The Managed Care Consumer Guide data provides information about the quality of care for different health plans as well as people's opinions about the care and services plans provide. This information will help consumers choose a managed care plan that meets their health care needs and the needs of his or her family.

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 plan profile data contains information about managed care plans serving New York State residents including the number of current enrolling members and counties/regions of the state they currently serve. Customer service telephone numbers are included along with their website address. Also included are NCQA accreditation ratings. These are important things to consider when choosing a managed care plan. Data on the ratings of each plan can be found in the Managed Care Regional Consumer Guide located at, https://health.data.ny.gov/Health/Managed-Care-Regional-Consumer-Guide/44t3-4uep. The "About" tab contains additional details concerning 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 New York State Department of Health (NYSDOH) collects annual data on children’s and adults’ use of health services. This information complements the quality of care and member satisfaction information collected through an annual public reporting system called the Quality Assurance Reporting Requirements (QARR). Utilization measures are designed to capture the frequency of certain services provided by health plans. NCQA does not view higher or lower services counts as better or worse performance. Plans with fewer than 30 eligible events are excluded from the statistical calculations of the percentiles.

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.

The data is published annually for the Medicaid Managed Care Reports for Quality Performance: Health Care Disparities in New York State 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.

*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: 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/

The column chart illustrates the utilization of alcohol and other drug services by service type and gender for Commercial HMO and Commercial PPO Payers. The chart uses statewide average rates of all insurance plans.

For more information, please visit http://www.health.ny.gov/health_care/managed_care/reports/quality_performance_improvement.htm#link5. The "About" tab contains additional details concerning this dataset.

The column chart illustrates the distribution of inpatient average length of stay by service category for Medicaid, Commercial HMO, and Commercial PPO Payers. The chart uses statewide average rates of all insurance plans.
For more information please visit http://www.health.ny.gov/health_care/managed_care/reports/quality_performance_improvement.htm#link5. The "About" tab contains additional details concerning this dataset.

The column chart illustrates the statewide rates of angioplasty utilization by gender and payer for measurement year.
The chart uses statewide average rates of all insurance plans. Removing the statewide average filter is not recommended.
For more information please visit http://www.health.ny.gov/health_care/managed_care/reports/quality_performance_improvement.htm#link5. The "About" tab contains additional details concerning this dataset.

The column chart illustrates the distribution of inpatient discharges by service category for Medicaid, Commercial HMO, and Commercial PPO Payers. The chart uses statewide average rates of all insurance plans. For more information please visit http://www.health.ny.gov/health_care/managed_care/reports/quality_performance_improvement.htm#link5. The "About" tab contains additional details concerning this dataset.

The column chart illustrates the statewide rates of emergency room visits by age group and payer. The chart uses statewide average rates of all insurance plans.

For more information please visit http://www.health.ny.gov/health_care/managed_care/reports/quality_performance_improvement.htm#link5. The "About" tab contains additional details concerning this dataset.

The column chart illustrates the statewide rates of cardiac catheterization utilization by gender and payer for the measurement year. The chart uses statewide average rates of all insurance plans. Removing the statewide average filter is not recommended. For more information please visit http://www.health.ny.gov/health_care/managed_care/reports/quality_performance_improvement.htm#link5. The "About" tab contains additional details concerning this dataset.