Virginia Health Information
 

Home > Health Insurance > CareFirst BlueChoice, Inc.

CareFirst BlueChoice, Inc.

Company Information

  • Company Providing Plan:CareFirst, BlueCross BlueShield
  • Address:10455 Mill Run Circle
    Owings Mills, MD 21117
  • Telephone :410-998-7011
  • Website:www.carefirst.com
2016
Number of Enrollees: *86,893
PMPM: *$373
Number of Physicians: 9,566
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

Arlington, Fairfax (lying east of route 123), Prince William (lying east of route 123)


Cities

Alexandria, Fairfax, Vienna

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

Administrative Data

2016 2015 2014 2013 2012
*Number of Enrollees 86,893 99,087 104,815 78,778 72,401
PMPM $373 $328 $320 $334 $311
*Medical Cost Ratio 79% 77% 78% 80% 82%
*Administrative Ratio 24% 24% 23% 18% 18%
*Profit/Loss Ratio -2% 0% 0% 3% 1%
Number of Physicians 9,566 9,475 9,015 8,475 8,565

*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 $402,239,015 $395,846,580 $375,372,382 $305,592,725 $257,058,160
*Income ($46,101,706) ($9,917,801) $22,090,620 $69,214,184 $25,940,441
*Net Worth $697,523,016 $741,104,638 $757,050,329 $733,350,796 $671,169,508

*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 94.63% 92.81% 92.73% 95.55%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 96.74% 95.78% 95.78% 97.61%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 97.52% 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 94.92% 92.25% 92.83% 95.45%
2014 94.29% 93.10% 92.91% 95.39%
2013 94.10% 93.27% 93.13% 95.56%
2012 93.64% 93.53% 93.40% 95.86%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 2015 96.94% 95.61% 95.90% 97.55%
2014 96.57% 96.03% 95.85% 97.54%
2013 96.36% 95.97% 95.93% 97.60%
2012 95.85% 95.88% 95.84% 97.42%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 2015 97.58% 96.84% 97.32% 96.73%
2014 96.88% 97.56% 97.50% 98.68%
2013 96.72% 97.45% 97.36% 98.63%
2012 96.70% 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 36.47% 35.69% 32.93% 40.24%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 45.15% 40.15% 40.47% 51.96%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 36.17% 35.55% 32.64% 40.33%
Engagement of Alcohol and Other Drug Dependence Treatment - Total 15.57% 12.51% 11.46% 16.72%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 24.76% 11.28% 15.68% 23.73%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 15.25% 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 34.93% 33.04% 33.42% 41.07%
2014 32.38% 32.51% 35.63% 44.19%
2013 31.54% 35.00% 39.01% 50.93%
2012 30.83% 37.48% 40.13% 51.23%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2015 38.64% 37.03% 39.62% 50.00%
2014 38.84% 37.09% 40.79% 52.00%
2013 36.29% 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 34.78% 32.96% 33.20% 40.93%
2014 32.08% 32.16% 35.21% 43.92%
2013 31.30% 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 14.83% 11.61% 12.46% 19.23%
2014 11.28% 10.64% 13.66% 19.19%
2013 14.23% 12.12% 14.64% 21.16%
2012 13.70% 11.95% 14.33% 20.35%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2015 17.05% 12.06% 15.42% 22.12%
2014 16.07% 13.00% 17.24% 25.29%
2013 18.57% 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 14.74% 11.57% 12.34% 18.67%
2014 11.06% 10.33% 13.45% 18.68%
2013 14.01% 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 98.66% 98.34% 98.09% 99.72%
25 month to 6 year old Child Access to Primary Care Practitioners 95.46% 94.33% 92.60% 96.46%
7-11 year old Child Access to Primary Care Practitioners 96.31% 94.38% 93.25% 98.25%
12-19 year old Child Access to Primary Care Practitioners 93.46% 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 98.42% 98.78% 98.03% 99.48%
2014 98.02% 98.49% 97.87% 99.62%
2013 97.49% 97.92% 97.99% 99.48%
2012 96.22% 97.87% 97.94% 99.58%
25 month to 6 year old Child Access to Primary Care Practitioners 2015 94.84% 94.16% 92.67% 96.64%
2014 94.26% 93.85% 92.33% 96.52%
2013 93.43% 93.53% 92.38% 96.50%
2012 90.07% 93.16% 92.31% 96.13%
7-11 year old Child Access to Primary Care Practitioners 2015 95.50% 94.23% 93.23% 97.92%
2014 95.05% 93.78% 93.02% 97.87%
2013 95.06% 93.78% 93.11% 97.89%
2012 92.52% 93.54% 92.93% 97.72%
12-19 year old Child Access to Primary Care Practitioners 2015 92.36% 91.30% 90.66% 96.19%
2014 91.34% 90.84% 90.44% 96.28%
2013 91.54% 90.58% 90.31% 96.28%
2012 88.27% 90.02% 90.01% 95.97%
Info
Prenatal and Postpartum Care 2016 Plan State Avg Nat Avg 90th Pctl.
