Snapshot of IMS LifeLink Claims Database
10% Random Sample
Prepared by:
Gary W. Moore and Bradley C. Martin
Health Data Unit of the UAMS Translational Research
Institute
What is LifeLink?
• LifeLink is an administrative claims database
– Captures bills paid to health providers by over 80
insurance and managed care plans.
• Demographic and enrollment information
– Geographic (state and zip3) of member residence
• Diagnostic information (ICD-9-CM)
• Procedures (HCPCs CPT-4) and Lab tests
• Prescriptions Dispensed
– Adjudicated claims for more than 40 million unique
enrollees per year
• 2006-2013
– 10% ember random sample obtained by UAMS TRI
Outline of LifeLink Statistics
• Demographic Characteristics
• Plan Characteristics
– HMO, PPO, Commercial, Medicare
• Geographic Representation
• Utilization
– Inpatient, Office, Hospital outpatient
– Most frequent diagnostic categories treated
IMS LifeLink PharMetrics Plus™ – U.S.
Age and Gender Distribution of Plan Members
Distribution (N, %) of Enrollees
by Gender
Distribution (N, %) of Enrollees
by Age Groups
Missing
8,419
0.094%
65+: Elderly
838,040
9.345%
Unknown
6,054
0.068%
Male
4,413,685
49.216%
13-18: Teen
723,269
8.065%
0-12: Child
Female
Male
Female
4,548,327
50.717%
0-12: Child
1,108,367
12.359%
Unknown
51-64: Adult
III
1,825,661
20.357%
31-50: Adult II
2,734,952
30.497%
13-18: Teen
19-30: Adult I
31-50: Adult II
19-30: Adult I 51-64: Adult III
1,729,358
65+: Elderly
19.284%
Missing
IMS LifeLink PharMetrics Plus™ – U.S.
Gender and Age Distribution of Plan Members
Gender by Age Group
3,000,000
538
2,500,000
1,400,229
2,000,000
529
958
Unknown
1,500,000
Female
944,449
867,126
Male
290
1,000,000
539,946
483
226
500,000
861,274
568,131
369,311
0
1,334,185
439,346
353,732
880,683
398,211
IMS LifeLink PharMetrics Plus™ – U.S.
LifeLink Members Covered by State
IMS LifeLink PharMetrics Plus™ – U.S.
Proportion of Population Enrolled in LifeLink by State
IMS LifeLink PharMetrics Plus™ – U.S.
Length of Enrollment of Plan Members
Percent of Total Enrollees (8,968,066) by Total Months Enrolled
(Jan 2006 - Jul 2013)
16
14.13
14
12
10
8
13.94
Average patient enrollment = 33.31 months
N (%) patients w/ enrollment > 2 years = 4.7 million (52.37%)
10.91
8.65
7.87
6.38
6
4
6.44
6.28
6.28
5.27
3.81
3.95
2.1
2
0
2.3
1.69
IMS LifeLink PharMetrics Plus™ – U.S.
Pharmacy Benefits Enrollment of Plan Members
Percent of Total Enrollees (8,968,066) by Total Months Enrolled (Rx Benefit)
(Jan 2006 - Jul 2013)
18
Proportion of subjects without pharmacy benefits
15.51
16
13.9
14
12
10.57
10
8.65
7.53
8
6
4
2
0
Average patient enrollment = 28.99 months
N (%) patients w/ enrollment > 2 years = 4.09 million (45.59%)
5.78
6.12
4.92
5.06
4.54
3.65
4.65
3.62
1.75
2.01
1.73
IMS LifeLink PharMetrics Plus™ – Arkansas
LifeLink Members by 3 Digit Zip Code Area in Arkansas
IMS LifeLink PharMetrics Plus™ – Texas
LifeLink Members by 3 Digit Zip Code Area in Texas
IMS LifeLink PharMetrics Plus™ – U.S.
