MIA EDA

library(tidyverse)

── Attaching core tidyverse packages ──────────────────────── tidyverse 2.0.0 ──
✔ dplyr     1.2.0     ✔ readr     2.2.0
✔ forcats   1.0.1     ✔ stringr   1.6.0
✔ ggplot2   4.0.2     ✔ tibble    3.3.1
✔ lubridate 1.9.5     ✔ tidyr     1.3.2
✔ purrr     1.2.1     
── Conflicts ────────────────────────────────────────── tidyverse_conflicts() ──
✖ dplyr::filter() masks stats::filter()
✖ dplyr::lag()    masks stats::lag()
ℹ Use the conflicted package (<http://conflicted.r-lib.org/>) to force all conflicts to become errors

library(dplyr)
library(ggplot2)

mia <- read.csv("MIA Appeals and Grievances.csv")

admin <- read.csv('Admin Complaints.csv')

str(mia)

'data.frame':   178 obs. of  95 variables:
 $ company.name                                                                 : chr  "4 Ever Life Insurance Company" "Aetna Dental, Inc." "Aetna Health Inc. ( a Pennsylvania corporation )" "Aetna Health Insurance Company" ...
 $ naic..                                                                       : int  80985 95910 95109 NA 60054 95163 61301 96202 47058 NA ...
 $ year                                                                         : int  2021 2021 2021 2021 2021 2021 2021 2021 2021 2021 ...
 $ adverse.decisions.company.total                                              : int  1 693 115 NA 188 NA 285 21128 7057 NA ...
 $ adverse.decisions.by.carrier.percent                                         : num  0 0.009 0.001 NA 0.002 NA 0.004 0.26 0.087 NA ...
 $ adverse.decisions.inpatient.hospital.services.number                         : int  1 0 39 NA 69 NA 0 12 2 NA ...
 $ adverse.decisions.inpatient.hospital.services.percent.total                  : num  1 0 0.339 NA 0.367 ...
 $ adverse.decisions.emergency.room.services.number                             : int  0 0 0 NA 0 NA 0 0 1 NA ...
 $ adverse.decisions.emergency.room.services.percent.total                      : num  0 0 0 NA 0 ...
 $ adverse.decisions.mental.health.services.number                              : int  0 0 4 NA 11 NA 0 298 31 NA ...
 $ adverse.decisions.mental.health.services.percent.total                       : num  0 0 0.0348 NA 0.0585 ...
 $ adverse.decisions.physician.services.number                                  : int  0 0 42 NA 68 NA 0 1182 184 NA ...
 $ adverse.decisions.physician.services.percent..total                          : num  0 0 0.365 NA 0.362 ...
 $ adverse.decisions.laboratory..radiology.services.number                      : int  0 0 2 NA 8 NA 0 3015 239 NA ...
 $ adverse.decisions.laboratory..radiology.services.percent..total.             : num  0 0 0.0174 NA 0.0426 ...
 $ adverse.decisions.pharmacy.services.number                                   : int  0 0 15 NA 19 NA 0 15727 5810 NA ...
 $ adverse.decisions.pharmacy.services.percent.total                            : num  0 0 0.13 NA 0.101 NA 0 0.744 0.823 NA ...
 $ adverse.decisions.pt..ot..st.services..incl.inpat.rehab..number.             : int  0 0 4 NA 5 NA 0 85 14 NA ...
 $ adverse.decisions.pt..ot..st.services..incl.inpat.rehab..percent..total..    : num  0 0 0.0348 NA 0.0266 ...
 $ adverse.decisions.skilled.nurse.faculty.sub.acute.nursing.home.number        : int  0 0 2 NA 2 NA 0 6 2 NA ...
 $ adverse.decisions.skilled.nurse.faculty.sub.acute.nursing.home.percent..total: num  0 0 0.0174 NA 0.0106 ...
 $ adverse.decisions.durable.medical.equipment.services.number                  : int  0 0 2 NA 2 NA 0 786 111 NA ...
 $ adverse.decisions.durable.medical.equipment.services.percent..total          : num  0 0 0.0174 NA 0.0106 ...
 $ adverse.decisions.dental.number                                              : int  0 693 0 NA 0 NA 285 4 659 NA ...
 $ adverse.decisions.dental.percent.total                                       : num  0 1 0 NA 0 ...
 $ adverse.decisions.home.health.services.number                                : int  0 0 0 NA 1 NA 0 9 4 NA ...
 $ adverse.decisions.home.health.services.percent.total                         : num  0 0 0 NA 0.00532 ...
 $ adverse.decisions.obesity..ivf..podiatry..hearing.and.vision.number.         : int  0 0 5 NA 3 NA 0 4 0 NA ...
 $ adverse.decisions.obesity..ivf..podiatry..hearing.and.vision.percent..total. : num  0 0 0.0435 NA 0.016 ...
 $ grievances.filed.company.total                                               : int  10 1 217 NA 143 174 134 1738 901 NA ...
 $ grievances.filed.percent.of.all.companies                                    : num  0.001 0 0.027 NA 0.018 0.022 0.017 0.215 0.112 NA ...
 $ grievance.inpatient.hospital.services.number                                 : int  2 0 23 NA 18 0 0 8 0 NA ...
 $ grievance.inpatient.hospital.services.percent..total                         : num  0.2 0 0.106 NA 0.126 0 0 0.005 0 NA ...
 $ grievance.emergency.room.services.number                                     : int  2 0 5 NA 1 0 0 2 0 NA ...
 $ grievance.emergency.room.services.percent.total                              : num  0.2 0 0.023 NA 0.007 0 0 0.001 0 NA ...
 $ grievance.mental.health.services.number                                      : int  0 0 0 NA 3 3 0 8 1 NA ...
 $ grievance.mental.health.services.percent.total                               : num  0 0 0 NA 0.014 0.021 0 0.005 0.001 NA ...
 $ grievance.physician.services.number                                          : int  2 0 96 NA 53 0 0 38 6 NA ...
 $ grievance.physician.services.percent.total                                   : num  0.2 0 0.442 NA 0.371 0 0 0.022 0.007 NA ...
 $ grievance.laboratory..radiology.services.number                              : int  4 0 34 NA 26 0 0 112 16 NA ...
 $ grievance.laboratory..radiology.services.percent.total.                      : num  0.4 0 0.157 NA 0.182 0 0 0.064 0.018 NA ...
 $ grievance.pharmacy.services.number                                           : int  0 0 46 NA 31 0 0 1476 796 NA ...
 $ grievance.pharmacy.services.percent.total                                    : num  0 0 0.212 NA 0.217 0 0 0.849 0.883 NA ...
 $ grievance.pt..ot..st.services..incl.inpat.rehab..number.                     : int  0 0 0 NA 1 0 0 6 0 NA ...
 $ grievance.pt..ot..st.services..incl.inpat.rehab..percent.total..             : num  0 0 0 NA 0.007 0 0 0.003 0 NA ...
 $ grievance.skilled.nurse.faculty.sub.acute.nursing.home.number                : int  0 0 0 NA 0 0 0 2 0 NA ...
 $ grievance.skilled.nurse.faculty.sub.acute.nursing.home.percent.total         : num  0 0 0 NA 0 0 0 0.001 0 NA ...
 $ grievance.durable.medical.equipment.services.number                          : int  0 0 0 NA 1 0 0 83 4 NA ...
 $ grievance.durable.medical.equipment.services.percent.total                   : num  0 0 0 NA 0.007 0 0 0.048 0.004 NA ...
 $ grievance.dental.number                                                      : int  0 1 0 NA 3 174 134 3 78 NA ...
 $ grievance.dental.percent.total                                               : num  0 1 0 NA 0.021 1 1 0.002 0.087 NA ...
 $ grievance.home.health.services.number                                        : int  0 0 1 NA 1 0 0 0 0 NA ...
 $ grievance.home.health.services.percent.total                                 : num  0 0 0.005 NA 0.007 0 0 0 0 NA ...
 $ grievance.obesity..ivf..podiatry..hearing.and.vision.number.                 : int  0 0 9 NA 5 0 0 0 0 NA ...
 $ grievance.obesity..ivf..podiatry..hearing.and.vision.percent.total.          : num  0 0 0.041 NA 0.035 0 0 0 0 NA ...
 $ grievances.upheld.number                                                     : int  3 0 110 NA 80 79 76 648 288 NA ...
 $ grievances.upheld.percent.total                                              : num  0.3 0 0.507 NA 0.559 0.454 0.567 0.373 0.32 NA ...
 $ grievances.overturned.number                                                 : int  7 1 94 NA 62 71 46 1088 608 NA ...
 $ grievances.overturned.percent.total                                          : num  0.7 1 0.433 NA 0.434 0.408 0.343 0.626 0.675 NA ...
 $ grievances.modified.number                                                   : int  0 0 13 NA 1 24 12 2 5 NA ...
 $ grievances.modified.percent.total                                            : num  0 0 0.06 NA 0.007 0.138 0.09 0.001 0.006 NA ...
 $ hospital.length.of.stay.total                                                : int  4 NA NA NA NA NA NA 8 NA NA ...
 $ hospital.length.of.stay.outcome                                              : int  2 NA NA NA NA NA NA 3 NA NA ...
 $ grievances.upheld.number.for.hospital.los                                    : int  2 NA NA NA NA NA NA 2 NA NA ...
 $ grievances.upheld.percent.for.hospital.los                                   : num  1 NA NA NA NA NA NA 0.667 NA NA ...
 $ grievances.overturned.number.for.hospital.los                                : int  0 NA NA NA NA NA NA 1 NA NA ...
 $ grievances.overturned.percent.for.hospital.los                               : num  0 NA NA NA NA NA NA 0.333 NA NA ...
 $ grievances.modified.number.for.hospital.los                                  : int  0 NA NA NA NA NA NA 0 NA NA ...
 $ grievances.modified.percent.for.hospital.los                                 : num  0 NA NA NA NA NA NA 0 NA NA ...
 $ emergency.cases...resolution.hours.1.st.quarter.                             : num  432 NA NA NA NA NA NA 24 24 NA ...
 $ emergency.cases...resolution.hours.2nd.quarter.                              : num  0 NA NA NA NA NA NA 24 24 NA ...
 $ emergency.cases...resolution.hours.3rd..quarter.                             : num  0 NA NA NA NA NA NA 24 24 NA ...
 $ emergency.cases...resolution.hours.4th.quarter.                              : num  0 NA NA NA NA NA NA 24 24 NA ...
 $ non.emergency.cases...resolution.days.1st.quarter                            : num  3 0 20.4 NA 17.3 22 34 16.5 15 NA ...
 $ non.emergency.cases...resolution.days.2nd.quarter                            : num  1 0 19.2 NA 21.7 25.6 28 22.3 15.5 NA ...
 $ non.emergency.cases...resolution.days.3rd.quarter                            : num  0 0 24.6 NA 22.3 28 24 23.4 19.8 NA ...
 $ non.emergency.cases...resolution.days.4th.quarter                            : num  0 22 23.9 NA 22 33.3 26 14.1 17.1 NA ...
 $ total.number.of..emergencies..cases                                          : int  2 NA NA NA NA NA NA 535 264 NA ...
 $ emergencies.outcome                                                          : int  2 NA NA NA NA NA NA 180 86 NA ...
 $ internal.emergency.grievances.upheld.number                                  : int  0 NA NA NA NA NA NA 41 18 NA ...
 $ internal.emergency.grievances.upheld.percent                                 : num  0 NA NA NA NA NA NA 0.228 0.209 NA ...
 $ internal.emergency.grievances.overturned.number                              : int  2 NA NA NA NA NA NA 139 68 NA ...
 $ internal.emergency.grievances.overturned.percent                             : num  1 NA NA NA NA NA NA 0.772 0.791 NA ...
 $ internal.emergency.grievances.modified.number                                : int  0 NA NA NA NA NA NA 0 0 NA ...
 $ internal.emergency.grievances.modified.percent                               : num  0 NA NA NA NA NA NA 0 0 NA ...
 $ complaints.investigated.total                                                : int  NA NA 8 1 3 NA 1 71 69 6 ...
 $ complaints.investigated.percent                                              : num  NA NA 0.03 0 0 NA 0 0.23 0.23 0.02 ...
 $ carrier.upheld.by.mia.number                                                 : int  NA NA 3 0 1 NA 0 27 16 1 ...
 $ carrier.upheld.by.mia.percent                                                : num  NA NA 0.38 0 0.33 NA 0 0.38 0.23 0.17 ...
 $ carrier.reversed.by.mia.number                                               : int  NA NA 1 1 1 NA 0 19 19 1 ...
 $ carrier.reversed.by.mia.percent                                              : num  NA NA 0.13 1 1 NA 0 0.27 0.28 0.17 ...
 $ carrier.modified.by.mia.number                                               : int  NA NA 0 0 0 NA 0 1 1 0 ...
 $ carrier.modified.by.mia.percent                                              : num  NA NA 0 0 0 NA 0 0.01 0.01 0 ...
 $ carrier.reversed.itself.during.investigation.number                          : int  NA NA 4 0 1 NA 1 24 33 4 ...
 $ carrier.reversed.itself.during.investigation.percent                         : num  NA NA 0.5 0 0.33 NA 1 0.34 0.48 0.67 ...