Postpartum Care 66.98% 74.50% 73.95% 88.85%
Timeliness of Prenatal Care 89.77% 86.71% 85.57% 96.28%
Prenatal and Postpartum Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Postpartum Care 2015 60.56% 73.91% 73.72% 87.50%
2014 66.67% 77.29% 77.64% 88.65%
2013 71.77% 81.38% 91.35% 97.14%
2012 71.77% 81.20% 80.22% 90.25%
Timeliness of Prenatal Care 2015 86.15% 86.80% 84.28% 94.56%
2014 80.09% 86.83% 88.00% 96.23%
2013 88.40% 91.63% 81.00% 90.48%
2012 88.40% 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 74.49% 73.20% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 5-11 63.13% 67.58% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 12-18 63.75% 65.72% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 19-50 74.64% 71.77% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 51-64 82.54% 79.36% N/A N/A
Medication Management for People With Asthma at least 50% Compliance - Ages 65-85 81.56% 82.66% N/A N/A
Medication Management for People With Asthma at least 75% Compliance - Total 56.09% 51.17% 48.54% 56.96%
Medication Management for People With Asthma at least 75% Compliance - Ages 5-11 42.72% 39.03% 37.58% 48.84%
Medication Management for People With Asthma at least 75% Compliance - Ages 12-18 43.37% 35.03% 35.83% 46.97%
Medication Management for People With Asthma at least 75% Compliance - Ages 19-50 56.11% 50.18% 46.16% 55.80%
Medication Management for People With Asthma at least 75% Compliance - Ages 51-64 65.25% 59.39% 57.47% 65.75%
Medication Management for People With Asthma at least 75% Compliance - Ages 65-85 70.92% 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 67.24% 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 57.30% 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 52.99% 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 67.85% 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 76.15% 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 76.23% 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 44.77% 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 36.56% 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 31.16% 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 44.74% 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 53.86% 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 49.18% 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 80.23% 80.60% 78.29% 85.46%
Controller/Total Asthma Medication Ratio - Ages 5-11 84.47% 91.67% 86.40% 93.97%
Controller/Total Asthma Medication Ratio - Ages 12-18 74.74% 81.12% 78.30% 86.34%
Controller/Total Asthma Medication Ratio - Ages 19-50 77.64% 75.24% 73.51% 81.08%
Controller/Total Asthma Medication Ratio - Ages 51-64 83.35% 83.27% 81.70% 88.64%
Controller/Total Asthma Medication Ratio - Ages 65-85 89.12% 88.55% 84.66% 91.94%
Asthma Medication Ratio Year Plan State Avg. Natl. Avg. 90th Pctl.
Controller/Total Asthma Medication Ratio - Total 2015 81.53% 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 86.87% 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 77.82% 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 78.52% 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 84.28% 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 86.40% 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 36.19% 41.91% 38.93% 48.61%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 38.18% 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 34.94% 41.43% 38.13% 50.00%
2014 34.37% 39.00% 38.01% 46.81%
2013 34.23% 35.14% 40.10% 51.06%
2012 33.27% 36.75% 38.72% 48.58%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 2015 38.11% 49.06% 46.18% 58.06%
2014 39.34% 46.49% 45.70% 57.75%
2013 40.37% 41.32% 46.66% 58.62%
2012 34.55% 38.87% 45.07% 54.05%
Info
Cardiovascular Disease Management 2016 Plan State Avg Nat Avg 90th Pctl.
Controlling High Blood Pressure 56.06% 56.91% 60.31% 74.43%
Persistence of Beta-Blockers 88.59% 90.70% 83.61% 90.83%
Cardiovascular Disease Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Controlling High Blood Pressure 2015 37.97% 58.35% 58.69% 73.89%
2014 N/A 59.30% 62.63% 75.63%
2013 51.29% 60.92% 63.30% 74.65%
2012 51.29% 59.78% 61.63% 72.94%
Persistence of Beta-Blockers 2015 86.89% 88.70% 84.68% 91.00%
2014 83.62% 84.03% 83.50% 91.43%
2013 78.79% 83.43% 83.39% 91.72%
2012 85.49% 82.94% 83.03% 92.98%
Info
Common Childhood Illnesses 2016 Plan State Avg Nat Avg 90th Pctl.
