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National site-of-care shift maps

About the maps

Both site-of-care shift maps display the distribution of 2019 volumes across each care site, by market (Health Referral Region). These maps are populated by Optum’s de-identified Clinformatics® Data Mart which is derived from a database of administrative health claims for members of large commercial and Medicare Advantage health plans.

How to use the maps

Use the drop-down menu at the top of each map to choose your procedure or outpatient service of interest. Each market is color-coded by percentage of market volumes delivered outside of the hospital. Hover over any market to see how volumes are delivered across each care setting and download each tab’s data by clicking the download button in the bottom left corner of each tab.

Site-of-care shift map for procedure volumes

The first map shows how a subset of procedures are distributed across four different care settings: the inpatient hospital (IP), the hospital outpatient department (HOPD), the ambulatory surgery center (ASC), and the physician’s office (office). 1, 2, 3

Site-of-care shift map for outpatient services

The second map shows how outpatient services are distributed across all outpatient care settings. For simplicity, you’ll see how each market’s volumes are distributed across the top three care sites with any remaining volumes grouped into a fourth “All others” category. 4, 5, 6


1 Calculation of volumes represents a distinct count of patients who are assigned one of the CPT codes that are categorized into each procedure grouping. Distinct assignments of CPT codes are made at the level of procedure grouping, care setting, and fiscal quarter.

2 In addition to traditional physician’s offices, this category includes volumes attributed to independent clinics, federally qualified health centers, and public health clinics. These three facility types contribute approximately 0.2% of volumes to the physician's office category.

3 Markets must have at least 50 procedure volumes across care settings to be included in the distribution of procedure volumes map except for SI joint fusion markets which were included with more than 40 procedure volumes.

4 Outpatient services defined using Advisory Board’s proprietary outpatient grouping methodology.

5 Markets must have at least 100 service volumes to be included in the distribution of outpatient services map.

6 Care sites assigned via algorithm that considers each NPI’s CMS assigned taxonomy code, listed place of service, listed type of bill, and mix of coded procedures/services. Care sites include ASC, Clinic-other, DME/Pharmacy/Other supplier, Home care, HOPD, Hospice, Imaging, Lab, Managed care services, Mental health/behavioral/social health, Nursing/intermediate facility, Office, Other, Physical/occupational therapy/rehab, Retail, Swing bed, Transportation services, Urgent care, ED, Telehealth.

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