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ANNUAL PROGRAM EVALUATION Addendum: Adult Annual Utilization

2014

V a l u e O p t i o n s - C T A n n u a l Q M / U M E v a l u a t i o n


Contents I. EVALUATION OF 2014 QM/UM PROJECT PLAN ADDENDUM ............................................................... 4

Goal 11: Monitor for under or over-utilization of behavioral health services; identify barriers and opportunities ........................................................................................................................................ 4

Adult Membership: ............................................................................................................................... 4

Adult Inpatient Psychiatric Hospitalization ........................................................................................... 7

Inpatient Detox – Hospital .................................................................................................................. 11

Inpatient Detox – Freestanding .......................................................................................................... 17

Mental Health Group Home ............................................................................................................... 20

Partial Hospitalization Program .......................................................................................................... 23

Intensive Outpatient Services ............................................................................................................. 24

Home Health ....................................................................................................................................... 25

Ambulatory Detox (AMD) ................................................................................................................... 26

Methadone Maintenance (MET)......................................................................................................... 27

Outpatient (OTP/TST).......................................................................................................................... 28


I. EVALUATION OF 2014 QM/UM PROJECT PLAN ADDENDUM Goal 11: Monitor for under or over-utilization of behavioral health services; identify barriers and opportunities

Description of activities and findings that include trending and analysis of the measures to assess performance over time:

Adult Membership:

Membership by Benefit Group

• Membership figures are based on the number of unique individuals in any membership group that were eligible during the reporting period.

• Total adult membership increased by 18.0% from 2013 to 2014 (473,754 to 559,190). This increase in membership is related to the implementation of the Affordable Care Act.

• The HUSKY A (Family Single) population increased by 22,665 members, a 10.9% increase since 2013.

• The HUKSY D (MLIA) population increased by 70,977 members, a 47.8% increase since 2013.

Membership CY '12 CY '13 CY '14HUSKY A (Family Single) 204,164 208,329 230,994HUSKY B 1,845 1,710 1,891HUSKY C (ABD Single) 40,076 38,521 37,058HUSKY C (LTC Single) 3,532 2,773 2,762HUSKY D (MLIA) 136,557 148,558 219,535All Benefits Duals Removed (Adult) 380,388 391,674 476,228All Benefits With Duals (Adult) 458,307 473,754 559,190Total Membership (Inc Youth) 777,265 796,769 894,651


Data Refresh

Since the implementation of the Affordable Care Act (ACA) in Q1 ’14, the impact of the data refresh has returned to a more historical level, indicating that efforts to process new enrollees has mostly caught up with the bolus in enrollment that occurred in the early implementation of the ACA. It is anticipated that the magnitude of the data refresh will be greater during periods of open enrollment. This refresh rate will continue to be monitored in anticipation of future such enrollment periods. Composition of Membership

The following graph and table are to be used in tandem to provide information about the profile of membership for the current reporting period. The graph titled “Composition of Membership” displays the volume of members by benefit group for the reporting period, which provides context to the tabulation of Admits/1,000 by benefit group and level of care. This table serves not only to compare utilization of one level of care by benefit group (vertical comparison), but also to compare the utilization of all levels of care for each benefit group (horizontal comparison).

Q1 '13 Q2 '13 Q3 '13 Q4 '13 Q1 '14 Q2 '14 Q3 '14 Q4 '14Original 316,408 320,017 321,524 325,868 355,844 392,991 412,481 427,909Refresh One Quarter Later 320,068 325,881 327,205 331,992 382,207 403,166 419,213 437,987Pct Change 1.16% 1.83% 1.77% 1.88% 7.41% 2.59% 1.63% 2.36%

Refresh Percent Change by QuartersAll Benefit Groups - Duals Removed

Admits/1,000 in 2014 IPF IPDH IPDF PHP IOP AMD MET OTPHUSKY A (Family Single) 0.69 0.10 0.48 0.27 1.25 0.05 0.39 12.05HUSKY B 1.63 0.00 0.10 0.61 0.61 0.00 0.10 10.40HUSKY C (ABD Single) 5.82 0.77 1.81 1.12 3.83 0.06 0.93 18.83HUSKY C (LTC Single) 1.88 0.00 0.00 0.00 0.00 0.00 0.05 25.46HUSKY D (MLIA) 2.58 0.88 4.10 1.45 5.75 0.17 2.10 21.80All Benefits Duals Removed 1.92 0.49 2.15 0.85 3.40 0.10 1.17 16.86


• Outpatient Services are authorized more often (highest Admits/1,000 rate) than any other level of care for each benefit group and for All Benefits Duals Removed.

