Care Demand Projections card

Pivotal uses historical claims to calculate the need for care by service line and sub-service line in a defined market, and presents it in the Care Demand Projections highlight card. On the graph the need for care is expressed in procedure volumes at a service line level for the current year, as well as projected 5 and 10 years out. The CSV download provides care demand data down to sub-service line level and lists the growth differences for each year. There are three types of service utilization rates available for the user to select - Local, Regional, and National - that aim to address specific nuances of each market defined by the user.

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Regional Use Rates

The Regional Use Rates are derived from historical claims submitted across the healthcare facilities within a Core Statistical Area the defined local market is part of that are then applied to the local population. This way of calculating the future demand of healthcare accounts for regional differences in healthcare usage. If a local market happens to be a part of more than one CSA, then the utilization rates from the CSA that is geographically most represented in the market are used to calculate the projected demand.

When a market does not fall within a CSA, regional demand is not available and local care is equivalent to national.

Local Use Rates

The Local Use Rate-based demand projections are also claims-based and account for geographical differences in healthcare utilization. In cases, where a local market is split between several CSAs or partially falls outside of one, the logic combines the regional rates across the CSA(s) and, when applicable, also blends in the National Use Rates to create a more accurate representation of the local market.

National Use Rate-Based Demand

When selecting the National Use Rate radio button, Pivotal customers are presented with normalized, nationally distributed Use Rates for each service consumed by healthcare patients across the United States.

For additional questions, please reach out to your Customer Success representative.