New York Health Plan Provider Networks For Medicaid And Commercial Insurance

Quarterly data from the New York State Department of Health details which health facilities and ancillary service providers participated in plan networks during the first quarter of 2019. It covers Medicaid, Commercial, and Exchange plans, including managed care and PPO/EPO types. The dataset was published by health.data.ny.gov in September 2019.

Use Cases

• Analyze network breadth by counting unique NPI identifiers per Plan Name and Servicing County.
• Assess market competition by mapping Commercial Provider Indicator and Commercial Non-MCO Medical Indicator against Plan Name and County FIPS.
• Identify service gaps by correlating Service 14, Service 15, and Service 18 columns with Zip code and County FIPS for specific plan types.
• Evaluate specialized program participation (e.g., HARP, PACE, MAP) using their Indicator columns filtered by Plan Name and Servicing County.

Strengths

• Contains detailed plan-specific indicators for multiple programs (FIDA, HARP, PACE, MAP, Partial CAPS).
• Geographic granularity is provided via Servicing County, County FIPS, and Zip code columns.
• Covers three major insurance categories: Medicaid, Commercial, and Exchange plans.

Limitations

• Data is from a single quarter (Q1 2019) and may be stale for current analysis.
• Sample size and total row count are unknown, limiting statistical reliability assessments.
• Lacks direct patient or utilization volume data to measure network effectiveness.

Provenance

Source

New York State Department of Health

Collection Method

Collected quarterly from health plans including managed care and PPO/EPO plans.

Time Range

January through March 2019

Freshness

Quarterly collection, but data is from 2019.

Geography

New York State, United States