Real world health care experiences

Real world health care experiences from over 150 million unique individuals since 1993

Optum Research Data

Assets

Linkages • Social Security Administration death file • Consumer socioeconomic database • Self-reported health risk assessments

Clinical • Medical groups’ EMR/EHRs • Integrated delivery networks’ EMR/EHRs • Hospitals’ EMR/EHRs

Administrative • Affiliated health plans • Optum employer customer health plans • Optum payer customer health plans

Cumulative population counts through 20141,2,3,4

Some segments with history since 1993. A

ffilia

ted

Adm

inis

trativ

e O

ptum

Em

ploy

er

Adm

inis

trativ

e O

ptum

C

linic

al

Optum Payer Administrative

(not linked)

5.7M

12.3M

20.4M

3.9M

57.6M

0.1M

1.6M

0.2M

8.4M

30.7M

29.6M

Unique Lives Linkable Assets: 144.4M Optum Payer: 26.1M

Optum share5 of US population in 2014, by segment

Administrative Data Clinical Data

Commercially Insured6

Medicare Advantage7

Medicare PDP Only7

Population w/Healthcare

Utilization8

30.6M 3.2M 5.7M 18.4M

19% 19% 24%

7%

Optum’s research data assets originate from providers’ EMR/EHR systems, as well as from the administrative claims and enrollment systems of both affiliated and non-affiliated health plans. Well over 150 million unique lives are available from across all payer types. In 2014, approximately 19% of the US population in commercial health plans, 19% of those in Medicare Advantage plans, and 24% of those in Medicare PDP only plans were represented in Optum’s administrative data assets. In addition, 7% of the US population with any health care utilization, regardless of insurance, were represented in Optum’s clinical data assets.

optum.com

Affiliated Health Plans, Commercially Insured Population with Medical and Pharmacy Benefits9,10

ADMINISTRATIVE DATA

Annual and cumulative membership, 1993-2014

Minimum available continuous enrollment11, millions of members, through 2014

Medical Claims12

Pharmacy Claims13

Lab Results14,15

% with 1 or more, all time 86% 75% 45%

Per member per year, all time 10.0 9.3 15.8

Record volume in 2014 108.6M 107.1M 114.7M

Utilization and densities through 2014

Age groups16, 2014

Census region16, 2014

Gender16, 2014

West: 20%

Mid- west: 24%

South: 38%

Northeast: 18%

0-9 10-17 18-24 25-34 35-44 45-54 55-64 65-74 75+

Optum17 1.6M 1.5M 1.4M 2.5M 2.3M 2.3M 1.8M 0.4M 0.1M

% ofOptum 12% 11% 10% 18% 17% 17% 13% 3% 1%

US Est.6 12% 12% 11% 15% 16% 18% 16% 1% 0%

OptumUS

M F

Optum17 6.9M 7.1M% of

Optum 49% 51%

US Est.6 50% 50%

F51%

M49%

optum.com

WestMid-west South

North-east

Optum17 2.8M 3.3M 5.3M 2.5M

% ofOptum 20% 24% 38% 18%

US Est.6 23% 23% 35% 19%

1.1M

1.4M

1.7M

2.2M

3.0M

4.2M

4.8M

5.5M 12

.0M

12.4

M

14.2

M

14.2

M

17.2

M

17.7

M

17.7

M

16.7

M

15.4

M

14.7

M

14.6

M

14.4

M

14.6

M

13.9

M

'93

'94

'95

'96

'97

'98

'99

'00

'01

'02

'03

'04

'05

'06

'07

'08

'09

'10

'11

'12

'13

'14

63.1MCumulative Total:

46.0M

19.9M

63.1M

30.6M20.7M

14.1M9.7M

28.2M

12.4M 7.9M 5.1M 2.9M

AllTime

Most Recent 5 Years

Avg. months enrolled:31.8

1+Day

12+Months

24+Months

36+Months

48+Months

60+Months

Affiliated Health Plans, Commercially Insured Population with Medical Benefits Only9,10

