The primary purpose for the Provider Network Data System is to collect data needed to evaluate the provider networks including physicians, hospitals, labs, home health agencies, durable medical equipment providers, etc., for all types of Managed Care plans in New York State, including HIV Special Need Plans (SNP), Family Health Plus (FHP) Buy-In, Programs of All-Inclusive Care for the Elderly (PACE), and Non-PACE Managed Long-Term Care (MLTC) plans. This dataset reflects institutional provider data. Provider Network Data System information is self reported. For more information, go to http://www.health.ny.gov/health_care/managed_care/.

The Institutional Provider Network Data displays information on health facilities and ancillary service providers (for example: hospitals, labs, home care agencies) participating in health plan networks from January through March, 2019. Plan network data is collected from Medicaid, Commercial, and Exchange plans on a quarterly basis by the Department of Health, including managed care plans, as well as PPO/EPO plans. For more information, please visit: https://pndslookup.health.ny.gov.

The Institutional Provider Network Data displays information on health facilities and ancillary service providers (for example: hospitals, labs, home care agencies) participating in health plan networks through the months of October to the end of December, 2018. Plan network data is collected from Medicaid, Commercial, and Exchange plans on a quarterly basis by the Department of Health, including managed care plans, as well as PPO/EPO plans.

This filtered view is based on the Health Facility Certification Information dataset and includes State-only licensed Diagnostic and Treatment Centers that provide general outpatient primary care and medical services.

Note: This annual report is no longer updated. Beginning with the 1st QSIR 2017, these reports will be updated quarterly only. Please see the link in the featured content. The Department of Health (NYSDOH) requires adult care facilities (ACFs) to complete an electronic filing of each facility's licensed adult home and enriched housing program bed census on an annual basis. These facilities include adult homes (AHs), enriched housing programs (EHPs), assisted living programs (ALPs), assisted living residences (ALRs), special needs assisted living residences (SNALR), and enhanced assisted living residences (EALR). Available bed and occupancy information in ACFs is self-reported and is not audited by NYSDOH. This dataset is refreshed on a annual basis. For more information, check out http://www.health.ny.gov/facilities/adult_care/.

The institutional Provider Network Data displays information on health facilities and ancillary service providers (for example: hospitals, labs, home care agencies) participating in health plan networks from July through September, 2018. Plan network data is collected from Medicaid, Commercial, and Exchange plans on a quarterly basis by the Department of Health, including managed care plans, as well as PPO/EPO plans.

This filtered view is based on the Health Facility Certification Information dataset and is limited to Diagnostic and Treatment Centers with type Ambulatory Surgery - Multispecialty and Renal Dialysis - Chronic.

The individual Provider Network Data displays information on individuals participating in health plan networks from July through September, 2018. Plan network data is collected from Medicaid, Commercial, and Exchange plans on a quarterly basis by the Department of Health, including managed care plans, as well as PPO/EPO plans.

The Institutional Provider Network Data displays information on health facilities and ancillary service providers (for example: hospitals, labs, home care agencies) participating in health plan networks from April through June, 2019. Plan network data is collected from Medicaid, Commercial, and Exchange plans on a quarterly basis by the Department of Health, including managed care plans, as well as PPO/EPO plans. For more information, please visit: https://pndslookup.health.ny.gov.

This column chart shows performance measurement rates for diabetes HbA1c testing by Health Home for the Centers for Medicare & Medicaid Services (CMS) Core Set and Health Home State Plan Amendment (SPA). To support ongoing assessment of the effectiveness of the Health Home model, the CMS has established a recommended Core Set of health care quality measures that it intends to promulgate in the rule making process.
Please refer to the Overview document for additional information.

This dataset contains measures that evaluate the quality of care delivered by Health Homes for the Centers for Medicare & Medicaid Services (CMS) Core Set and Health Home State Plan Amendment (SPA). To support ongoing assessment of the effectiveness of the Health Home model, the CMS has established a recommended Core Set of health care quality measures that it intends to promulgate in the rulemaking process.
The data used in the Health Home Quality Measures are taken from the following sources:
• Medicaid Data Mart: Claims and encounters data generated from the Medicaid Data Warehouse (MDW).
• QARR Member Level Files: Sample of the health plan eligible member’s quality.
• New York State Delivery System Inform Incentive Program (DSRIP) Data Warehouse: Claims and encounters data generated from the Medicaid Data Warehouse (MDW).

Please refer to the Overview document for additional information.

