Summary Data for Finger Lakes
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1 MEDICAID INSTITUTE AT UNITED HOSPITAL FUND Medicaid Regional Data Compendium, 214 Chartbook 1: Finger Lakes This chartbook is part of a broader data compendium from the Medicaid Institute at United Hospital Fund. It presents data on the demographics, service usage, and quality measures for Medicaid beneficiaries from the Finger Lakes region. The chartbook is based on data for the Medicaid population residing in the region, regardless of where they receive care; it is not a comprehensive look at care provided in the region. For details on data elements, please see the accompanying methods and sources. Medicaid Regional Data Compendium, 214 was prepared by Lee Kennedy-Shaffer and Chad Shearer of the Medicaid Institute at United Hospital Fund. The entire publication is available at and Funded by the New York State Department of Health. Fairly small per-capita Medicaid population. Higher share of younger beneficiaries and lower share of older beneficiaries than the state as a whole. Unadjusted inpatient admission rate lower than the statewide average. Rate of potentially avoidable hospitalizations (PQIs) for most adult conditions slightly worse than risk-adjusted expectations (but slightly below statewide averages). PQIs for children better than risk-adjusted expectations for all selected indicators, especially gastroenteritis and short-term diabetes complications. More potentially preventable emergency room visits than the risk-adjusted expectation. Summary Data for Finger Lakes Counties Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne, Yates Total Population as of July 1, 213 1,282,68 Medicaid Beneficiaries with a Claim in ,826 (2.% of Total Population) Medicaid Claims in ,222,82 (47.6 Claims per Beneficiary) Medicaid Beneficiaries Enrolled in Managed Care 157,146 (61.2% of Medicaid Beneficiaries) Mainstream Managed Care Plans Excellus Health Plan, MVP Health Plan, NYS Catholic Health Plan, United Healthcare Plan Managed Long-Term Care Plans ElderPlan, Fidelis Care at Home, Independent Living for Seniors Health Homes in the Region Greater Rochester Health Home Network, Huther Doyle Memorial Institute Health Homes of Upstate New York Finger Lakes, Onondaga Case Management Services Health Homes of Upstate New York Central NOVEMBER 214
2 Medicaid Regional Data Compendium, 214 Characteristics of Medicaid Beneficiaries Medicaid Beneficiaries by Age Group 4% 35% 3% Percentage of Beneficiaries 25% 2% 15% 1% 5% % Medicaid Beneficiaries by Medicare Enrollment Status 9% 8% 7% Percentage of Beneficiaries 6% 5% 4% 3% 2% 1% % No Medicare Medicare Finger Lakes State Note: Age group and enrollment status are for Medicaid beneficiaries with a claim in 213. MEDICAID INSTITUTE AT UNITED HOSPITAL FUND 2
3 Medicaid Regional Data Compendium, 214 Diagnosis and Provider Data Top 25 Diagnostic Categories of All-Payer Inpatient Admissions (212) Rank Diagnosis Category Number of Discharges Percent of Discharges Statewide Percentage 1 Liveborn 13, % 9.43% 2 Septicemia (except in labor) 5, % 3.3% 3 Osteoarthritis 4, % 2.5% 4 Congestive heart failure; nonhypertensive 3, % 2.28% 5 Mood disorders 3, % 2.49% 6 Pneumonia (except that caused by tuberculosis or sexually transmitted disease) 3, % 2.19% 7 Cardiac dysrhythmias 2, % 2.2% 8 Spondylosis; intervertebral disc disorders; other back problems 2, % 1.39% 9 Skin and subcutaneous tissue infections 2, % 1.73% 1 Acute myocardial infarction 2, % 1.4% 11 Chronic obstructive pulmonary disease and bronchiectasis 2, % 1.48% 12 Complication of device; implant or graft 2, % 1.52% 13 Acute cerebrovascular disease 2, % 1.31% 