Institutional Provider Network Data: New York Health Plan Participation, 2018 Q1-Q2

Institutional Provider Network Data displays information on health facilities and ancillary service providers participating in health plan networks from January through June, 2018. Plan network data is collected from Medicaid, Commercial, and Exchange plans on a quarterly basis by the Department of Health. The dataset includes managed care plans, as well as PPO/EPO plans, and is hosted by health.data.ny.gov.

Use Cases

• Map provider locations using Street Address, State (Standardized), and Room or Suite Number for network coverage analysis.
• Analyze plan participation patterns using columns like HARP Indicator, PACE Indicator, and HIVSNP Indicator across different provider types.
• Link provider records to other datasets using the National Provider Identifier (NPI) as a unique key.
• Filter providers by specific services offered using the Service 2, Service 4, and Service 10 columns (from 5 available service columns).

Strengths

• Data covers multiple plan types (Medicaid, Commercial, Exchange) and plan structures (managed care, PPO/EPO).
• Includes a standardized unique identifier (National Provider Identifier) for record linkage.
• Provides physical address details (Street Address, State, Room or Suite Number) for geospatial analysis.

Limitations

• Row count is unknown, which may limit suitability assessment.
• Last updated 2019-03-25 14:44:08; freshness should be verified.
• Description metadata is limited; actual data quality requires manual inspection after download.

Provenance

Source

Department of Health, collected from health plans.

Collection Method

Quarterly collection from Medicaid, Commercial, and Exchange plans.

Time Range

January 2018 through June 2018 (Quarters 1 and 2).

Freshness

Data covers 2018 Q1-Q2; last metadata update was 2019-03-25.

Geography

Likely focuses on New York State, given the organization (health.data.ny.gov) and plan naming conventions (e.g., NYSOH).