About eQARR 2011

eQARR (Quality Assurance Reporting Requirements) was developed by the New York State Department of Health (NYSDOH) to enable consumers to evaluate the quality of health care services provided by New York State's managed care plans. Using eQARR, you can determine how well a health plan performed in the areas of provider network, child and adolescent health, women's health, adults living with illness, behavioral health, and satisfaction with care.

The data in eQARR 2011 reflects services and care delivered during 2010 unless otherwise specified (see perinatal health and rotation details below).

The Measures

QARR measures are largely adopted from the National Committee for Quality Assurance's (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS®) with New York State-specific measures added to address public health issues of particular importance in New York. When available, national averages (benchmarks) from NCQA are also included for the commercial HMO, commercial PPO and Medicaid populations. Child Health Plus populations currently don't have any national benchmarks.

QARR data is collected by health plans and the information is validated by a licensed organization. Only valid information is included in the data.

QARR also includes information collected from a national consumer satisfaction survey program called Consumer Assessment of Healthcare Providers and Systems (CAHPS®). CAHPS is collected every year for commercial adult enrollees. The NYSDOH sponsors a consumer satisfaction survey for Medicaid enrollees every two years.

The perinatal health measures are calculated by the New York State Department of Health using birth data submitted by the health plans and the Department's Vital Statistics file. Perinatal health measures are from 2009, as that is the most recent data available.

Types of Insurance

Information on four types of managed care insurance is included in this report: commercial HMO, commercial PPO, Medicaid, and Child Health Plus.

Commercial HMO Individual or employer sponsored health insurance. This is a form of health insurance where a health plan contracts with a network of providers to provide care; the member selects a primary care provider to coordinate care; and referrals to some services or specialists may be required.
Commercial PPO Individual or employer sponsored health insurance. This is a form of health insurance where a health plan contracts with a network of providers to provide care; there is no primary care provider assignment; and referrals to some services or specialists are not usually required.
Medicaid Government sponsored health insurance. This is a form of health insurance where a health plan contracts with a network of providers to provide care; the member selects a primary care provider to coordinate care; and referrals to some services or specialists may be required. This includes people who are eligible for Medicaid managed care and Family Health Plus (NYS's expansion program for adults age 19 and older).
Child Health Plus Government sponsored health insurance, although individuals may pay part of premium for some eligibility levels. This is a form of health insurance where a health plan contracts with a network of providers to provide care; the member selects a primary care provider to coordinate care; and referrals to some services or specialists may be required. This in NYS's version of the federal State Children's Health Insurance Program (SCHIP) for people up to age 19.

Rotation of Measures

Some services require more resource intensive methods of collection, and these measures are often rotated to control collection burden. When a measure is rotated for the reporting year, the data from the prior collection cycle is included. The measures which were not collected as part of the 2010 QARR measurement set include: Childhood Immunization, Cholesterol Management, Colorectal Cancer Screening, Comprehensive Diabetes Care, Lead Screening and CAHPS for Medicaid. Rates displayed for these measures are based upon services delivered during 2009.

The Results

Plan-specific rates (percentages) are accompanied by a symbol to denote whether the plan's rate is statistically above (Significantly Better than the Statewide Average) or below (Significantly Worse than the Statewide Average) 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.

Regions of New York State

For the purposes of eQARR, the counties of New York State were grouped into the following six regions:

Long Island

  • Nassau
  • Suffolk

New York City

  • Bronx
  • Kings (Brooklyn)
  • New York (Manhattan)
  • Queens
  • Richmond (Staten Island)

Hudson Valley

  • Dutchess
  • Orange
  • Putnam
  • Rockland
  • Sullivan
  • Ulster
  • Westchester

Northeast

  • Albany
  • Clinton
  • Columbia
  • Delaware
  • Essex
  • Franklin
  • Fulton
  • Greene
  • Hamilton
  • Montgomery
  • Otsego
  • Rensselaer
  • Saratoga
  • Schenectady
  • Schoharie
  • Warren
  • Washington