Appropriate Testing for Children With Pharyngitis 93.30% 90.38% 84.50% 93.75%
Common Childhood Illnesses Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Testing for Children With Pharyngitis 2015 91.85% 90.13% 83.12% 93.11%
2014 91.40% 88.64% 83.29% 91.40%
2013 90.95% 87.54% 81.45% 91.30%
2012 89.49% 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) 54.14% 60.88% 61.06% 78.35%
Comprehensive Diabetes Care-HbA1c control (<8.0%) 56.61% 58.36% 56.62% 66.39%
Comprehensive Diabetes Care-Rate of Eye Exams 49.03% 58.46% 52.96% 72.04%
Comprehensive Diabetes Care-Rate of Medical Attention for Diabetic Nephropathy 88.36% 90.56% 90.03% 92.71%
Comprehensive Diabetes Care-Rate of Poor HbA1c control 34.39% 30.47% 32.15% 20.98%
Comprehensive Diabetes Care-Testing for HbA1c 87.48% 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 43.95% 61.03% 58.80% 75.68%
2014 63.37% 63.33% 63.85% 76.00%
2013 30.73% 42.35% 64.44% 76.22%
2012 N/A N/A N/A N/A
Comprehensive Diabetes Care-HbA1c control (<8.0%) 2015 53.91% 57.59% 55.81% 66.67%
2014 58.16% 59.12% 58.53% 68.61%
2013 36.81% 55.47% 58.87% 69.16%
2012 N/A N/A N/A N/A
Comprehensive Diabetes Care-Rate of Eye Exams 2015 45.37% 57.15% 52.47% 70.44%
2014 47.92% 57.54% 54.98% 71.93%
2013 47.74% 56.05% 54.65% 71.53%
2012 48.34% 57.24% 55.70% 74.09%
Comprehensive Diabetes Care-Rate of Medical Attention for Diabetic Nephropathy 2015 87.90% 91.11% 90.10% 93.40%
2014 81.42% 86.26% 84.72% 89.60%
2013 80.73% 84.97% 83.75% 89.19%
2012 79.51% 85.74% 83.70% 89.54%
Comprehensive Diabetes Care-Rate of Poor HbA1c control 2015 36.12% 30.83% 33.90% 20.20%
2014 31.25% 31.37% 30.48% 19.33%
2013 54.51% 34.40% 30.71% 19.46%
2012 33.98% 27.02% 28.85% 18.18%
Comprehensive Diabetes Care-Testing for HbA1c 2015 88.79% 91.13% 90.54% 94.69%
2014 89.24% 89.01% 90.34% 94.86%
2013 86.63% 88.32% 89.62% 94.23%
2012 86.34% 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 88.26% 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 89.35% 89.72% 87.84% 92.86%
2014 87.50% 88.05% 87.86% 93.59%
2013 86.28% 88.24% 87.95% 94.49%
2012 84.17% 88.39% 87.47% 93.70%
Info
Immunizations 2016 Plan State Avg Nat Avg 90th Pctl.
Childhood Immunization for Multiple diseases including Chicken Pox 80.65% 84.29% 78.93% 89.03%
Childhood Immunization for Multiple diseases including pneumovax 79.95% 82.08% 77.04% 87.50%
Flu Vaccinations for Adults Ages 18–64 47.59% 47.13% N/A N/A
Immunizations for Adolescents - Combination 87.15% 77.95% 77.63% 88.81%
Immunizations for Adolescents - Meningococcal 88.55% 79.65% 79.20% 90.02%
Immunizations for Adolescents - Tdap 92.06% 91.29% 87.77% 95.38%
Immunizations Year Plan State Avg. Natl. Avg. 90th Pctl.
Childhood Immunization for Multiple diseases including Chicken Pox 2015 73.29% 81.56% 78.59% 88.08%
2014 76.85% 80.25% 80.18% 88.07%
2013 71.99% 80.24% 78.39% 87.14%
2012 84.11% 82.72% 79.83% 88.00%
Childhood Immunization for Multiple diseases including pneumovax 2015 71.63% 79.45% 76.49% 87.10%
2014 75.46% 78.11% 78.13% 86.26%
2013 70.37% 78.73% 76.21% 85.40%
2012 74.30% 78.74% 77.05% 86.00%
Flu Vaccinations for Adults Ages 18–64 2015 0.48% 0.50% 47.85% 58.01%
2014 0.52% 0.52% 49.45% 59.73%
2013 0.45% 0.49% 49.06% 59.59%
2012 N/A N/A N/A N/A
Immunizations for Adolescents - Combination 2015 74.07% 69.50% 74.25% 88.47%
2014 68.98% 67.04% 70.73% 87.34%
2013 62.96% 60.89% 66.54% 84.18%
2012 N/A N/A N/A N/A
Immunizations for Adolescents - Meningococcal 2015 0.78% 0.72% 76.12% 89.29%
2014 0.73% 0.69% 72.59% 88.27%
2013 0.68% 0.64% 68.70% 85.25%
2012 N/A N/A N/A N/A
Immunizations for Adolescents - Tdap 2015 0.80% 0.85% 86.03% 94.39%
2014 0.78% 0.85% 84.49% 95.15%
2013 0.74% 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 74.34% 70.29% 66.56% 74.77%
Antidepressant Medication Management-Continuation Phase Treatment 59.94% 53.51% 50.69% 58.60%
Follow-up After Hospitalization For Mental Illness within 7 days after hospital discharge 52.23% 52.99% 52.06% 67.31%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge 72.61% 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 71.02% 67.61% 65.82% 74.06%
2014 68.82% 68.52% 65.88% 75.35%
2013 68.42% 65.67% 63.60% 73.26%
2012 71.39% 69.62% 69.03% 77.57%
Antidepressant Medication Management-Continuation Phase Treatment 2015 54.83% 49.81% 50.15% 57.56%
2014 50.05% 50.31% 49.83% 59.11%
2013 48.72% 48.37% 46.58% 57.12%
2012 55.08% 52.80% 53.51% 61.69%
Follow-up After Hospitalization For Mental Illness within 7 days after hospital discharge 2015 55.07% 47.66% 50.57% 67.57%
2014 54.57% 51.82% 52.21% 70.33%
2013 57.04% 55.07% 53.70% 69.16%
2012 58.16% 61.69% 57.57% 73.88%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge 2015 72.83% 71.58% 69.72% 83.80%
2014 71.70% 72.52% 70.72% 85.71%
2013 74.12% 73.03% 72.56% 84.19%
2012 73.79% 77.74% 75.42% 86.45%
Info
Persistent Medications 2016 Plan State Avg Nat Avg 90th Pctl.