names(mia) <- tolower(names(mia))
names(mia) <- gsub(' ',"_",names(mia))
names(mia) <- gsub("\\.", "_",names(mia))

colnames(mia)

 [1] "company_name"                                                                 
 [2] "naic__"                                                                       
 [3] "year"                                                                         
 [4] "adverse_decisions_company_total"                                              
 [5] "adverse_decisions_by_carrier_percent"                                         
 [6] "adverse_decisions_inpatient_hospital_services_number"                         
 [7] "adverse_decisions_inpatient_hospital_services_percent_total"                  
 [8] "adverse_decisions_emergency_room_services_number"                             
 [9] "adverse_decisions_emergency_room_services_percent_total"                      
[10] "adverse_decisions_mental_health_services_number"                              
[11] "adverse_decisions_mental_health_services_percent_total"                       
[12] "adverse_decisions_physician_services_number"                                  
[13] "adverse_decisions_physician_services_percent__total"                          
[14] "adverse_decisions_laboratory__radiology_services_number"                      
[15] "adverse_decisions_laboratory__radiology_services_percent__total_"             
[16] "adverse_decisions_pharmacy_services_number"                                   
[17] "adverse_decisions_pharmacy_services_percent_total"                            
[18] "adverse_decisions_pt__ot__st_services__incl_inpat_rehab__number_"             
[19] "adverse_decisions_pt__ot__st_services__incl_inpat_rehab__percent__total__"    
[20] "adverse_decisions_skilled_nurse_faculty_sub_acute_nursing_home_number"        
[21] "adverse_decisions_skilled_nurse_faculty_sub_acute_nursing_home_percent__total"
[22] "adverse_decisions_durable_medical_equipment_services_number"                  
[23] "adverse_decisions_durable_medical_equipment_services_percent__total"          
[24] "adverse_decisions_dental_number"                                              
[25] "adverse_decisions_dental_percent_total"                                       
[26] "adverse_decisions_home_health_services_number"                                
[27] "adverse_decisions_home_health_services_percent_total"                         
[28] "adverse_decisions_obesity__ivf__podiatry__hearing_and_vision_number_"         
[29] "adverse_decisions_obesity__ivf__podiatry__hearing_and_vision_percent__total_" 
[30] "grievances_filed_company_total"                                               
[31] "grievances_filed_percent_of_all_companies"                                    
[32] "grievance_inpatient_hospital_services_number"                                 
[33] "grievance_inpatient_hospital_services_percent__total"                         
[34] "grievance_emergency_room_services_number"                                     
[35] "grievance_emergency_room_services_percent_total"                              
[36] "grievance_mental_health_services_number"                                      
[37] "grievance_mental_health_services_percent_total"                               
[38] "grievance_physician_services_number"                                          
[39] "grievance_physician_services_percent_total"                                   
[40] "grievance_laboratory__radiology_services_number"                              
[41] "grievance_laboratory__radiology_services_percent_total_"                      
[42] "grievance_pharmacy_services_number"                                           
[43] "grievance_pharmacy_services_percent_total"                                    
[44] "grievance_pt__ot__st_services__incl_inpat_rehab__number_"                     
[45] "grievance_pt__ot__st_services__incl_inpat_rehab__percent_total__"             
[46] "grievance_skilled_nurse_faculty_sub_acute_nursing_home_number"                
[47] "grievance_skilled_nurse_faculty_sub_acute_nursing_home_percent_total"         
[48] "grievance_durable_medical_equipment_services_number"                          
[49] "grievance_durable_medical_equipment_services_percent_total"                   
[50] "grievance_dental_number"                                                      
[51] "grievance_dental_percent_total"                                               
[52] "grievance_home_health_services_number"                                        
[53] "grievance_home_health_services_percent_total"                                 
[54] "grievance_obesity__ivf__podiatry__hearing_and_vision_number_"                 
[55] "grievance_obesity__ivf__podiatry__hearing_and_vision_percent_total_"          
[56] "grievances_upheld_number"                                                     
[57] "grievances_upheld_percent_total"                                              
[58] "grievances_overturned_number"                                                 
[59] "grievances_overturned_percent_total"                                          
[60] "grievances_modified_number"                                                   
[61] "grievances_modified_percent_total"                                            
[62] "hospital_length_of_stay_total"                                                
[63] "hospital_length_of_stay_outcome"                                              
[64] "grievances_upheld_number_for_hospital_los"                                    
[65] "grievances_upheld_percent_for_hospital_los"                                   
[66] "grievances_overturned_number_for_hospital_los"                                
[67] "grievances_overturned_percent_for_hospital_los"                               
[68] "grievances_modified_number_for_hospital_los"                                  
[69] "grievances_modified_percent_for_hospital_los"                                 
[70] "emergency_cases___resolution_hours_1_st_quarter_"                             
[71] "emergency_cases___resolution_hours_2nd_quarter_"                              
[72] "emergency_cases___resolution_hours_3rd__quarter_"                             
[73] "emergency_cases___resolution_hours_4th_quarter_"                              
[74] "non_emergency_cases___resolution_days_1st_quarter"                            
[75] "non_emergency_cases___resolution_days_2nd_quarter"                            
[76] "non_emergency_cases___resolution_days_3rd_quarter"                            
[77] "non_emergency_cases___resolution_days_4th_quarter"                            
[78] "total_number_of__emergencies__cases"                                          
[79] "emergencies_outcome"                                                          
[80] "internal_emergency_grievances_upheld_number"                                  
[81] "internal_emergency_grievances_upheld_percent"                                 
[82] "internal_emergency_grievances_overturned_number"                              
[83] "internal_emergency_grievances_overturned_percent"                             
[84] "internal_emergency_grievances_modified_number"                                
[85] "internal_emergency_grievances_modified_percent"                               
[86] "complaints_investigated_total"                                                
[87] "complaints_investigated_percent"                                              
[88] "carrier_upheld_by_mia_number"                                                 
[89] "carrier_upheld_by_mia_percent"                                                
[90] "carrier_reversed_by_mia_number"                                               
[91] "carrier_reversed_by_mia_percent"                                              
[92] "carrier_modified_by_mia_number"                                               
[93] "carrier_modified_by_mia_percent"                                              
[94] "carrier_reversed_itself_during_investigation_number"                          
[95] "carrier_reversed_itself_during_investigation_percent"                         