Central

  • Broome
  • Cayuga
  • Chenango
  • Cortland
  • Herkimer
  • Jefferson
  • Lewis
  • Madison
  • Oneida
  • Onondaga
  • Oswego
  • St. Lawrence
  • Tioga
  • Tompkins

Western

  • Allegany
  • Cattaraugus
  • Chautauqua
  • Chemung
  • Erie
  • Genesee
  • Livingston
  • Monroe
  • Niagara
  • Ontario
  • Orleans
  • Schuyler
  • Seneca
  • Steuben
  • Wayne
  • Wyoming
  • Yates

New York's Health Plans

eQARR contains information about managed care plans serving New York State residents including the counties and populations they serve on the Plan Profile Table. Customer Service telephone numbers are included along with their web sites. If you click on a plan's name, you will link to the plan's web site. Data from plans with low enrollment are not reported, but are included in the statewide average calculations.

Also included are NCQA accreditation ratings. NYSDOH does not require NCQA accreditation; the decision to seek NCQA accreditation is voluntary. NCQA ratings are the result of a comprehensive process conducted by a team of physicians and managed care experts. Plans are reviewed against more than 60 different standards designed to evaluate clinical and administrative systems related to such issues as customer service, confidentiality and consumer protection. Accreditation reviews occur throughout the year following this publication therefore changes may occur in ratings. For more information, see What Does NCQA Review When it Accredits an HMO?.

Domains

The measures in eQARR are divided into the following six domains. Information from the CAHPS consumer satisfaction survey is included in the Provider Network, Adults Living with Illness as well as in the Satisfaction with Care sections.

Provider Network

Board Certification
The percentage of physicians whose board certification is active as of December 31 of the measurement year in each of the following fields: family medicine, internal medicine, obstetrics and gynecology, and pediatrics. (Commercial HMO, Commercial PPO, Medicaid)
Satisfaction with Provider Communication
The percentage of members who responded "usually" or "always" when asked how often their doctor listened to them carefully, explained things in a way they could understand, showed respect for what they had to say, and spent enough time with them. (Commercial HMO, Commercial PPO, Medicaid)
Satisfaction with Personal Doctor
The percentage of members responding 8, 9, or 10 (on a scale of 0 to 10, where 0 is the worst personal doctor possible and 10 is the best personal doctor) when asked "How would you rate your personal doctor?" (Commercial HMO, Commercial PPO, Medicaid)
Satisfaction with Specialist
The percentage of members responding 8, 9, or 10 (on a scale of 0 to 10, where 0 is the worst specialist possible and 10 is the best specialist possible) when asked "How would you rate your specialist?" (Commercial HMO, Commercial PPO, Medicaid)

