The column chart shows rates of satisfaction with Medicaid managed care by year. The chart can be filtered by measure by changing the option under the filter tab. The chart uses statewide average rates of all insurance plans. Removing the statewide average filter is not recommended. For more information, check out http://www.health.ny.gov/health_care/managed_care/reports/quality_performance_improvement.htm. The "About" tab contains additional details concerning this dataset.

As a way of monitoring managed care plan performance and improving the quality of care provided to New York State residents, the New York State Department of Health (NYSDOH) collects data for four types of managed care insurance (commercial HMO, commercial Preferred Provider Organization, Medicaid managed care, and Child Health Plus) on an annual basis.

This map shows the total incentive payments disbursed to Eligible Professionals (EPs) and Eligible Hospitals (EHs) by county beginning in 2011, through the NY Medicaid Electronic Health Records (EHR) Incentive Program, a CMS Promoting Interoperability Program. The darker shading represents the counties that have received the most payments.
Authorized by the American Recovery and Reinvestment Act (ARRA) of 2009, this program provides multi-year financial incentives to EPs and EHs who adopt, implement, or upgrade, and subsequently demonstrate meaningful use, of Certified Electronic Health Record Technology (CEHRT).
For more information please visit: https://www.health.ny.gov/ehr.

The datasets contain number of Medicaid PQI hospitalizations (numerator), county Medicaid population (denominator), observed rate, expected number of hospitalizations and rate, and risk-adjusted rate for Agency for Healthcare Research and Quality Prevention Quality Indicators – Adult (AHRQ PQI) for Medicaid enrollees beginning in 2011.

The chart shows risk adjusted Potentially Preventable Readmission rates by hospital for Medicaid enrollees beginning in 2011.
The Potentially Preventable Readmission (PPR) software created by 3M Health Information Systems, identifies hospital admissions clinically related to an initial admission within a specified time period. For this dataset, readmissions were evaluated within a 30-day time period from the discharge date of the initial hospital admission. A PPR may have resulted from a deficiency in the process of care and treatment at the initial hospitalization or lack of post discharge follow up. PPRs are not defined by unrelated events that occur post-discharge, such as admissions for trauma.
For each hospital, the total number of at risk admissions, the total number of observed PPR chains, the observed PPR rate, the expected PPR rate, and risk adjusted PPR rate are presented by year. For more information, check out http://www.health.ny.gov/health_care/medicaid/. The "About" tab contains additional details concerning this dataset.

The datasets contain number of Medicaid PQI hospitalizations (numerator), county Medicaid population (denominator), observed rate, expected number of hospitalizations and rate, and risk-adjusted rate for Agency for Healthcare Research and Quality Prevention Quality Indicators – Adult (AHRQ PQI) for Medicaid enrollees beginning in 2011.

Note: The final update to this dataset was on 7/31/2023. The dataset is representative of financial incentive payments disbursed to Eligible Professionals (EPs) and Eligible Hospitals (EHs) by the NY Medicaid Electronic Health Records (EHR) Incentive Program, a CMS Promoting Interoperability Program. Authorized by the American Recovery and Reinvestment Act (ARRA) of 2009, this program provides multi-year financial incentives to EPs and EHs who adopt, implement, or upgrade, and subsequently demonstrate meaningful use of Certified Electronic Health Record Technology (CEHRT).

The dataset contains Potentially Preventable Readmission observed, expected, and risk adjusted rates by hospital for Medicaid enrollees beginning in 2011.

The chart shows observed vs. expected Potentially Preventable Readmission rates by hospital for Medicaid enrollees in 2014.
The Potentially Preventable Readmission (PPR) software created by 3M Health Information Systems, identifies hospital admissions clinically related to an initial admission within a specified time period. For this dataset, readmissions were evaluated within a 30-day time period from the discharge date of the initial hospital admission. A PPR may have resulted from a deficiency in the process of care and treatment at the initial hospitalization or lack of post discharge follow up. PPRs are not defined by unrelated events that occur post-discharge, such as admissions for trauma.
For each hospital, the total number of at risk admissions, the total number of observed PPR chains, the observed PPR rate, the expected PPR rate, and risk adjusted PPR rate are presented by year. For more information, check out http://www.health.ny.gov/health_care/medicaid/. The "About" tab contains additional details concerning this dataset.