colSums(is.na(mia))

                                                                 company_name 
                                                                            0 
                                                                       naic__ 
                                                                           45 
                                                                         year 
                                                                            0 
                                              adverse_decisions_company_total 
                                                                           25 
                                         adverse_decisions_by_carrier_percent 
                                                                           25 
                         adverse_decisions_inpatient_hospital_services_number 
                                                                           25 
                  adverse_decisions_inpatient_hospital_services_percent_total 
                                                                           25 
                             adverse_decisions_emergency_room_services_number 
                                                                           25 
                      adverse_decisions_emergency_room_services_percent_total 
                                                                           25 
                              adverse_decisions_mental_health_services_number 
                                                                           25 
                       adverse_decisions_mental_health_services_percent_total 
                                                                           25 
                                  adverse_decisions_physician_services_number 
                                                                           25 
                          adverse_decisions_physician_services_percent__total 
                                                                           25 
                      adverse_decisions_laboratory__radiology_services_number 
                                                                           25 
             adverse_decisions_laboratory__radiology_services_percent__total_ 
                                                                           25 
                                   adverse_decisions_pharmacy_services_number 
                                                                           25 
                            adverse_decisions_pharmacy_services_percent_total 
                                                                           25 
             adverse_decisions_pt__ot__st_services__incl_inpat_rehab__number_ 
                                                                           25 
    adverse_decisions_pt__ot__st_services__incl_inpat_rehab__percent__total__ 
                                                                           25 
        adverse_decisions_skilled_nurse_faculty_sub_acute_nursing_home_number 
                                                                           25 
adverse_decisions_skilled_nurse_faculty_sub_acute_nursing_home_percent__total 
                                                                           25 
                  adverse_decisions_durable_medical_equipment_services_number 
                                                                           25 
          adverse_decisions_durable_medical_equipment_services_percent__total 
                                                                           25 
                                              adverse_decisions_dental_number 
                                                                           25 
                                       adverse_decisions_dental_percent_total 
                                                                           25 
                                adverse_decisions_home_health_services_number 
                                                                           25 
                         adverse_decisions_home_health_services_percent_total 
                                                                           25 
         adverse_decisions_obesity__ivf__podiatry__hearing_and_vision_number_ 
                                                                           25 
 adverse_decisions_obesity__ivf__podiatry__hearing_and_vision_percent__total_ 
                                                                           25 
                                               grievances_filed_company_total 
                                                                           43 
                                    grievances_filed_percent_of_all_companies 
                                                                           43 
                                 grievance_inpatient_hospital_services_number 
                                                                           43 
                         grievance_inpatient_hospital_services_percent__total 
                                                                           43 
                                     grievance_emergency_room_services_number 
                                                                           43 
                              grievance_emergency_room_services_percent_total 
                                                                           43 
                                      grievance_mental_health_services_number 
                                                                           42 
                               grievance_mental_health_services_percent_total 
                                                                           42 
                                          grievance_physician_services_number 
                                                                           42 
                                   grievance_physician_services_percent_total 
                                                                           42 
                              grievance_laboratory__radiology_services_number 
                                                                           42 
                      grievance_laboratory__radiology_services_percent_total_ 
                                                                           42 
                                           grievance_pharmacy_services_number 
                                                                           49 
                                    grievance_pharmacy_services_percent_total 
                                                                           49 
                     grievance_pt__ot__st_services__incl_inpat_rehab__number_ 
                                                                           49 
             grievance_pt__ot__st_services__incl_inpat_rehab__percent_total__ 
                                                                           49 
                grievance_skilled_nurse_faculty_sub_acute_nursing_home_number 
                                                                           49 
         grievance_skilled_nurse_faculty_sub_acute_nursing_home_percent_total 
                                                                           49 
                          grievance_durable_medical_equipment_services_number 
                                                                           44 
                   grievance_durable_medical_equipment_services_percent_total 
                                                                           44 
                                                      grievance_dental_number 
                                                                           44 
                                               grievance_dental_percent_total 
                                                                           44 
                                        grievance_home_health_services_number 
                                                                           44 
                                 grievance_home_health_services_percent_total 
                                                                           44 
                 grievance_obesity__ivf__podiatry__hearing_and_vision_number_ 
                                                                           43 
          grievance_obesity__ivf__podiatry__hearing_and_vision_percent_total_ 
                                                                           43 
                                                     grievances_upheld_number 
                                                                           60 
                                              grievances_upheld_percent_total 
                                                                           60 
                                                 grievances_overturned_number 
                                                                           60 
                                          grievances_overturned_percent_total 
                                                                           60 
                                                   grievances_modified_number 
                                                                           60 
                                            grievances_modified_percent_total 
                                                                           60 
                                                hospital_length_of_stay_total 
                                                                          151 
                                              hospital_length_of_stay_outcome 
                                                                          151 
                                    grievances_upheld_number_for_hospital_los 
                                                                          151 
                                   grievances_upheld_percent_for_hospital_los 
                                                                          151 
                                grievances_overturned_number_for_hospital_los 
                                                                          151 
                               grievances_overturned_percent_for_hospital_los 
                                                                          151 
                                  grievances_modified_number_for_hospital_los 
                                                                          151 
                                 grievances_modified_percent_for_hospital_los 
                                                                          151 
                             emergency_cases___resolution_hours_1_st_quarter_ 
                                                                          133 
                              emergency_cases___resolution_hours_2nd_quarter_ 
                                                                          133 
                             emergency_cases___resolution_hours_3rd__quarter_ 
                                                                          133 
                              emergency_cases___resolution_hours_4th_quarter_ 
                                                                          133 
                            non_emergency_cases___resolution_days_1st_quarter 
                                                                           40 
                            non_emergency_cases___resolution_days_2nd_quarter 
                                                                           40 
                            non_emergency_cases___resolution_days_3rd_quarter 
                                                                           40 
                            non_emergency_cases___resolution_days_4th_quarter 
                                                                           40 
                                          total_number_of__emergencies__cases 
                                                                          136 
                                                          emergencies_outcome 
                                                                          136 
                                  internal_emergency_grievances_upheld_number 
                                                                          136 
                                 internal_emergency_grievances_upheld_percent 
                                                                          136 
                              internal_emergency_grievances_overturned_number 
                                                                          136 
                             internal_emergency_grievances_overturned_percent 
                                                                          136 
                                internal_emergency_grievances_modified_number 
                                                                          136 
                               internal_emergency_grievances_modified_percent 
                                                                          136 
                                                complaints_investigated_total 
                                                                           94 
                                              complaints_investigated_percent 
                                                                           94 
                                                 carrier_upheld_by_mia_number 
                                                                           94 
                                                carrier_upheld_by_mia_percent 
                                                                           94 
                                               carrier_reversed_by_mia_number 
                                                                           94 
                                              carrier_reversed_by_mia_percent 
                                                                           94 
                                               carrier_modified_by_mia_number 
                                                                           94 
                                              carrier_modified_by_mia_percent 
                                                                           94 
                          carrier_reversed_itself_during_investigation_number 
                                                                           94 
                         carrier_reversed_itself_during_investigation_percent 
                                                                           94 