Child and Adolescent Health

Childhood Immunization (4-3-1-2-3-1-4)
The percentage of two-year olds who were fully immunized. The HEDIS specifications for fully immunized consisted of the following vaccines: 4 Diptheria/Tetanus/Pertussis, 3 Polio, 1 Measles/Mumps/Rubella, 2 H Influenza type B, 3 Hepatitis B, 1 Varicella, and 4 pneumococcal. This measure was not collected for 2010; 2009 data is presented in this report.(Commercial HMO, Commercial PPO, Medicaid, Child Health Plus)
Lead Testing
The percentage of two-year olds that had their blood tested for lead poisoning at least once. This measure was not collected for 2010; 2009 data is presented in this report. (Commercial HMO, Commercial PPO, Medicaid, Child Health Plus)
Well-Child and Preventive Care Visits in the First 15 Months of life
The percentage of children who had five or more well-child and preventive health visits in their first 15 months of life. (Commercial HMO, Commercial PPO, Medicaid, Child Health Plus)
Well-Child and Preventive Care Visits During the 3rd, 4th, 5th and 6th Years
The percentage of children between the ages of three and six years who had a well-child and preventive health visit in the past year. (Commercial HMO, Commercial PPO, Medicaid, Child Health Plus)
Adolescent Well-Care Visits
The percentage of adolescents (ages 12-21) who had at least one well-care or preventive visit during the measurement year. (Commercial HMO, Commercial PPO, Medicaid, Child Health Plus)
Annual Dental Visit
The percentage of children and adolescents ages 2 through 18 years, who had at least one dental visit within the last year. When a Medicaid plan does not offer dental care as part of its benefit package, enrollees have access to dental services through fee-for-service. (Medicaid, Child Health Plus)
Appropriate Treatment for Upper Respiratory Infection (URI)
The percentage of children, ages 3 months to 18 years, who were diagnosed with an upper respiratory infection (common cold) and who were NOT given a prescription for an antibiotic. A higher score indicates more appropriate treatment of children with URI. (Commercial HMO, Commercial PPO, Medicaid, Child Health Plus)
Appropriate Testing for Pharyngitis
The percentage of children, ages two to 18 years, who were diagnosed with pharyngitis, were prescribed an antibiotic, and who were given a group A streptococcus test. (Commercial HMO, Commercial PPO, Medicaid, Child Health Plus)
Use of Appropriate Medications for People with Asthma Ages 5-11
The percentage of children ages 5 to 11 years with persistent asthma who received appropriate medications to control their condition. (Commercial HMO, Commercial PPO, Medicaid, Child Health Plus)
Appropriate Asthma Medications Three or More Controller Dispensing Events for People with Asthma Ages 5-11
The percentage of members, ages 5 to 11 years, with persistent asthma who had three or more controller medication dispensing events in the last year. (Child Health Plus)
Follow-Up Care for Children Prescribed ADHD Medication
The percentage of children, ages 6 to 12 years, who were newly prescribed ADHD medication and who had at least 3 follow-up visits within a 10-month period of taking the medication. There are two measures to assess follow-up care for children taking ADHD medication. (Commercial HMO, Commercial PPO, Medicaid, Child Health Plus)
  1. Initiation Phase:The percentage of children with a new prescription for ADHD medication and who had one follow-up visit with a practitioner within the 30 days after starting the medication. (Commercial HMO, Commercial PPO, Medicaid, Child Health Plus)
  2. Continuation & Maintenance Phase:The percentage of children with a new prescription for ADHD medication who remained on the medication for 7 months and who had at least 2 follow-up visits in the 9-month period after the initiation phase ended. (Commercial HMO, Commercial PPO, Medicaid, Child Health Plus)
Weight Assessment and Counseling for Nutrition and Physical Activity
The percentage of children and adolescents ages 3-17 who thad an outpatient visit with a PCP or OB/GYN practitioner during the measurement year, receiving the following three components of care during the measurement year (Commercial HMO, Commercial PPO, Medicaid, Child Health Plus):
  1. BMI Percentile,
  2. Counseling for Nutrition, and
  3. Counseling for Physical Activity.
Adolescent Preventive Care
The percentage of adolescents ages 12-17 who had at least one outpatient visit with a PCP or OB/GYN practitioner during the measurement year, and received the following four components of care during the measurement year (Commercial HMO, Commercial PPO, Medicaid, Child Health Plus):
  1. Assessment or counseling or education on risk behaviors associated with sexual activity,
  2. Assessment or counseling or education for depression,
  3. Assessment or counseling or education about the risks of tobacco use, and
  4. Assessment or counseling or education about the risks of substance use (including alcohol and excluding tobacco).