This dataset contains individual provider netowrk data.The primary purpose for the Provider Network Data System is to collect data needed to evaluate the provider networks including physicians, hospitals, labs, home health agencies, durable medical equipment providers, etc., for all types of Managed Care plans in New York State, including HIV Special Need Plans (SNP), Family Health Plus (FHP) Buy-In, Programs of All-Inclusive Care for the Elderly (PACE), and Non-PACE Managed Long-Term Care (MLTC) plans. For more information, check out: http://www.health.ny.gov/health_care/managed_care/.

This data set contains information on selected chronic health conditions in the Medicaid population at the zip code level. The chronic health conditions were identified through 3M Clinical Risk Group software and Medicaid enrollment/eligibility, encounter, claim and pharmacy data over a 12-month period.

This dataset contains information on selected chronic health conditions in the Medicaid population at the county level. The chronic health conditions were identified through 3M Clinical Risk Group software and Medicaid enrollment/eligibility, encounter, claim and pharmacy data over a 12-month period.

The datasets contain number of Medicaid PDI hospitalizations (numerator), county or zip Medicaid population (denominator), observed rate, expected number of hospitalizations and rate, and risk-adjusted rate for Agency for Healthcare Research and Quality Pediatric Quality Indicators – Pediatric (AHRQ PDI) for Medicaid enrollees beginning in 2011. The Agency for Healthcare Research and Quality (AHRQ) Pediatric Quality Indicators (PDIs) are a set of population based measures that can be used with hospital inpatient discharge data to identify ambulatory care sensitive conditions. These are conditions where 1) the need for hospitalization is potentially preventable with appropriate outpatient care, or 2) conditions that could be less severe if treated early and appropriately. Both the Urinary Tract Infection and Gastroenteritis PDIs include admissions for patients aged 3 months through 17 years. The asthma PDI includes admissions for patients aged 2 through 17 years. Eligible admissions for the Diabetes Short-term Complications PDI includes admissions for patients aged 6 through 17 years.

This data set contains statewide Medicaid beneficiary counts by valid NYS five-digit zip code. Also in this file are counts of beneficiaries who are dual eligible for Medicaid and Medicare, total inpatient admissions, and total emergency room visits.

The primary purpose for the Provider Network Data System is to collect data needed to evaluate the provider networks including physicians, hospitals, labs, home health agencies, durable medical equipment providers, etc., for all types of Managed Care plans in New York State, including HIV Special Need Plans (SNP), Family Health Plus (FHP) Buy-In, Programs of All-Inclusive Care for the Elderly (PACE), and Non-PACE Managed Long-Term Care (MLTC) plans.

This dataset reflects institutional provider data.

Provider Network Data System information is self-reported.

For more information, check out http://www.health.ny.gov/health_care/managed_care/.

This chart shows the overall risk adjusted rate per 100,000 for Medicaid prevention quality indicators for pediatric discharges by county and year.The datasets contain number of Medicaid PDI hospitalizations (numerator), county or zip Medicaid population (denominator), observed rate, expected number of hospitalizations and rate, and risk-adjusted rate for Agency for Healthcare Research and Quality Pediatric Quality Indicators – Pediatric (AHRQ PDI) for Medicaid enrollees beginning in 2011.

The Agency for Healthcare Research and Quality (AHRQ) Pediatric Quality Indicators (PDIs) are a set of population based measures that can be used with hospital inpatient discharge data to identify ambulatory care sensitive conditions. These are conditions where 1) the need for hospitalization is potentially preventable with appropriate outpatient care, or 2) conditions that could be less severe if treated early and appropriately. Both the Urinary Tract Infection and Gastroenteritis PDIs include admissions for patients aged 3 months through 17 years. The asthma PDI includes admissions for patients aged 2 through 17 years. Eligible admissions for the Diabetes Short-term Complications PDI includes admissions for patients aged 6 through 17 years.

The rates were calculated using Medicaid inpatient hospital data for the numerator and Medicaid enrollment in the county or zip code for the denominator.