summary(mia)

 company_name           naic__           year     
 Length:178         Min.   :21113   Min.   :2021  
 Class :character   1st Qu.:60321   1st Qu.:2021  
 Mode  :character   Median :68381   Median :2022  
                    Mean   :70971   Mean   :2022  
                    3rd Qu.:85766   3rd Qu.:2023  
                    Max.   :96940   Max.   :2024  
                    NA's   :45                    
 adverse_decisions_company_total adverse_decisions_by_carrier_percent
 Min.   :     1                  Min.   :0.00000                     
 1st Qu.:    27                  1st Qu.:0.00000                     
 Median :   286                  Median :0.00300                     
 Mean   :  5190                  Mean   :0.04993                     
 3rd Qu.:  1421                  3rd Qu.:0.01400                     
 Max.   :111426                  Max.   :1.00100                     
 NA's   :25                      NA's   :25                          
 adverse_decisions_inpatient_hospital_services_number
 Min.   :   0.00                                     
 1st Qu.:   0.00                                     
 Median :   0.00                                     
 Mean   :  76.76                                     
 3rd Qu.:  20.00                                     
 Max.   :1786.00                                     
 NA's   :25                                          
 adverse_decisions_inpatient_hospital_services_percent_total
 Min.   :0.00000                                            
 1st Qu.:0.00000                                            
 Median :0.00000                                            
 Mean   :0.06061                                            
 3rd Qu.:0.01900                                            
 Max.   :1.00000                                            
 NA's   :25                                                 
 adverse_decisions_emergency_room_services_number
 Min.   :  0.000                                 
 1st Qu.:  0.000                                 
 Median :  0.000                                 
 Mean   :  4.993                                 
 3rd Qu.:  0.000                                 
 Max.   :199.000                                 
 NA's   :25                                      
 adverse_decisions_emergency_room_services_percent_total
 Min.   :0.000000                                       
 1st Qu.:0.000000                                       
 Median :0.000000                                       
 Mean   :0.000316                                       
 3rd Qu.:0.000000                                       
 Max.   :0.014925                                       
 NA's   :25                                             
 adverse_decisions_mental_health_services_number
 Min.   :   0.00                                
 1st Qu.:   0.00                                
 Median :   0.00                                
 Mean   :  47.33                                
 3rd Qu.:   5.00                                
 Max.   :1628.00                                
 NA's   :25                                     
 adverse_decisions_mental_health_services_percent_total
 Min.   :0.000000                                      
 1st Qu.:0.000000                                      
 Median :0.000000                                      
 Mean   :0.012250                                      
 3rd Qu.:0.003583                                      
 Max.   :0.416667                                      
 NA's   :25                                            
 adverse_decisions_physician_services_number
 Min.   :   0.0                             
 1st Qu.:   0.0                             
 Median :   0.0                             
 Mean   : 237.8                             
 3rd Qu.:  78.0                             
 Max.   :4605.0                             
 NA's   :25                                 
 adverse_decisions_physician_services_percent__total
 Min.   :0.00000                                    
 1st Qu.:0.00000                                    
 Median :0.00000                                    
 Mean   :0.05578                                    
 3rd Qu.:0.05655                                    
 Max.   :0.50000                                    
 NA's   :25                                         
 adverse_decisions_laboratory__radiology_services_number
 Min.   :    0.0                                        
 1st Qu.:    0.0                                        
 Median :    0.0                                        
 Mean   :  801.6                                        
 3rd Qu.:   22.0                                        
 Max.   :16634.0                                        
 NA's   :25                                             
 adverse_decisions_laboratory__radiology_services_percent__total_
 Min.   :0.00000                                                 
 1st Qu.:0.00000                                                 
 Median :0.00000                                                 
 Mean   :0.08811                                                 
 3rd Qu.:0.10600                                                 
 Max.   :1.00000                                                 
 NA's   :25                                                      
 adverse_decisions_pharmacy_services_number
 Min.   :    0                             
 1st Qu.:    0                             
 Median :    0                             
 Mean   : 2845                             
 3rd Qu.:   84                             
 Max.   :63958                             
 NA's   :25                                
 adverse_decisions_pharmacy_services_percent_total
 Min.   :0.0000                                   
 1st Qu.:0.0000                                   
 Median :0.0000                                   
 Mean   :0.1734                                   
 3rd Qu.:0.2940                                   
 Max.   :0.8710                                   
 NA's   :25                                       
 adverse_decisions_pt__ot__st_services__incl_inpat_rehab__number_
 Min.   :   0.0                                                  
 1st Qu.:   0.0                                                  
 Median :   0.0                                                  
 Mean   : 206.9                                                  
 3rd Qu.:   5.0                                                  
 Max.   :4565.0                                                  
 NA's   :25                                                      
 adverse_decisions_pt__ot__st_services__incl_inpat_rehab__percent__total__
 Min.   :0.00000                                                          
 1st Qu.:0.00000                                                          
 Median :0.00000                                                          
 Mean   :0.02434                                                          
 3rd Qu.:0.00300                                                          
 Max.   :0.50800                                                          
 NA's   :25                                                               
 adverse_decisions_skilled_nurse_faculty_sub_acute_nursing_home_number
 Min.   :  0.000                                                      
 1st Qu.:  0.000                                                      
 Median :  0.000                                                      
 Mean   :  6.497                                                      
 3rd Qu.:  0.000                                                      
 Max.   :238.000                                                      
 NA's   :25                                                           
 adverse_decisions_skilled_nurse_faculty_sub_acute_nursing_home_percent__total
 Min.   :0.000000                                                             
 1st Qu.:0.000000                                                             
 Median :0.000000                                                             
 Mean   :0.002245                                                             
 3rd Qu.:0.000000                                                             
 Max.   :0.057000                                                             
 NA's   :25                                                                   
 adverse_decisions_durable_medical_equipment_services_number
 Min.   :   0.00                                            
 1st Qu.:   0.00                                            
 Median :   0.00                                            
 Mean   :  75.12                                            
 3rd Qu.:  14.00                                            
 Max.   :1668.00                                            
 NA's   :25                                                 
 adverse_decisions_durable_medical_equipment_services_percent__total
 Min.   :0.00000                                                    
 1st Qu.:0.00000                                                    
 Median :0.00000                                                    
 Mean   :0.01934                                                    
 3rd Qu.:0.01064                                                    
 Max.   :1.00000                                                    
 NA's   :25                                                         
 adverse_decisions_dental_number adverse_decisions_dental_percent_total
 Min.   :    0                   Min.   :0.0000                        
 1st Qu.:    4                   1st Qu.:0.0020                        
 Median :   47                   Median :0.8889                        
 Mean   :  826                   Mean   :0.5286                        
 3rd Qu.:  526                   3rd Qu.:1.0000                        
 Max.   :16732                   Max.   :1.1250                        
 NA's   :25                      NA's   :25                            
 adverse_decisions_home_health_services_number
 Min.   :  0.000                              
 1st Qu.:  0.000                              
 Median :  0.000                              
 Mean   :  6.431                              
 3rd Qu.:  2.000                              
 Max.   :143.000                              
 NA's   :25                                   
 adverse_decisions_home_health_services_percent_total
 Min.   :0.0000000                                   
 1st Qu.:0.0000000                                   
 Median :0.0000000                                   
 Mean   :0.0019877                                   
 3rd Qu.:0.0008317                                   
 Max.   :0.0710000                                   
 NA's   :25                                          
 adverse_decisions_obesity__ivf__podiatry__hearing_and_vision_number_
 Min.   :   0.0                                                      
 1st Qu.:   0.0                                                      
 Median :   0.0                                                      
 Mean   :  52.9                                                      
 3rd Qu.:   8.0                                                      
 Max.   :1160.0                                                      
 NA's   :25                                                          
 adverse_decisions_obesity__ivf__podiatry__hearing_and_vision_percent__total_
 Min.   :0.00000                                                             
 1st Qu.:0.00000                                                             
 Median :0.00000                                                             
 Mean   :0.02345                                                             
 3rd Qu.:0.00200                                                             
 Max.   :0.66700                                                             
 NA's   :25                                                                  
 grievances_filed_company_total grievances_filed_percent_of_all_companies
 Min.   :    1.0                Min.   :0.00000                          
 1st Qu.:   10.5                1st Qu.:0.00100                          
 Median :   80.0                Median :0.00800                          
 Mean   :  599.7                Mean   :0.05862                          
 3rd Qu.:  300.0                3rd Qu.:0.02850                          
 Max.   :11526.0                Max.   :1.00200                          
 NA's   :43                     NA's   :43                               
 grievance_inpatient_hospital_services_number
 Min.   :  0.000                             
 1st Qu.:  0.000                             
 Median :  0.000                             
 Mean   :  7.141                             
 3rd Qu.:  4.000                             
 Max.   :171.000                             
 NA's   :43                                  
 grievance_inpatient_hospital_services_percent__total
 Min.   :0.00000                                     
 1st Qu.:0.00000                                     
 Median :0.00000                                     
 Mean   :0.03231                                     
 3rd Qu.:0.01200                                     
 Max.   :0.75000                                     
 NA's   :43                                          
 grievance_emergency_room_services_number
 Min.   : 0.00                           
 1st Qu.: 0.00                           
 Median : 0.00                           
 Mean   : 1.63                           
 3rd Qu.: 0.00                           
 Max.   :33.00                           
 NA's   :43                              
 grievance_emergency_room_services_percent_total
 Min.   :0.00000                                
 1st Qu.:0.00000                                
 Median :0.00000                                
 Mean   :0.01071                                
 3rd Qu.:0.00000                                
 Max.   :0.66700                                
 NA's   :43                                     
 grievance_mental_health_services_number
 Min.   :  0.000                        
 1st Qu.:  0.000                        
 Median :  0.000                        
 Mean   :  6.294                        
 3rd Qu.:  1.000                        
 Max.   :219.000                        
 NA's   :42                             
 grievance_mental_health_services_percent_total
 Min.   :0.000000                              
 1st Qu.:0.000000                              
 Median :0.000000                              
 Mean   :0.015603                              
 3rd Qu.:0.005381                              
 Max.   :0.485000                              
 NA's   :42                                    
 grievance_physician_services_number grievance_physician_services_percent_total
 Min.   :  0.00                      Min.   :0.0000                            
 1st Qu.:  0.00                      1st Qu.:0.0000                            
 Median :  0.00                      Median :0.0000                            
 Mean   : 34.97                      Mean   :0.0868                            
 3rd Qu.: 18.75                      3rd Qu.:0.1032                            
 Max.   :722.00                      Max.   :0.7500                            
 NA's   :42                          NA's   :42                                
 grievance_laboratory__radiology_services_number
 Min.   :   0.00                                
 1st Qu.:   0.00                                
 Median :   0.00                                
 Mean   :  78.24                                
 3rd Qu.:  28.50                                
 Max.   :1705.00                                
 NA's   :42                                     
 grievance_laboratory__radiology_services_percent_total_
 Min.   :0.000                                          
 1st Qu.:0.000                                          
 Median :0.000                                          
 Mean   :0.100                                          
 3rd Qu.:0.151                                          
 Max.   :1.000                                          
 NA's   :42                                             
 grievance_pharmacy_services_number grievance_pharmacy_services_percent_total
 Min.   :   0.0                     Min.   :0.0000                           
 1st Qu.:   0.0                     1st Qu.:0.0000                           
 Median :   0.0                     Median :0.0000                           
 Mean   : 293.3                     Mean   :0.1959                           
 3rd Qu.:  64.0                     3rd Qu.:0.3410                           
 Max.   :5927.0                     Max.   :1.0000                           
 NA's   :49                         NA's   :49                               
 grievance_pt__ot__st_services__incl_inpat_rehab__number_
 Min.   :  0.00                                          
 1st Qu.:  0.00                                          
 Median :  0.00                                          
 Mean   :  5.07                                          
 3rd Qu.:  1.00                                          
 Max.   :124.00                                          
 NA's   :49                                              
 grievance_pt__ot__st_services__incl_inpat_rehab__percent_total__