Annual Monitoring for Patients on Persistent Medications 84.33% 84.90% 83.34% 87.04%
Persistent Medications Year Plan State Avg. Natl. Avg. 90th Pctl.
Annual Monitoring for Patients on Persistent Medications 2015 83.91% 83.34% 82.94% 86.72%
2014 84.28% 83.28% 82.33% 86.25%
2013 83.49% 83.44% 82.32% 86.12%
2012 82.09% 83.30% 82.11% 86.32%
Info
Pharmacotherapy of COPD Exacerbation 2016 Plan State Avg Nat Avg 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator 87.21% 84.12% 76.30% 85.98%
Pharmacotherapy of COPD Exacerbation - Corticosteroid 80.98% 79.54% 70.70% 81.82%
Pharmacotherapy of COPD Exacerbation Year Plan State Avg. Natl. Avg. 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator 2015 83.55% 78.48% 79.09% 87.10%
2014 73.47% 80.03% 80.14% 86.90%
2013 75.66% 78.88% 79.47% 87.58%
2012 80.56% 80.97% 80.45% 87.50%
Pharmacotherapy of COPD Exacerbation - Corticosteroid 2015 80.97% 72.98% 75.30% 84.56%
2014 75.51% 75.53% 75.28% 83.54%
2013 80.09% 73.76% 75.40% 83.33%
2012 79.51% 73.69% 73.65% 81.32%
Info
Preventive Care 2016 Plan State Avg Nat Avg 90th Pctl.
Breast Cancer Screening 72.12% 71.80% 72.90% 80.63%
Chlamydia Screening in Women-all Age groups 51.52% 49.79% 48.98% 63.50%
Colorectal Cancer Screening 63.70% 65.83% 61.71% 74.09%
Preventive Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Breast Cancer Screening 2015 71.89% 72.07% 73.08% 81.53%
2014 71.60% 72.22% 73.52% 81.91%
2013 71.47% 72.82% 73.71% 80.78%
2012 N/A N/A N/A N/A
Chlamydia Screening in Women-all Age groups 2015 49.58% 47.89% 52.32% 64.06%
2014 50.98% 48.07% 51.65% 63.48%
2013 50.89% 47.46% 46.20% 59.63%
2012 48.77% 46.98% 45.16% 57.69%
Colorectal Cancer Screening 2015 57.40% 64.43% 62.32% 73.84%
2014 56.99% 63.41% 64.06% 74.86%
2013 59.26% 65.36% 62.85% 72.75%
2012 57.11% 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 45.86% 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 44.97% 46.31% 42.44% 51.66%
2014 44.10% 42.48% 42.16% 51.85%
2013 44.72% 43.20% 42.08% 50.99%
2012 45.10% 45.42% 43.34% 55.44%
Info
Weight Assessment and Counseling 2016 Plan State Avg Nat Avg 90th Pctl.
Adult BMI Assessment 78.35% 77.87% 76.17% 91.85%
Children/Adolescents BMI Assessment - Total 66.51% 69.07% 65.62% 88.08%
Counseling for Nutrition for Children/Adolescents - Total 66.04% 66.76% 61.76% 83.68%
Counseling for Physical Activity for Children/Adolescents - Total 58.02% 60.41% 55.96% 79.44%
Weight Assessment and Counseling Year Plan State Avg. Natl. Avg. 90th Pctl.
Adult BMI Assessment 2015 56.37% 75.90% 74.19% 91.76%
2014 68.98% 76.28% 75.36% 91.20%
2013 63.64% 72.78% 74.24% 90.00%
2012 45.60% 60.89% N/A N/A
Children/Adolescents BMI Assessment - Total 2015 43.46% 60.49% 60.37% 83.78%
2014 60.19% 61.63% 61.08% 85.37%
2013 43.75% 52.14% 54.90% 83.13%
2012 44.44% 43.29% 49.34% 78.51%
Counseling for Nutrition for Children/Adolescents - Total 2015 47.43% 63.88% 58.94% 80.79%
2014 65.74% 65.02% 60.64% 80.05%
2013 60.19% 61.17% 56.48% 79.32%
2012 54.86% 51.32% 54.19% 75.00%
Counseling for Physical Activity for Children/Adolescents - Total 2015 44.39% 59.53% 54.50% 78.85%
2014 62.27% 62.13% 57.09% 77.30%
2013 53.94% 56.47% 53.16% 74.70%
2012 43.98% 45.42% 49.91% 70.66%
Health Plan Stability/Descriptive
Info
Administrative Data 2016 Plan State Avg Nat Avg 90th Pctl.
