79 0.79 0.77 0.93
Average number of antibiotic prescriptions per member per year - Ages 0-9 0.92 0.97 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 10-17 0.55 0.60 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 18-34 0.68 0.69 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 35-49 0.80 0.77 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 50-64 0.89 0.87 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 65-74 1.00 0.99 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 75-85 0.99 1.23 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 85 plus 0.91 0.73 N/A N/A
Days suppplied per antibiotic prescription - Total 9.69 10.09 10.01 11.06
Days suppplied per antibiotic prescription - Ages 0-9 9.63 10.04 N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 12.35 12.80 N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 9.57 10.07 N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 9.37 9.62 N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 9.35 9.82 N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 9.63 9.93 N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 10.46 10.59 N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus 9.32 9.43 N/A N/A
Prescriptions of concern - Total 0.39 0.38 0.38 0.48
Prescriptions of concern - Ages 0-9 0.40 0.43 N/A N/A
Prescriptions of concern - Ages 10-17 0.22 0.24 N/A N/A
Prescriptions of concern - Ages 18-34 0.31 0.31 N/A N/A
Prescriptions of concern - Ages 35-49 0.41 0.40 N/A N/A
Prescriptions of concern - Ages 50-64 0.47 0.46 N/A N/A
Prescriptions of concern - Ages 65-74 0.52 0.51 N/A N/A
Prescriptions of concern - Ages 75-85 0.52 0.65 N/A N/A
Prescriptions of concern - Ages 85 plus 0.44 0.34 N/A N/A
Antibiotic Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Average number of antibiotic prescriptions per member per year - Total 2015 0.80 0.80 0.81 0.97
2014 0.78 0.75 0.79 0.96
2013 0.80 0.83 0.81 0.98
2012 N/A N/A N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 0-9 2015 0.84 0.94 N/A N/A
2014 0.79 0.84 N/A N/A
2013 0.85 0.93 N/A N/A
2012 N/A N/A N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 10-17 2015 0.53 0.60 N/A N/A
2014 0.52 0.56 N/A N/A
2013 0.54 0.62 N/A N/A
2012 N/A N/A N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 18-34 2015 0.70 0.70 N/A N/A
2014 0.68 0.67 N/A N/A
2013 0.71 0.74 N/A N/A
2012 N/A N/A N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 35-49 2015 0.82 0.80 N/A N/A
2014 0.82 0.76 N/A N/A
2013 0.83 0.83 N/A N/A
2012 N/A N/A N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 50-64 2015 0.91 0.90 N/A N/A
2014 0.90 0.84 N/A N/A
2013 0.91 0.92 N/A N/A
2012 N/A N/A N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 65-74 2015 1.03 1.07 N/A N/A
2014 1.02 0.96 N/A N/A
2013 1.02 1.05 N/A N/A
2012 N/A N/A N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 75-85 2015 1.11 1.08 N/A N/A
2014 1.05 1.09 N/A N/A
2013 1.13 1.11 N/A N/A
2012 N/A N/A N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 85 plus 2015 0.98 1.67 N/A N/A
2014 1.07 1.37 N/A N/A
2013 0.98 1.67 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Total 2015 9.92 10.26 10.12 11.03
2014 10.10 10.44 10.32 11.18
2013 10.34 10.44 10.45 11.35
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 0-9 2015 9.71 9.99 N/A N/A
2014 9.73 10.01 N/A N/A
2013 9.90 10.00 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 2015 12.82 13.32 N/A N/A
2014 13.63 13.65 N/A N/A
2013 13.83 13.72 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 2015 10.34 10.33 N/A N/A
2014 10.59 10.65 N/A N/A
2013 10.69 10.61 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 2015 9.46 9.83 N/A N/A
2014 9.60 9.95 N/A N/A
2013 9.86 9.93 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 2015 9.34 9.90 N/A N/A
2014 9.44 10.04 N/A N/A
2013 9.73 10.07 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 2015 9.82 10.18 N/A N/A
2014 9.81 10.43 N/A N/A
2013 10.18 10.23 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 2015 10.03 9.93 N/A N/A
2014 9.82 10.54 N/A N/A
2013 9.91 10.32 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus 2015 10.81 9.54 N/A N/A
2014 10.72 10.65 N/A N/A
2013 10.82 8.73 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Total 2015 0.39 0.40 0.41 0.52
2014 0.39 0.37 0.39 0.49
2013 0.40 0.42 0.41 0.52
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 0-9 2015 0.37 0.41 N/A N/A
2014 0.36 0.38 N/A N/A
2013 0.40 0.44 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 10-17 2015 0.22 0.25 N/A N/A
2014 0.20 0.22 N/A N/A
2013 0.22 0.25 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 18-34 2015 0.30 0.32 N/A N/A
2014 0.30 0.30 N/A N/A
2013 0.32 0.34 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 35-49 2015 0.43 0.42 N/A N/A
2014 0.43 0.41 N/A N/A
2013 0.45 0.45 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 50-64 2015 0.49 0.49 N/A N/A
2014 0.48 0.45 N/A N/A
2013 0.50 0.50 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 65-74 2015 0.55 0.57 N/A N/A
2014 0.55 0.51 N/A N/A
2013 0.57 0.56 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 75-85 2015 0.58 0.59 N/A N/A
2014 0.56 0.51 N/A N/A
2013 0.60 0.57 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 85 plus 2015 0.49 0.82 N/A N/A
2014 0.57 0.55 N/A N/A
2013 0.48 1.15 N/A N/A
2012 N/A N/A N/A N/A
Info
Child and Adolescent Well Child Visits 2016 Plan State Avg Nat Avg 90th Pctl.
