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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
12012Child Health PlusStatewide AverageChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review633633355566363615347
22012Child Health Plus1050178HIP (EmblemHealth)Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
32012Child Health Plus1070680Independent HealthChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
42012Child Health Plus1080383MVPChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
52012Child Health Plus1090384CDPHPChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review545432596363615347
62012Child Health Plus1130185MetroPlus Health PlanChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
72012Child Health Plus1140685HealthNow New York Inc.Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewHealth plan submitted invalid data
82012Child Health Plus1240287WellCare of New YorkChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
92012Child Health Plus1260187UnitedHealthcare Community PlanChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
102012Child Health Plus1350196EmpireChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review898956636363615347
112012Child Health Plus1390598Excellus BlueCross BlueShieldChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review21721710147Significantly worse than the statewide average6363615347
122012Child Health Plus2010186Affinity Health PlanChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
132012Child Health Plus2020487Total CareChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
142012Child Health Plus2040287Hudson Health PlanChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
152012Child Health Plus2060193Fidelis Care New YorkChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review10410466636363615347
162012Child Health Plus2090194Healthfirst PHSP, Inc.Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
172012Child Health Plus2150195Neighborhood Health ProvidersChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
182012Child Health Plus2180196Health Plus (Amerigroup)Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
192012Child Health Plus2190696Univera Community HealthChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
202012Commercial HMOStatewide AverageChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review789789391506052504842
212012Commercial HMO1040678Univera HealthcareChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review323217536052504842
222012Commercial HMO1050178HIP (EmblemHealth)Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review353518516052504842
232012Commercial HMO1070680Independent HealthChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review838340486052504842
242012Commercial HMO1080383MVPChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review585829506052504842
252012Commercial HMO1090384CDPHPChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review909054606052504842
262012Commercial HMO1140685HealthNow New York Inc.Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review13513557426052504842
272012Commercial HMO1160286AetnaChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
282012Commercial HMO1170186OxfordChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review17817887496052504842
292012Commercial HMO1350196EmpireChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review646433526052504842
302012Commercial HMO1390598Excellus BlueCross BlueShieldChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review989847486052504842
312012Commercial HMO1430100Easy Choice Health Plan of NYChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
322012Commercial PPOStatewide AverageChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review16211621816506460544641
332012Commercial PPO1050178HIP (EmblemHealth)Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
342012Commercial PPO1080383MVP Preferred PPOChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review696928416460544641
352012Commercial PPO1090384CDPHP Universal Benefits, Inc.Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review555535646460544641
362012Commercial PPO1160286Aetna Life Insurance Company - New YorkChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review13613673546460544641
372012Commercial PPO1170186Oxford Health Insurance Company, Inc. - New YorkChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review177177104596460544641
382012Commercial PPO1180186CGLIC (CHLIC)Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review929255606460544641
392012Commercial PPO1261187UnitedHealthcare Insurance Company of New York, Inc.Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review13213281616460544641
402012Commercial PPO1350196Empire HealthChoice HMO, Inc.Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review473473228486460544641
412012Commercial PPO1390598Excellus BlueCross BlueShieldChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review37537516143Significantly worse than the statewide average6460544641
422012Commercial PPO7010100GHI (EmblemHealth)Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review10610649466460544641
432012Medicaid Managed CareStatewide AverageChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review283228321792638274695745
442012Medicaid Managed Care1050178HIP (EmblemHealth)Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review999973748274695745
452012Medicaid Managed Care1070680Independent Health's MediSourceChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review808056708274695745
462012Medicaid Managed Care1080383MVPChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review84843036Significantly worse than the statewide average8274695745
472012Medicaid Managed Care1090384CDPHPChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review186186108588274695745
482012Medicaid Managed Care1130185MetroPlus Health PlanChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review168168119718274695745
492012Medicaid Managed Care1140685HealthNow New York Inc.Child and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative ReviewSample size too small to report
502012Medicaid Managed Care1240287WellCare of New YorkChild and Adolescent HealthCaring for Children and Adolescents with IllnessesFollow-Up Care for Children Prescribed ADHD Medication:Continuation PhaseADHD-ContinuationAdministrative Review353520578274695745

About

Open Data NY - DOH Open Data NY - DOH

created Mar 08, 2013

updated Jan 09, 2014

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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, or go to the "About" tab.

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Meta
Category
Health
Permissions
Public
Tags
managed care, medicaid, plan performance
Row Count
26958
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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