Distribution of Payer Type of Plan Members
Number of Enrollees (N, %) by Pay Type Group
Medicare Risk
only; 55,477;
Rx
0.62%
Only
; 0;
0.00
Medicare Risk and Any
%
Other; 21,645; 0.24%
Self-Insured only; 2,442,836;
27.24%
Medicare Cost only;
28,258; 0.32%
All other Pay Type
combinations; 71,772;
0.80%
Commercial and Self-Insured;
252,039; 2.81%
All other Pay Type combinations
Commercial and Self-Insured
Commercial only
Medicaid and/or SCHIP
Medicare Cost only
Medicare Risk and Any Other
Medicare Risk only
Rx Only
Self-Insured only
Medicaid
and/or SCHIP;
142,129;
1.58%
Commercial only; 5,953,910;
66.39%
IMS LifeLink PharMetrics Plus™ – U.S.
Distribution of Payer Type by Children, Adults, and Elderly
Number of Enrollees by Pay Type Group by Age Group
7,000,000
184,563
6,000,000
5,000,000
Commercial and Self-Insured
Commercial only
4,000,000
Medicaid and/or SCHIP
4,284,460
Medicare Cost only
Medicare Risk and Any Other
Medicare Risk only
3,000,000
Self-Insured only
All other Pay Type combinations
2,000,000
43,940
1,163,353
1,000,000
1,694,763
23,534
500,317
537,138
210,186
0
0-18: Child
19-64: Adult
65+: Elderly
IMS LifeLink PharMetrics Plus™ – U.S.
Distribution of Payer Type by Year
Number of Enrollees by Pay Type Group by Year
5,000,000
16,868
15,556
4,500,000
19,633
4,000,000
14,695
20,331
14,653
3,500,000
Commercial and Self-Insured
Commercial only
12,715
3,218,790
3,000,000
4,875
3,050,029
2,642,195
2,547,502
Medicare Cost only
2,420,528
Medicare Risk and Any Other
2,776,241
2,500,000
Medicaid and/or SCHIP
Medicare Risk only
2,000,000
2,019,236
2,371,805
Rx Only
Self-Insured only
All other Pay Type combinations
1,500,000
67,571
73,527
85,139
88,866
86,941
39,827
60,709
1,000,000
37,171
1,324,241
1,333,725
1,358,286
1,397,108
1,327,074
1,089,295
500,000
968,462
683,182
0
2006
2007
2008
2009
2010
2011
2012
2013
IMS LifeLink PharMetrics Plus™ – U.S.
Distribution of Insurance Product Type of Plan Members
Number of Enrollees (N, %) by Product Type Group
All other Product Type combinations
Preferred Provider Organization (PPO)
only; 6,352,896; 70.84%
Consumer Directed Health Care only
Health Maintenance Organization (HMO) only
Preferred Provider Organization
(PPO) and Any Other; 556,027;
6.20%
Indemnity/Traditional only
Point of Service (POS) only
Preferred Provider Organization (PPO) and Any Other
Preferred Provider Organization (PPO) only
Point of Service (POS)
only; 545,027; 6.08%
Indemnity/Traditional only;
267,692; 2.98%
Health Maintenance
Organization (HMO) only;
979,005; 10.92%
Consumer Directed Health Care
only; 36,417; 0.41%
All other Product Type combinations;
231,002; 2.58%
IMS LifeLink PharMetrics Plus™ – U.S.
Distribution of Insurance Product Type of Children, Adults, and
Elderly
Number of Enrollees by Product Type by Age Group
7,000,000
6,000,000
665,580
388,376
5,000,000
400,175
Consumer Directed Health Care only
Health Maintenance Organization (HMO) only
4,000,000
Indemnity/Traditional only
Point of Service (POS) only
Preferred Provider Organization (PPO) and Any Other
3,000,000
Preferred Provider Organization (PPO) only
All other Product Type combinations
4,502,659
2,000,000
211,897
109,790
94,700
1,000,000
100,950
46,514
61,001
1,335,843
509,219
0
0-18: Child
19-64: Adult
65+: Elderly
IMS LifeLink PharMetrics Plus™ – U.S.