This column chart illustrates the rates of emergency room visits and total inpatient dischargers by Health Home. The New York State Department of Health (NYSDOH) collects annual data on children’s and adults’ use of health services. This information complements the Health Home Quality Measures information collected for the State Plan Amendment (SPA) and Core Set of health care quality measures. Utilization measures are designed to capture the frequency of certain services. NCQA does not view higher or lower services counts as better or worse performance. Please refer to the Overview document for additional information.

The primary purpose for the Provider Network Data System is to collect data needed to evaluate the provider networks including physicians, hospitals, labs, home health agencies, durable medical equipment providers, etc., for all types of health plans in New York State. Beginning in 2017, the PNDS includes Medicaid Managed Care (MMC), HIV Special Need Plans (SNP), Health and Recovery Plans (HARP), Child Health Plus (CHP), Programs of All-Inclusive Care for the Elderly (PACE), Non-PACE Managed Long-Term Care (MLTC) plans, Qualified Health Plans (QHP), Essential Plans (EP), and commercial plans (commercial plan reporting will be incomplete until Q2 2017). This dataset reflects individual provider data. Provider Network Data System information is self-reported by health plans. The PNDS data dictionary can be found at http://www.health.ny.gov/health_care/managed_care/docs/dictionary.pdf. To use the NYS Provider & Health Plan Look-Up Tool, click on the following link, https://pndslookup.health.ny.gov/.

The Justice Center for the Protection of People with Special Needs was established in 2013 by the Protection of People with Special Needs Act. The Department adopted regulations to define those adult care facilities that, based on licensed capacity coupled with self-reported quarterly census data, are subject to the conjoined jurisdiction of the New York State Department of Health and the Justice Center for the Protection of People with Special Needs (“Justice Center”). Adult care facilities that are determined to be subject to the conjoined jurisdiction of the New York State Department of Health and the Justice Center are the entities listed in this dataset. For information on how to file a complaint, please refer to the "Notes" section below. For more information about the Justice Center visit https://www.justicecenter.ny.gov/ .

This dataset contains measures of Health Home member service utilization. The New York State Department of Health (NYSDOH) collects annual data on children’s and adults’ use of health services. This information complements the Health Home Quality Measures information collected for the State Plan Amendment (SPA) and Core Set of health care quality measures. Utilization measures are designed to capture the frequency of certain services. NCQA does not view higher or lower services counts as better or worse performance.

The data used in the Health Home Utilization Measures are taken from the following sources:
• Medicaid Data Mart: Claims and encounters data generated from the Medicaid Data Warehouse (MDW).

Please refer to the Overview document for additional information.

This column chart illustrates the rates of mental health services by Health Home. The New York State Department of Health (NYSDOH) collects annual data on children’s and adults’ use of health services. This information complements the Health Home Quality Measures information collected for the State Plan Amendment (SPA) and Core Set of health care quality measures. Utilization measures are designed to capture the frequency of certain services. NCQA does not view higher or lower services counts as better or worse performance. Please refer to the Overview document for additional information.

This quarterly report contains demographic and bed availability information reported by Adult Care Facilities (ACFs). The regulations governing the operation of Adult Care Facilities (ACFs) – Standards for Adult Homes 487.10(e)(2), Adult Care Facilities Standards for Enriched Housing Programs 488.10(e)(4), and Standards for Residences for Adults 490.10(e)(4) – require each operator to submit a quarterly statistical information report. Available bed and census information is self-reported and is not audited by NYSDOH.

The ACF census database allows for; 1) Demographic information on Adult Care Facilities licensed in New York State; and 2) A mechanism to collect and report on the availability of certified adult care and assisted living facilities. For more information, check out: http://www.health.ny.gov/facilities/adult_care/.

The primary purpose for the Provider Network Data System is to collect data needed to evaluate the provider networks including physicians, hospitals, labs, home health agencies, durable medical equipment providers, etc., for all types of health plans in New York State. Beginning in 2017, the PNDS includes Medicaid Managed Care (MMC), HIV Special Need Plans (SNP), Health and Recovery Plans (HARP), Child Health Plus (CHP), Programs of All-Inclusive Care for the Elderly (PACE), Non-PACE Managed Long-Term Care (MLTC) plans, Qualified Health Plans (QHP), Essential Plans (EP), and commercial plans (commercial plan reporting will be incomplete until Q2 2017). This dataset reflects institutional provider data. Provider Network Data System information is self-reported by health plans. The PNDS data dictionary can be found at http://www.health.ny.gov/health_care/managed_care/docs/dictionary.pdf. To use the NYS Provider & Health Plan Look-Up Tool, click on the following link, https://pndslookup.health.ny.gov/.

