Data Sources & Methodology
Transparency in data sourcing and estimation methods for the United Medical HealthWest market analysis.
Public Data Limitations
This analysis uses publicly available data sources. Actual discharge destination data (which IRFs patients go to, SNF vs IRF split) is not publicly available and requires:
- Louisiana LAHIDD - State hospital discharge database ($500-2,000 purchase)
- CMS IRF-PAI - Patient assessment data (requires Data Use Agreement, 3-6 months)
- Commercial Intelligence - Definitive Healthcare, Sg2, Trella Health ($10K-50K/year)
Primary Data Sources
Publicly accessible datasets used in this analysis
| Source | Data Type | Usage | Limitations | Updated |
|---|---|---|---|---|
| Hospital Quality Metrics | Ochsner Medical Center readmission rates, quality scores, affiliated physician counts | Medicare fee-for-service only; no discharge destination data | 2023 | |
| Discharge Volumes by DRG | Acute care hospital discharge statistics by diagnosis group | Shows discharges FROM hospitals, not TO post-acute care; requires filtering | 2023 | |
| IRF Capture Rates | 10-15% standard IRF capture rate for rehab-appropriate discharges | National averages may not reflect Greater New Orleans market conditions | 2024 | |
| IRF-Qualifying Diagnoses | Definition of IRF-appropriate patient populations | Clinical criteria only; does not indicate actual referral patterns | 2024 |
Estimation Methodology
How we calculate market size and opportunity in the absence of proprietary data
| Metric | Calculation Method | Confidence Level |
|---|---|---|
| Total Hospital Discharges | Estimated based on facility size, regional benchmarks, and Medicare volume categories | Medium |
| IRF-Appropriate Discharges | 10% of total discharges (industry standard for rehab-qualifying diagnoses) | Medium-High |
| Current IRF Capture Rate | 10-15% of IRF-appropriate patients (MedPAC national benchmark) | Medium |
| SNF Leakage | Remainder of IRF-appropriate patients (85-90%) assumed to go to SNF | Low-Medium |
| Geographic Distribution | 20-30% of Ochsner Main patients estimated to be West Bank residents | Low |
Key Assumptions
What We Assume:
- 10% of acute care discharges are IRF-appropriate - Based on MedPAC national data for stroke, orthopedic, neurological, and trauma diagnoses meeting CMS 60% rule criteria.
- Current IRF capture rate is 10-15% - Industry benchmark; remainder (85-90%) assumed to go to SNFs due to physician preference, case manager defaults, or patient/family choice.
- Hospital volumes estimated - West Jefferson: 15K-20K annual discharges; Ochsner Main: 35K-40K; Ochsner West Bank: 8K-12K (based on facility size, bed count, and regional comparisons).
- 20-30% of Ochsner Main patients are West Bank residents - Geographic assumption based on bridge traffic patterns and lack of comprehensive acute care on West Bank.
How to Validate These Assumptions:
- Purchase Louisiana LAHIDD data to see actual discharge destinations
- Request CMS IRF-PAI data (requires Data Use Agreement)
- Conduct surveys with case managers and physicians at target hospitals
- Track actual referral patterns once liaison program begins
- Subscribe to commercial market intelligence services (Definitive Healthcare, Sg2)
Ochsner Medical Center - Verified Data
Confirmed metrics from Medicare.gov (CMS Provider ID: 190036)
Confirmed Metrics:
- Readmission Rate:16.2%
- National Average:15.0%
- Affiliated Physicians:2,306
- Overall Star Rating:4 / 5
- Net Patient Revenue:$2 Billion
Strategic Implications:
- •High readmission rate creates opportunity to position United Medical HealthWest as readmission prevention partner
- •Large physician network (2,306) represents massive referral opportunity
- •Dominant market position ($2B revenue) indicates high discharge volumes