• The HUSKY A (Family Single) population is the largest benefit group in adult membership. In 2014, Outpatient authorization rates for HUSKY A members greatly exceeded admission rates at higher levels of care.

• The HUSKY C (ABD Single) population had the greatest utilization of the Inpatient Psychiatric level of care on an Admits/1,000 basis when compared to other benefit groups.

• The HUSKY C (LTC Single) population had the highest Outpatient Admits/1,000 rate. • The HUSKY D (MLIA) population had the most diverse utilization of care of any

benefit group. The HUSKY D (MLIA) population utilized each level of care at the highest Admits/1,000 rate with the exceptions of Inpatient Psychiatric and Outpatient levels of care. HUSKY D (MLIA) Admits/1,000 rate for Freestanding detox (IPDF) are more than double the rate of any other benefit group.


Adult Inpatient Psychiatric Hospitalization

The core measures of utilization for inpatient psychiatric care have remained relatively unchanged from 2012 to 2014. The exception was the decrease in Admits/1,000 for the HUSKY D (MLIA) population in 2014, during the implementation of the Affordable Care Act. Admits/1,000

• The Admits/1,000 for All Benefit Groups decreased by 0.40 from 2013 to 2014, a 17.2% decrease. This is a statistically significant decrease, driven by the increase in membership due to the Affordable Care Act, which primarily impacted the HUSKY D (MLIA) population.

• The Admits/1,000 for HUSKY D (MLIA) decreased by 32.8% from 2013 to 2014. This is a statistically significant change, related to the growth in HUSKY D (MLIA) membership. The actual number of HUSKY D (MLIA) admissions increased slightly from 2013 to 2014 (4,788 to 5,273).

Admits/1,000 CY '12 CY '13 CY '14HUSKY A (Family Single) 0.81 0.74 0.69HUSKY B 0.98 1.73 1.63HUSKY C (ABD Single) 6.47 5.98 5.82HUSKY C (LTC Single) 2.20 1.81 1.88HUSKY D (MLIA) 4.31 3.84 2.58All Benefits Duals Removed 2.52 2.32 1.92

Number of Admits CY '12 CY '13 CY '14HUSKY A (Family Single) 1,577 1,471 1,568HUSKY B 9 15 16HUSKY C (ABD Single) 2,431 2,269 2,162HUSKY C (LTC Single) 48 36 36HUSKY D (MLIA) 4,851 4,788 5,273All Benefits Duals Removed 8,965 8,604 9,055


• The decreases in Admits/1,000 were primarily confined to Q1 ’14, and levelled off in subsequent quarters. (Please see quarterly graphs on page 10).

Days/1,000

The results of Days/1,000 data follow the same trends as the Admits/1,000 data from 2013 to 2014.

Days/1,000 CY '12 CY '13 CY '14HUSKY A (Family Single) 5.76 5.07 5.04HUSKY B 5.33 19.94 8.97HUSKY C (ABD Single) 61.19 58.30 56.09HUSKY C (LTC Single) 40.47 30.34 22.75HUSKY D (MLIA) 34.07 30.60 20.46All Benefits Duals Removed 20.80 19.25 15.84

Number of Cases CY '12 CY '13 CY '14HUSKY A (Family Single) 1,611 1,492 1,589HUSKY B 9 15 16HUSKY C (ABD Single) 2,476 2,327 2,225HUSKY C (LTC Single) 49 36 36HUSKY D (MLIA) 4,947 4,881 5,379All Benefits Duals Removed 9,146 8,778 9,245


Average Length of Stay

• The average length of stay (ALOS) for each benefit group remained relatively unchanged from 2013 to 2014.

• HUSKY A (Family Single) members consistently have the shortest annual ALOS (of graphed benefit groups), ranging from 6.91 days to 7.30 days.

• HUSKY C (ABD Single) members consistently have the longest annual ALOS (of graphed benefit groups), ranging from 9.28 days to 9.81 days.