 Min.   :0.0000                                                  
 1st Qu.:0.0000                                                  
 Median :0.0000                                                  
 Mean   :0.0164                                                  
 3rd Qu.:0.0040                                                  
 Max.   :0.5000                                                  
 NA's   :49                                                      
 grievance_skilled_nurse_faculty_sub_acute_nursing_home_number
 Min.   : 0.000                                               
 1st Qu.: 0.000                                               
 Median : 0.000                                               
 Mean   : 1.333                                               
 3rd Qu.: 0.000                                               
 Max.   :41.000                                               
 NA's   :49                                                   
 grievance_skilled_nurse_faculty_sub_acute_nursing_home_percent_total
 Min.   :0.000000                                                    
 1st Qu.:0.000000                                                    
 Median :0.000000                                                    
 Mean   :0.001883                                                    
 3rd Qu.:0.000000                                                    
 Max.   :0.062000                                                    
 NA's   :49                                                          
 grievance_durable_medical_equipment_services_number
 Min.   :  0.0                                      
 1st Qu.:  0.0                                      
 Median :  0.0                                      
 Mean   : 13.6                                      
 3rd Qu.:  1.0                                      
 Max.   :376.0                                      
 NA's   :44                                         
 grievance_durable_medical_equipment_services_percent_total
 Min.   :0.00000                                           
 1st Qu.:0.00000                                           
 Median :0.00000                                           
 Mean   :0.01767                                           
 3rd Qu.:0.00700                                           
 Max.   :1.00000                                           
 NA's   :44                                                
 grievance_dental_number grievance_dental_percent_total
 Min.   :   0.00         Min.   :0.0000                
 1st Qu.:   0.00         1st Qu.:0.0000                
 Median :   9.00         Median :0.1425                
 Mean   : 143.85         Mean   :0.4713                
 3rd Qu.:  77.25         3rd Qu.:1.0000                
 Max.   :3169.00         Max.   :1.0000                
 NA's   :44              NA's   :44                    
 grievance_home_health_services_number
 Min.   :0.0000                       
 1st Qu.:0.0000                       
 Median :0.0000                       
 Mean   :0.2239                       
 3rd Qu.:0.0000                       
 Max.   :6.0000                       
 NA's   :44                           
 grievance_home_health_services_percent_total
 Min.   :0.000000                            
 1st Qu.:0.000000                            
 Median :0.000000                            
 Mean   :0.000265                            
 3rd Qu.:0.000000                            
 Max.   :0.008000                            
 NA's   :44                                  
 grievance_obesity__ivf__podiatry__hearing_and_vision_number_
 Min.   :  0.00                                              
 1st Qu.:  0.00                                              
 Median :  0.00                                              
 Mean   : 19.59                                              
 3rd Qu.:  2.00                                              
 Max.   :481.00                                              
 NA's   :43                                                  
 grievance_obesity__ivf__podiatry__hearing_and_vision_percent_total_
 Min.   :0.00000                                                    
 1st Qu.:0.00000                                                    
 Median :0.00000                                                    
 Mean   :0.02937                                                    
 3rd Qu.:0.00200                                                    
 Max.   :1.00000                                                    
 NA's   :43                                                         
 grievances_upheld_number grievances_upheld_percent_total
 Min.   :   0.00          Min.   :0.0000                 
 1st Qu.:   6.25          1st Qu.:0.4025                 
 Median :  46.50          Median :0.5130                 
 Mean   : 246.71          Mean   :0.5408                 
 3rd Qu.: 154.75          3rd Qu.:0.6677                 
 Max.   :4917.00          Max.   :1.0000                 
 NA's   :60               NA's   :60                     
 grievances_overturned_number grievances_overturned_percent_total
 Min.   :   0                 Min.   :0.0000                     
 1st Qu.:   4                 1st Qu.:0.2687                     
 Median :  29                 Median :0.4395                     
 Mean   : 265                 Mean   :0.4069                     
 3rd Qu.: 115                 3rd Qu.:0.5525                     
 Max.   :5270                 Max.   :1.0000                     
 NA's   :60                   NA's   :60                         
 grievances_modified_number grievances_modified_percent_total
 Min.   :  0.00             Min.   :0.00000                  
 1st Qu.:  0.00             1st Qu.:0.00000                  
 Median :  2.00             Median :0.01824                  
 Mean   : 23.98             Mean   :0.04666                  
 3rd Qu.: 11.50             3rd Qu.:0.05675                  
 Max.   :432.00             Max.   :0.33300                  
 NA's   :60                 NA's   :60                       
 hospital_length_of_stay_total hospital_length_of_stay_outcome
 Min.   :  1.0                 Min.   : 1.000                 
 1st Qu.:  1.5                 1st Qu.: 1.000                 
 Median :  8.0                 Median : 3.000                 
 Mean   : 18.3                 Mean   : 4.741                 
 3rd Qu.: 23.0                 3rd Qu.: 5.000                 
 Max.   :118.0                 Max.   :18.000                 
 NA's   :151                   NA's   :151                    
 grievances_upheld_number_for_hospital_los
 Min.   : 0.000                           
 1st Qu.: 1.000                           
 Median : 1.000                           
 Mean   : 2.889                           
 3rd Qu.: 3.500                           
 Max.   :13.000                           
 NA's   :151                              
 grievances_upheld_percent_for_hospital_los
 Min.   :0.0000                            
 1st Qu.:0.3483                            
 Median :0.7140                            
 Mean   :0.6282                            
 3rd Qu.:1.0000                            
 Max.   :1.0000                            
 NA's   :151                               
 grievances_overturned_number_for_hospital_los
 Min.   :0.00                                 
 1st Qu.:0.00                                 
 Median :1.00                                 
 Mean   :1.63                                 
 3rd Qu.:2.50                                 
 Max.   :7.00                                 
 NA's   :151                                  
 grievances_overturned_percent_for_hospital_los
 Min.   :0.0000                                
 1st Qu.:0.0000                                
 Median :0.2778                                
 Mean   :0.5405                                
 3rd Qu.:0.7085                                
 Max.   :5.5385                                
 NA's   :151                                   
 grievances_modified_number_for_hospital_los
 Min.   :0.0000                             
 1st Qu.:0.0000                             
 Median :0.0000                             
 Mean   :0.2222                             
 3rd Qu.:0.0000                             
 Max.   :1.0000                             
 NA's   :151                                
 grievances_modified_percent_for_hospital_los
 Min.   :0.00000                             
 1st Qu.:0.00000                             
 Median :0.00000                             
 Mean   :0.03289                             
 3rd Qu.:0.00000                             
 Max.   :0.25000                             
 NA's   :151                                 
 emergency_cases___resolution_hours_1_st_quarter_
 Min.   :  0.00                                  
 1st Qu.: 18.00                                  
 Median : 24.00                                  
 Mean   : 79.65                                  
 3rd Qu.: 31.90                                  
 Max.   :660.10                                  
 NA's   :133                                     
 emergency_cases___resolution_hours_2nd_quarter_
 Min.   :  0.00                                 
 1st Qu.: 21.00                                 
 Median : 24.00                                 
 Mean   : 59.44                                 
 3rd Qu.: 42.00                                 
 Max.   :527.40                                 
 NA's   :133                                    
 emergency_cases___resolution_hours_3rd__quarter_
 Min.   :  0.00                                  
 1st Qu.: 22.00                                  
 Median : 24.00                                  
 Mean   : 68.41                                  
 3rd Qu.: 41.00                                  
 Max.   :494.80                                  
 NA's   :133                                     
 emergency_cases___resolution_hours_4th_quarter_
 Min.   :  0.00                                 
 1st Qu.: 15.00                                 
 Median : 24.00                                 
 Mean   : 47.61                                 
 3rd Qu.: 34.00                                 
 Max.   :298.30                                 
 NA's   :133                                    
 non_emergency_cases___resolution_days_1st_quarter
 Min.   :  0.00                                   
 1st Qu.:  6.00                                   
 Median : 19.90                                   
 Mean   : 36.56                                   
 3rd Qu.: 28.68                                   
 Max.   :689.50                                   
 NA's   :40                                       
 non_emergency_cases___resolution_days_2nd_quarter
 Min.   :  0.00                                   
 1st Qu.:  7.00                                   
 Median : 21.30                                   
 Mean   : 40.76                                   
 3rd Qu.: 28.88                                   
 Max.   :729.90                                   
 NA's   :40                                       
 non_emergency_cases___resolution_days_3rd_quarter
 Min.   :  0.00                                   
 1st Qu.:  1.25                                   
 Median : 15.10                                   
 Mean   : 31.97                                   
 3rd Qu.: 25.00                                   
 Max.   :719.50                                   
 NA's   :40                                       
 non_emergency_cases___resolution_days_4th_quarter
 Min.   :  0.000                                  
 1st Qu.:  6.175                                  
 Median : 15.700                                  
 Mean   : 35.265                                  
 3rd Qu.: 27.850                                  
 Max.   :832.900                                  
 NA's   :40                                       
 total_number_of__emergencies__cases emergencies_outcome
 Min.   :   1.0                      Min.   :  1.0      
 1st Qu.:  23.5                      1st Qu.: 21.0      
 Median : 177.0                      Median : 63.0      
 Mean   : 311.5                      Mean   :140.0      
 3rd Qu.: 320.2                      3rd Qu.:169.5      
 Max.   :2491.0                      Max.   :904.0      
 NA's   :136                         NA's   :136        
 internal_emergency_grievances_upheld_number
 Min.   :  0.00                             
 1st Qu.: 10.50                             
 Median : 25.00                             
 Mean   : 52.67                             
 3rd Qu.: 53.50                             
 Max.   :382.00                             
 NA's   :136                                
 internal_emergency_grievances_upheld_percent
 Min.   :0.0000                              
 1st Qu.:0.3069                              
 Median :0.4105                              
 Mean   :0.4225                              
 3rd Qu.:0.5120                              
 Max.   :1.0000                              
 NA's   :136                                 
 internal_emergency_grievances_overturned_number
 Min.   :  0.00                                 
 1st Qu.: 12.25                                 
 Median : 35.00                                 
 Mean   : 85.62                                 
 3rd Qu.: 93.75                                 
 Max.   :506.00                                 
 NA's   :136                                    
 internal_emergency_grievances_overturned_percent
 Min.   :0.0000                                  
 1st Qu.:0.4617                                  
 Median :0.5895                                  
 Mean   :0.5625                                  
 3rd Qu.:0.6824                                  
 Max.   :1.0000                                  
 NA's   :136                                     
 internal_emergency_grievances_modified_number
 Min.   : 0.000                               
 1st Qu.: 0.000                               
 Median : 0.000                               
 Mean   : 1.667                               
 3rd Qu.: 2.000                               
 Max.   :16.000                               
 NA's   :136                                  
 internal_emergency_grievances_modified_percent complaints_investigated_total
 Min.   :0.00000                                Min.   :  1.00               
 1st Qu.:0.00000                                1st Qu.:  1.00               
 Median :0.00000                                Median :  5.00               
 Mean   :0.01509                                Mean   : 31.83               
 3rd Qu.:0.01727                                3rd Qu.: 16.25               
 Max.   :0.09100                                Max.   :395.00               
 NA's   :136                                    NA's   :94                   
 complaints_investigated_percent carrier_upheld_by_mia_number
 Min.   :0.00000                 Min.   :  0.000             
 1st Qu.:0.00000                 1st Qu.:  0.000             
 Median :0.02000                 Median :  1.500             
 Mean   :0.09476                 Mean   :  9.738             
 3rd Qu.:0.05000                 3rd Qu.:  6.000             
 Max.   :1.02000                 Max.   :131.000             
 NA's   :94                      NA's   :94                  
 carrier_upheld_by_mia_percent carrier_reversed_by_mia_number
 Min.   :0.0000                Min.   :  0.000               
 1st Qu.:0.0000                1st Qu.:  0.000               
 Median :0.2912                Median :  1.000               
 Mean   :0.4095                Mean   :  8.595               
 3rd Qu.:0.4550                3rd Qu.:  4.250               
 Max.   :6.0000                Max.   :105.000               
 NA's   :94                    NA's   :94                    
 carrier_reversed_by_mia_percent carrier_modified_by_mia_number
 Min.   : 0.0000                 Min.   : 0.0                  
 1st Qu.: 0.0000                 1st Qu.: 0.0                  
 Median : 0.1700                 Median : 0.0                  
 Mean   : 0.5389                 Mean   : 0.5                  
 3rd Qu.: 0.3000                 3rd Qu.: 0.0                  
 Max.   :14.0000                 Max.   :14.0                  
 NA's   :94                      NA's   :94                    
 carrier_modified_by_mia_percent
 Min.   :0.00000                
 1st Qu.:0.00000                
 Median :0.00000                
 Mean   :0.04162                
 3rd Qu.:0.00000                
 Max.   :1.00000                
 NA's   :94                     
 carrier_reversed_itself_during_investigation_number
 Min.   :  0.00                                     
 1st Qu.:  1.00                                     
 Median :  2.00                                     
 Mean   : 12.98                                     
 3rd Qu.:  6.00                                     
 Max.   :145.00                                     
 NA's   :94                                         
 carrier_reversed_itself_during_investigation_percent
 Min.   : 0.0000                                     
 1st Qu.: 0.1275                                     
 Median : 0.4119                                     
 Mean   : 0.6328                                     
 3rd Qu.: 0.5725                                     
 Max.   :10.3571                                     
 NA's   :94                                          

