The Managed Care Consumer Guide data provides information about the quality of care for different health plans as well as people's opinions about the care and services plans provide. This information will help consumers choose a managed care plan that meets their health care needs and the needs of his or her family.

The Statewide Planning and Research Cooperative System (SPARCS) Inpatient De-Identified dataset contains discharge level detail on patient characteristics, diagnoses, treatments, services, and charges. This data contains basic record level detail regarding the discharge; however, the data does not contain protected health information (PHI) under Health Insurance Portability and Accountability Act (HIPAA). The health information is not individually identifiable; all data elements considered identifiable have been redacted. For example, the direct identifiers regarding a date have the day and month portion of the date removed.

The dataset contains hospital stroke designation and Coverdell registry participation status, acute stroke discharges counts (numerators, denominators), observed, expected and risk-adjusted acute stroke in-hospital/30-day post admission mortality rates with corresponding 95% confidence intervals. Mortality rates risk adjustment was based on the methodology developed by the New York State Department of Health.

The purpose of this data set is reporting of hospital-specific risk adjusted acute stroke mortality rates (RAMR) to inform hospitals, to aid initiatives to improve hospital quality performance and measurement, and to identify performance outliers for public reporting.

This dataset is a summary of hospital inpatient discharges from every hospital including Article 28 facilities; Ambulatory Surgery and Emergency Department visits, from the Statewide Planning and Research Cooperative System (SPARCS). The data is rolled up by patient county of residence. This dataset was modified in September 2013 to be in sync with the release of the Hospital Inpatient Discharges (SPARCS De-Identified) datasets. Please refer to the data dictionary for information on the current data available.

The SPARCS data has been divided into two distinct datasets: Hospital Discharges by Patient County of Residence and Hospital Discharges by Facility. This is to preserve the confidentiality of identifiable individual information.This dataset does not include facility names.

This dataset contains information submitted by New York State Article 28 Hospitals as part of the New York Statewide Planning and Research Cooperative (SPARCS) and Institutional Cost Report (ICR) data submissions. The file contains information on the volume of discharges, All Payer Refined Diagnosis Related Group (APR-DRG), the severity of illness level (SOI), medical or surgical classification the median charge, median cost, average charge and average cost per discharge.

This dataset includes Medicaid clinical metrics for Clinical Improvement Projects (Domain 3) of the Delivery System Reform Incentive Payment (DSRIP) Program. The DSRIP program will promote community-level collaborations and focus on system reform, specifically a goal to achieve a 25 percent reduction in avoidable hospital use over five years. As a part of the DSRIP program, Performing Provider System will employ multiple projects both to transform health care delivery as well as to address the broad needs of the population that the performing provider system serves. These projects described in Attachment J are grouped into different strategies, such as behavioral health, within each Domain (System Transformation Projects (Domain 2), Clinical Improvement Projects (Domain 3), and Population-wide Projects (Domain 4). For each strategy, there is a set of metrics that the performing provider system will be responsible for if they do any one of the projects within that strategy. This dataset includes only Domain 3 Clinical Metrics.

The plan profile data contains information about managed care plans serving New York State residents including the number of current enrolling members and counties/regions of the state they currently serve. Customer service telephone numbers are included along with their website address. Also included are NCQA accreditation ratings. These are important things to consider when choosing a managed care plan. Data on the ratings of each plan can be found in the Managed Care Regional Consumer Guide located at, https://health.data.ny.gov/Health/Managed-Care-Regional-Consumer-Guide/44t3-4uep. The "About" tab contains additional details concerning this dataset.

The Statewide Planning and Research Cooperative System (SPARCS) Inpatient De-identified downloadable file contains discharge level detail on patient characteristics, diagnoses, treatments, services, and charges. This data file contains basic record level detail for the discharge. The de-identified data file does not contain data that is protected health information (PHI) under HIPAA. The health information is not individually identifiable; all data elements considered identifiable have been redacted. For example, the direct identifiers regarding a date have the day and month portion of the date removed. For more information, including changes to the data from previous years, please visit http://www.health.ny.gov/statistics/sparcs/access/.

This dataset aggregates and displays the number of New York State Medicaid enrollees by eligibility year and month within each NYS Economic Region, health insurance plan information, and enrollee demographics.

This dataset represents self‐reported performance data by HIV ambulatory care programs. All HIV ambulatory programs throughout New York State with a significant HIV caseload (a total caseload of at least 30 HIV‐infected patients receiving ambulatory HIV care at one or more sites) are expected to self‐report their annual quality of care performance data using standardized submission tools and methodologies. With the assistance of the online eHIVQUAL application, performance data results are instantly available to HIV programs, allowing them to immediately utilize their data findings to prioritize upcoming quality activities, and are available for generating benchmarking reports across New York State. See Limitations regarding redaction of small‐population data.