Well Child Visits in the First 15 Months of Life 86.98% 83.40% 80.76% 90.36%
Well Child Visits in the 3rd - 6th Years 82.32% 82.50% 78.30% 90.11%
Adolescent Well-Care Visits 51.10% 50.35% 49.68% 67.70%
Child and Adolescent Well Child Visits Year Plan State Avg. Natl. Avg. 90th Pctl.
Well Child Visits in the First 15 Months of Life 2015 85.39% 84.01% 79.35% 89.12%
2014 73.87% 82.63% 79.12% 89.64%
2013 74.32% 83.44% 79.34% 89.83%
2012 73.90% 83.14% 78.67% 91.43%
Well Child Visits in the 3rd - 6th Years 2015 78.22% 80.48% 77.75% 89.74%
2014 80.73% 80.03% 77.37% 88.75%
2013 79.94% 78.43% 75.89% 88.25%
2012 78.99% 76.56% 74.36% 86.52%
Adolescent Well-Care Visits 2015 48.90% 49.34% 48.26% 64.50%
2014 49.48% 48.09% 47.51% 64.76%
2013 49.10% 46.84% 46.27% 63.82%
2012 47.32% 44.66% 44.76% 63.11%
Info
Mental Health Utilization 2016 Plan State Avg Nat Avg 90th Pctl.
Mental Health Utilization - Any service - Total 5.98% 6.65% 6.82% 10.37%
Mental Health Utilization - Any service - Ages 0-12 4.33% 5.25% N/A N/A
Mental Health Utilization - Any service - Ages 13-17 10.27% 12.10% N/A N/A
Mental Health Utilization - Any service - Ages 18-64 6.18% 6.59% N/A N/A
Mental Health Utilization - Any service - Ages 65 plus 2.27% 3.39% N/A N/A
Mental Health Utilization - Inpatient - Total 0.26% 0.25% 0.24% 0.31%
Mental Health Utilization - Inpatient - Ages 0-12 0.07% 0.07% N/A N/A
Mental Health Utilization - Inpatient - Ages 13-17 0.68% 0.79% N/A N/A
Mental Health Utilization - Inpatient - Ages 18-64 0.27% 0.25% N/A N/A
Mental Health Utilization - Inpatient - Ages 65 plus 0.12% 0.18% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Total 0.10% 0.12% 0.17% 0.35%
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 0-12 0.02% 0.07% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 13-17 0.38% 0.43% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 18-64 0.09% 0.11% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 65 plus 0.03% 0.02% N/A N/A
Mental Health Utilization - Outpatient or ED - Total 5.90% 6.63% 6.77% 10.32%
Mental Health Utilization - Outpatient or ED - Ages 0-12 4.32% 5.26% N/A N/A
Mental Health Utilization - Outpatient or ED - Ages 13-17 10.12% 12.16% N/A N/A
Mental Health Utilization - Outpatient or ED - Ages 18-64 6.08% 6.56% N/A N/A
Mental Health Utilization - Outpatient or ED - Ages 65 plus 2.21% 3.22% N/A N/A
Mental Health Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Mental Health Utilization - Any service - Total 2015 6.13% 6.65% 6.71% 9.72%
2014 8.96% 7.59% 7.15% 10.70%
2013 8.59% 6.78% 7.20% 11.03%
2012 N/A N/A N/A N/A
Mental Health Utilization - Any service - Ages 0-12 2015 4.60% 5.08% N/A N/A
2014 6.96% 5.49% N/A N/A
2013 6.70% 5.17% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Any service - Ages 13-17 2015 9.96% 11.13% N/A N/A
2014 12.85% 12.47% N/A N/A
2013 12.28% 10.96% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Any service - Ages 18-64 2015 6.35% 6.69% N/A N/A
2014 9.27% 7.72% N/A N/A
2013 8.86% 6.86% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Any service - Ages 65 plus 2015 2.49% 3.67% N/A N/A