totals_only <- mia |>
  filter(company_name == "Total")

str(admin)

'data.frame':   70 obs. of  12 variables:
 $ year                                                : int  2021 2021 2021 2021 2021 2021 2021 2021 2021 2021 ...
 $ Type.of.Procedure                                   : chr  "Air Ambulance" "Cosmetic" "Dental Care Services" "Durable Medical Equipment" ...
 $ carrier.code                                        : chr  "B" "D" "J" "I" ...
 $ total                                               : int  2 3 32 7 2 6 1 2 45 1 ...
 $ carrier.upheld.by.MIA.numner                        : int  2 0 10 2 0 4 0 2 27 0 ...
 $ carrier.upheld.by.mia.percent                       : num  1 0 0.31 0.29 0 0.67 0 1 0.6 0 ...
 $ carrier.revesered.by.mia.number                     : int  0 2 4 3 0 1 1 0 11 0 ...
 $ carrier.reversed.by.mia.percent                     : num  0 0.67 0.13 0.43 0 0.17 1 0 0.24 0 ...
 $ carrier.modifed.by.mia.numbner                      : int  0 1 1 0 0 0 0 0 0 0 ...
 $ carrier.modifed.by.mia.percent                      : num  0 0.33 0.03 0 0 0 0 0 0 0 ...
 $ carrier.reversed.itself.during.investigation.number : int  0 0 17 2 2 1 0 0 7 1 ...
 $ carrier.reversed.itself.during.investigation.percent: num  0 5 0.53 0.29 1 0.17 0 0 0.16 1 ...