ADMINISTRATIVE DATA



Medical Claims12

Lab Results14,15

% with 1 or more, all time 76% 45%

Per member per year, all time 11.8 16.9

Record volume in 2014 108.1M 94.6M


Age groups16, 2014


Gender16, 2014

West: 16%

Mid- west: 22%

South: 46%

Northeast: 17%

optum.com

M F


Optum 49% 51%

US Est.6 50% 50%

F 51%

M 49%

WestMid-west South

North-east

Optum17 1.9M 2.7M 5.6M 2.0M

% ofOptum 16% 22% 46% 17%

US Est.6 23% 23% 35% 19%

0-9 10-17 18-24 25-34 35-44 45-54 55-64 65-74 75+

Optum17 1.4M 1.3M 1.3M 1.8M 1.7M 1.8M 1.6M 0.8M 0.6M

% ofOptum 11% 10% 10% 14% 14% 15% 13% 7% 5%

US Est.6 12% 12% 11% 15% 16% 18% 16% 1% 0%

OptumUS

0.1M

0.3M

0.3M

0.4M

0.3M

0.5M

0.5M

0.9M 7.

0M

7.5M

7.9M 9.2M 10.2

M

10.1

M

9.7M

9.8M

9.7M

9.9M 11.0

M

12.3

M

13.0

M

12.3

M

'93

'94

'95

'96

'97

'98

'99

'00

'01

'02

'03

'04

'05

'06

'07

'08

'09

'10

'11

'12

'13

'14


29.0M

16.1M

39.4M

20.0M14.2M

9.8M7.1M

21.3M

11.6M7.9M 5.4M 3.5M

AllTime

Most Recent 5 Years


1+Day

12+Months

24+Months

36+Months

48+Months

60+Months

Affiliated Health Plans, Medicare Advantage Population with Medical and Pharmacy Benefits9,10

ADMINISTRATIVE DATA




Age groups16, 2014


Gender16, 2014

West: 31%

Mid- west: 22%

South: 33%

Northeast: 15%

optum.com

Medical Claims12

Pharmacy Claims13

Lab Results14,15




WestMid-west South

North-east

Optum17 1.0M 0.7M 1.0M 0.5M

% ofOptum 31% 22% 33% 15%

US Est.18,19 23% 23% 35% 19%

M FOptum17 1.4M 1.8M

% ofOptum 43% 57%

US Est.18,19 43% 57%

F57%

M43%

0.0M

0.0M

0.0M

0.1M

0.2M 0.4M

0.4M

0.4M

0.4M

0.3M

0.4M

0.4M 1.

3M 1.7M

1.6M

1.7M 1.9M 2.3M 2.4M 2.7M 3.0M

3.2M

'93

'94

'95

'96

'97

'98

'99

'00

'01

'02

'03

'04

'05

'06

'07

'08

'09

'10

'11

'12

'13

'14


5.1M

3.9M

6.4M

3.7M2.8M

2.1M1.4M

4.7M

2.8M2.1M

1.5M1.0M

AllTime

Most Recent 5 Years


1+Day

12+Months

24+Months

36+Months

48+Months

60+Months

0-55 55-64 65-74 75+

Optum17 0.1M 0.2M 1.5M 1.3M

% ofOptum 4% 7% 47% 42%

US Est.18,19 6% 8% 49% 38%

OptumUS

Affiliated Health Plans, Medicare PDP Population with Pharmacy Benefits Only9,10

ADMINISTRATIVE DATA




Age groups16, 2014


Gender16, 2014

West: 18%

Mid- west: 21%

South: 39%

Northeast: 23%

optum.com

Pharmacy Claims13

% with 1 or more, all time 89%

Per member per year, all time 41.9

Record volume in 2014 207.5M

M FOptum17 2.3M 3.3M

% ofOptum 40% 60%

US Est.18,19 41% 59%

F60%

M40%

WestMid-west South

North-east

Optum17 1.0M 1.2M 2.2M 1.2M

% ofOptum 18% 21% 40% 21%

US Est.18,19 23% 23% 35% 19%

5.0M 5.3M

4.5M

4.7M 5.0M 5.2M

4.6M 5.