ALOS CY '12 CY '13 CY '14HUSKY A (Family Single) 7.11 6.91 7.30HUSKY B 5.44 11.53 5.50HUSKY C (ABD Single) 9.28 9.81 9.76HUSKY C (LTC Single) 18.16 16.72 12.43HUSKY D (MLIA) 7.84 7.90 7.92All Benefits Duals Removed 8.16 8.28 8.27

Number of Discharges CY '12 CY '13 CY '14HUSKY A (Family Single) 1,590 1,471 1,557HUSKY B 9 15 16HUSKY C (ABD Single) 2,419 2,264 2,183HUSKY C (LTC Single) 49 36 35HUSKY D (MLIA) 4,855 4,781 5,269All Benefits Duals Removed 8,974 8,593 9,060


Admits/1,000 & Days/1,000: Quarterly

These graphs are provided to illustrate the impact of the Affordable Care Act on the Admits/1,000 and Days/1,000 measures throughout this analysis. The “per 1,000” calculations for HUSKY D (MLIA) decreased dramatically during Q1 ’14, when the Affordable Care Act was implemented, but in subsequent quarters, these measures have remained relatively steady from quarter to quarter.


Inpatient Detox (IPD)

Inpatient Detox – Hospital The utilization of hospital-based detoxification in each benefit group population appears to have reached levels that would be expected in future quarters. The average length of stay had been increasing steadily over the last few quarters, but levelled off in Q4 ‘14.

Admits/1,000

• A change in authorization procedures led to an increase in admissions for hospital-based

detoxification, beginning in March of 2014. There was a statistically significant increase in Admits/1,000 for each graphed benefit group from 2013 to 2014. Quarterly data is included below in order to better review the utilization for this level of care.


Number of Admits CY '12 CY '13 CY '14HUSKY A (Family Single) 67 42 232HUSKY B 0 0 0HUSKY C (ABD Single) 57 40 285HUSKY C (LTC Single) 0 0 0HUSKY D (MLIA) 294 195 1,790All Benefits Duals Removed 426 279 2,307


Admits/1,000: Quarterly

• The Admits/1,000 for each benefit group have decreased slightly from Q3 ’14 to Q4 ’14.

Admits/1,000 Q4 '12 Q1 '13 Q2 '13 Q3 '13 Q4 '13 Q1 '14 Q2 '14 Q3 '14 Q4 '14 Q1 '15HUSKY A (Family Single) 0.02 0.02 0.02 0.02 0.03 0.07 0.12 0.11 0.10 0.11HUSKY B 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00HUSKY C (ABD Single) 0.12 0.19 0.12 0.05 0.06 0.40 0.87 0.94 0.86 0.86HUSKY C (LTC Single) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00HUSKY D (MLIA) 0.18 0.14 0.18 0.18 0.13 0.52 1.07 0.98 0.88 0.73All Benefits Duals Removed 0.09 0.08 0.08 0.08 0.06 0.28 0.59 0.56 0.51 0.45

Number of Admits Q4 '12 Q1 '13 Q2 '13 Q3 '13 Q4 '13 Q1 '14 Q2 '14 Q3 '14 Q4 '14 Q1 '15HUSKY A (Family Single) 12 8 10 10 14 38 70 65 59 65HUSKY B 0 0 0 0 0 0 0 0 0 0HUSKY C (ABD Single) 11 18 11 5 6 38 82 87 78 75HUSKY C (LTC Single) 0 0 0 0 0 0 0 0 0 0HUSKY D (MLIA) 52 42 55 58 40 228 542 523 497 413All Benefits Duals Removed 77 69 77 73 60 304 694 675 634 553


Days/1,000

• A change in authorization procedures led to an increase in Admits/1,000, and therefore Days/1,000, for hospital-based detoxification. This began in March of 2014. Quarterly data is included below in order to better review the utilization for this level of care.


Number of Cases CY '12 CY '13 CY '14HUSKY A (Family Single) 67 42 232HUSKY B 0 0 0HUSKY C (ABD Single) 60 40 286HUSKY C (LTC Single) 0 0 0HUSKY D (MLIA) 298 197 1,792All Benefits Duals Removed 435 281 2,310


Days/1,000: Quarterly

• The Days/1,000 for each benefit group have decreased slightly from Q3 ’14 to Q4 ’14, with the exception of HUSKY A (Family Single), which increased slightly.