The observed counts and rates, expected counts and rates, risk-adjusted rates and the difference between the number of observed and expected PDI hospitalizations for each AHRQ PDI are presented by either resident county (including a statewide total) or resident zip code (including a statewide total). For more information, check out: http://www.health.ny.gov/health_care/medicaid/. The "About" tab contains additional details concerning this dataset.

The primary purpose for the Provider Network Data System is to collect data needed to evaluate the provider networks including physicians, hospitals, labs, home health agencies, durable medical equipment providers, etc., for all types of Managed Care plans in New York State, including HIV Special Need Plans (SNP), Family Health Plus (FHP) Buy-In, Programs of All-Inclusive Care for the Elderly (PACE), and Non-PACE Managed Long-Term Care (MLTC) plans. This dataset reflects individual provider data. Provider Network Data System information is self-reported. For more information, check out http://www.health.ny.gov/health_care/managed_care/.

This dataset includes Medicaid Managed Care, Commercial HMO, and Commercial PPO performance data from the Quality Assurance Reporting Requirements (QARR) by member demographic characteristics. QARR is largely based on measures of quality developed and published by the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS®). Plans are required to submit quality performance data each year. Demographic information analyzed in this report includes members’ sex, age, race/ethnicity, Medicaid aid category, cash assistance status, behavioral health conditions including serious mental illness (SMI) and substance use disorder (SUD), payer status, and region of residence. Measuring the quality of care, and the ability to measure disparities in care is an important first step to a better understanding of the underlying factors that drive differences in care among certain populations within Medicaid Managed Care, Commercial HMO, and Commercial PPO.
These data are published annually for Medicaid Managed Care in the Health Care Disparities in New York State Report and on the NYSDOH web site: https://www.health.ny.gov/health_care/managed_care/reports/

This dataset aggregates and displays the number of New York State Medicaid enrollees by eligibility year and month within each NYS Economic Region, health insurance plan information, and enrollee demographics.

The datasets contain number of Medicaid PDI hospitalizations (numerator), county or zip Medicaid population (denominator), observed rate, expected number of hospitalizations and rate, and risk-adjusted rate for Agency for Healthcare Research and Quality Pediatric Quality Indicators – Pediatric (AHRQ PDI) for Medicaid enrollees beginning in 2011.

The primary purpose for the Provider Network Data System is to collect data needed to evaluate the provider networks including physicians, hospitals, labs, home health agencies, durable medical equipment providers, etc., for all types of Managed Care plans in New York State, including HIV Special Need Plans (SNP), Family Health Plus (FHP) Buy-In, Programs of All-Inclusive Care for the Elderly (PACE), and Non-PACE Managed Long-Term Care (MLTC) plans.

This dataset reflects institutional provider data.
Provider Network Data System information is self reported. For more information, go to http://www.health.ny.gov/health_care/managed_care/.

This dataset includes Medicaid clinical metrics for Clinical Improvement Projects (Domain 3) of the Delivery System Reform Incentive Payment (DSRIP) Program. The DSRIP program will promote community-level collaborations and focus on system reform, specifically a goal to achieve a 25 percent reduction in avoidable hospital use over five years. As a part of the DSRIP program, Performing Provider System will employ multiple projects both to transform health care delivery as well as to address the broad needs of the population that the performing provider system serves. These projects described in Attachment J are grouped into different strategies, such as behavioral health, within each Domain (System Transformation Projects (Domain 2), Clinical Improvement Projects (Domain 3), and Population-wide Projects (Domain 4). For each strategy, there is a set of metrics that the performing provider system will be responsible for if they do any one of the projects within that strategy. This dataset includes only Domain 3 Clinical Metrics.

This dataset contains institutional provider data. The primary purpose for the Provider Network Data System is to collect data needed to evaluate the provider networks including physicians, hospitals, labs, home health agencies, durable medical equipment providers, etc., for all types of Managed Care plans in New York State, including HIV Special Need Plans (SNP), Family Health Plus (FHP) Buy-In, Programs of All-Inclusive Care for the Elderly (PACE), and Non-PACE Managed Long-Term Care (MLTC) plans. For more information, check out: http://www.health.ny.gov/health_care/managed_care/.