Distribution of Insurance Product Type by Year
Number of Enrollees by Product Type Group by Year
5,000,000
14,711
18,906
4,500,000
642,732
580,564
4,000,000
10,138
601,864
3,500,000
227,270
254,661
21,444
208,239
514,575
421,386
386,376
49,171
50,885
112,833
213,911
54,363
34,013
480,602
91,971
207,048
29,608
7,995
3,000,000
518,224
40,519
408,640
82,991
201,374
28,782
357,640
320,667
41,390
2,500,000
Consumer Directed Health Care only
39,530
78,998
172,404
8,698
219,491
336,429
2,000,000
3,265,982
3,231,584
3,242,747
3,117,958
2,692,332
2,454,069
1,970,450
500,000
0
2006
Point of Service (POS) only
Preferred Provider Organization (PPO) and Any Other
All other Product Type combinations
3,263,166
1,000,000
Indemnity/Traditional only
Preferred Provider Organization (PPO) only
52,997
1,500,000
Health Maintenance Organization (HMO) only
2007
2008
2009
2010
2011
2012
2013
IMS LifeLink PharMetrics Plus™ – U.S.
Descriptive Statistics for Enrollees with at least one Retail Pharmacy Rx Fill in Year
Millions
Number of Retail Pharmcy Rx Fills by Year
40
35
30
25
20
15
10
5
0
Retail Pharmcy Rx Fills
2006
2007
2008
2009
2010
2011
2012
2013
17,577,180
30,444,424
36,120,978
36,028,158
33,040,719
31,387,382
29,475,951
12,253,831
NOTE: Year 2013 is limited to the months from January to July.
IMS LifeLink PharMetrics Plus™ – U.S.
Descriptive Statistics for Enrollees with at least one Retail Pharmacy Rx Fill in Year
Thousands
Number of Enrollees with at least one Retail Pharmacy Rx Fill in Year
3,000
2,500
2,000
1,500
1,000
500
0
Enrollees
2006
2007
2008
2009
2010
2011
2012
2013
1,711,184
2,273,077
2,651,154
2,610,649
2,398,059
2,348,464
2,272,620
1,597,936
NOTE: Year 2013 is limited to the months from January to July.
IMS LifeLink PharMetrics Plus™ – U.S.
Descriptive Statistics for Enrollees with at least one Retail Pharmacy Rx Fill in Year
Median, Mean, and Standard Deviation for Retail Pharmacy Rx Fills Per Enrollee per Year
20
18
16
14
12
10
8
6
4
2
0
2006
2007
2008
2009
2010
2011
2012
2013
5
7
7
7
7
7
7
5
Mean
10.27
13.39
13.62
13.80
13.78
13.37
12.97
7.67
StdDev
14.03
18.01
18.32
18.45
18.21
17.89
17.36
8.93
Median
NOTE: Year 2013 is limited to the months from January to July.
IMS LifeLink PharMetrics Plus™ – U.S.
25 Most Frequent Retail Pharmacy Rx Fills of LifeLink Members by Drug Group
Overall (January 2006 -> July 2013) Top 25 Retail Pharmacy Rx Fills by Drug Group (GPI-2)
(decreasing order of frequency)
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
Thousands
16,000
18,000
36 - ANTIHYPERTENSIVES
58 - ANTIDEPRESSANTS
39 - ANTIHYPERLIPIDEMICS
65 - ANALGESICS - OPIOID
27 - ANTIDIABETICS
49 - ULCER DRUGS
25 - CONTRACEPTIVES
33 - BETA BLOCKERS
44 - ANTIASTHMATIC AND BRONCHODILATOR AGENTS
28 - THYROID AGENTS
90 - DERMATOLOGICALS
37 - DIURETICS
66 - ANALGESICS - ANTI-INFLAMMATORY
72 - ANTICONVULSANTS
01 - PENICILLINS
57 - ANTIANXIETY AGENTS
34 - CALCIUM CHANNEL BLOCKERS
03 - MACROLIDES
61 - ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ANOREXIANTS
42 - NASAL AGENTS - SYSTEMIC AND TOPICAL
60 - HYPNOTICS
22 - CORTICOSTEROIDS
43 - COUGH/COLD/ALLERGY
86 - OPHTHALMIC AGENTS
41 - ANTIHISTAMINES
IMS LifeLink PharMetrics Plus™ – U.S.
