Staked out territory by Massachusetts hospital systems

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In 2011, we would tell our payer clients (tongue firmly ensconced in cheek) that the answer to all questions was “private exchanges”. In 2012, the punchline changed to “narrow networks”.

In 2013, what is not a joke is that payers and health systems are really having to grapple with difficult strategic choices on partnerships, affiliations and M&A relating to facilities and medical groups in order to actually deliver on the value promise of narrow networks (higher value care).

Two key inputs into these choices are:

  1. The geographic catchment area of each entity 
  2. The referral patterns across entities (graph/ network analysis)

In this post, we briefly illustrate some high-level analysis on the first.

Using data from CHIA on Massachusetts admissions by hospital by zip code and combining that with other information about hospital ownership we’ve created the following interactive visual using Tableau (love it!). Assuming you’ve got Javascript enabled and that the interactive works on your browser the way it’s supposed to (sorry mobile phone users!), you should be able to select a hospital system (or more than one using CTRL or SHIFT in the usual way) and see their hospitals, the prime patient catchment area of these hospitals and in the lower chart, the proportion of their inpatients who come from the prime catchment area. If you find the interactive is not easy to use within the blog, you can open it in a full window here.

While what you will see is not unexpected, it’s still quite stark to see how the different hospital systems play across geographies. What’s most interesting is how the geographical catchment area changes as you select different combinations of systems. Also worth noting is that while most hospitals draw from local areas, marquee hospitals such as Dana Farber, Children’s, MGH and the Brigham get over half their inpatients from outside their local geographies.

What we share here is built off public data and is pretty high level. In order to figure out the appropriate scenario to plan for in their market, payers, providers and self-insured employers will look at these patterns but also much more detailed views including referral flows (graph/network analysis) using proprietary data including claims data and contract information.

A tip of the hat to Ray A. Campbell, Former CEO of the Massachusetts Health Data Consortium and thanks to high-school student Ishaan Bhojwani for compiling the dataset. Here’s a link to his site.

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