Healthcare Provider Network Participation For Q2 2019

Quarterly data from April through June 2019 details individual participation in health plan networks. The dataset includes provider information and network indicators for Medicaid, Commercial, and Exchange plans, collected by the New York State Department of Health.

Use Cases

• Analyze provider participation across Medicaid, Commercial, and Exchange plans using the `Medicaid Provider Indicator`, `Commercial Non-MCO Medical Indicator 8`, and `NYSOH Individual Network` columns.
• Identify providers with specific accessibility features like `Wheel Chair Accessibility` or language capabilities (`Language 3`, `Language 5`) for network adequacy assessments.
• Map provider locations and service areas by joining `Town/City` and `Zip Code` with external geographic datasets.
• Examine provider specialties and affiliations using `Board Status - Primary Specialty` and `Hospital Affiliation Operating Certificate (OPCERT) #3`.
• Track quarterly changes in network composition by analyzing the `Quarter/Year` field alongside various plan indicator columns.

Strengths

• Data covers three major insurance types: Medicaid, Commercial, and Exchange plans.
• Includes over 30 specific features per provider, detailing network participation, specialties, and accessibility.

Limitations

• Dataset is static, covering only a single quarter (Q2 2019), limiting longitudinal analysis.
• Sample size and row count are unknown, making it difficult to assess statistical power.
• Geographic coverage is limited to providers participating in New York State health plans.

Provenance

Source

New York State Department of Health via health.data.ny.gov.

Collection Method

Collected quarterly from Medicaid, Commercial, and Exchange health plans.

Time Range

April through June 2019.

Freshness

Quarterly basis, but last known update was September 2019.

Geography

New York State, USA.