6M

5.7M

'06

'07

'08

'09

'10

'11

'12

'13

'14


10.2M

7.7M

12.4M

7.4M5.4M 4.2M

3.2M

9.2M

5.4M3.7M 2.9M 2.1M

AllTime

Most Recent 5 Years


1+Day

12+Months

24+Months

36+Months

48+Months

60+Months

0-55 55-64 65-74 75+

Optum17 0.4M 0.4M 2.5M 2.3M

% ofOptum 7% 7% 44% 42%

US Est.18,19 13% 9% 41% 37%

OptumUS

Affiliated Health Plans, Linkages Note: Not all linkages are available in all affiliated segments. See footnotes for details.

LINKED DATA

Benefit plan design data20, annual and cumulative membership, 2001-2014

STD, LTD and WC benefits21,22,23, annual and cumulative membership, 2001-2014

Pharmacy benefit structure, e.g.: •Tier levels, types and cost sharing •Premiums, deductibles, copays, coinsurance, limits, thresholds

•Mail order benefits Medical benefit structure, e.g.: • In- and out-of-network copays and coinsurance

• Individual and family deductibles and out-of-pocket thresholds

10.3% have short term disability, long term disability, or workers' compensation cases.

optum.com

Socioeconomic data31, annual and cumulative membership with at least one valid, non-missing socioeconomic attribute, 2007- 2014

Availability of selected socio-economic attributes:

Education 100%

Language 99%

Race/ethnicity 96%

Net worth 92%

Home ownership 78%

Household income 69%

5.8M 7.1M 9.0M 11.1

M

12.6

M

19.3

M

20.3

M

19.6

M

19.4

M

19.5

M

19.9

M

19.4

M

20.8

M

20.7

M

'01

'02

'03

'04

'05

'06

'07

'08

'09

'10

'11

'12

'13

'14


0k 1k 66k 33

8k

352k

439k 65

4k 794k

629k

700k

620k

600k

598k

407k

'01

'02

'03

'04

'05

'06

'07

'08

'09

'10

'11

'12

'13

'14

2,348kCumulative Total:

20.1

M

19.6

M

19.0

M

18.9

M

19.3

M

19.7

M

20.0

M

18.9

M

'07

'08

'09

'10

'11

'12

'13

'14



LINKED DATA

Oncology management data26, annual and cumulative membership, 2008-2014

Health risk assessments27,28, annual and cumulative membership, 2009- 2014

Availability of selected clinical attributes:

Availability of selected self-reported attributes:

optum.com

Current clinical status 96%

Histology 95%

Stage at diagnosis 89%

Tumor types: Breast 59%

Lung 14%

Prostate 12%

Colon 11%

Rectal 4%

Health status 100%

Height, weight, BMI, BSA 99%

Stress 98%

Tobacco use 98%

Alcohol use 98%

Pain 94%

Physical/emotional problems 90%

Sleep 84%

Clinical information from EMRs/EHRs during health plan enrollment24,25, annual and cumulative membership, 2007-2014

Availability of selected clinical attributes during health plan enrollment:

Is notes eligible 83%Has diagnosis 68%Has lab result 67%

Has vital sign measurement 57%In an IDN 55%

Has RX administration 19%

5k 7k 13k 23

k

21k

19k

15k

'08

'09

'10

'11

'12

'13

'14

91.6kCumulative Total:

0.9M 1.1M 1.2M 1.4M 1.

7M 1.8M

1.8M

1.6M

'07

'08

'09

'10

'11

'12

'13

'14


0.3M 0.

7M 0.8M 1.