Days/1,000 Q4 '12 Q1 '13 Q2 '13 Q3 '13 Q4 '13 Q1 '14 Q2 '14 Q3 '14 Q4 '14 Q1 '15HUSKY A (Family Single) 0.11 0.08 0.09 0.09 0.12 0.29 0.59 0.55 0.61 0.59HUSKY B 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00HUSKY C (ABD Single) 0.70 1.07 0.51 0.27 0.34 2.06 5.86 6.11 5.20 5.14HUSKY C (LTC Single) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00HUSKY D (MLIA) 0.75 0.69 0.85 0.81 0.57 2.57 6.11 6.00 5.26 3.89All Benefits Duals Removed 0.39 0.39 0.39 0.35 0.29 1.37 3.39 3.38 3.04 2.42

Number of Cases Q4 '12 Q1 '13 Q2 '13 Q3 '13 Q4 '13 Q1 '14 Q2 '14 Q3 '14 Q4 '14 Q1 '15HUSKY A (Family Single) 12 8 10 11 15 38 73 70 65 73HUSKY B 0 0 0 0 0 0 0 0 0 0HUSKY C (ABD Single) 12 18 11 5 6 39 88 92 84 79HUSKY C (LTC Single) 0 0 0 0 0 0 0 0 0 0HUSKY D (MLIA) 53 44 59 62 40 230 577 558 533 436All Benefits Duals Removed 79 71 81 78 61 307 738 720 682 588



• The ALOS for each benefit group has increased from 2013 to 2014. Authorizations for this level of care were predominantly completed by CHN until March 2014. Therefore, the increase in ALOS was expected given the complexities/co-morbidities experienced by members admitted to hospitals for detox.

• The change in ALOS from 2013 to 2014 for the HUSKY D (MLIA) population (as well as All Benefit Groups) was calculated to be statistically significant.


Number of Discharges CY '12 CY '13 CY '14HUSKY A (Family Single) 67 42 224HUSKY B 0 0 0HUSKY C (ABD Single) 60 39 282HUSKY C (LTC Single) 0 0 0HUSKY D (MLIA) 298 195 1,769All Benefits Duals Removed 433 278 2,275


Average Length of Stay: Quarterly

• The ALOS for HUSKY A (Family Single) has increased steadily since Q1 ’14.

ALOS Q4 '12 Q1 '13 Q2 '13 Q3 '13 Q4 '13 Q1 '14 Q2 '14 Q3 '14 Q4 '14 Q1 '15HUSKY A (Family Single) 4.50 5.13 3.67 5.40 4.07 4.06 4.69 5.02 6.33 4.96HUSKY B 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00HUSKY C (ABD Single) 5.67 5.61 4.36 5.20 5.60 4.91 6.76 6.40 6.24 6.01HUSKY C (LTC Single) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00HUSKY D (MLIA) 4.35 5.10 4.75 4.34 4.61 5.01 5.65 6.13 5.94 5.32All Benefits Duals Removed 4.58 5.24 4.55 4.53 4.55 4.87 5.69 6.06 6.01 5.36

Number of Discharges Q4 '12 Q1 '13 Q2 '13 Q3 '13 Q4 '13 Q1 '14 Q2 '14 Q3 '14 Q4 '14 Q1 '15HUSKY A (Family Single) 12 8 9 10 15 35 68 64 57 73HUSKY B 0 0 0 0 0 0 0 0 0 0HUSKY C (ABD Single) 12 18 11 5 5 33 83 86 80 75HUSKY C (LTC Single) 0 0 0 0 0 0 0 0 0 0HUSKY D (MLIA) 51 40 55 62 38 195 542 522 510 415All Benefits Duals Removed 77 67 76 77 58 263 693 672 647 563


Inpatient Detox – Freestanding The core measures of utilization for free-standing detoxification have remained relatively unchanged from 2013 to 2014, indicating that there is little change in the utilization of care in the population or daily impact on the behavioral healthcare system.