25 Most Frequent Retail Pharmacy Rx Fills of LifeLink Members by Drug Name
Overall (January 2006 -> July 2013) Top 25 Retail Pharmacy Rx Fills by Drug Name (GPI-8)
(decreasing order of frequency)
0
1000
2000
3000
4000
5000
Thousands
6000
7000
65991702 - HYDROCODONE COMBINATION
28100010 - LEVOTHYROXINE
39400075 - SIMVASTATIN
36100030 - LISINOPRIL
33200030 - METOPROLOL
03400010 - AZITHROMYCIN
25990002 - ETHINYL ESTRADIOL ORAL CONTRACEPTIVE
39400010 - ATORVASTATIN
01200010 - AMOXICILLIN
27250050 - METFORMIN
49270060 - OMEPRAZOLE
37600040 - HYDROCHLOROTHIAZIDE
44201010 - ALBUTEROL
34000003 - AMLODIPINE
57100010 - ALPRAZOLAM
60204080 - ZOLPIDEM
58160070 - SERTRALINE
36994002 - ARB DIURETIC COMBINATION
33200020 - ATENOLOL
58300040 - BUPROPION
42200032 - FLUTICASONE
25992002 - TRIPHASIC OC
44505050 - MONTELUKAST
58160020 - CITALOPRAM
49270025 - ESOMEPRAZOLE
IMS LifeLink PharMetrics Plus™ – U.S.
Inpatient Hospitalizations by Year
Thousands
Frequency of Inpatient Hospitalizations by Year
350
300
250
200
150
100
50
0
IMS LifeLink PharMetrics Plus™ – U.S.
Primary Discharge Diagnosis Types of Inpatient Hospitalizations
Number of Inpatient Hospitalizations by CCS Level I Category of Primary Discharge Dx
0
50
100
150
200
Thousands
250
300
1 - Infectious and parasitic diseases
2 - Neoplasms
3 - Endocrine; nutritional; and metabolic diseases and immunity disorders
4 - Diseases of the blood and blood-forming organs
5 - Mental Illness
6 - Diseases of the nervous system and sense organs
7 - Diseases of the circulatory system
8 - Diseases of the respiratory system
9 - Diseases of the digestive system
10 - Diseases of the genitourinary system
11 - Complications of pregnancy; childbirth; and the puerperium
12 - Diseases of the skin and subcutaneous tissue
13 - Diseases of the musculoskeletal system and connective tissue
14 - Congenital anomalies
15 - Certain conditions originating in the perinatal period
16 - Injury and poisoning
17 - Symptoms; signs; and ill-defined conditions and factors influencing health status
18 - Residual codes; unclassified; all E codes [259. and 260.]
IMS LifeLink PharMetrics Plus™ – U.S.
12 Most Frequent Discharge Diagnosis Types of Inpatient
Hospitalizations
Number of Inpatient Hospitalizations by CCS Level II Category of Primary Discharge Dx
(Top 12 CCS Level II Dx Categories in decreasing order of frequency)
0
50
100
150
Thousands
200
7.2 - Diseases of the heart
15.1 - Liveborn [218.]
11.3 - Complications mainly related to pregnancy
11.4 - Indications for care in pregnancy; labor; and delivery
9.6 - Lower gastrointestinal disorders
13.2 - Non-traumatic joint disorders
11.5 - Complications during labor
8.1 - Respiratory infections
16.10 - Complications
10.1 - Diseases of the urinary system
5.8 - Mood disorders [657]
13.3 - Spondylosis; intervertebral disc disorders; other back problems [205.]
863.925
All Other CCS Level II Dx Categories
IMS LifeLink PharMetrics Plus™ – U.S.
Outpatient Office Encounters by Year
Millions
Outpatient Office Encounters by Year
25
20
15
10
5
0
IMS LifeLink PharMetrics Plus™ – U.S.
