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Quality Assurance Reporting Requirements: Beginning 2008

Row numberMeasurement YearPayerPlan IDPlan NameDomainSub DomainMeasure DescriptionMeasureMethod of Data CollectionEligible PopulationDenominatorNumeratorRateLevel of SignificancePercentile 90thPercentile 75thPercentile 50thPercentile 25thPercentile 10th
12014Commercial HMO1040678Univera HealthcareAdult HealthManaging Cardiovascular Conditions for AdultsControlling High Blood PressureControlling High BPHybrid Review344733523068.6675.8974.4769.0556.9748.75
22014Commercial HMO1040678Univera HealthcareProvider NetworkProvider NetworkSatisfaction with SpecialistSatisfaction w/SpecCAHPS Survey13211184.46
32014Commercial HMO1040678Univera HealthcareAdult HealthManaging Acute Illness for AdultsAdvising Smokers to QuitAdvise Smokers to QuitCAHPS Survey8083.7589.7886.6084.5680.6078.34
42014Commercial HMO1040678Univera HealthcareWomens HealthPreventive Care for WomenChlamydia Screening (Ages 16-20)Chlamydia 16-20yrAdministrative Review55954327851.2067.9059.1654.2551.2046.13
52014Commercial HMO1040678Univera HealthcareChild and Adolescent HealthCaring for Children and Adolescents with IllnessesAsthma Medication Ratio (Ages 5-11)ASA Med Ratio 5-11yrAdministrative Review43393589.7489.7486.2383.0281.8267.74
62014Commercial HMO1040678Univera HealthcareUse of ServicesUse of ServicesEngagement of Alcohol and Other Drug Treatment (Ages 18+)Engagement of AOD Tx 18+yrAdministrative Review4414417416.7817.7116.7816.1414.2012.53
72014Commercial HMO1040678Univera HealthcareSatisfaction with CareSatisfaction with Access to Care and Health Plan for AdultsGetting Care QuicklyGetting Care QuicklyCAHPS Survey18216791.75Significantly better than the statewide average
82014Commercial HMO1040678Univera HealthcareWomens HealthPreventive Care for WomenBreast Cancer ScreeningBreast Cancer ScreenAdministrative Review30113006225374.9578.1176.1774.9571.9366.97
92014Commercial HMO1040678Univera HealthcareChild and Adolescent HealthCaring for Children and Adolescents with IllnessesMedication Management for People with Asthma 50% Days Covered (Ages 5-11)ASA Med Mgmt 50% 5-11yrAdministrative Review43392256.4163.3357.1656.4153.0050.00
102014Commercial HMO1040678Univera HealthcareAdult HealthManaging Acute Illness for AdultsDiscussing Smoking Cessation MedicationsSmoke Cessation-MedsCAHPS Survey8056.2561.3359.0956.9954.5548.02
112014Commercial HMO1040678Univera HealthcareChild and Adolescent HealthCaring for Children and Adolescents with IllnessesMedication Management for People with Asthma 75% Days Covered (Ages 5-18)ASA Med Mgmt 75% 5-18yrAdministrative Review76651827.6938.5634.6530.3027.6926.05
122014Commercial HMO1040678Univera HealthcareWomens HealthPreventive Care for WomenPostpartum CarePostpartum CareHybrid Review38519617388.27Significantly better than the statewide average89.0588.2782.9863.2560.52
132014Commercial HMO1040678Univera HealthcareSatisfaction with CareSatisfaction with Access to Care and Health Plan for AdultsPlan Information on CostInformation on CostCAHPS Survey1157968.66
142014Commercial HMO1040678Univera HealthcareWomens HealthPreventive Care for WomenTimeliness of Prenatal CarePrenatal CareHybrid Review38519618091.8497.5696.8893.6188.5982.06
152014Commercial HMO1040678Univera HealthcareChild and Adolescent HealthCaring for Children and Adolescents with IllnessesAppropriate Treatment for Upper Respiratory Infection (URI)Appro Tx for URIAdministrative Review4724726286.86Significantly worse than the statewide average93.5692.8990.5989.3888.11
162014Commercial HMO1040678Univera HealthcareChild and Adolescent HealthChild Preventive CareWell-Child Visits in First 15 Months of Life-1 VisitsWC Visits 15m-1Administrative Review23523510.433.010.870.430.000.00
172014Commercial HMO1040678Univera HealthcareWomens HealthPreventive Care for WomenChlamydia Screening (Ages 21-24)Chlamydia 21-24yrAdministrative Review74172841056.3271.3765.6260.5658.4754.00