Admits/1,000

• The Admits/1,000 for All Benefit Groups decreased only slightly from 2013 to 2014, but calculated as statistically significant because of the influx of new membership with the implementation of the Affordable Care Act, which primarily impacted the HUSKY D (MLIA) population.

• The Admits/1,000 for HUSKY D (MLIA) decreased from 2013 to 2014, due to the influx of new membership with the implementation of the Affordable Care Act. This is a statistically significant decrease. The total number of admissions for HUSKY D (MLIA) however, increased by 14.4% from 2013 to 2014.


Number of Admits CY '12 CY '13 CY '14HUSKY A (Family Single) 986 1,029 1,079HUSKY B 4 3 1HUSKY C (ABD Single) 682 658 673HUSKY C (LTC Single) 0 0 0HUSKY D (MLIA) 6,981 7,314 8,364All Benefits Duals Removed 8,662 9,019 10,117


Days/1,000

The results of Days/1,000 data follow the same trends as the Admits/1,000 data from 2013 to 2014.


Number of Cases CY '12 CY '13 CY '14HUSKY A (Family Single) 994 1,039 1,094HUSKY B 4 3 1HUSKY C (ABD Single) 686 659 676HUSKY C (LTC Single) 0 0 0HUSKY D (MLIA) 7,053 7,374 8,437All Benefits Duals Removed 8,746 9,090 10,208



• The ALOS has remained flat across all time periods and benefit groups. Protocol driven detox regimens drive the length of stay at free-standing facilities.

• The change in ALOS from 2013 to 2014 for the HUSKY D (MLIA) population (as well as All Benefit Groups) was statistically significant. This result occurs because small deviations with a large population can indicate statistical significance, without clinical significance.


Number of Discharges CY '12 CY '13 CY '14HUSKY A (Family Single) 984 1,024 1,086HUSKY B 4 3 1HUSKY C (ABD Single) 685 656 673HUSKY C (LTC Single) 0 0 0HUSKY D (MLIA) 6,993 7,302 8,352All Benefits Duals Removed 8,675 8,999 10,112


Mental Health Group Home

Admits/1,000

• There has been minimal change in the Admits/1,000 between CY 2013 and CY

2014.

Admits/1,000 CY '12 CY '13 CY '14HUSKY A (Family Dual) 0.00 0.00 0.00HUSKY A (Family Single) 0.00 0.00 0.00HUSKY B 0.00 0.00 0.00HUSKY C (ABD Dual) 0.09 0.06 0.08HUSKY C (ABD Single) 0.09 0.11 0.09HUSKY C (LTC Dual) 0.00 0.00 0.00HUSKY C (LTC Single) 0.00 0.00 0.00HUSKY D (MLIA) 0.01 0.01 0.00All Benefits Duals Removed 0.01 0.02 0.02

Number of Admits CY '12 CY '13 CY '14HUSKY A (Family Dual) 0 0 0HUSKY A (Family Single) 3 0 1HUSKY B 0 0 0HUSKY C (ABD Dual) 54 39 47HUSKY C (ABD Single) 33 42 34HUSKY C (LTC Dual) 0 0 0HUSKY C (LTC Single) 0 0 0HUSKY D (MLIA) 7 16 8All Benefits Duals Removed 97 97 90


Days/1,000

• There has been minimal change in the Days/1,000 between CY 2013 and CY 2014.

Days/1,000 CY '12 CY '13 CY '14HUSKY A (Family Dual) 0.00 0.00 0.00HUSKY A (Family Single) 0.36 0.14 0.01HUSKY B 0.00 0.00 0.00HUSKY C (ABD Dual) 51.31 49.36 47.45HUSKY C (ABD Single) 60.39 52.36 54.67HUSKY C (LTC Dual) 1.70 0.70 0.00HUSKY C (LTC Single) 0.00 0.00 0.00HUSKY D (MLIA) 1.80 3.79 2.58All Benefits Duals Removed 12.73 12.03 9.85

Number of Cases CY '12 CY '13 CY '14HUSKY A (Family Dual) 0 0 0HUSKY A (Family Single) 4 1 1HUSKY B 0 0 0HUSKY C (ABD Dual) 137 122 123HUSKY C (ABD Single) 98 95 91HUSKY C (LTC Dual) 1 1 0HUSKY C (LTC Single) 0 0 0HUSKY D (MLIA) 13 23 23All Benefits Duals Removed 253 242 238


ALOS

• The ALOS for MH Group Homes continues to increase.

