National Capital Area Market Plan

The Office of the Lead Agent (OLA) has almost 500,000 eligible military healthcare beneficiaries in the National Capitol Area, including 221,000 enrollees in TRICARE. Seeking the optimal configuration of clinical services, the OLA commissioned a study to analyze the healthcare utilization patterns of all NCA beneficiaries. The Innova Group, teamed with The Bristol Group and Wingler and Sharp Architects, was selected to assist because of Innova’s experience in population-based military healthcare planning and the ability to deliver market planning that optimizes resource alignment.

To quantify demand for healthcare services, Innova assembled a comprehensive database allowing record-level consideration of four million population-and-utilization encounters. Innova’s planners then coupled workgroup input with Innova’s extensive knowledge of access patterns to develop an algorithm for appropriate market definition. Innova considered natural boundaries, beneficiary clusters, and arterial routes; and then scrutinized migration patterns through primary care patient visit information. Innova further stratified the market picture to show a demand by service line, by beneficiary, and by age.

The resulting tool aggregated 907 zip codes into twelve distinct markets, not only producing a clear picture of health services demand but also determining the relative access alignment of existing facilities to best serve that demand.