182014Commercial HMO1040678Univera HealthcareAccess to primary careAccess to Primary CareChildren and Adolescents' Access to Primary Care Practitioners (Ages 12-19 Years)Access to Care 12-19yrAdministrative Review25662566240293.6196.8496.1094.3793.2291.94
192014Commercial HMO1040678Univera HealthcareChild and Adolescent HealthChild Preventive CareWell-Child & Preventive Care Visits in First 15 Months of Life (5+ Visits)WC Visits 15m-5+Administrative Review23523522796.6097.6197.2095.0390.3578.65
202014Commercial HMO1040678Univera HealthcareSatisfaction with CareSatisfaction with Access to Care and Health Plan for AdultsClaims ProcessingClaims ProcessingCAHPS Survey807391.00
212014Commercial HMO1040678Univera HealthcareAdult HealthManaging Respiratory Conditions for AdultsAsthma Medication Ratio (Ages 19-64)ASA Med Ratio 19-64yrAdministrative Review37627421779.2085.1079.4877.3671.0766.01
222014Commercial HMO1040678Univera HealthcareChild and Adolescent HealthCaring for Children and Adolescents with IllnessesAppropriate Testing for PharyngitisPharyngitisAdministrative Review42642634180.05Significantly worse than the statewide average92.7391.9289.8585.2282.59
232014Commercial HMO1040678Univera HealthcareChild and Adolescent HealthChild Preventive CareWell-Child Visits in First 15 Months of Life-3 VisitsWC Visits 15m-3Administrative Review23523510.433.532.141.150.620.37
242014Commercial HMO1040678Univera HealthcareAdult HealthManaging Preventive Care for AdultsAspirin UseAspirin UseCAHPS Survey8051.2551.1450.9144.5136.7832.97
252014Commercial HMO1040678Univera HealthcareSatisfaction with CareSatisfaction with Access to Care and Health Plan for AdultsRating of HP - High UsersRating HP High UsersCAHPS Survey1178572.39
262014Commercial HMO1040678Univera HealthcareAdult HealthManaging Respiratory Conditions for AdultsAsthma Medication Ratio (Ages 51-64)ASA Med Ratio 51-64yrAdministrative Review19811710388.0388.7788.0383.3877.3067.78
272014Commercial HMO1040678Univera HealthcareAccess to primary careAccess to Primary CareChildren and Adolescents' Access to Primary Care Practitioners (Ages 25 Mos-6 Years)Access to Care 25m-6yrAdministrative Review12201220114794.0296.6696.5295.6394.0291.50
282014Commercial HMO1040678Univera HealthcareBehavioral HealthBehavioral HealthFollow-Up After Hospitalization for Mental Illness Within 30 DaysFUH within 30 daysAdministrative Review70703550.00Significantly worse than the statewide average83.2879.8173.2664.0455.58
292014Commercial HMO1040678Univera HealthcareAdult HealthManaging Medications for AdultsAnnual Monitoring for Patients on Persistent Medications- Combined RatePersist Meds-CombinedAdministrative Review40724062338783.3885.6484.6783.9682.2681.16
302014Commercial HMO1040678Univera HealthcareSatisfaction with CareSatisfaction with Experience of Care for AdultsRating of Overall HealthcareRating of HealthcareCAHPS Survey18313774.94
312014Commercial HMO1040678Univera HealthcareProvider NetworkProvider NetworkBoard Certified PediatricsBoard Cert-PedsAdministrative Review35427878.5387.5683.8381.8178.5376.76
322014Commercial HMO1040678Univera HealthcareAdult HealthManaging Medications for AdultsAnnual Monitoring for Patients on Persistent Medications- DigoxinPersist Meds-DigoxinAdministrative ReviewSample size too small to report
332014Commercial HMO1040678Univera HealthcareSatisfaction with CareSatisfaction with Access to Care and Health Plan for AdultsGetting Care NeededGetting Care NeededCAHPS Survey19317590.61
342014Commercial HMO1040678Univera HealthcareAdult HealthManaging Respiratory Conditions for AdultsMedication Management for People with Asthma 75% Days Covered (Ages 5-64)ASA Med Mgmt 75% 5-64yrAdministrative Review45231812037.7452.1947.9542.4237.7436.26
352014Commercial HMO1040678Univera HealthcareChild and Adolescent HealthCaring for Children and Adolescents with IllnessesUse of Appropriate Medications for People with Asthma (Ages 12-18)Asthma Meds 12-18yrAdministrative ReviewSample size too small to report
362014Commercial HMO1040678Univera HealthcareChild and Adolescent HealthCaring for Children and Adolescents with IllnessesMedication Management for People with Asthma 50% Days Covered(Ages 12-18)ASA Med Mgmt 50% 12-18yrAdministrative ReviewSample size too small to report