Administrative Ratio 0.24 0.15 N/A N/A
Medical Cost Ratio 0.79 0.83 N/A N/A
Number of Enrollees 86,893 136,796 N/A N/A
Number of Physicians 9,566 73,426 N/A N/A
Premium Per Member Per Month $373 $370 N/A N/A
Profit/Loss Ratio -0.02 0.03 N/A N/A
Administrative Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Administrative Ratio 2015 0.24 0.14 N/A N/A
2014 0.23 0.14 N/A N/A
2013 0.18 0.14 N/A N/A
2012 0.18 0.10 N/A N/A
Medical Cost Ratio 2015 0.77 0.82 N/A N/A
2014 0.78 0.81 N/A N/A
2013 0.80 0.83 N/A N/A
2012 0.82 0.84 N/A N/A
Number of Enrollees 2015 99,087 124,097 N/A N/A
2014 104,815 115,428 N/A N/A
2013 78,778 98,253 N/A N/A
2012 72,401 111,525 N/A N/A
Number of Physicians 2015 9,475 90,027 N/A N/A
2014 9,015 63,157 N/A N/A
2013 8,475 64,207 N/A N/A
2012 8,565 62,436 N/A N/A
Premium Per Member Per Month 2015 $328 $375 N/A N/A
2014 $320 $412 N/A N/A
2013 $334 $544 N/A N/A
2012 $311 $378 N/A N/A
Profit/Loss Ratio 2015 0.00 0.04 N/A N/A
2014 0.00 0.06 N/A N/A
2013 0.03 0.03 N/A N/A
2012 0.01 0.07 N/A N/A
Info
Board Certification Rates for Providers 2016 Plan State Avg Nat Avg 90th Pctl.
Board Certification for Geriatricians 73.60% 73.44% N/A N/A
Board Certification for Pediatricians 84.37% 87.02% N/A N/A
Board Certification Rate for Family Medicine Physicians 80.75% 80.32% N/A N/A
Board Certification Rate for Internal Medicine Physicians 80.84% 81.15% N/A N/A
Board Certification Rate for OB/GYN Providers 75.29% 83.36% N/A N/A
Board Certification Rate for Other Specialists 80.34% 83.25% N/A N/A
Board Certification Rates for Providers Year Plan State Avg. Natl. Avg. 90th Pctl.
Board Certification for Geriatricians 2015 74.84% 71.06% N/A N/A
2014 90.00% 74.73% 64.82% 87.50%
2013 78.29% 71.19% 63.29% 83.33%
2012 77.24% 73.37% 65.21% 87.23%
Board Certification for Pediatricians 2015 85.39% 88.14% N/A N/A
2014 89.93% 88.13% 83.89% 91.52%
2013 84.01% 86.01% 81.01% 90.29%
2012 83.32% 86.06% 83.97% 91.65%
Board Certification Rate for Family Medicine Physicians 2015 87.60% 82.53% N/A N/A
2014 89.87% 82.93% 77.41% 89.90%
2013 80.49% 81.36% 76.60% 88.80%
2012 80.90% 81.09% 77.40% 89.19%
Board Certification Rate for Internal Medicine Physicians 2015 82.78% 82.59% N/A N/A
2014 90.02% 83.98% 79.07% 88.73%
2013 84.17% 80.80% 78.18% 87.44%
2012 82.18% 81.93% 79.29% 88.24%
Board Certification Rate for OB/GYN Providers 2015 74.55% 83.51% N/A N/A
2014 79.66% 83.71% 79.30% 88.80%
2013 66.44% 80.44% 76.89% 87.80%
2012 57.34% 80.51% 79.23% 86.38%
Board Certification Rate for Other Specialists 2015 73.09% 82.88% N/A N/A
2014 85.23% 84.44% 78.09% 89.67%
2013 68.84% 79.95% 74.88% 88.36%
2012 69.58% 79.00% 75.49% 87.62%
Info
Financial Data 2016 Plan State Avg Nat Avg 90th Pctl.
Income $-46,101,706 $38,212,136 N/A N/A
Net Worth $697,523,016 $267,217,323 N/A N/A
Premiums Earned $402,239,015 $644,862,921 N/A N/A
Financial Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Income 2015 $-9,917,801 $19,029,685 N/A N/A
2014 $22,090,620 $50,732,622 N/A N/A
2013 $69,214,184 $44,817,532 N/A N/A
2012 $25,940,441 $57,195,463 N/A N/A
Net Worth 2015 $741,104,638 $237,291,717 N/A N/A
2014 $757,050,329 $250,764,247 N/A N/A
2013 $733,350,796 $222,343,959 N/A N/A
2012 $671,169,508 $232,468,936 N/A N/A
Premiums Earned 2015 $395,846,580 $552,705,214 N/A N/A
2014 $375,372,382 $470,221,984 N/A N/A
2013 $305,592,725 $403,549,832 N/A N/A
2012 $257,058,160 $442,669,442 N/A N/A
Info
Years in Business 2016 Plan State Avg Nat Avg 90th Pctl.
