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.

The Managed Long-Term Care (MLTC) performance data is an annual evaluation (semi-annual prior to 2022) of New York state-certified MLTC plans. Rates are calculated for each performance measure by plan and describe their population, quality of care, and enrollees’ satisfaction. These data also present the statewide demographic profile of MLTC enrollees and statewide rates of emergency room, hospital, and nursing home utilization. Refer to the Measures document to learn more about specific MLTC measures. In the future, as more evaluations are performed, measures can be trended over time. Refer to the Overview document for information on the data sources, time frames, and limitations of this dataset.

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/

The Managed Long-Term Care (MLTC) consumer guide data provides information about the quality of care offered by the different plans and people’s opinions about the care and the services the plans provide. This information will help consumers choose a managed long-term care plan that meets their health care needs. The Managed Long-Term Care Regional Consumer Guide dataset contains each plan’s current ratings, the regions of the state they serve, customer service telephone number, and website.

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.

*Due to COVID-19 impacts, measures requiring hybrid review are not included in this dataset for year 2019.

These data are published annually for Medicaid Managed Care in the Health Care Disparities in New York State Report and on the NYSDOH website: http://www.health.ny.gov/health_care/managed_care/reports/

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 website: https://www.health.ny.gov/health_care/managed_care/reports/

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 website: http://www.health.ny.gov/health_care/managed_care/reports/