14 Urinary tract infections 2,13 1.5% 1.36% 15 OB-related trauma to perineum and vulva 2, % 1.26% 16 Diabetes mellitus with complications 2, % 1.52% 17 Schizophrenia and other psychotic disorders 1, % 1.69% 18 Alcohol-related disorders 1, % 1.85% 19 Other complications of birth; puerperium affecting management of mother 1,9 1.34% 1.61% 2 Other complications of pregnancy 1, % 1.34% 21 Complications of surgical procedures or medical care 1, % 1.3% 22 Coronary atherosclerosis and other heart disease 1, % 1.67% 23 Previous C-section 1, % 1.16% 24 Respiratory failure; insufficiency; arrest (adult) 1, %.67% 25 Intestinal obstruction without hernia 1, %.79% Total of Top 25 74, % 48.53% All Other Diagnoses 67, % 51.47% Total for Region 141,979 Top Five Inpatient Providers Serving the Region s Medicaid Beneficiaries (213) Provider Name Number of Claims Number of Unique Patients Percent of Unique Patients Strong Memorial Hospital 18,51 8, % Rochester General Hospital 12,58 6, % Highland Hospital of Rochester 7,51 4, % Unity Hospital Rochester 6,533 3, % Arnot Ogden Medical Center 2,951 2, % Total of Top Five Providers 47,13 MEDICAID INSTITUTE AT UNITED HOSPITAL FUND 3
4 Medicaid Regional Data Compendium, 214 Visit Rates (Unadjusted) Emergency Room Visit Rate per 1, Members 7, 6, 5, 4, 3, 2, 1, Inpatient Admission Rate per 1, Members 2,5 1/211 2/211 3/211 4/211 5/211 6/211 7/211 8/211 9/211 1/211 11/211 12/211 1/212 2/212 3/212 4/212 5/212 6/212 7/212 8/212 9/212 1/212 11/212 12/212 1/213 2/213 3/213 4/213 5/213 6/213 7/213 8/213 9/213 1/213 11/213 12/213 2, 1,5 1, 5 Primary Care Visit Rate per 1, Members 4, 35, 3, 25, 2, 15, 1, 5, 1/211 2/211 3/211 4/211 5/211 6/211 7/211 8/211 9/211 1/211 11/211 12/211 1/212 2/212 3/212 4/212 5/212 6/212 7/212 8/212 9/212 1/212 11/212 12/212 1/213 2/213 3/213 4/213 5/213 6/213 7/213 8/213 9/213 1/213 11/213 12/213 1/211 2/211 3/211 4/211 5/211 6/211 7/211 8/211 9/211 1/211 11/211 12/211 1/212 2/212 3/212 4/212 5/212 6/212 7/212 8/212 9/212 1/212 11/212 12/212 1/213 2/213 3/213 4/213 5/213 6/213 7/213 8/213 9/213 1/213 11/213 12/213 Finger Lakes State MEDICAID INSTITUTE AT UNITED HOSPITAL FUND 4
5 Medicaid Regional Data Compendium, 214 Quality Measures Potentially Preventable Emergency Room Visits (Rate per 1, Members) Finger Lakes (Observed) Finger Lakes (Expected) State (Observed) 38,37 36,8 45,81 Prevention Quality Indicators for Adult Discharges (Hospitalization Rate per 1, Members) 2, 1,8 1,6 1,4 1,2 1, Diabetes Overall Respiratory Overall Circulatory Overall Dehydration UTI Adult Acute Adult Chronic Adult Composite Prevention Quality Indicators for Pediatric Discharges (Hospitalization Rate per 1, Members) Asthma Diabetes Short- Term Gastroenteritis UTI Pediatric Acute Pediatric Chronic Pediatric Composite Finger Lakes (Observed) Finger Lakes (Expected) State (Observed) Note: All expected rates are standardized for age, sex, and race/ethnicity. Quality measures are annual rates for 212. MEDICAID INSTITUTE AT UNITED HOSPITAL FUND 5
6 Medicaid Regional Data Compendium, 214 DSRIP Project Design Grants Awarded in the Region Provider Name Counties Served Total Award Conditions Public Hospital Finger Lakes PPS Allegany, Cayuga, Chemung, Genesee, Livingston, Monroe, Ontario, Orleans, Schuyler, Seneca, Steuben, Wayne, Wyoming, Yates $1,, None at this time MEDICAID INSTITUTE AT UNITED HOSPITAL FUND 6
Very large per-capita Medicaid population.
MEDICAID INSTITUTE AT UNITED HOSPITAL FUND Medicaid Regional Data Compendium, 214 Chartbook 2: New York City This chartbook is part of a broader data compendium from the Medicaid Institute at United Hospital
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