Years in Business 30 34 N/A N/A
Years in Business Year Plan State Avg. Natl. Avg. 90th Pctl.
Years in Business 2015 29 33 N/A N/A
2014 28 32 N/A N/A
2013 27 31 N/A N/A
2012 26 30 N/A N/A
Member Satisfaction
Info
Member Satisfaction 2016 Plan State Avg Nat Avg 90th Pctl.
Getting Care Quickly 85.94% 85.81% 85.14% 90.00%
Getting Needed Care 88.53% 86.38% 87.25% 91.54%
How Well Doctors Communicate 95.54% 95.22% 95.39% 97.21%
Members highly rating their HMO (8 to 10 on a 0-10 scale) 68.16% 62.47% 62.27% 74.92%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 88.15% 83.44% 84.72% 88.74%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) 77.09% 77.49% 77.19% 83.29%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) 80.11% 84.65% 84.57% 88.37%
Member Satisfaction Year Plan State Avg. Natl. Avg. 90th Pctl.
Getting Care Quickly 2015 84.66% 85.61% 85.00% 89.71%
2014 86.44% 86.12% 85.79% 90.17%
2013 85.31% 86.65% 86.84% 90.75%
2012 83.33% 85.74% 85.81% 90.18%
Getting Needed Care 2015 86.42% 86.51% 86.79% 91.23%
2014 87.40% 88.34% 87.95% 92.13%
2013 84.33% 87.20% 88.05% 92.37%
2012 86.04% 86.83% 87.88% 91.65%
How Well Doctors Communicate 2015 93.69% 94.90% 95.20% 97.10%
2014 94.42% 95.30% 95.26% 97.16%
2013 93.28% 94.13% 94.94% 96.97%
2012 92.51% 94.08% 94.39% 96.44%
Members highly rating their HMO (8 to 10 on a 0-10 scale) 2015 68.48% 62.71% 62.65% 74.57%
2014 70.44% 58.77% 64.71% 76.75%
2013 73.51% 65.03% 66.21% 78.29%
2012 64.81% 64.01% 63.16% 74.19%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 2015 82.83% 83.49% 83.85% 89.05%
2014 85.75% 85.38% 84.24% 88.27%
2013 82.48% 83.04% 84.52% 89.47%
2012 85.19% 84.35% 83.55% 88.27%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) 2015 76.52% 76.25% 76.99% 82.76%
2014 80.42% 79.49% 78.26% 83.66%
2013 78.36% 76.64% 78.14% 84.28%
2012 74.40% 75.50% 76.51% 82.08%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) 2015 83.16% 83.85% 84.24% 88.77%
2014 81.80% 84.37% 84.70% 88.96%
2013 81.43% 83.92% 84.96% 89.71%
2012 80.91% 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 40.16% 34.87% 35.80% 45.93%
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics - Ages 1-17 56.85% 61.93% 58.30% 75.00%
Use of Multiple Concurrent Antipsychotics in Children and Adolescents - Ages 1-17 2.21% 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 41.76% 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 55.02% 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 0.94% 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 2.28% 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 0.03% 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 70.27% 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 72.01% 74.11% 74.57% 81.25%
2014 71.96% 72.44% 74.82% 81.95%
2013 71.49% 73.66% 74.48% 81.27%
2012 70.70% 72.73% 74.28% 81.82%
Info
Respiratory 2016 Plan State Avg Nat Avg 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection 89.89% 88.81% 88.51% 94.80%
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis 23.59% 27.03% 28.19% 41.72%
Respiratory Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection 2015 89.16% 87.71% 88.11% 94.26%
2014 88.83% 87.19% 87.39% 94.57%
2013 85.08% 82.80% 85.30% 92.63%
2012 82.29% 81.66% 84.23% 92.25%
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis 2015 23.66% 25.68% 26.11% 38.04%
2014 23.27% 25.67% 25.79% 36.11%
2013 23.84% 22.74% 23.86% 30.84%
2012 20.42% 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 0.82 0.79 0.77 0.93
Average number of antibiotic prescriptions per member per year - Ages 0-9 0.96 0.97 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 10-17 0.66 0.60 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 18-34 0.73 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 0.94 0.87 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 65-74 1.09 0.99 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 75-85 1.19 1.23 N/A N/A
Average number of antibiotic prescriptions per member per year - Ages 85 plus 1.37 0.73 N/A N/A
Days suppplied per antibiotic prescription - Total 10.18 10.09 10.01 11.06
Days suppplied per antibiotic prescription - Ages 0-9 9.85 10.04 N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 12.93 12.80 N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 10.08 10.07 N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 9.70 9.62 N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 10.03 9.82 N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 10.47 9.93 N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 10.60 10.59 N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus 10.57 9.43 N/A N/A
