We've heard speculation that the Covid-19 pandemic brought substantial migration out of cities, enough to noticeably impact health care utilization. We tested whether this disruption would impact planner's ability to accurately forecast volumes, as they typically rely on historical populations trends as a baseline. We found that broad migration shifts didn't materialize for two main reasons:
- While an increasing number of urban residents expressed the desire to move out of cities, few acted on it. Those cities that did experience an urban exodus, such as San Francisco, were outliers rather than the norm.
- Of those who did move from urban areas during the pandemic, a significant portion were temporary. One survey found that after a year, roughly one-quarter of pandemic movers had returned to their original residence. For example, more than 60% of those who left New York in the early pandemic were marked as temporary according to U.S. Postal Service data.
At the national level, migration within the U.S. during the pandemic was slightly below historical trends at an all-time low rate of 8.4% in 2021, continuing a long-running decline.
As a result, national level health care utilization did not broadly shift out of urban areas. Even those regions that experienced outsized migration relative to the rest of the country didn't do so at a rate that changed the overall market landscape.
For example, 377,775 people moved out of the Los Angeles-Long Beach region in 2021, 59,000 more that we'd expect based on pre-Covid migration patterns. This change translates to 7,700 fewer inpatient volumes and 615,000 fewer outpatient volumes than we would otherwise expect based on regional health care use rates taken from our Market Scenario Planner tool.
Not only does this change pale in comparison to the area's total market size, but it also means minimal impact at the facility level. For the average inpatient hospital in the Los Angeles – Long Beach region, that's a decline of only 20 volumes.
The table below compares the expected decline in total volumes to the area's total market size, along with the other regions that experienced the greatest population losses (and gains) in 2021.
Forecast volumes based on market changes, not Covid-19 migration
Pandemic-related migration wasn't enough to significantly impact patient volumes, so planners must continue to factor in the same mechanisms as before to generate market-specific estimates of future health care utilization.
That's where our Market Scenario Planner tool can assist. The tool generates current and projected patient utilization estimates for any given geographic area in the U.S. These 5- and 10-year growth estimates are based on demographic and non-demographic factors, such as population aging, migration, site-of-care shifts, and technology innovation. Generating a set of customized projections to inform business development and strategic decisions only takes a few minutes.
To request a walkthrough of the Market Scenario Planner tool for your market, submit a request through the AskAdvisory Portal.