Urban-Rural Healthcare Access Dashboard
Urban-Rural Healthcare Access Dashboard
Introduction
The goal of the Urban-Rural Healthcare Access dashboard is to show how healthcare access and usage differ between urban and rural areas in Georgia. Healthcare access is looked at from four different angles:
- Medical care access: This involves how often people use medical services and how far they travel for different types of healthcare facilities and specialists, as well as for common medical procedures.
- Dental care access: This shows how often people use preventive or diagnostic dental services, how far they travel for these services, and the percentage of people getting at least one or two preventive or diagnostic dental check-ups a year.
- Procedure availability: This part includes data on the number of medical services done, their costs, and how far people travel to get these services. You can see details for specific medical procedures and diagnosis related groups.
- Provider availability: This shows the number of healthcare providers by different specialties (in total and for active or full time equivalent providers), the number of providers per 100,000 people, and how far people travel to see these providers in each county.
You can filter and view these metrics by different years, payers, geographic areas (like county and region), and by measures of social vulnerability. The Urban-Rural Healthcare Access dashboard works best on large screens. Check the Methods and Limitations section for more details on how the metrics were created.
Methods
Inclusion and Exclusion Criteria
Claims were excluded if they were denied or orphaned adjustments (adjustments for which the primary claim cannot be identified). Claims and eligibility months were also excluded for patients from outside of Georgia or for whom their home county could not be determined. Only primary paid claims were included.
Visit
Visits represent a medical encounter on the same day by the same person and may include multiple claims within the Georgia APCD.
Dental Visit
Dental visits represent a preventive or diagnostic dental visit on the same day by the same person and may include multiple claims within the Georgia APCD. Procedure codes on the dental claim are limited to codes beginning with D1 or D0.
Visits per 1000 Members per Month
The reported visit rates represent the proportion of visits per 1,000 member months of medical or dental coverage (p1kmpm), depending on the visit type. Visit rates are raw and have not been adjusted or “weighted” according to a target population.
Average Distance to Service
Distance to service is based on the straight-line distance between the centroids of the patient and provider zip codes. Distance to service is only calculated for providers with populated zip code information and located in Georgia (not available otherwise). For Procedure Availability, the average distance is aggregated by the provider county; for all other sheets, this metric is aggregated by patients’ county.
Average Amount Paid
Average amount paid for the given procedure or diagnosis related group (DRG), including both health plan and patient paid amounts.
Average Out of Pocket
Average amount paid by the patient for the given procedure or diagnosis related group (DRG).
Procedure Availability
Common medical procedure codes or diagnosis related groups, sourced from the Center for Improving Value in Health Care’s (CIVHC) Shop for Care Methodology.
Provider Counts
Individual providers are identified from paid professional claims in office, federally qualified health center, or clinic settings. Total providers are providers with any visits in a given year while active providers are providers with at least 11 visits in a given year. Full-time equivalent (FTE) ratios are determined among active providers based on active days or patient volume from claims:
- 1 FTE provider based on active days has at least 150 unique days of service per year while part-time is represented as a proportion of active days out of 150.
- 1 FTE provider based on annual patient count is a provider seeing at least as many patients as the median patient count for the specialty while part-time is represented as the ratio of patients to the median.
If a provider has visits in multiple geographic areas (county, region, etc.) in a given year, they will be counted in each of those geographic areas.
Provider counts per 100,000 members
Provider counts (for each availability type) divided by annualized eligible members with medical coverage per year, multiplied by 100,000.
Social Vulnerability Index
County-level classifications are based on the 2022 Centers for Disease Control and Prevention and Agency for Toxic Substances and Disease Registry (CDC/ATSDR) Social Vulnerability Index (SVI). It includes the total SVI score (an overall reflection of social vulnerability), 4 high level themes, and individual indicators of social vulnerabilities (e.g. percent of the county under 18, over 64, with limited English, no high school diploma, uninsured, unemployed, etc.). The scores are aggregated in quartiles of low, low-medium, medium-high, and high risk, with a higher risk indicating greater vulnerability.
Urban-Rural Classification
The CDC’s National Center for Health Statistics (NCHS) Urban-Rural Classification Scheme for Counties is a six-level measure of urbanicity based on the Office of Management and Budget’s (OMB) county divisions for metropolitan and micropolitan statistical areas.
- The dashboard shows telehealth trends, age-gender variation, and county distribution for six urban-rural classifications: Non-core, Micropolitan, Small Metro, Medium Metro, Large Fringe Metro, and Large Central Metro.
- A binary urban or rural status is also used in the dashboard, which categorizes urban counties as Small Metro, Medium Metro, Large Fringe Metro, and Large Central Metro, while rural counties are Non-core and Micropolitan counties.
Payer
Based on the submitter and plan type on the claim, assigns the payer as Commercial, Medicaid, Medicare (includes Medicare Advantage), and State Health Benefit Plan (SHBP).
Caveats and Limitations
Missing Data
This Snapshot is based on data present in the Georgia All-Payer Claims Database with service dates through September 2024. The GA APCD is still missing important payer data that will be added in the coming year. Georgia Medicaid has some incomplete data elements and Medicare Parts A and B data, as well as data from self-insured plans, were not included in this Snapshot. Metrics may thus change in subsequent releases as these data and additional historical data are added.
Data Suppression and De-Identification
Reported metrics that are derived from patient counts less than 11 individuals are suppressed and will not be included in dashboard or data. APCD data is de-identified, used, and disclosed with guidance from the US Department of Health and Human Services in accordance with section 164.514(a) of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.