The primary purpose for the Provider Network Data System is to collect data needed to evaluate the provider networks including physicians, hospitals, labs, home health agencies, durable medical equipment providers, etc., for all types of health plans in New York State. Beginning in 2017, the PNDS includes Medicaid Managed Care (MMC), HIV Special Need Plans (SNP), Health and Recovery Plans (HARP), Child Health Plus (CHP), Programs of All-Inclusive Care for the Elderly (PACE), Non-PACE Managed Long-Term Care (MLTC) plans, Qualified Health Plans (QHP), Essential Plans (EP), and commercial plans (commercial plan reporting will be incomplete until Q2 2017). This dataset reflects individual provider data. Provider Network Data System information is self-reported by health plans. The PNDS data dictionary can be found at http://www.health.ny.gov/health_care/managed_care/docs/dictionary.pdf . To use the NYS Provider & Health Plan Look-Up Tool, click on the following link, https://pndslookup.health.ny.gov/ .

The primary purpose for the Provider Network Data System is to collect data needed to evaluate the provider networks including physicians, hospitals, labs, home health agencies, durable medical equipment providers, etc., for all types of health plans in New York State. Beginning in 2017, the PNDS includes Medicaid Managed Care (MMC), HIV Special Need Plans (SNP), Health and Recovery Plans (HARP), Child Health Plus (CHP), Programs of All-Inclusive Care for the Elderly (PACE), Non-PACE Managed Long-Term Care (MLTC) plans, Qualified Health Plans (QHP), Essential Plans (EP), and commercial plans (commercial plan reporting will be incomplete until Q2 2017). This dataset reflects individual provider data. Provider Network Data System information is self-reported by health plans. The PNDS data dictionary can be found at http://www.health.ny.gov/health_care/managed_care/docs/dictionary.pdf. To use the NYS Provider & Health Plan Look-Up Tool, click on the following link, https://pndslookup.health.ny.gov/.

The primary purpose for the Provider Network Data System is to collect data needed to evaluate the provider networks including physicians, hospitals, labs, home health agencies, durable medical equipment providers, etc., for all types of health plans in New York State. Beginning in 2017, the PNDS includes Medicaid Managed Care (MMC), HIV Special Need Plans (SNP), Health and Recovery Plans (HARP), Child Health Plus (CHP), Programs of All-Inclusive Care for the Elderly (PACE), Non-PACE Managed Long-Term Care (MLTC) plans, Qualified Health Plans (QHP), Essential Plans (EP), and commercial plans. This dataset reflects institutional provider data. Provider Network Data System information is self-reported by health plans. The PNDS data dictionary can be found at http://www.health.ny.gov/health_care/managed_care/docs/dictionary.pdf . To use the NYS Provider & Health Plan Look-Up Tool, click on the following link: https://pndslookup.health.ny.gov/ .

This column chart shows performance measurement rates for medication management for people with asthma by Health Home for the Centers for Medicare & Medicaid Services (CMS) Core Set and Health Home State Plan Amendment (SPA). To support ongoing assessment of the effectiveness of the Health Home model, the CMS has established a recommended Core Set of health care quality measures that it intends to promulgate in the rule making process.
Please refer to the Overview document for additional information.

This column chart shows performance measure rates for behavioral health by Health Home for follow-up after hospitalizations. The base dataset contains measures that evaluate the quality of care delivered by Health Homes for the Centers for Medicare & Medicaid Services (CMS) Core Set and Health Home State Plan Amendment (SPA). To support ongoing assessment of the effectiveness of the Health Home model, the CMS has established a recommended Core Set of health care quality measures that it intends to promulgate in the rule making process.
Please refer to the Overview document for additional information.

This column chart shows performance measurement rates for engagement in care for HIV/AIDS by Health Home for the Centers for Medicare & Medicaid Services (CMS) Core Set and Health Home State Plan Amendment (SPA). To support ongoing assessment of the effectiveness of the Health Home model, the CMS has established a recommended Core Set of health care quality measures that it intends to promulgate in the rule making process.
Please refer to the Overview document for additional information.

This column chart shows performance measure rates of adult health by Health Home for plan-all cause readmissions. The base dataset contains measures that evaluate the quality of care delivered by Health Homes for the Centers for Medicare & Medicaid Services (CMS) Core Set and Health Home State Plan Amendment (SPA). To support ongoing assessment of the effectiveness of the Health Home model, the CMS has established a recommended Core Set of health care quality measures that it intends to promulgate in the rule making process.
Please refer to the Overview document for additional information.