This line chart compares the median cost vs. median charge for septicemia and disseminated Infections with a major severity of illness by hospital. The dataset contains information submitted by New York State Article 28 Hospitals as part of the New York Statewide Planning and Research Cooperative (SPARCS) and Institutional Cost Report (ICR) data submissions. The dataset contains information on the volume of discharges, All Payer Refined Diagnosis Related Group (APR-DRG), the severity of illness level (SOI), medical or surgical classification the median charge, median cost, average charge and average cost per discharge. When interpreting New York’s data, it is important to keep in mind that variations in cost may be attributed to many factors. Some of these include overall volume, teaching hospital status, facility specific attributes, geographic region and quality of care provided.For more information, check out: http://www.health.ny.gov/statistics/sparcs/. The "About" tab contains additional details concerning this dataset.

The Statewide Planning and Research Cooperative System (SPARCS) Inpatient De-identified File contains discharge level detail on patient characteristics, diagnoses, treatments, services, and charges. This data file contains basic record level detail for the discharge. The de-identified data file does not contain data that is protected health information (PHI) under HIPAA. The health information is not individually identifiable; all data elements considered identifiable have been redacted. For example, the direct identifiers regarding a date have the day and month portion of the date removed.

The dataset contains Potentially Preventable Visit (PPV) observed, expected, and risk-adjusted rates for Medicaid beneficiaries by patient county beginning in 2011. The Potentially Preventable Visits (PPV) obtained from software created by 3M Health Information Systems are emergency visits that may result from a lack of adequate access to care or ambulatory care coordination. These ambulatory sensitive conditions could be reduced or eliminated with adequate patient monitoring and follow up.

The dataset shows each of the 65 individual Potentially Preventable Complication (PPC) measures, providing observed and risk-adjusted rates for all payer discharges by hospital and statewide, beginning in 2013.

Potentially Preventable Complications (PPC), obtained from software created by 3M Health Information Systems, are defined as harmful events or negative outcomes that develop or occur during hospitalization and may result from processes of care and treatment rather than from natural progression of the underlying illness.

The PPCs were calculated using Statewide Planning and Research Cooperative System (SPARCS) inpatient data.

The dataset groups 65 individual Potentially Preventable Complication (PPC) measures into 8 different categories, providing observed and risk-adjusted rates for all payer discharges by hospital and statewide, beginning in 2013.

Potentially Preventable Complications (PPC), obtained from software created by 3M Health Information Systems, are defined as harmful events or negative outcomes that develop or occur during hospitalization and may result from processes of care and treatment rather than from natural progression of the underlying illness.

The PPCs were calculated using Statewide Planning and Research Cooperative System (SPARCS) inpatient data.

The Managed Long-Term Care (MLTC) consumer guide data provides information about the quality of care offered by the different plans and people’s opinions about the care and the services the plans provide. This information will help consumers choose a managed long-term care plan that meets their health care needs. The Managed Long-Term Care Regional Consumer Guide dataset contains each plan’s current ratings, the regions of the state they serve, customer service telephone number, and website.

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 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.

The dataset contains Potentially Preventable Visit (PPV) observed, expected, and risk-adjusted rates for Medicaid beneficiaries by zip code beginning in 2011.

The Potentially Preventable Visits (PPV) obtained from software created by 3M Health Information Systems are emergency visits that may result from a lack of adequate access to care or ambulatory care coordination. These ambulatory sensitive conditions could be reduced or eliminated with adequate patient monitoring and follow up.

The rates were calculated using Medicaid inpatient and outpatient data for the numerator and Medicaid enrollment in the county or zip code for the denominator.

The observed, expected and risk adjusted rates for PPV are presented by either resident county (including a statewide total) or resident zip code (including a statewide total). For more information, check out: http://www.health.ny.gov/health_care/medicaid/. The "About" tab contains additional details concerning this dataset.

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.

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 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 dataset represents self‐reported performance data by HIV ambulatory care programs. All HIV ambulatory programs throughout New York State with a significant HIV caseload (a total caseload of at least 30 HIV‐infected patients receiving ambulatory HIV care at one or more sites) are expected to self‐report their annual quality of care performance data using standardized submission tools and methodologies. With the assistance of the online eHIVQUAL application, performance data results are instantly available to HIV programs, allowing them to immediately utilize their data findings to prioritize upcoming quality activities, and are available for generating benchmarking reports across New York State. See Limitations regarding redaction of small‐population data.

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.

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.