Medicare Program Integrity and Healthcare Equity Analytics

County Level Healthcare Disparity Assessment Framework | Data Period: 2019 to 2022

3,198
Counties Analyzed
Complete national coverage
99.1%
Model Accuracy
Validated classification performance
255
High Risk Counties
8% of counties analyzed
2.5M
Underserved Beneficiaries
In high risk counties
29.5M
Medicare Beneficiaries
52% of total Medicare population
98.4%
HRSA Concordance
251 of 255 counties confirmed
18.4 hrs
Processing Time
For complete national analysis
r = 0.94
Temporal Stability
Across four year period

Geographic Distribution of High Risk Counties

Southeast
89 (35%)
Southwest
58 (23%)
Midwest
51 (20%)
Northeast
34 (13%)
Northwest
23 (9%)

State Healthcare Equity Index Distribution

Grade Score Range States Status
A 80 to 100 2 Excellent
B 70 to 79 12 Good
C 60 to 69 20 Average
D 50 to 59 12 Below Average
F Below 50 5 Critical

Model Validation Metrics

Model Accuracy 99.1%
HRSA Concordance 98.4%
Precision 97%
Recall 95%
Cross Validation (10 fold) 91.3%
MedPAC Consistency 91%
CMS Alignment 85.7%

State Performance Examples

Healthcare Equity Index scores range from 36.0 to 84.7 across 51 jurisdictions

Top Performing States (Grade A)

Utah 84.7
Minnesota 82.3

Lowest Performing States (Grade F)

District of Columbia 36.0
West Virginia Grade F

External Validation Results

External Source Concordance Interpretation
HRSA HPSA Database 98.4% 251 of 255 high risk counties confirmed
CMS High Cost Regions 85.7% Identifies 6 of 7 known regions
MedPAC Geographic Analysis 91% Consistent with Congressional patterns
Medicare Trustees Report Within 5% Aligns with actuarial projections

Healthcare Equity Index Formula

Composite Scoring Methodology

HEI = 0.30(Access) + 0.30(Quality) + 0.40(Equity)
Score Range: 36.0 to 84.7 across 51 U.S. jurisdictions
Normalized to 0 to 100 scale using min max normalization

Component Weights:

Access: 30% Quality: 30% Equity: 40%
🏥
1,704
Severe Provider Shortage Counties
HPSA score greater than 15 on 25 point scale
👥
20.4M
Beneficiaries Lacking Access
Inadequate primary care availability
🌾
20 pts
Rural vs Urban Disparity
Vulnerability scores: 78.5 vs 58.2

Data Sources Integrated

Dataset Coverage Variables
CMS Geographic Variation 29.5M beneficiaries 247 metrics
HRSA HPSA Database 3,016 counties Shortage indicators
Area Health Resources Files All U.S. counties 4,300+ variables
Census ACS National Demographics

Machine Learning Configuration

Parameter Value
Model Type Random Forest Classifier
Decision Trees 100
Maximum Depth 10 levels
Feature Inputs 9 features
Training Split 70% (n = 2,238 counties)
Validation Split 30% (n = 960 counties)
County Year Observations 12,792
Bootstrap Iterations 1,000

Medicare Spending Variation Context

64%
Spending Variation
$8,295 to $13,644 per beneficiary
50%
MedPAC Regional Variation
Without quality improvement
3,016
HPSA Designated Counties
Active shortage designations

Medicare Program Integrity and Healthcare Equity Analytics Framework

Data Period: 2019 to 2022 | Analysis: 29.5 million beneficiaries across 3,198 counties

Note: This framework identifies statistical patterns in healthcare access and delivery. County classifications reflect systematic analysis of federal data and require confirmation through appropriate agency review.