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QARR: Provider Network by Payer

This is a chart based on Quality Assurance Reporting Requirements: Beginning 2008.

Row numberMeasurement YearPayerPlan IDPlan NameDomainSub DomainMeasure DescriptionMeasureMethod of Data CollectionEligible PopulationDenominatorNumeratorRateLevel of SignificancePercentile 90thPercentile 75thPercentile 50thPercentile 25thPercentile 10th
12013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkBoard Certified Family MedicineBoard Cert-Family MedAdministrative Review48827756.7674.6274.6259.2843.9343.93
22013Commercial HMOStatewide AverageProvider NetworkProvider NetworkBoard Certified Family MedicineBoard Cert-Family MedAdministrative Review173521367878.8383.7882.7780.5176.1974.73
32013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkBoard Certified Family MedicineBoard Cert-Family MedAdministrative Review182161415777.7285.2283.4178.8975.7172.49
42013Commercial PPOStatewide AverageProvider NetworkProvider NetworkBoard Certified Family MedicineBoard Cert-Family MedAdministrative Review249421923677.1286.2980.4477.575.1172.12
52013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkBoard Certified Geriatric SpecialistsBoard Cert-GeriatricAdministrative Review18511662.773.3373.3362.555.2955.29
62013Commercial PPOStatewide AverageProvider NetworkProvider NetworkBoard Certified Geriatric SpecialistsBoard Cert-GeriatricAdministrative Review2921195666.9672.2869.967.0565.3263.25
72013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkBoard Certified Geriatric SpecialistsBoard Cert-GeriatricAdministrative Review2150149369.4473.6471.8869.4465.6160
82013Commercial HMOStatewide AverageProvider NetworkProvider NetworkBoard Certified Geriatric SpecialistsBoard Cert-GeriatricAdministrative Review2115142167.1974.5872.4369.5463.4353.66
92013Commercial PPOStatewide AverageProvider NetworkProvider NetworkBoard Certified Internal Medicine Board Cert-Int MedAdministrative Review723845681678.4982.2879.5278.9277.9776.31
102013Commercial HMOStatewide AverageProvider NetworkProvider NetworkBoard Certified Internal Medicine Board Cert-Int MedAdministrative Review449033481177.5282.1279.7678.6476.5670.38
112013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkBoard Certified Internal Medicine Board Cert-Int MedAdministrative Review2252155669.0981.7381.7373.6460.1460.14
122013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkBoard Certified Internal Medicine Board Cert-Int MedAdministrative Review445343489178.3583.2381.3577.6676.6772.7
132013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkBoard Certified OB/GYNBoard Cert-OB/GYNAdministrative Review146080655.2180.3580.3560.3426.1926.19
142013Commercial PPOStatewide AverageProvider NetworkProvider NetworkBoard Certified OB/GYNBoard Cert-OB/GYNAdministrative Review182771432378.3784.2881.1178.6774.8970.83
152013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkBoard Certified OB/GYNBoard Cert-OB/GYNAdministrative Review164951291178.2782.2779.8477.4774.6764.86
162013Commercial HMOStatewide AverageProvider NetworkProvider NetworkBoard Certified OB/GYNBoard Cert-OB/GYNAdministrative Review142351110778.0380.679.8678.375.9273.38
172013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkBoard Certified Other SpecialistsBoard Cert-OtherAdministrative Review14406899062.477.1577.1563.9646.0946.09
182013Commercial PPOStatewide AverageProvider NetworkProvider NetworkBoard Certified Other SpecialistsBoard Cert-OtherAdministrative Review18566114077475.8282.5179.8177.8872.7268.87
192013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkBoard Certified Other SpecialistsBoard Cert-OtherAdministrative Review15722012328178.4182.4481.5879.275.9370.09
202013Commercial HMOStatewide AverageProvider NetworkProvider NetworkBoard Certified Other SpecialistsBoard Cert-OtherAdministrative Review1274989762776.5781.580.9479.4473.4673.35
212013Commercial HMOStatewide AverageProvider NetworkProvider NetworkBoard Certified Pediatrics Board Cert-PedsAdministrative Review199541609480.6685.8283.2881.1978.8878.07
222013Commercial PPOStatewide AverageProvider NetworkProvider NetworkBoard Certified Pediatrics Board Cert-PedsAdministrative Review308742468079.9485.6683.1781.1979.2371.37
232013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkBoard Certified Pediatrics Board Cert-PedsAdministrative Review212261688179.5385.5982.3579.5377.973.82
242013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkBoard Certified Pediatrics Board Cert-PedsAdministrative Review1721109963.86757572.1241.4541.45
252013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkSatisfaction with Personal Doctor Satisfaction w/PCPCAHPS Survey77.82
262013Commercial PPOStatewide AverageProvider NetworkProvider NetworkSatisfaction with Personal Doctor Satisfaction w/PCPCAHPS Survey85.47
272013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkSatisfaction with Personal Doctor Satisfaction w/PCPCAHPS Survey89.61
282013Commercial HMOStatewide AverageProvider NetworkProvider NetworkSatisfaction with Personal Doctor Satisfaction w/PCPCAHPS Survey84.34
292013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkSatisfaction with SpecialistSatisfaction w/SpecCAHPS Survey74.17
302013Commercial PPOStatewide AverageProvider NetworkProvider NetworkSatisfaction with SpecialistSatisfaction w/SpecCAHPS Survey83.08
312013Commercial HMOStatewide AverageProvider NetworkProvider NetworkSatisfaction with SpecialistSatisfaction w/SpecCAHPS Survey81.87
322013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkSatisfaction with SpecialistSatisfaction w/SpecCAHPS Survey75.68
332013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkSatisfaction with Provider CommunicationSatisf w/CommunicationCAHPS Survey94.1
342013Commercial HMOStatewide AverageProvider NetworkProvider NetworkSatisfaction with Provider CommunicationSatisf w/CommunicationCAHPS Survey94.43
352013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkSatisfaction with Provider CommunicationSatisf w/CommunicationCAHPS Survey89.47
362013Commercial PPOStatewide AverageProvider NetworkProvider NetworkSatisfaction with Provider CommunicationSatisf w/CommunicationCAHPS Survey94.7