2M

1.2M

1.0M

'09

'10

'11

'12

'13

'14



LINKED DATA

Primary data collection population32 as of January 31, 2015

4.7M available for prospective data collection including direct-to-patient survey, medical chart review, medical device information, NDI link, etc., as of January 31, 2015.

optum.com

West: 23%

Mid- west: 25%

South: 45%

Northeast: 7% White 62%

Hispanic 13%

Black 10%

Asian 5%

Unknown 10%

Age Gender

Census region Race/ethnicity

Availability of direct-to-patient contact methods:

Phone number 66%

Opt-in email address 8%

Mortality29,30, full date of annual and cumulative deaths during enrollment, 1993-2014

2k 3k 5k 7k 12k

19k

27k

30k

97k

103k

101k

104k

131k

157k

157k

166k

170k

173k

160k

105k

101k

60k

'93

'94

'95

'96

'97

'98

'99

'00

'01

'02

'03

'04

'05

'06

'07

'08

'09

'10

'11

'12

'13

'14

1,890kCumulative Total:

Provider-based Clinical EMR/EHR Systems 34 EMR/EHR Systems Contributing9,33

CLINICAL DATA

Annual and cumulative patients, 2007-2014

Minimum available clinical observation periods34, millions of patients, through 2014


Age groups38, 2014


Gender38, 2014

West: 13%

Mid- west: 32%

South: 45%

Northeast: 9%

optum.com

Vital

Signs35 Drug

Admins36 Lab

Results37 % with 1 or more, all time 65% 25% 57%

Per patient per year, all time 11.1 3.0 20.5


0-9 10-17 18-24 25-34 35-44 45-54 55-64 65-74 75+

Optum17 1.1M 0.9M 0.9M 1.4M 1.5M 1.8M 1.8M 1.4M 1.2M

% ofOptum 10% 8% 7% 12% 12% 15% 15% 11% 10%

US Est.39,40 13% 10% 8% 13% 12% 14% 14% 9% 8%

OptumUS

M F


Optum 43% 57%

US Est.39,40 47% 53%

F57%

M43%

WestMid-west South

North-east

Optum17 0.4M 1.5M 1.6M 0.1M

% ofOptum 12% 40% 45% 3%

US Est.39,40 24% 21% 37% 18%

13.0

M

14.6

M

16.4

M

18.5

M

20.6

M

21.5

M

20.7

M

18.4

M

'07

'08

'09

'10

'11

'12

'13

'14


23.5M

21.6M

36.5M

20.3M 17.4M14.5M

11.7M

32.9M

18.1M14.6M

10.6M2.9M

AllTime

Most Recent 5 Years

Avg. months observed:38.9

1+Day

12+Months

24+Months

36+Months

48+Months

60+Months

Provider-based Clinical EMR/EHR Systems Linked to Health Plan Data9,33,41

CLINICAL DATA

Annual and cumulative patients, 2007-2014

Minimum available clinical observation periods34, millions of patients, through 2014


Age groups38, 2014


Gender38, 2014

West: 11%

Mid- west: 49%

South: 38%

Northeast: 2%

optum.com

Vital

Signs35 Drug

Admins36 Lab

Results37 % with 1 or more, all time 70% 24% 61%

Per patient per year, all time 10.7 2.2 20.1


0-9 10-17 18-24 25-34 35-44 45-54 55-64 65-74 75+

Optum17 149k 160k 156k 274k 319k 371k 350k 261k 173k

% ofOptum 7% 7% 7% 12% 14% 17% 16% 12% 8%

US Est.39,40 13% 10% 8% 13% 12% 14% 14% 9% 8%

OptumUS

M F


Optum 43% 57%

US Est.39,40 47% 53%

F57%

M43%

WestMid-west South

North-east

Optum17 97k 428k 331k 15k

% ofOptum 11% 49% 38% 2%

US Est.39,40 24% 21% 37% 18%

2.0M 2.3M 2.7M 3.

