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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
12013Commercial PPOStatewide AverageProvider NetworkProvider NetworkBoard Certified Family MedicineBoard Cert-Family MedAdministrative Review249421923677.1286.2980.4477.575.1172.12
22013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkBoard Certified Family MedicineBoard Cert-Family MedAdministrative Review48827756.7674.6274.6259.2843.9343.93
32013Commercial HMOStatewide AverageProvider NetworkProvider NetworkBoard Certified Family MedicineBoard Cert-Family MedAdministrative Review173521367878.8383.7882.7780.51000000000000576.1974.73
42013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkBoard Certified Family MedicineBoard Cert-Family MedAdministrative Review182161415777.7285.2283.4178.8975.70999999999999472.489999999999995
52013Commercial HMOStatewide AverageProvider NetworkProvider NetworkBoard Certified Geriatric SpecialistsBoard Cert-GeriatricAdministrative Review2115142167.1974.5872.43000000000000769.54000000000000663.4353.66
62013Commercial PPOStatewide AverageProvider NetworkProvider NetworkBoard Certified Geriatric SpecialistsBoard Cert-GeriatricAdministrative Review2921195666.95999999999999472.2869.90000000000000667.0565.31999999999999363.25
72013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkBoard Certified Geriatric SpecialistsBoard Cert-GeriatricAdministrative Review18511662.773.3373.3362.555.2955.29
82013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkBoard Certified Geriatric SpecialistsBoard Cert-GeriatricAdministrative Review2150149369.4473.6471.8869.4465.6160
92013Commercial HMOStatewide AverageProvider NetworkProvider NetworkBoard Certified Internal Medicine Board Cert-Int MedAdministrative Review449033481177.5282.1279.76000000000000578.6476.5670.38
102013Commercial PPOStatewide AverageProvider NetworkProvider NetworkBoard Certified Internal Medicine Board Cert-Int MedAdministrative Review723845681678.48999999999999582.2879.5278.9277.9776.31
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 Review445343489178.34999999999999483.2381.34999999999999477.6676.6772.7
132013Commercial HMOStatewide AverageProvider NetworkProvider NetworkBoard Certified OB/GYNBoard Cert-OB/GYNAdministrative Review142351110778.0380.59999999999999479.8678.375.9273.38
142013Commercial PPOStatewide AverageProvider NetworkProvider NetworkBoard Certified OB/GYNBoard Cert-OB/GYNAdministrative Review182771432378.3784.2881.1178.6774.8970.83
152013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkBoard Certified OB/GYNBoard Cert-OB/GYNAdministrative Review146080655.2180.34999999999999480.34999999999999460.3426.1926.19
162013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkBoard Certified OB/GYNBoard Cert-OB/GYNAdministrative Review164951291178.2782.2779.8477.4774.6764.86
172013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkBoard Certified Other SpecialistsBoard Cert-OtherAdministrative Review14406899062.477.15000000000000677.15000000000000663.9646.0946.09
182013Commercial HMOStatewide AverageProvider NetworkProvider NetworkBoard Certified Other SpecialistsBoard Cert-OtherAdministrative Review1274989762776.56999999999999381.580.9479.4473.45999999999999473.349999999999994
192013Commercial PPOStatewide AverageProvider NetworkProvider NetworkBoard Certified Other SpecialistsBoard Cert-OtherAdministrative Review18566114077475.81999999999999382.5179.8177.8872.7268.87
202013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkBoard Certified Other SpecialistsBoard Cert-OtherAdministrative Review15722012328178.4182.4481.5879.275.93000000000000770.09
212013Commercial HMOStatewide AverageProvider NetworkProvider NetworkBoard Certified Pediatrics Board Cert-PedsAdministrative Review199541609480.6685.8283.2881.1978.8878.069999999999993
222013Commercial PPOStatewide AverageProvider NetworkProvider NetworkBoard Certified Pediatrics Board Cert-PedsAdministrative Review308742468079.9485.6683.1781.1979.2371.37
232013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkBoard Certified Pediatrics Board Cert-PedsAdministrative Review1721109963.86757572.1241.4541.45
242013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkBoard Certified Pediatrics Board Cert-PedsAdministrative Review212261688179.5385.5982.3579.5377.90000000000000673.819999999999993
252013Commercial HMOStatewide AverageProvider NetworkProvider NetworkSatisfaction with Personal Doctor Satisfaction w/PCPCAHPS Survey84.34
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
282013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkSatisfaction with Personal Doctor Satisfaction w/PCPCAHPS Survey77.819999999999993
292013Commercial HMOStatewide AverageProvider NetworkProvider NetworkSatisfaction with SpecialistSatisfaction w/SpecCAHPS Survey81.87
302013Commercial PPOStatewide AverageProvider NetworkProvider NetworkSatisfaction with SpecialistSatisfaction w/SpecCAHPS Survey83.08
312013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkSatisfaction with SpecialistSatisfaction w/SpecCAHPS Survey74.17
322013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkSatisfaction with SpecialistSatisfaction w/SpecCAHPS Survey75.680000000000007
332013Medicaid Managed CareStatewide AverageProvider NetworkProvider NetworkSatisfaction with Provider CommunicationSatisf w/CommunicationCAHPS Survey89.47
342013Commercial PPOStatewide AverageProvider NetworkProvider NetworkSatisfaction with Provider CommunicationSatisf w/CommunicationCAHPS Survey94.7
352013HIV Special Needs PlansStatewide AverageProvider NetworkProvider NetworkSatisfaction with Provider CommunicationSatisf w/CommunicationCAHPS Survey94.1
362013Commercial HMOStatewide AverageProvider NetworkProvider NetworkSatisfaction with Provider CommunicationSatisf w/CommunicationCAHPS Survey94.43

About

Open Data NY - DOH Open Data NY - DOH

created Mar 10, 2013

updated Oct 31, 2016

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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. The "About" tab contains additional details concerning this dataset.

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Meta
Category
Health
Permissions
Public
Tags
managed care, medicaid, plan performance, quality-safety-costs
Row Count
36
Dataset Summary
Time Period
Beginning 2008
Posting Frequency
Annually
Dataset Owner
Bureau of Quality Measurement and Improvement
Coverage
Statewide
Granularity
Health Plan
Units
Rates and Percentages
Organization
Office of Quality and Patient Safety
Data Frequency
Annually
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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