Primary Diagnosis Types of Outpatient Office Encounters
Number of Outpatient Office Encounters by CCS Level I Category of Primary Discharge Dx
0
5
10
15
20
25
Millions
30
1 - Infectious and parasitic diseases
2 - Neoplasms
3 - Endocrine; nutritional; and metabolic diseases and immunity disorders
4 - Diseases of the blood and blood-forming organs
5 - Mental Illness
6 - Diseases of the nervous system and sense organs
7 - Diseases of the circulatory system
8 - Diseases of the respiratory system
9 - Diseases of the digestive system
10 - Diseases of the genitourinary system
11 - Complications of pregnancy; childbirth; and the puerperium
12 - Diseases of the skin and subcutaneous tissue
13 - Diseases of the musculoskeletal system and connective tissue
14 - Congenital anomalies
15 - Certain conditions originating in the perinatal period
16 - Injury and poisoning
17 - Symptoms; signs; and ill-defined conditions and factors influencing health status
18 - Residual codes; unclassified; all E codes [259. and 260.]
IMS LifeLink PharMetrics Plus™ – U.S.
12 Most Frequent Discharge Diagnosis Types of Outpatient Office
Encounters
Number of Outpatient Office Encounters by CCS Level II Category of Primary Dx
(Top 12 CCS Level II Dx Categories in decreasing order of frequency)
0
2
4
6
8
10
Millions
12
17.2 - Factors influencing health care
13.3 - Spondylosis; intervertebral disc disorders; other back problems [205.]
8.1 - Respiratory infections
13.9 - Other bone disease and musculoskeletal deformities [212.]
6.7 - Eye disorders
13.2 - Non-traumatic joint disorders
5.8 - Mood disorders [657]
8.9 - Other upper respiratory disease [134.]
13.8 - Other connective tissue disease [211.]
17.1 - Symptoms; signs; and ill-defined conditions
7.1 - Hypertension
6.8 - Ear conditions
54.578
All Other CCS Level II Dx Categories
IMS LifeLink PharMetrics Plus™ – U.S.
Outpatient Facility / Hospital Encounter by Year
x 100000
Outpatient Facility / Hospital Encounters by Year
45
40
35
30
25
20
15
10
5
0
IMS LifeLink PharMetrics Plus™ – U.S.
Primary Diagnoses of Outpatient Facility / Hospital Encounters
Number of Outpatient Facility / Hospital Encounters by CCS Level I Category of Primary Dx
0
500
1,000
1,500
2,000
2,500
Thousands
3,000
3,500
1 - Infectious and parasitic diseases
2 - Neoplasms
3 - Endocrine; nutritional; and metabolic diseases and immunity disorders
4 - Diseases of the blood and blood-forming organs
5 - Mental Illness
6 - Diseases of the nervous system and sense organs
7 - Diseases of the circulatory system
8 - Diseases of the respiratory system
9 - Diseases of the digestive system
10 - Diseases of the genitourinary system
11 - Complications of pregnancy; childbirth; and the puerperium
12 - Diseases of the skin and subcutaneous tissue
13 - Diseases of the musculoskeletal system and connective tissue
14 - Congenital anomalies
15 - Certain conditions originating in the perinatal period
16 - Injury and poisoning
17 - Symptoms; signs; and ill-defined conditions and factors influencing health status
18 - Residual codes; unclassified; all E codes [259. and 260.]
IMS LifeLink PharMetrics Plus™ – U.S.
12 Most Frequent Primary Diagnoses of Outpatient Facility / Hospital
Encounters
Number of Outpatient Facility / Hospital Encounters by CCS Level II Category of Primary Discharge Dx
(Top 12 CCS Level II Dx Categories in decreasing order of frequency)
0
500
1,000
1,500
Thousands
2,000
17.2 - Factors influencing health care
17.1 - Symptoms; signs; and ill-defined conditions
7.2 - Diseases of the heart
10.1 - Diseases of the urinary system
8.1 - Respiratory infections
13.3 - Spondylosis; intervertebral disc disorders; other back problems [205.]
16.7 - Sprains and strains [232.]
13.2 - Non-traumatic joint disorders
10.3 - Diseases of female genital organs
13.8 - Other connective tissue disease [211.]
16.6 - Open wounds
6.7 - Eye disorders
13,858.122
All Other CCS Level II Dx Categories