1M 3.5M 3.6M

3.6M

3.2M

'07

'08

'09

'10

'11

'12

'13

'14


3.9M

3.7M

5.8M

3.4M3.0M

2.4M1.9M

5.3M

3.1M2.6M

1.8M0.5M

AllTime

Most Recent 5 Years

Avg. months observed:41.0

1+Day

12+Months

24+Months

36+Months

48+Months

60+Months

Optum Payer Customers’ Health Plans42,43

Commercially Insured Population with Medical and Pharmacy Benefits 14 data contributors

ADMINISTRATIVE DATA

Annual and cumulative membership, 2004-Q3 2014

Minimum available continuous enrollment11, millions of members, through Q3 2014

Utilization and densities through Q3 2014

Age groups16, 2014


Gender16, 2014

West: 1%

Mid- west: 18%

South: 40%

Northeast: 42%

optum.com

Medical Claims12

Pharmacy Claims13

Lab Results14,15




0-9 10-17 18-24 25-34 35-44 45-54 55-64 65-74 75+

Optum17 202k 203k 217k 337k 303k 364k 348k 80k 15k% of

Optum 10% 10% 10% 16% 15% 18% 17% 4% 1%

US Est.6 12% 12% 11% 15% 16% 18% 16% 1% 0%

OptumUS

WestMid-west South

North-east

Optum17 14k 368k 821k 866k

% of Optum 1% 18% 40% 42%US

Estimate6 23% 23% 35% 19%

(Q3)

M F


Optum 49% 51%

US Est.6 50% 50%

F51%

M49%

8.8M

9.1M

8.0M

7.9M

7.1M

5.8M

4.7M

4.6M

3.9M

3.6M

2.1M

'04

'05

'06

'07

'08

'09

'10

'11

'12

'13

'14


14.7M

5.3M

20.4M

10.1M6.3M

4.5M2.7M

8.4M

3.3M 2.2M 0.9M 0.6M

AllTime

Most Recent 5 Years


1+Day

12+Months

24+Months

36+Months

48+Months

60+Months

Optum Payer Customers’ Health Plans42,43

Commercially Insured Population with Medical Benefits Only 13 data contributors

ADMINISTRATIVE DATA




Age groups16, 2014


Gender16, 2014

West: 1%

Mid- west:

0%

South: 41%

Northeast: 58%

optum.com

Medical Claims12

Lab Results14,15

% with 1 or more, all time 79% 6%

Per member per year, all time 13.4 23.6

Record volume in 2014 1.4M 0.3M

(Q3)

0-9 10-17 18-24 25-34 35-44 45-54 55-64 65-74 75+


Optum 10% 10% 11% 14% 14% 17% 15% 6% 2%

US Est.6 12% 12% 11% 15% 16% 18% 16% 1% 0%

OptumUS

WestMid-west South

North-east

Optum17 2k 1k 74k 106k

% of Optum 1% 0% 41% 58%US

Estimate6 23% 23% 35% 19%

M F

Optum17 88k 95k% of

Optum 48% 52%

US Est.6 50% 50%

F52%

M48%

2.7M 2.9M

3.0M

1.4M 1.6M

1.1M

0.9M

1.0M 1.1M

0.9M

0.2M

'04

'05

'06

'07

'08

'09

'10

'11

'12

'13

'14


4.1M

1.2M

5.7M

3.1M

1.1M 0.7M 0.4M1.8M0.6M 0.4M 0.1M 0.0M

AllTime

Most Recent 5 Years


1+Day

12+Months

24+Months

36+Months

48+Months

60+Months

Optum Employer Customers’ Health Plans45,46

Commercially Insured Population with Medical and Pharmacy Benefits 57 data contributors

ADMINISTRATIVE DATA




Age groups16, 2014


Gender16, 2014

West: 14%

Mid- west: 31%

South: 36%

Northeast: 19%

optum.com

(Q2)

% with >1,

all time

Per member per year, all time

Activity volume,

2014

Medical Claims12 80% 14.5 27.5M

Pharmacy Claims13 75% 12.7 33.4M

Lab Results14,15 5% 0.9 306k

STD, LTD and WC Cases47 6% 0.03 34k

HRA Surveys48 13% 0.1 39k

Linked EMRs/EHRs 2% n/a n/a

0-9 10-17 18-24 25-34 35-44 45-54 55-64 65-74 75+


Optum 8% 9% 10% 10% 13% 19% 21% 6% 4%

US Est.6 12% 12% 11% 15% 16% 18% 16% 1% 0%

OptumUS

M F


Optum 44% 56%US

Estimate6 50% 50%

F56%

M44%

WestMid-west South

North-east

Optum17 179k 401k 456k 241k

% ofOptum 14% 31% 36% 19%

US Est.6 23% 23% 35% 19%

0.0M

0.1M 0.4M

1.9M 2.1M 3.