372014Commercial HMO1040678Univera HealthcareChild and Adolescent HealthCaring for Children and Adolescents with IllnessesAsthma Medication Ratio (Ages 12-18)ASA Med Ratio 12-18yrAdministrative ReviewSample size too small to report
382014Commercial HMO1040678Univera HealthcareProvider NetworkProvider NetworkBoard Certified Other SpecialistsBoard Cert-OtherAdministrative Review3155258281.84Significantly better than the statewide average83.1081.8480.2077.1874.78
392014Commercial HMO1040678Univera HealthcareAdult HealthManaging Acute Illness for AdultsUse of Imaging Studies for Low Back PainLow Back PainAdministrative Review7215468185.16Significantly better than the statewide average85.3380.9078.9375.2272.06
402014Commercial HMO1040678Univera HealthcareWomens HealthPreventive Care for WomenCervical Cancer ScreeningCervical Cancer ScreenHybrid Review648427920673.84Significantly worse than the statewide average81.6380.8079.5176.6474.75
412014Commercial HMO1040678Univera HealthcareAccess to primary careAccess to Primary CareAdults' Access to Preventive and Ambulatory Health Services (Ages 65 and over)Access to Care 65+Administrative Review41241240498.0698.0798.0697.8096.2994.80
422014Commercial HMO1040678Univera HealthcareSatisfaction with CareSatisfaction with Experience of Care for AdultsWellness DiscussionWellness DiscussCAHPS Survey18314277.38
432014Commercial HMO1040678Univera HealthcareAdult HealthManaging Respiratory Conditions for AdultsAsthma Medication Ratio (Ages 19-50)ASA Med Ratio 19-50yrAdministrative Review17815711472.6181.2675.5072.4468.1261.13
442014Commercial HMO1040678Univera HealthcareProvider NetworkProvider NetworkSatisfaction with Provider CommunicationSatisf w/CommunicationCAHPS Survey16916396.27
452014Commercial HMO1040678Univera HealthcareProvider NetworkProvider NetworkBoard Certified OB/GYNBoard Cert-OB/GYNAdministrative Review29925384.6285.3783.5580.5376.9473.58
462014Commercial HMO1040678Univera HealthcareAdult HealthManaging Respiratory Conditions for AdultsUse of Appropriate Medications for People with Asthma (Ages 19-50)Asthma Meds 19-50yrAdministrative Review17815814088.6191.3989.0788.4684.8083.39
472014Commercial HMO1040678Univera HealthcareAdult HealthManaging Respiratory Conditions for AdultsMedication Management for People with Asthma 50% Days Covered( Ages 19-50)ASA Med Mgmt 50% 19-50yrAdministrative Review1781407553.5770.1667.6564.4862.5756.24
482014Commercial HMO1040678Univera HealthcareUse of ServicesUse of ServicesInitiation of Alcohol and Other Drug Treatment (Ages 13-17)Initiation of AOD Tx 13-17yrAdministrative ReviewSample size too small to report
492014Commercial HMO1040678Univera HealthcareBehavioral HealthBehavioral HealthAntidepressant Medication Management-Effective Acute Phase TreatmentAMM - Acute PhaseAdministrative Review182053334564.7366.1265.4964.6763.7160.97
502014Commercial HMO1040678Univera HealthcareAdult HealthManaging Respiratory Conditions for AdultsMedication Management for People with Asthma 50% Days Covered (Ages 5-64)ASA Med Mgmt 50% 5-64yrAdministrative Review45231818156.92Significantly worse than the statewide average72.2769.2365.5364.6358.64

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Open Data NY - DOH Open Data NY - DOH

created Mar 09, 2013

updated Jun 09, 2016

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Description

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. 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. 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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Tags
managed care, medicaid, plan performance, qarr, quality-safety-costs
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Row
Row Count
37973
Dataset Summary
Organization
Office of Quality and Patient Safety
Time Period
Beginning 2008
Posting Frequency
Annual
Data Frequency
Annual
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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