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Managed Care Plan Utilization Data: Beginning 2009

Row numberMeasurement yearPayerPlan IDPlan NameMeasureMeasure DescriptionAge CategoryGenderRatePercentile 10thPercentile 25thPercentile 50thPercentile 75thPercentile 90thLevel of SignificanceMembermonthsEventsDays
12014Commercial HMO1000001StatewideIP Maternity DaysInpatient Maternity Total DaysAllBoth genders32253644992411567163
22014Commercial HMO1000001StatewideIP Maternity DISCHInpatient Maternity DischargesAge 10-19Both genders239000815291380
32014Commercial HMO1000001StatewideIP Total DISCHInpatient Total DischargesAge 65-74Both genders113756578714137091
42014Commercial HMO1000001StatewideIP Total DISCHInpatient Total DischargesAge 85 or olderBoth genders331264057284226
52014Commercial HMO1000001StatewideIP Total DISCHInpatient Total DischargesAge 1-9Both genders15259552932639983
62014Commercial HMO1000001StatewideIP Surgery ALOSInpatient Surgery Average Length Of StayAge 75-84Both genders7.71085536134716
72014Commercial HMO1000001StatewideIP Medicine DISCHInpatient Medicine DischargesAge 45-64Both genders301070576326707106593
82014Commercial HMO1000001StatewideIP Medicine ALOSInpatient Medicine Average Length Of StayAge 75-84Both genders5.210855312076294
92014Commercial HMO1000001StatewideIP Maternity ALOSInpatient Maternity Average Length Of StayAllBoth genders2.8253644992411567163
102014Commercial HMO1000001StatewideIP Total DaysInpatient Total DaysAge 85 or olderBoth genders1921264057284226
112014Commercial HMO1000001StatewideIP Medicine ALOSInpatient Medicine Average Length Of StayAge 65-74Both genders4.5756578400318073
122014Commercial HMO1000001StatewideIP Maternity DISCHInpatient Maternity DischargesAge 45-64Both genders010705763362896
132014Commercial HMO1000001StatewideIP Medicine DISCHInpatient Medicine DischargesAge 75-84Both genders13310855312076294
142014Commercial HMO1000001StatewideIP Total DISCHInpatient Total DischargesAge 75-84Both genders204108553184211105
152014Commercial HMO1000001StatewideIP Maternity DISCHInpatient Maternity DischargesAge 20-44Both genders26107586552322464887
162014Commercial HMO1000001StatewideIP Total DISCHInpatient Total DischargesAge 0-1Both genders8224777116888857
172014Commercial HMO1000001StatewideIP Maternity DaysInpatient Maternity Total DaysAge 45-64Both genders110705763362896
182014Commercial HMO1000001StatewideIP Total ALOSInpatient Total Average Length Of StayAge 85 or olderBoth genders5.8264057284226
192014Commercial HMO1000001StatewideIP Surgery DaysInpatient Surgery Total DaysAge 65-74Both genders293756578306718488
202014Commercial HMO1000001StatewideIP Maternity ALOSInpatient Maternity Average Length Of StayAge 20-44Both genders2.8107586552322464887
212014Commercial HMO1000001StatewideIP Surgery ALOSInpatient Surgery Average Length Of StayAge 1-9Both genders4.400000000000000425955296722986
222014Commercial HMO1000001StatewideIP Surgery DaysInpatient Surgery Total DaysAge 0-1Both genders1602477712943310
232014Commercial HMO1000001StatewideIP Medicine DISCHInpatient Medicine DischargesAge 20-44Both genders11107586551002835598
242014Commercial HMO1000001StatewideIP Maternity DISCHInpatient Maternity DischargesAllBoth genders11253644992411567163
252014Commercial HMO1000001StatewideIP Medicine DaysInpatient Medicine Total DaysAge 10-19Both genders25390008126398114
262014Commercial HMO1000001StatewideIP Medicine DISCHInpatient Medicine DischargesAge 85 or olderBoth genders258264055682851
272014Commercial HMO1000001StatewideIP Medicine ALOSInpatient Medicine Average Length Of StayAge 0-1Both genders424777113635392
282014Commercial HMO1000001StatewideIP Total DaysInpatient Total DaysAge 10-19Both genders463900081449115077
292014Commercial HMO1000001StatewideIP Total ALOSInpatient Total Average Length Of StayAge 65-74Both genders5.2756578714137091
302014Commercial HMO1000001StatewideIP Surgery DaysInpatient Surgery Total DaysAge 1-9Both genders1425955296722986
312014Commercial HMO1000001StatewideIP Total DaysInpatient Total DaysAge 45-64Both genders2611070576352189232483