3M 3.7M 4.

4M 4.6M 5.0M

4.2M

4.1M

3.7M

2.4M

'01

'02

'03

'04

'05

'06

'07

'08

'09

'10

'11

'12

'13

'14


6.5M

5.1M

8.4M

5.0M3.9M

3.1M 2.5M

6.6M

3.4M2.4M

1.8M 0.9M

AllTime

Most Recent 5 Years


1+Day

12+Months

24+Months

36+Months

48+Months

60+Months

1. Optum Payer administrative data includes commercial members, Medicaid members (1.6M not shown elsewhere in this document), and Medicare members (438k not shown elsewhere in this document) through Q3 2014. Optum Employer administrative data includes commercial members through Q2 2014. All other sources through Q4 2014. Affiliated health plan administrative data includes 753k Medicare Advantage members with medical benefits only (not shown elsewhere in this document).

2. Areas are mutually exclusive and not to scale. Curved labels denote counts for the entire circle. Each discrete area formed by the overlapping circles is also labeled with its mutually exclusive count.

3. Optum Payer and Employer member counts exclude members where an affiliated health plan is the payer.

4. Members that have multiple discreet enrollment periods are categorized in the segment where they have the longest continuous period of enrollment. Enrollment periods are combined if separated by 32 days or less.

5. Administrative population segments include commercial and Medicare members of affiliated plans, and commercial members of Optum Employer customers’ and Optum Payer customers’ health plans who were enrolled any time in 2014. Optum clinical population includes unique patients who had clinical activity any time in 2014.

6. Source of estimate of US commercially insured population: US Census Bureau, Current Population Survey, Annual Social and Economic Supplement, 2014. Health insurance questions asked respondents about their status in the previous year (2013). Accessed at http://www.census.gov/cps/data/cpstablecreator.html.

7. Source of estimate of US Medicare Advantage and Medicare PDP populations: US Department of Health & Human Services, Centers for Medicare & Medicaid Services, Monthly enrollment by plan report for December 2014. Accessed at http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MCRAdvPartDEnrolData/Monthly-Enrollment-by-Plan.html.

8. Source of estimate of US healthcare utilizers: US Department of Health & Human Services, Agency for Healthcare Research & Quality, Medical Expenditure Panel Survey (MEPS), Projected Expenditure Data File for 2014. Percent of US population with non-zero medical expenditures found from MEPS and applied to 2014 US population estimate for 2014 from US Census Bureau, Current Population Survey to obtain denominator. MEPS data accessed at http://meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=NHEA-Aligned MEPS. US Census data accessed at http://www.census.gov/cps/data/cpstablecreator.html.

9. Statistics current through December 31, 2014. 10. Members counted here may also be counted in other

administrative segments because they can move between segments over time. Members do not appear in multiple administrative segments during the same period of time.

11. The longest continuous period of enrollment is selected for members that have multiple discreet enrollment periods. Enrollment periods are combined if separated by 32 days or

less. 12. A medical claim is defined as a unique combination of

member, provider, and service date. 13. A pharmacy claim is defined as a unique combination of

member, valid NDC code, and fill date. 14. A lab result is defined as a unique combination of member,

valid LOINC code, and result date. 15. Lab results per member per year calculated for members with

at least one result. 16. Includes members enrolled at any time in 2014. 17. Excludes members where attribute is unknown. 18. Source of US estimate of Medicare Advantage and Medicare

PDP populations by age & sex: US Department of Health & Human Services, Centers for Medicare & Medicaid, CMS Statistics Reference Booklet, 2014. Accessed at http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMS-Statistics-Reference-Booklet/2014.html.