ALOS CY '12 CY '13 CY '14HUSKY A (Family Dual) 0.00 0.00 0.00HUSKY A (Family Single) 110.00 707.00 0.00HUSKY B 0.00 0.00 0.00HUSKY C (ABD Dual) 262.64 464.36 586.78HUSKY C (ABD Single) 249.52 365.38 491.89HUSKY C (LTC Dual) 0.00 731.00 0.00HUSKY C (LTC Single) 0.00 0.00 0.00HUSKY D (MLIA) 273.50 320.50 346.30All Benefits Duals Removed 250.82 415.93 519.56

Number of Discharges CY '12 CY '13 CY '14HUSKY A (Family Dual) 0 0 0HUSKY A (Family Single) 3 1 0HUSKY B 0 0 0HUSKY C (ABD Dual) 59 45 41HUSKY C (ABD Single) 44 40 37HUSKY C (LTC Dual) 0 1 0HUSKY C (LTC Single) 0 0 0HUSKY D (MLIA) 6 8 10All Benefits Duals Removed 112 95 88


E. Day Treatment Programs: Partial Hospital Programs (PHP) and Intensive Outpatient Programs (IOP) Partial Hospitalization Program

• As seen in the Inpatient Psychiatric Facility graphs, the 2014 decreases are limited to Q1 ’14 and primarily due to the increase in enrollment.


Number of Admits CY '12 CY '13 CY '14HUSKY A (Family Single) 733 639 611HUSKY B 2 7 6HUSKY C (ABD Single) 580 461 415HUSKY C (LTC Single) 0 0 0HUSKY D (MLIA) 2,772 2,658 2,956All Benefits Duals Removed 4,099 3,774 3,988


Intensive Outpatient Services





Home Health

Admits/1,000

• The Admits/1,000 for most benefit groups have decreased minimally between CY 2013 and CY 2014.

Admits/1,000 CY '12 CY '13 CY '14HUSKY A (Family Dual) 0.70 0.95 0.66HUSKY A (Family Single) 0.11 0.08 0.08HUSKY B 0.11 0.00 0.10HUSKY C (ABD Dual) 1.50 1.61 1.58HUSKY C (ABD Single) 1.84 2.08 1.95HUSKY C (LTC Dual) 0.06 0.03 0.06HUSKY C (LTC Single) 0.09 0.25 0.21HUSKY D (MLIA) 0.36 0.39 0.28All Benefits Duals Removed 0.51 0.54 0.45

Number of Admits CY '12 CY '13 CY '14HUSKY A (Family Dual) 46 58 43HUSKY A (Family Single) 213 165 186HUSKY B 1 0 1HUSKY C (ABD Dual) 959 991 988HUSKY C (ABD Single) 730 789 725HUSKY C (LTC Dual) 13 6 13HUSKY C (LTC Single) 2 5 4HUSKY D (MLIA) 418 481 576All Benefits Duals Removed 2,384 2,497 2,536


Ambulatory Detox (AMD)

• Admits/1,000 for HUSKY D (MLIA) had been decreasing steadily from quarter to quarter since the beginning of 2013, but began to hold steady after Q1 ’14.



Number of Admits CY '12 CY '13 CY '14HUSKY A (Family Single) 154 148 118HUSKY B 0 0 0HUSKY C (ABD Single) 36 35 22HUSKY C (LTC Single) 0 0 0HUSKY D (MLIA) 452 426 339All Benefits Duals Removed 642 609 479


Methadone Maintenance (MET)

• The Admits/1,000 for the HUSKY D (MLIA) population decreased from 2013 to 2014. As seen in the Inpatient Psychiatric Facility graphs, this decrease is limited to the first quarter in 2014 and primarily due to the increase in enrollment.


Number of Admits CY '12 CY '13 CY '14HUSKY A (Family Single) 638 872 877HUSKY B 1 0 1HUSKY C (ABD Single) 349 379 344HUSKY C (LTC Single) 1 1 1HUSKY D (MLIA) 2,991 3,227 4,287All Benefits Duals Removed 3,980 4,479 5,510


Outpatient (OTP/TST)




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