Prescriptions of concern - Total 0.40 0.38 0.38 0.48
Prescriptions of concern - Ages 0-9 0.41 0.43 N/A N/A
Prescriptions of concern - Ages 10-17 0.28 0.24 N/A N/A
Prescriptions of concern - Ages 18-34 0.34 0.31 N/A N/A
Prescriptions of concern - Ages 35-49 0.42 0.40 N/A N/A
Prescriptions of concern - Ages 50-64 0.50 0.46 N/A N/A
Prescriptions of concern - Ages 65-74 0.58 0.51 N/A N/A
Prescriptions of concern - Ages 75-85 0.62 0.65 N/A N/A
Prescriptions of concern - Ages 85 plus 0.64 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 0.84 0.80 0.81 0.97
2014 0.47 0.75 0.79 0.96
2013 0.77 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 0.90 0.94 N/A N/A
2014 0.50 0.84 N/A N/A
2013 0.80 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 0.65 0.60 N/A N/A
2014 0.33 0.56 N/A N/A
2013 0.57 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 0.75 0.70 N/A N/A
2014 0.45 0.67 N/A N/A
2013 0.70 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 0.48 0.76 N/A N/A
2013 0.77 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 0.97 0.90 N/A N/A
2014 0.52 0.84 N/A N/A
2013 0.90 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 1.19 1.07 N/A N/A
2014 0.55 0.96 N/A N/A
2013 1.09 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 1.26 1.08 N/A N/A
2014 0.53 1.09 N/A N/A
2013 1.22 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 1.21 1.67 N/A N/A
2014 1.47 1.37 N/A N/A
2013 0.92 1.67 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Total 2015 10.36 10.26 10.12 11.03
2014 10.26 10.44 10.32 11.18
2013 10.46 10.44 10.45 11.35
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 0-9 2015 9.90 9.99 N/A N/A
2014 9.98 10.01 N/A N/A
2013 9.92 10.00 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 10-17 2015 13.44 13.32 N/A N/A
2014 13.28 13.65 N/A N/A
2013 13.44 13.72 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 18-34 2015 10.39 10.33 N/A N/A
2014 10.28 10.65 N/A N/A
2013 10.59 10.61 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 35-49 2015 9.89 9.83 N/A N/A
2014 9.88 9.95 N/A N/A
2013 10.00 9.93 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 50-64 2015 10.13 9.90 N/A N/A
2014 9.91 10.04 N/A N/A
2013 10.22 10.07 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 65-74 2015 10.17 10.18 N/A N/A
2014 10.53 10.43 N/A N/A
2013 10.28 10.23 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 75-85 2015 10.63 9.93 N/A N/A
2014 10.93 10.54 N/A N/A
2013 10.59 10.32 N/A N/A
2012 N/A N/A N/A N/A
Days suppplied per antibiotic prescription - Ages 85 plus 2015 10.86 9.54 N/A N/A
2014 11.64 10.65 N/A N/A
2013 8.36 8.73 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Total 2015 0.41 0.40 0.41 0.52
2014 0.23 0.37 0.39 0.49
2013 0.38 0.42 0.41 0.52
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 0-9 2015 0.39 0.41 N/A N/A
2014 0.21 0.38 N/A N/A
2013 0.37 0.44 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 10-17 2015 0.26 0.25 N/A N/A
2014 0.13 0.22 N/A N/A
2013 0.24 0.25 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 18-34 2015 0.35 0.32 N/A N/A
2014 0.21 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 0.44 0.42 N/A N/A
2014 0.25 0.41 N/A N/A
2013 0.41 0.45 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 50-64 2015 0.53 0.49 N/A N/A
2014 0.29 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 0.63 0.57 N/A N/A
2014 0.29 0.51 N/A N/A
2013 0.59 0.56 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 75-85 2015 0.65 0.59 N/A N/A
2014 0.29 0.51 N/A N/A
2013 0.66 0.57 N/A N/A
2012 N/A N/A N/A N/A
Prescriptions of concern - Ages 85 plus 2015 0.59 0.82 N/A N/A
2014 0.74 0.55 N/A N/A
2013 0.62 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 85.85% 83.40% 80.76% 90.36%
Well Child Visits in the 3rd - 6th Years 84.99% 82.50% 78.30% 90.11%
Adolescent Well-Care Visits 57.12% 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 85.47% 84.01% 79.35% 89.12%
2014 81.55% 82.63% 79.12% 89.64%
2013 83.33% 83.44% 79.34% 89.83%
2012 80.70% 83.14% 78.67% 91.43%
Well Child Visits in the 3rd - 6th Years 2015 84.30% 80.48% 77.75% 89.74%
2014 82.11% 80.03% 77.37% 88.75%
2013 80.28% 78.43% 75.89% 88.25%
2012 75.67% 76.56% 74.36% 86.52%
Adolescent Well-Care Visits 2015 55.42% 49.34% 48.26% 64.50%
2014 51.99% 48.09% 47.51% 64.76%
2013 50.18% 46.84% 46.27% 63.82%
2012 45.83% 44.66% 44.76% 63.11%
Info
Mental Health Utilization 2016 Plan State Avg Nat Avg 90th Pctl.
