About the maps

All our site-of-care shift maps display the distribution of 2024 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 a procedure or outpatient service. Each market is color-coded by the percentage of market volumes delivered outside 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.

What is the state of shift in your market?

Use the first map to see the percentage of market volumes delivered outside the hospital for the 15 procedures we track. If you see an above-median freestanding share, depicted by darker shading, your market has shifted more quickly than others. If it’s a below-median share, depicted by lighter shading, your market has shifted more slowly. Variation usually comes down to a combination of four different factors:

• Regulation: Liberal certificate of need (CON) rules or clinical requirements for freestanding care.
• Physician independence: The extent to which physicians work closely with hospitals versus independently in the community, and especially the extent to which they have ownership stakes in freestanding facilities like ASC’s.
• Health plan activity: The extent to which health plans are pushing for care in lower-cost sites. For example, in some markets health plans reimburse joint replacement at ASC rates regardless of setting.
• Volume: Whether there’s sufficient procedural volumes in the market for physicians to be able to schedule full days in the freestanding setting. In lower volume markets or those with less specialized surgeons, the surgeons may not want to schedule time outside the hospital for small numbers of patients appropriate for freestanding care.