The Individual Provider Network Data displays information on individuals 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.

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.

The Individual Provider Network Data displays information on individuals 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 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/ .

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 individual Provider Network Data displays information on individuals participating in health plan networks from October through 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.

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.

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 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 individual Provider Network Data displays information on individuals participating in health plan networks from January through July, 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 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/ .

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 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 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 column chart illustrates the number of short-stay admissions to a nursing facility 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 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 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 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 chlamydia screening in young women 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 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 potentially preventable readmissions and prevention quality indicator- chronic composite. 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 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.