Women's Health

Breast Cancer Screening
The percentage of women between the ages of 40 and 69 who had a mammogram during the measurement year or the year prior. (Commercial HMO, Commercial PPO, Medicaid)
Cervical Cancer Screening
The percentage of women between the ages of 24 and 64 who had a Pap test within the measurement year or the two years prior. (Commercial HMO, Commercial PPO, Medicaid)
Chlamydia Screening
The percentage of sexually active young women who had at least one test for Chlamydia during the measurement year. The measure is reported separately for ages 16 through 20 and 21 through 24. (Commercial HMO, Commercial PPO, Medicaid)
Timeliness of Prenatal Care
The percentage of women who gave birth in the last year who had a prenatal care visit in their first trimester or within 42 days of enrollment in their health plan. (Commercial HMO, Commercial PPO, Medicaid)
Postpartum Care
The percentage of women who gave birth in the last year who had a postpartum care visit between 21 and 56 days after they gave birth. (Commercial HMO, Commercial PPO, Medicaid)
Frequency of Ongoing Prenatal Care
The percentage of women who received 81 percent or more of the expected number of prenatal care visits, adjusted for gestational age and month the member enrolled in the health plan. (Medicaid)
Perinatal Health
These measures reflect results of perinatal care for women who had a live birth during 2009. The results are calculated by the Office of Health Insurance Programs using data from the health plans and from Vital Statistics. 2009 data is presented in this report. (Commercial HMO, Commercial PPO, Medicaid)
  1. Prenatal Care in the First Trimester: The percentage of women continuously enrolled for 10 or more months who delivered a live birth and had their first prenatal care visit in the first trimester of pregnancy.
  2. Risk-Adjusted Low Birthweight (LBW)*: The percentage of live infants weighing less than 2500 grams among all deliveries by women continuously enrolled in a plan for 10 or more months. A low rate is desirable for this measure.
  3. Risk-Adjusted Primary C-section: The percentage of live infants born by cesarean delivery to women, continuously enrolled for 10 or more months, who had no prior cesarean deliveries. A low rate is desirable for this measure.
  4. Vaginal Birth After C-section: The percentage of women continuously enrolled for 10 or more months who delivered a live birth vaginally after having had a prior cesarean delivery.
*For more information about the risk-adjustment methodologies, please refer to the Technical Notes section