2014 5.06% 4.08% N/A N/A
2013 4.98% 3.25% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Total 2015 0.24% 0.25% 0.24% 0.31%
2014 0.26% 0.30% 0.26% 0.35%
2013 0.25% 0.26% 0.26% 0.37%
2012 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 0-12 2015 0.05% 0.07% N/A N/A
2014 0.06% 0.09% N/A N/A
2013 0.04% 0.06% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 13-17 2015 0.71% 0.77% N/A N/A
2014 0.79% 0.99% N/A N/A
2013 0.80% 0.82% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 18-64 2015 0.24% 0.24% N/A N/A
2014 0.25% 0.29% N/A N/A
2013 0.23% 0.25% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 65 plus 2015 0.16% 0.10% N/A N/A
2014 0.14% 0.18% N/A N/A
2013 0.18% 0.18% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Total 2015 0.12% 0.10% 0.16% 0.34%
2014 0.10% 0.11% 0.16% 0.36%
2013 0.10% 0.09% 0.14% 0.28%
2012 N/A N/A N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 0-12 2015 0.04% 0.05% N/A N/A
2014 0.04% 0.06% N/A N/A
2013 0.04% 0.05% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 13-17 2015 0.46% 0.37% N/A N/A
2014 0.39% 0.42% N/A N/A
2013 0.37% 0.34% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 18-64 2015 0.10% 0.09% N/A N/A
2014 0.08% 0.10% N/A N/A
2013 0.08% 0.08% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 65 plus 2015 0.05% 0.02% N/A N/A
2014 0.02% 0.02% N/A N/A
2013 0.03% 0.02% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Outpatient or ED - Total 2015 6.06% 6.59% 6.64% 9.70%
2014 8.90% 7.52% 7.07% 10.63%
2013 8.53% 6.72% 7.12% 10.93%
2012 N/A N/A N/A N/A
Mental Health Utilization - Outpatient or ED - Ages 0-12 2015 4.58% 5.07% N/A N/A
2014 6.96% 5.47% N/A N/A
2013 6.70% 5.15% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Outpatient or ED - Ages 13-17 2015 9.82% 11.02% N/A N/A
2014 12.78% 12.33% N/A N/A
2013 12.16% 10.84% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Outpatient or ED - Ages 18-64 2015 6.27% 6.62% N/A N/A
2014 9.21% 7.64% N/A N/A
2013 8.80% 6.80% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Outpatient or ED - Ages 65 plus 2015 2.40% 3.64% N/A N/A
2014 4.97% 3.97% N/A N/A
2013 4.90% 3.17% N/A N/A
2012 N/A N/A N/A N/A
Info
Plan All-Cause Readmissions 2016 Plan State Avg Nat Avg 90th Pctl.
Plan All-Cause Readmissions Ages 18-44 0.12% 0.12% N/A N/A
Plan All-Cause Readmissions Ages 45-54 0.12% 0.12% N/A N/A
Plan All-Cause Readmissions Ages 55-64 0.13% 0.11% N/A N/A
Plan All-Cause Readmissions Total 0.13% 0.12% N/A N/A
Plan All-Cause Readmissions Year Plan State Avg. Natl. Avg. 90th Pctl.
Plan All-Cause Readmissions Ages 18-44 2015 0.12% 0.12% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Plan All-Cause Readmissions Ages 45-54 2015 0.13% 0.11% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Plan All-Cause Readmissions Ages 55-64 2015 0.14% 0.11% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A
Plan All-Cause Readmissions Total 2015 0.13% 0.11% N/A N/A
2014 N/A N/A N/A N/A
2013 N/A N/A N/A N/A
2012 N/A N/A N/A N/A