19. Source of US estimate of Medicare Advantage and Medicare PDP populations by census regions: US Department of Health & Human Services, Centers for Medicare & Medicaid, MA State/County Penetration Report, December 2014. Accessed at http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MCRAdvPartDEnrolData/MA-State-County-Penetration.html.

20. Pharmacy benefit design data can be linked for members with pharmacy benefits in a subset of affiliated health plans.

21. Short term disability (STD), long term disability (LTD), and workers' compensation (WC) cases can be linked for members employed by Optum Employer customers using affiliated health plans.

22. Additional STD, LTD, and WC case data (not shown) are available for members employed by Optum Employer customers using non-affiliated health plans.

23. STD, LTD and WC cases available through June 30, 2014. 24. Includes members with at least one clinical data point during

active health plan enrollment. 25. Additional linked clinical data (not shown) is available for

members employed by Optum Employer customers using non-affiliated health plans.

26. Oncology management data can be linked to fully insured members in affiliated commercial health plans.

27. Health risk assessment (HRA) data can be linked to members in affiliated commercial health plans.

28. Additional linked HRA data (not shown here) is available for members employed by Optum Employer customers using non-affiliated health plans.

29. The Social Security Administration began restricting reported deaths available in their Death Master File in November 2011.

30. Death data can be linked to members in all affiliated health plans, except Medicare PDP plans.

31. Shows cumulative and annual counts of members with at least one valid, non-missing attribute. Socioeconomic data can be linked to members in all affiliated health plans, except Medicare PDP plans.

32. Primary data collection can be performed with fully insured members in affiliated commercial health plans.

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28. Patients without sufficient clinical data to meet a minimum quality threshold are excluded.

29. The minimum available clinical observation period for each patient is determined by the earliest and latest dates of clinical activity.

30. A vital sign is defined as a unique combination of patient ID, observation date and valid clinical observation of height, weight, BMI, blood pressure, heart rate, temperature, spirometry tests, ejection fraction measurements, or T&Z scores.

31. A drug administration is defined as a unique combination of patient ID, administration date, and valid NDC code for a drug administration given by a provider or at a provider's location.

32. A lab result is defined as a unique combination of patient ID, lab result date, and valid LOINC code.

33. Includes patients with at least one clinical observation at any time in 2014.

34. Source of US estimate of healthcare utilizers by age & sex: US Department of Health & Human Services, Agency for Healthcare Research & Quality, Medical Expenditure Panel Survey (MEPS), Projected Expenditure Data File for 2014. Percent of US population with non-zero medical expenditures found from MEPS and applied to 2014 US population estimate for 2014 from US Census Bureau, Current Population Survey to obtain denominator. MEPS data accessed at http://meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=NHEA-Aligned MEPS. US Census data accessed at http://www.census.gov/cps/data/cpstablecreator.html.

35. Source of estimate for total US population by census regions:

US Census Bureau, Current Population Survey, Annual Social and Economic Supplement, 2014. Health insurance questions asked respondents about their status in the previous year (2013). Accessed at http://www.census.gov/cps/data/cpstablecreator.html.

36. Population includes linked patients that have both clinical activity and health plan enrollment any time between 2007 and 2014.

37. Statistics current through September 30, 2014. 38. Members are not linked with any other sources, however

members from affiliated health plans have been excluded at the plan level.

39. Source of US estimate of Medicaid population: US Census Bureau, Current Population Survey, Annual Social and Economic Supplement, 2014. Health insurance questions asked respondents about their status in the previous year (2013). Accessed at http://www.census.gov/cps/data/cpstablecreator.html.

40. Statistics current through June 30, 2014. 41. Counts exclude members where an affiliated health plan is the

payer. 42. An STD, LTD, and WC case is defined as a unique

combination of member and incident date. Percent with at least one case, and cases per member per year are calculated based on the subset of employers that contribute this type of data.

43. An HRA is defined as a unique combination of member and HRA completion date. Percent with at least one HRA, and HRAs per member per year are calculated based on the subset of employers that contribute this type of data.

Footnotes

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