Adults Living With Illness

Colon Cancer Screening
The percentage of adults, ages 50 to 75 years, who had appropriate screening for colorectal cancer.This measure was not collected for 2010; 2009 data is presented in this report.(Commercial HMO, Commercial PPO)
Use of Imaging Studies for Low Back Pain
The percentage of members, ages 18 to 50, with low back pain who did not have an imaging study (X-ray, MRI, CT scan). (Commercial HMO, Commercial PPO, Medicaid)
Adult BMI Assessment
The percentage of members 18-74 years of age who had an outpatient visit and who had their body mass index (BMI) documented during the measurement year or the year prior the measurement year. (Commercial HMO, Commercial PPO, Medicaid)
Annual Dental Visit
The percentage of adults ages 19 through 21 years, who had at least one dental visit within the last year. When a Medicaid plan does not offer dental care as part of its benefit package, enrollees have access to dental services through fee-for-service. (Medicaid)
Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis
The percentage of adults, ages 18 to 64, with acute bronchitis who did not receive a prescription for antibiotics. (Commercial HMO, Commercial PPO, Medicaid)
Medical Assistance with Smoking Cessation
The percentage of members, 18 years and older, who are current smokers or tobacco users and who received medical information about smoking cessation within the last 12 months (6 months for Medicaid) from a health care provider. This measure is collected as part of the CAHPS survey. (Commercial HMO, Commercial PPO, Medicaid)
  1. Advising Smokers to Quit: The percentage of eligible adults who received advice from a health care provider to quit smoking. (Commercial HMO, Commercial PPO, Medicaid)
  2. Discussing Smoking Cessation Medications: The percentage of eligible adults whose health care provider discussed or recommended smoking cessation medications. (Commercial HMO, Commercial PPO, Medicaid)
  3. Discussing Smoking Cessation Strategies: The percentage of eligible adults whose health care provider discussed or recommended other smoking cessation methods or strategies. (Commercial HMO, Commercial PPO, Medicaid)
Flu Shot for Adults
The percentage of members, ages 50 to 64, who have had a flu shot. This measure is collected as part of the CAHPS survey. (Commercial HMO, Commercial PPO, Medicaid)
Controlling High Blood Pressure
The percentage of members, ages 18 to 85 years, who have hypertension and who have controlled their blood pressure (below 140/90). (Commercial HMO, Commercial PPO, Medicaid)
Cholesterol Management for Patients with Cardiovascular Conditions
The percentage of members, ages 18 to 75 years, with a cardiovascular condition, who had LDL-C screening performed and whose LDL-C levels were in control (< 100mg/dL). This measure was not collected for 2010; 2009 data is presented in this report. (Commercial HMO, Commercial PPO, Medicaid)
  1. Screening Test: The percentage of members who had a cholesterol screening test.
  2. Level Controlled (LDL-C < 100mg/dL): The percentage of members who had a cholesterol level LDL-C result of < 100mg/dL.
Persistence of Beta Blocker Use
The percentage of members, age 35 years and older, who were hospitalized after a heart attack and received persistent beta-blocker treatment. (Commercial HMO, Commercial PPO)
Use of Appropriate Medications for People with Asthma Ages 12-50
The percentage of members, ages 12 to 50 years, with persistent asthma who received appropriate medication to control their condition. (Commercial HMO, Commercial PPO, Medicaid)
Appropriate Asthma Medications Three or More Controller Dispensing Events for People with Asthma Ages 12-50
The percentage of members, ages 12 to 50 years, with persistent asthma who had three or more controller medication dispensing events in the last year. (Commercial HMO, Commercial PPO, Medicaid)
Use of Spirometry Testing in the Assessment and Diagnosis of COPD
The percentage of members 40 years of age and older with a new diagnosis of COPD who received spirometry testing to confirm the diagnosis. (Commercial HMO, Commercial PPO, Medicaid)
Pharmacotherapy Management of COPD Exacerbation
The percentage of times that members 40 years of age and older who have had an acute inpatient discharge or ED visit for COPD, received the two recommended types of medications to manage the exacerbation. This measure is presented as two separate rates.(Commercial HMO, Commercial PPO, Medicaid)