Mental Health Utilization - Any service - Total 7.73% 6.65% 6.82% 10.37%
Mental Health Utilization - Any service - Ages 0-12 5.38% 5.25% N/A N/A
Mental Health Utilization - Any service - Ages 13-17 12.86% 12.10% N/A N/A
Mental Health Utilization - Any service - Ages 18-64 7.86% 6.59% N/A N/A
Mental Health Utilization - Any service - Ages 65 plus 3.55% 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 0.08% 0.07% N/A N/A
Mental Health Utilization - Inpatient - Ages 13-17 0.90% 0.79% N/A N/A
Mental Health Utilization - Inpatient - Ages 18-64 0.24% 0.25% N/A N/A
Mental Health Utilization - Inpatient - Ages 65 plus 0.08% 0.18% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Total 0.14% 0.12% 0.17% 0.35%
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 0-12 0.06% 0.07% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 13-17 0.52% 0.43% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 18-64 0.13% 0.11% N/A N/A
Mental Health Utilization - Intensive Outpatient or Partial Hospitalization - Ages 65 plus 0.04% 0.02% N/A N/A
Mental Health Utilization - Outpatient or ED - Total 7.62% 6.63% 6.77% 10.32%
Mental Health Utilization - Outpatient or ED - Ages 0-12 5.34% 5.26% N/A N/A
Mental Health Utilization - Outpatient or ED - Ages 13-17 12.55% 12.16% N/A N/A
Mental Health Utilization - Outpatient or ED - Ages 18-64 7.75% 6.56% N/A N/A
Mental Health Utilization - Outpatient or ED - Ages 65 plus 3.49% 3.22% N/A N/A
Mental Health Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Mental Health Utilization - Any service - Total 2015 7.61% 6.65% 6.71% 9.72%
2014 14.14% 7.59% 7.15% 10.70%
2013 7.36% 6.78% 7.20% 11.03%
2012 N/A N/A N/A N/A
Mental Health Utilization - Any service - Ages 0-12 2015 4.95% 5.08% N/A N/A
2014 7.09% 5.49% N/A N/A
2013 4.44% 5.17% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Any service - Ages 13-17 2015 12.59% 11.13% N/A N/A
2014 20.55% 12.47% N/A N/A
2013 11.36% 10.96% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Any service - Ages 18-64 2015 7.82% 6.69% N/A N/A
2014 15.12% 7.72% N/A N/A
2013 7.73% 6.86% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Any service - Ages 65 plus 2015 3.88% 3.67% N/A N/A
2014 11.70% 4.08% N/A N/A
2013 3.75% 3.25% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Total 2015 0.27% 0.25% 0.24% 0.31%
2014 0.66% 0.30% 0.26% 0.35%
2013 0.39% 0.26% 0.26% 0.37%
2012 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 0-12 2015 0.07% 0.07% N/A N/A
2014 0.16% 0.09% N/A N/A
2013 0.11% 0.06% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 13-17 2015 0.96% 0.77% N/A N/A
2014 1.60% 0.99% N/A N/A
2013 1.00% 0.82% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 18-64 2015 0.26% 0.24% N/A N/A
2014 0.67% 0.29% N/A N/A
2013 0.39% 0.25% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Inpatient - Ages 65 plus 2015 0.18% 0.10% N/A N/A
2014 1.02% 0.18% N/A N/A
2013 0.58% 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 0.14% 0.10% 0.16% 0.34%
2014 0.28% 0.11% 0.16% 0.36%
2013 0.15% 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 0.05% 0.05% N/A N/A
2014 0.09% 0.06% N/A N/A
2013 0.08% 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 0.54% 0.37% N/A N/A
2014 1.11% 0.42% N/A N/A
2013 0.61% 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 0.13% 0.09% N/A N/A
2014 0.25% 0.10% N/A N/A
2013 0.13% 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 0.03% 0.02% N/A N/A
2014 0.11% 0.02% N/A N/A
2013 0.04% 0.02% N/A N/A
2012 N/A N/A N/A N/A
Mental Health Utilization - Outpatient or ED - Total 2015 7.55% 6.59% 6.64% 9.70%
2014 13.98% 7.52% 7.07% 10.63%
2013 7.26% 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 4.94% 5.07% N/A N/A
2014 7.05% 5.47% N/A N/A
2013 4.43% 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 12.45% 11.02% N/A N/A
2014 20.35% 12.33% N/A N/A
2013 11.25% 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 7.76% 6.62% N/A N/A
2014 14.95% 7.64% N/A N/A
2013 7.62% 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 3.79% 3.64% N/A N/A
2014 10.99% 3.97% N/A N/A
2013 3.41% 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 0.10% 0.12% N/A N/A
Plan All-Cause Readmissions Ages 55-64 0.10% 0.11% N/A N/A
Plan All-Cause Readmissions Total 0.11% 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 0.11% 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 0.10% 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 0.11% 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 0.11% 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