names(admin) <- tolower(names(admin))
names(admin) <- gsub(' ',"_",names(admin))
names(admin) <- gsub("\\.", "_",names(admin))

admin_totals_only <- admin |>
  filter(type_of_procedure == "Total")

colnames(admin)

 [1] "year"                                                
 [2] "type_of_procedure"                                   
 [3] "carrier_code"                                        
 [4] "total"                                               
 [5] "carrier_upheld_by_mia_numner"                        
 [6] "carrier_upheld_by_mia_percent"                       
 [7] "carrier_revesered_by_mia_number"                     
 [8] "carrier_reversed_by_mia_percent"                     
 [9] "carrier_modifed_by_mia_numbner"                      
[10] "carrier_modifed_by_mia_percent"                      
[11] "carrier_reversed_itself_during_investigation_number" 
[12] "carrier_reversed_itself_during_investigation_percent"

summary(admin)

      year      type_of_procedure  carrier_code           total       
 Min.   :2021   Length:70          Length:70          Min.   :  1.00  
 1st Qu.:2021   Class :character   Class :character   1st Qu.:  1.00  
 Median :2022   Mode  :character   Mode  :character   Median :  3.50  
 Mean   :2022                                         Mean   : 38.20  
 3rd Qu.:2023                                         3rd Qu.: 30.25  
 Max.   :2024                                         Max.   :395.00  
 carrier_upheld_by_mia_numner carrier_upheld_by_mia_percent
 Min.   :  0.00               Min.   :0.0000               
 1st Qu.:  0.00               1st Qu.:0.0000               
 Median :  2.00               Median :0.2975               
 Mean   : 11.69               Mean   :0.3407               
 3rd Qu.:  9.75               3rd Qu.:0.5000               
 Max.   :131.00               Max.   :1.0000               
 carrier_revesered_by_mia_number carrier_reversed_by_mia_percent
 Min.   :  0.00                  Min.   :0.0000                 
 1st Qu.:  0.00                  1st Qu.:0.0000                 
 Median :  1.00                  Median :0.1200                 
 Mean   : 10.31                  Mean   :0.1770                 
 3rd Qu.:  4.00                  3rd Qu.:0.2828                 
 Max.   :105.00                  Max.   :1.0000                 
 carrier_modifed_by_mia_numbner carrier_modifed_by_mia_percent
 Min.   : 0.0                   Min.   :0.00000               
 1st Qu.: 0.0                   1st Qu.:0.00000               
 Median : 0.0                   Median :0.00000               
 Mean   : 0.6                   Mean   :0.01483               
 3rd Qu.: 0.0                   3rd Qu.:0.00000               
 Max.   :14.0                   Max.   :0.33000               
 carrier_reversed_itself_during_investigation_number
 Min.   :  0.00                                     
 1st Qu.:  1.00                                     
 Median :  1.50                                     
 Mean   : 15.54                                     
 3rd Qu.: 11.00                                     
 Max.   :144.00                                     
 carrier_reversed_itself_during_investigation_percent
 Min.   :0.0000                                      
 1st Qu.:0.1300                                      
 Median :0.4300                                      
 Mean   :0.5384                                      
 3rd Qu.:1.0000                                      
 Max.   :5.0000                                      

Adverse Decisions

adp1 <- totals_only |>
  select(year,adverse_decisions_company_total)|>
  ggplot(aes(x = year, y = adverse_decisions_company_total)) +
  geom_line(color = "blue") +
  geom_point() +
  labs(
    title = "Total Amount of Adverse Decisions Over Time",
  caption = "Source: Maryland Insurance Administration")

adp1

adverse_growth <- totals_only |>
  select(year,adverse_decisions_company_total) |>
  arrange(year)|>
  mutate(
    pct_change = (adverse_decisions_company_total - lag(adverse_decisions_company_total)) / lag(adverse_decisions_company_total) * 100
  )

adverse_growth

  year adverse_decisions_company_total pct_change
1 2021                           81143         NA
2 2022                           95327  17.480251
3 2023                          109123  14.472290
4 2024                          111426   2.110463

top_companies_ad <- mia |>
  filter(`company_name` != "Total") |>
  group_by(`company_name`) |>
  summarise(total = sum(`adverse_decisions_company_total`, na.rm = TRUE)) |>
  arrange(desc(total)) |>
  head(10) |>
  ggplot(aes(x = reorder(`company_name`, total), y = total)) +
  geom_bar(stat = "identity") +
  coord_flip() +
  labs(
    title = "Top 10 Companies with Adverse Decisions 2021-2024",
    caption = 'Source: Maryland Insurance Administration',
    x = 'Company Name',
    y = 'Total'
  ) +
  theme(plot.title = element_text(size = 10, face = "bold"))

top_companies_ad

totals_adverse_services <- totals_only |>
  select(
    year,
    adverse_decisions_inpatient_hospital_services_number,
    adverse_decisions_emergency_room_services_number,
    adverse_decisions_mental_health_services_number,
   adverse_decisions_physician_services_number,
  adverse_decisions_laboratory__radiology_services_number,
    adverse_decisions_pharmacy_services_number,
    adverse_decisions_pt__ot__st_services__incl_inpat_rehab__number_,
    adverse_decisions_skilled_nurse_faculty_sub_acute_nursing_home_number,
   adverse_decisions_durable_medical_equipment_services_number,
    adverse_decisions_dental_number,
    adverse_decisions_home_health_services_number,
    adverse_decisions_obesity__ivf__podiatry__hearing_and_vision_number_
  )

totals_adverse_services_long <- totals_adverse_services |>
  pivot_longer(
    cols = -year,
    names_to = "service",
    values_to = "count"
  )

adverse_service_growth <- totals_adverse_services_long |>
  arrange(service, year) |>
  group_by(service) |>
  mutate(
    pct_change = (count - lag(count)) / lag(count) * 100
  ) |>
  ungroup() 


adverse_service_growth

# A tibble: 48 × 4
    year service                                                count pct_change
   <int> <chr>                                                  <int>      <dbl>
 1  2021 adverse_decisions_dental_number                        15133     NA    
 2  2022 adverse_decisions_dental_number                        15065     -0.449
 3  2023 adverse_decisions_dental_number                        16732     11.1  
 4  2024 adverse_decisions_dental_number                        16256     -2.84 
 5  2021 adverse_decisions_durable_medical_equipment_services_…  1364     NA    
 6  2022 adverse_decisions_durable_medical_equipment_services_…  1161    -14.9  
 7  2023 adverse_decisions_durable_medical_equipment_services_…  1668     43.7  
 8  2024 adverse_decisions_durable_medical_equipment_services_…  1554     -6.83 
 9  2021 adverse_decisions_emergency_room_services_number          10     NA    
10  2022 adverse_decisions_emergency_room_services_number         112   1020    
# ℹ 38 more rows

ggplot(adverse_service_growth, aes(x = year, y = service, fill = pct_change)) +
  geom_tile(color = "white") +
  geom_text(aes(label = paste0(round(pct_change, 1), "%")), size = 3) +
  scale_fill_gradient2(
    name = "% Change"
  ) +
  labs(
    title = "Percent Change in Adverse Decisions by Service",
    caption = "Source: Maryland Insurance Administration"
  ) +
  theme_minimal() +
  theme(
    axis.text.y = element_text(size = 8)
  )

ggplot(totals_adverse_services_long, aes(x = year, y = count)) +
  geom_line( color = "darkgreen") +
  geom_point() +
  facet_wrap(~ service, scales = "free_y", ncol = 3) +
  labs(
    title = "Adverse Decisions by Service Over Time (2021-2024)",
    x = "Year",
    y = "Count",
    caption = "Source: Maryland Insurance Administration"
  ) +
  theme_minimal() +
  theme(
    strip.text = element_text(size = 7, face = "bold"),
    axis.text.x = element_text(angle = 45, hjust = 1, size = 7)
  )