  1. Corticosteroid Rate: The percentage of instances when the member was prescribed a systemic corticosteroid within 14 days of the event.
  2. Bronchodilator Rate: The percentage of instances when the member was prescribed a bronchodilator within 30 days of the event.
Comprehensive Diabetes Care
This measure reports components of care for members with diabetes and the rate at which they received necessary components of diabetes care. Measures presented here are grouped into those that monitor diabetes and those that measure outcomes for diabetes. This measure was not collected for 2010; 2009 data is presented in this report. (Commercial HMO, Commercial PPO, Medicaid)
  1. HbA1c Testing: The percentage of members with diabetes who received a Hemoglobin A1c (HbA1c) test within the past year.
  2. Lipid Profile: The percentage of members with diabetes who had a cholesterol test done over the past year.
  3. Dilated Eye Exam: The percentage of members with diabetes who had a retinal eye screening exam over the last two years.
  4. Nephropathy Monitoring: The percentage of members with diabetes who received medical attention or were monitored for kidney damage.
  5. Received All Four Tests: The percentage of members with diabetes who had a HcA1c test, a cholesterol test, a retinal eye screening exam, and received medical attention or were monitored for kidney damage. (Medicaid only)
  6. Poor HbA1c Control: The percentage of members with diabetes whose most recent HbA1c level indicated poor control ( HbA1c result >9.0 percent, no HbA1c test, or missing HbA1c test result). A low rate is desirable for this measure.
  7. Lipids Controlled: The percentage of members with diabetes whose most recent level of bad cholesterol was in control (LDL-C <100 mg/dL).
  8. Blood pressure controlled: The percentage of members with diabetes who have controlled their blood pressure (below 140/90).
  9. HbA1c and Lipids controlled: The percentage of members with diabetes whose most recent HbA1c level indicated ≤9.0 percent and level of bad cholesterol was in control (LDL-C <100 mg/dL). (Medicaid only)
Drug Therapy for Rheumatoid Arthritis
The percentage of members with rheumatoid arthritis who were prescribed disease modifying anti-rheumatic drug therapy during the measurement year. (Commercial HMO, Commercial PPO, Medicaid)
Annual Monitoring for Patients on Persistent Medications
The percentage of members 18 years and older who were taking certain medications for at least six months and who received specific monitoring tests. The following numerators specify categories of medications that are of interest: (Commercial HMO, Commercial PPO, Medicaid)
  1. The percentage of members who received at least a 180 day supply of ACE inhibitors and/or ARBs, and who had at least one blood test for potassium and a monitoring test for kidney function in the measurement year.
  2. The percentage of members who received at least a 180 day supply of digoxin, and who had at least one blood test for potassium and a monitoring test for kidney function in the measurement year.
  3. The percentage of members who received at least a 180 day supply of diuretics, and who had at least one blood test for potassium and a monitoring test for kidney function in the measurement year.
  4. The percentage of members who received at least a 180 day supply of an anticonvulsant and who had at least one blood test for therapeutic drug level in the measurement year.
  5. The combined rate is the sum of the four numerators divided by the sum of the four denominators.
HIV/AIDS Comprehensive Care
These measures include quality indicators of recommended treatment and preventive care for people living with HIV/AIDS who are enrolled in Medicaid Managed Care. These measures are New York State specific and have no national comparison. (Medicaid)
  1. Engaged in Care: The percentage of members with with HIV/AIDS, 2 years of age or older, who had two visits for primary care or HIV related care with at least one visit during each half of the past year. The intent is to measure the number of members who are receiving ongoing primary care for their HIV and preventive health needs. (Medicaid)
  2. Viral Load Monitoring: The percentage of members with with HIV/AIDS, 2 years of age or older, who had two viral load tests performed with at least one test during each half of the past year. (Medicaid)
  3. Syphilis Screening: The percentage of members with with HIV/AIDS, 19 years of age or older, who were screened for syphilis in the past year. (Medicaid)