322014Commercial HMO1000001StatewideIP Medicine DISCHInpatient Medicine DischargesAge 65-74Both genders63756578400318073
332014Commercial HMO1000001StatewideIP Total DaysInpatient Total DaysAge 1-9Both genders46259552932639983
342014Commercial HMO1000001StatewideIP Total ALOSInpatient Total Average Length Of StayAge 75-84Both genders6108553184211105
352014Commercial HMO1000001StatewideIP Medicine DaysInpatient Medicine Total DaysAge 20-44Both genders40107586551002835598
362014Commercial HMO1000001StatewideIP Total DISCHInpatient Total DischargesAge 45-64Both genders581070576352189232483
372014Commercial HMO1000001StatewideIP Medicine DaysInpatient Medicine Total DaysAge 45-64Both genders1191070576326707106593
382014Commercial HMO1000001StatewideIP Surgery DISCHInpatient Surgery DischargesAge 75-84Both genders681085536134716
392014Commercial HMO1000001StatewideIP Total ALOSInpatient Total Average Length Of StayAllBoth genders429099335112863453957
402014Commercial HMO1000001StatewideIP Total DISCHInpatient Total DischargesAllBoth genders4729099335112863453957
412014Commercial HMO1000001StatewideIP Total DaysInpatient Total DaysAllBoth genders18729099335112863453957
422014Commercial HMO1000001StatewideIP Medicine ALOSInpatient Medicine Average Length Of StayAge 10-19Both genders3.1390008126398114
432014Commercial HMO1000001StatewideIP Surgery ALOSInpatient Surgery Average Length Of StayAge 65-74Both genders6756578306718488
442014Commercial HMO1000001StatewideIP Surgery ALOSInpatient Surgery Average Length Of StayAge 20-44Both genders4.210758655806633953
452014Commercial HMO1000001StatewideIP Maternity ALOSInpatient Maternity Average Length Of StayAge 45-64Both genders2.510705763362896
462014Commercial HMO1000001StatewideIP Medicine ALOSInpatient Medicine Average Length Of StayAge 85 or olderBoth genders5264055682851
472014Commercial HMO1000001StatewideIP Surgery ALOSInpatient Surgery Average Length Of StayAge 45-64Both genders51070576324439122042
482014Commercial HMO1000001StatewideIP Maternity DaysInpatient Maternity Total DaysAge 20-44Both genders72107586552322464887
492014Commercial HMO1000001StatewideIP Surgery DISCHInpatient Surgery DischargesAge 45-64Both genders271070576324439122042
502014Commercial HMO1000001StatewideIP Surgery ALOSInpatient Surgery Average Length Of StayAge 0-1Both genders11.32477712943310

About

Open Data NY - DOH Open Data NY - DOH

created Mar 29, 2013

updated Feb 09, 2016

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Description

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. For more information please visit, http://www.health.ny.gov/health_care/managed_care/reports/quality_performance_improvement.htm#link5 or go to the "About" tab.

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Health
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Tags
managed care, qarr, plan performance report, medicaid access, utilization, quality-safety-costs
Row Label
Row
Row Count
82011
Dataset Summary
Organization
Office of Quality and Patient Safety
Time Period
Beginning 2009
Posting Frequency
Annually
Data Frequency
Annually
Dataset Owner
Bureau of Quality Measurement and Improvement
Coverage
Statewide
Granularity
Health Plan
Units
Percentage, rate per 1000 member year
Notes
Notes
This dataset allows the public to understand the frequency of certain services provided by a health plan performed in the areas of outpatient, inpatient, mental health, alcohol and other drug, selected procedures, and antibiotic prescriptions. It compares types of insurances across a standardized national measurement set. And it represents information about the utilization of health care being delivered by providers across the health care delivery system (inpatient and outpatient services) for people insured by managed care health plans.
Disclaimers
Limitations
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.
Dataset Information
Agency
Health, Department of

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