About

Open Data NY - DOH Open Data NY - DOH

created Mar 10, 2013

updated Nov 18, 2014

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Description

The column chart shows performance measurement rates for the managed care provider network by payer. The chart uses the statewide average rates of all insurance plans. For more information, check out http://www.health.ny.gov/health_care/managed_care/reports/quality_performance_improvement.htm, or go to the "About" tab.

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Meta
Category
Health
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Public
Tags
managed care, medicaid, plan performance
Row Count
36
Dataset Summary
Organization
Office of Quality and Patient Safety
Time Period
Beginning 2008
Posting Frequency
Annually
Data Frequency
Annually
Dataset Owner
Bureau of Quality Measurement and Improvement
Coverage
Statewide
Granularity
Health Plan
Units
Rates and Percentages
Notes
Notes
Plan-specific rates (percentages) are accompanied by a symbol to denote whether the plan's rate is statistically above (+) or below (-) the statewide average. When comparing plan rates and associated significance ratings, you may notice plans that have the same numerical rating, but a different significance rating. While this may seem like an error, plan significance ratings are based on how much a plan's rate differs from the statewide average and the number of individuals included in the rate. Therefore, plans can have the same rate but have different significance ratings because their rates are based on different numbers of enrollees.
Disclaimers
Limitations
Not all measures are collected each year. Some services require more resource intensive methods of collection, and these measures are collected every other year to reduce the burden associated with reviewing patient records. Refer to the Health Measures Descriptions document to learn about the specific measures included in this dataset. Measure specification changes and health plan mergers and closures preclude the ability to trend this data over time. Please use caution when attempting to compare measures and/or health plans over time.
Dataset Information
Agency
Health, Department of

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