Behavioral Health

Antidepressant Medication Management
This measure is for members ages 18 years and older who were diagnosed with depression and treated with an antidepressant medication and has two components of care. (Commercial HMO, Commercial PPO, Medicaid)
  1. Effective Acute Phase Treatment: The percentage of members who remained on antidepressant medication during the entire 12-week acute treatment phase.
  2. Effective Continuation Phase Treatment: The percentage of members who remained on antidepressant medication for at least six months.
Follow-up After Hospitalization for Mental Illness
This measure is for members ages 6 years and older who were hospitalized for treatment of selected mental health disorders (such as depression or bipolar disorder) and has two time-frame components. (Commercial HMO, Commercial PPO, Medicaid)
  1. Within 7 Days: The percentage of members who were seen on an ambulatory basis or who were in intermediate treatment with a mental health provider within 7 days of discharge.
  2. Within 30 Days: The percentage of members who were seen on an ambulatory basis or who were in intermediate treatment with a mental health provider within 30 days of discharge.

Satisfaction with Care

Getting Care Needed
The percentage of members responding "usually or "always" when asked a set of questions to identify if, in the last 12 months (6 months for Medicaid), they received care they needed. This measure was not collected for 2010; 2009 Medicaid data is presented in this report. (Commercial HMO, Commercial PPO, Medicaid)
  1. How often was it easy to get appointments with specialists?
  2. How often was it easy to get the care, tests, or treatment you thought you needed through your health plan?
Getting Care Quickly
The percentage of members responding "usually" or "always" when asked a set of questions to identify, if, in the last 12 months (6 months for Medicaid), they received health services quickly. This measure was not collected for 2010; 2009 Medicaid data is presented in this report. (Commercial HMO, Commercial PPO, Medicaid)
  1. When you needed care right away for an illness, injury, or condition, how often did you get care as soon as you wanted?
  2. Not counting the times you needed health care right away, how often did you get an appointment for health care as soon as you wanted?
Claims Processing
The percentage of members responding "usually" or "always" when asked a set of questions to identify how, in the last 12 months, their health plan handled claims. The following questions are contained in this composite: (Commercial HMO, Commercial PPO)
  1. How often did your health plan handle your claims quickly?
  2. How often did your health plan handle your claims correctly?
Plan Information on Costs
The percentage of members responding "usually" or "always" when asked a set of questions to identify if, in the last 12 months, they looked for information about health care costs. The following questions are contained in this composite: (Commercial HMO, Commercial PPO)
  1. How often were you able to find out from your health plan how much you would have to pay for a health care service or treatment?
  2. How often were you able to find out from your health plan how much you would have to pay for specific prescription medicines?
Customer Service
The percentage of members responding "usually or "always" when asked a set of questions to identify if, in the last 12 months (6 months for Medicaid), they used their health plan's customer service. This measure was not collected for 2010; 2009 Medicaid data is presented in this report. (Commercial HMO, Commercial PPO, Medicaid)
  1. How often did your health plan's customer service give you the information or help you needed?
  2. How often did your health plan's customer service staff treat you with courtesy and respect?
Rating of Health Plan
The proportion of members responding 8, 9 or 10 on scale of 0 to 10, where 0 is the worst health plan possible and 10 is the best health plan possible. This measure was not collected for 2010; 2009 Medicaid data is presented in this report. (Commercial HMO, Commercial PPO, Medicaid)
Shared Decision Making
The percentage of members responding "definitely yes" when asked a set of questions to identify if, in the last 12 months (6 months for Medicaid), they made healthcare decisions with their doctor. The following questions are contained in this composite: (Commercial HMO, Commercial PPO)
  1. Did a doctor or other health provider talk with you about the pros and cons of each choice for your treatment or healthcare?
  2. When there was more than one choice for your treatment of healthcare, did a doctor or other health provider ask which choice was best for you?
Care Coordination
The percentage who responded "usually" or "always" when asked how often their personal doctor seemed informed and up-to-date about care they received from other doctors or health providers. This measure was not collected for 2010; 2009 Medicaid data is presented in this report. (Commercial HMO, Commercial PPO, Medicaid)
Wellness Discussion
The percentage who responded "usually" or "always" when asked how often their doctor or other health provider discussed things to do to prevent illness. This measure was not collected for 2010; 2009 Medicaid data is presented in this report. (Commercial HMO, Commercial PPO, Medicaid)
Rating of Overall Healthcare
The proportion of members responding 8, 9 or 10 on scale of 0 to 10, where 0 is the worst healthcare possible and 10 is the best healthcare possible. This measure was not collected for 2010; 2009 Medicaid data is presented in this report. (Commercial HMO, Commercial PPO, Medicaid)
Getting Needed Counseling or Treatment
The percentage who responded "usually" or "always" when asked how often, in the past 6 months, it was easy to get counseling or treatment for a personal or family problem through their health plan. This measure was not collected for 2010; 2009 Medicaid data is presented in this report. (Medicaid)
Rating of Counseling or Treatment
The percentage of members responding 8, 9, or 10 on a scale of 0 to 10, where 0 is the worst counseling or treatment possible and 10 is the best counseling or treatment possible. This measure was not collected for 2010; 2009 Medicaid data is presented in this report. (Medicaid)

Other Related Managed Care Reports and Websites

  • The 2011 Report on Managed Care Performance: A Report on Quality, Satisfaction with Care and Consumer Satisfaction is a NYSDOH publication of provider network, access to care, quality of care and consumer satisfaction plan performance during 2010. This report represents Commercial HMO, Commercial PPO, Medicaid and Child Health Plus data results.
  • The 2011 Managed Care Utilization and Access Report:A NYSDOH report which contains information about access to care, and use of services, such as inpatient and outpatient care rates. This report contains data on Commercial HMO, Commercial PPO, Medicaid and Child Health Plus plan performance during 2010.
  • A Consumer's Guide to Managed Care: NYSDOH publishes six regional guides for Commercial HMO, Commercial PPO, Medicaid, and Child Health Plus Managed Care. The Consumer Guides rate plans on domains of care and measures of consumer satisfaction. Plans are ranked based upon performance in all areas. The New York City, Long Island and Western Medicaid guides are also available in Spanish.

Need More Information

If you have any questions or comments about eQARR or would like copies of the Consumer Guides or the 2011 Report on Managed Care Performance, please contact the Division of Quality & Evaluation at (518)486-9012 or e-mail nysqarr@health.state.ny.us.