Grievances

grp1 <- totals_only |>
  select(year,grievances_filed_company_total)|>
  ggplot(aes(x = year, y = grievances_filed_company_total)) +
  geom_line() +
  geom_point() +
  labs(
    title = "Total Amount of Grievances Over Time",
    caption = "Source: Maryland Insurance Administration"
  )
grp1

grievance_growth <- totals_only |>
  select(year,grievances_filed_company_total) |>
  arrange(year) |>
  mutate(
    pct_change = (grievances_filed_company_total - lag(grievances_filed_company_total)) / lag(grievances_filed_company_total) * 100
  )

grievance_growth

  year grievances_filed_company_total pct_change
1 2021                           8073         NA
2 2022                          10305  27.647715
3 2023                          10574   2.610383
4 2024                          11526   9.003215

top_companies_gr <- mia |>
  filter(`company_name` != "Total") |>
  group_by(`company_name`) |>
  summarise(total = sum(`grievances_filed_company_total`, na.rm = TRUE)) |>
  arrange(desc(total)) |>
  head(10) |>
  ggplot(aes(x = reorder(`company_name`, total), y = total)) +
  geom_bar(stat = "identity") +
  coord_flip() +
  labs(title = "Top 10 Companies with Grievances 2021-2024",
       x = 'Company Name',
       y= 'Total',
       caption = "Source: Maryland Insurance Administration"
       ) 
top_companies_gr

outcome <- mia |>
filter(`company_name` != "Total") |>
  summarise(
    upheld = sum(`grievances_upheld_number`, na.rm = TRUE),
    overturned = sum(`grievances_overturned_number`, na.rm = TRUE),
    modified = sum(`grievances_modified_number`, na.rm = TRUE)
  )|>
  pivot_longer(everything(), names_to = "outcome", values_to = "count") |>
  ggplot(aes(x = outcome, y = count, fill = outcome)) +
  geom_bar(stat = "identity") +
labs(
  title = "Grievances Outcome 202-2024",
  caption = "Source: Maryland Insurance Administration"
)
outcome

totals_grievances_services <- totals_only |>
  select(
    year,
    grievance_inpatient_hospital_services_number,
    grievance_emergency_room_services_number,
    grievance_mental_health_services_number,
    grievance_physician_services_number,
    grievance_laboratory__radiology_services_number,
    grievance_pharmacy_services_number,
    grievance_pt__ot__st_services__incl_inpat_rehab__number_,
    grievance_skilled_nurse_faculty_sub_acute_nursing_home_number,
    grievance_durable_medical_equipment_services_number,
    grievance_dental_number,
    grievance_home_health_services_number,
    grievance_obesity__ivf__podiatry__hearing_and_vision_number_
  )

totals_grievances_services_long <- totals_grievances_services |>
  pivot_longer(
    cols = -year,
    names_to = "service",
    values_to = "count"
  )

grievance_service_growth <- totals_grievances_services_long |>
  arrange(service, year) |>
  group_by(service) |>
  mutate(
    pct_change = (count - lag(count)) / lag(count) * 100
  ) |>
  ungroup()

grievance_service_growth

# A tibble: 48 × 4
    year service                                             count pct_change
   <int> <chr>                                               <int>      <dbl>
 1  2021 grievance_dental_number                              2375      NA   
 2  2022 grievance_dental_number                              3169      33.4 
 3  2023 grievance_dental_number                              2157     -31.9 
 4  2024 grievance_dental_number                              1937     -10.2 
 5  2021 grievance_durable_medical_equipment_services_number   123      NA   
 6  2022 grievance_durable_medical_equipment_services_number   216      75.6 
 7  2023 grievance_durable_medical_equipment_services_number   196      -9.26
 8  2024 grievance_durable_medical_equipment_services_number   376      91.8 
 9  2021 grievance_emergency_room_services_number               20      NA   
10  2022 grievance_emergency_room_services_number               30      50   
# ℹ 38 more rows

ggplot(grievance_service_growth, aes(x = year, y = service, fill = pct_change)) +
  geom_tile(color = "white") +
  geom_text(aes(label = paste0(round(pct_change, 1), "%")), size = 3) +
  scale_fill_gradient2(
    name = "% Change"
  ) +
  labs(
    title = "Percent Change in Grievances by Service",
    caption = "Source: Maryland Insurance Administration"
  ) +
  theme_minimal() +
  theme(
    axis.text.y = element_text(size = 8)
  )

ggplot(totals_grievances_services_long, aes(x = year, y = count)) +
  geom_line( color = "darkgreen") +
  geom_point() +
  facet_wrap(~ service, scales = "free_y", ncol = 3) +
  labs(
    title = "Grievances by Service Over Time (2021-2024)",
    x = "Year",
    y = "Count",
    caption = "Source: Maryland Insurance Administration"
  ) +
  theme_minimal() +
  theme(
    strip.text = element_text(size = 7, face = "bold"),
    axis.text.x = element_text(angle = 45, hjust = 1, size = 7)
  )

gr_outcome <- totals_only|>
select(year,grievances_overturned_number,grievances_upheld_number,grievances_modified_number)|>
   group_by(year) |>
  pivot_longer(-year, names_to = "outcome", values_to = "count") |>
  ggplot(aes(x = year, y = count, color = outcome)) +
  geom_line(size = 1) +
  geom_point()+
  labs(
    title = "Grievances Outcome"
  )

Warning: Using `size` aesthetic for lines was deprecated in ggplot2 3.4.0.
ℹ Please use `linewidth` instead.

  gr_outcome

Hospital Length Of Stay

mia_los<- totals_only |>
select(year,grievances_upheld_number_for_hospital_los,grievances_overturned_number_for_hospital_los,grievances_modified_number_for_hospital_los)|>  group_by(year) |>
  pivot_longer(-year, names_to = "outcome", values_to = "count") |>
  ggplot(aes(x = year, y = count, color = outcome)) +
  geom_line(size = 1) +
  geom_point() +
  labs(
    title = "Grievances Outcome For Hospital Length of Stay",
    y = "Number of Cases",
    color = "Outcome",
    caption = "Source:Maryland Insurance Administration"
  )
mia_los

Emergency Cases Resolution Hours

emer_res <- totals_only|>
  select(year, emergency_cases___resolution_hours_1_st_quarter_,emergency_cases___resolution_hours_2nd_quarter_,emergency_cases___resolution_hours_3rd__quarter_,emergency_cases___resolution_hours_4th_quarter_) 

emer_res_long <- emer_res |>
  pivot_longer(
    cols = -year,
    names_to = "Quarters",
    values_to = "Resolution_Hours"
  )

eme_plot <- ggplot(emer_res_long, 
  aes(x = year, y = Resolution_Hours, fill = Quarters)) +
  geom_bar(stat = "identity", color = "black",
           position = position_dodge(width = 0.9)) +
  labs(
    title = "Quarterly Emergency Resolution Hours By Year",
    x = "Year",
    y = "Resolution Hours",
    fill = "Quarter",
    caption = "Source: Maryland Insurance Administration"
  ) +
  theme_minimal()

eme_plot

Non-Emergency Cases Resolution Days

non_emer_res <- totals_only|>
  select(year, non_emergency_cases___resolution_days_1st_quarter,non_emergency_cases___resolution_days_2nd_quarter,non_emergency_cases___resolution_days_3rd_quarter,non_emergency_cases___resolution_days_4th_quarter) 

non_emer_res_long <- non_emer_res |>
  pivot_longer(
    cols = -year,
    names_to = "quarters",
    values_to = "resolution_Days"
  )

non_eme_plot <- ggplot(non_emer_res_long, 
  aes(x = year, y = resolution_Days, fill = quarters)) +
  geom_bar(stat = "identity", color = "black",
           position = position_dodge(width = 0.9)) +
  labs(
    title = "Quarterly Emergency Resolution Days By Year",
    x = "Year",
    y = "Resolution Days",
    fill = "Quarter",
    caption = "Source: Maryland Insurance Administration"
  ) +
  theme_minimal()

non_eme_plot

MIA Outcome

mia_dec<- totals_only |>
  select(year,carrier_upheld_by_mia_number,carrier_modified_by_mia_number,carrier_reversed_by_mia_number)|>
  pivot_longer(-year, names_to = "outcome", values_to = "count") |>
  ggplot(aes(x = year, y = count, color = outcome)) +
  geom_line(size = 1) +
  geom_point() +
  labs(
    title = "MIA Decisions Over Time",
    y = "Number of Cases",
    color = "Outcome",
    caption = "Source: Maryland Insurance Administration"
  )
mia_dec

admin |>
  filter(type_of_procedure != "TOTAL") |>
  pivot_longer(
    cols = c(carrier_upheld_by_mia_numner, 
             carrier_revesered_by_mia_number, 
             carrier_modifed_by_mia_numbner),
    names_to = "decision",
    values_to = "count"
  ) |>
  ggplot(aes(x = type_of_procedure, y = count, fill = decision)) +
  geom_bar(stat = "identity", position = position_dodge()) +
  facet_wrap(~ year, ncol = 2) +
  labs(
    title = "MIA Appeal Decisions by Procedure Type (2021-2024)",
    x = "Type of Procedure",
    y = "Number of Decisions",
    fill = "Decision Type",
    caption = "Source: Maryland Insurance Administration"
  ) +
  theme_minimal() +
  theme(axis.text.x = element_text(angle = 90, hjust = 1, size = 7))