2016 New York State Managed Care Plan Performance Report

Managed care plans provide health services to millions of New Yorkers. Choosing a health plan that meets your needs and the needs of your family is an important decision. The New York State Managed Care Plan Performance Report is designed to help you make an informed decision by providing you with clear, easy-to-read information on primary and preventive health visits, access to health care, and medical management of select chronic diseases. Information from a consumer satisfaction survey tells you what consumers think of their managed care plan and the quality of the services they received over the last year. Health plans are required to have their information validated by an independent auditor prior to sending it to the Department. Only valid information is published in this report. Information on five types of insurance is included: commercial HMO, commercial PPO, Medicaid, HIV Special Needs Plan (SNP) and Child Health Plus. Child Health Plus is New York State's version of the federal State Children's Health Insurance Program, and children up to age 19 are qualified. Beginning in 2014, Child Health Plus data is reported in combination with Medicaid Managed Care data.

Managed care plans that were in operation during the entire 2015 calendar year were required to report data. This report contains information on 24 health insurance organizations, all of which report data on one or more product lines, depending on their business lines in New York State. Please note when you are reviewing this report that not all health plans serve commercial, Medicaid and/or Child Health Plus enrollees in every region of the state. To determine which managed care plans participate in your area please see our Managed Care Regional Consumer Guides.

The first section in this report lists the health plans currently enrolling members in New York State, the regions of the state they currently serve and whether they also enroll Medicaid or Child Health Plus members, along with other important information. There are important things to consider when choosing a managed care plan. Does your current doctor participate in the plan? Does the plan enroll members in your county of residence? Does the plan offer special services that will enhance the health of your family? Talk to your friends, family, coworkers and health care providers before making your choice.

In addition to the introductory information, this report is divided into eight sections:

  • Information on Health Plans Serving New York State Residents
  • Provider Network
  • Child and Adolescent Care
  • Women’s Health
  • Adult Health
  • Behavioral Health
  • Satisfaction With Care

Each section contains groups of quality performance measures with results for each plan and the statewide average. Symbols are provided to indicate whether the plan performed better, worse or the same as the statewide average.

Learn More

Please contact us at:

Bureau of Quality Measurement Evaluation
Office of Quality and Patient Safety
New York State Department of Health
Corning Tower, Room 1938
Empire State Plaza
Albany, New York 12237
Telephone: 518-486-9012
Fax: 518-486-6098
Email: nysqarr@health.ny.gov