Interpreting medical claims data with visual analytics

Nov 10th, 2023


The healthcare industry generates as much as 30 percent of the world’s stored data. A single patient creates an estimated 80 megabytes in medical imaging and electronic medical record (EMR) data each year, while the average hospital produces around 50 petabytes of data in that time.

Patient and provider information of this volume has the power to inform stakeholder sales strategies, fuel innovation, and improve care outcomes. But there’s a catch: in order to utilize healthcare claims data to your advantage, you have to be able to understand and interpret it.

Definitive Healthcare data shows that a company developing medical devices for congestive heart failure (CHF) patients had a potential market of nearly 2 million U.S. patients in the 2022 claims year. But how do they put this information into a more meaningful context? How do they shape all of this available data into an actionable strategy?

Data visualization tools create stories around analytics and allow people to see and understand the data in a way that they might not have been able to before. With access to a tool like the DHC Visuals dashboard, users can see proprietary data, account intelligence, and all-payor claims analytics displayed in one interactive, graphic layout.

In this blog, we’ll look at three ways that you can leverage data visualization tools to inform your business and drive your sales strategy.

1. Determine your best territory plan

Visually engaging, interactive maps provide users with an at-a-glance method for gauging both national and regional market size—giving you a visual representation of where those nearly 2 million congestive heart failure patients are seeking treatment.

The heatmap pictured below shows CHF patient concentrations by hospital, with the size of each plot point representing relative hospital patient volumes. At a first glance, users can see that the Northeast, Southeast, and Midwest regions report the highest volumes of congestive heart failure patients. From there, they can focus their sales efforts in those areas with the greatest patient demand.

2022 CHF patient volume by hospital

A map of the U.S. showing congestive heart failure patients

Fig. 1 Analysis of data from the DHC Visuals Hospital Therapy Area Analytics dashboard for congestive heart failure. Medical claims data is sourced from multiple clearinghouses for the 2022 claims year. 

On the DHC Visuals dashboard, users can access a list of the top hospitals either by national market or by selected regional market. The list populates hospital-level detail like total number of CHF patients, total charges, number of ER visits, length of stay, CHF patient readmission rates, and more.

Using this data, we’ve created a list of the top 20 hospitals by total CHF patients. CHF patient totals are represented by each hospital’s percentage share of the more than 75,000 patients seen across all 20 hospitals.

Hospitals ranked by CHF patient volume

RankHospitalDefinitive IDStateCHF patients as % of all patientsShare of 2022 CHF patientsExplore dataset
1AdventHealth Orlando (FKA Florida Hospital Orlando)873FL23.73%7.21%Explore
2NewYork-Presbyterian Weill Cornell Medical Center541974NY24.62%6.74%Explore
3Cedars-Sinai Medical Center430CA32.31%6.15%Explore
4Norton Hospital1678KY29.01%5.20%Explore
5Mayo Clinic Hospital - Saint Marys Campus2191MN25.51%5.99%Explore
6Yale New Haven Hospital731CT29.35%5.18%Explore
7Lehigh Valley Hospital - Cedar Crest3525PA30.39%5.09%Explore
8Corewell Health William Beaumont University Hospital (AKA Beaumont Hospital - Royal Oak)2066MI28.48%4.73%Explore
9ECU Health Medical Center (FKA Vidant Medical Center)3019NC33.70%4.96%Explore
10Methodist Hospital3862TX24.26%5.06%Explore
11Massachusetts General Hospital1973MA26.78%4.76%Explore
12Methodist University Hospital3818TN26.53%4.66%Explore
13Evanston Hospital (AKA NorthShore Evanston Hospital)1154IL25.32%4.33%Explore
14Carilion Roanoke Memorial Hospital4338VA33.07%4.66%Explore
15Charlton Memorial Hospital1927MA32.99%4.11%Explore
16Memorial Hermann Southwest Hospital274147TX31.39%4.59%Explore
17Baylor Scott & White Medical Center - Temple3849TX34.43%4.23%Explore
18Christiana Hospital744DE20.22%4.30%Explore
19Novant Health New Hanover Regional Medical Center3013NC27.24%4.22%Explore
20Montefiore Hospital - Moses Campus273024NY28.91%3.84%Explore

Fig. 2 Analysis of CHF patient data from the DHC Visuals Hospital Therapy Area Analytics dashboard for congestive heart failure. Medical claims data is sourced from multiple clearinghouses for the 2022 claims year.

In 2022, for instance, AdventHealth Orlando had the highest volume of CHF patients in the national market, with 0.27% of all CHF patients in the national market, or 7.21% of CHF patients among the top 20 hospitals by CHF patient volume. Identifying these high-volume hospitals allows users to map their target territories and form a strong lead base before executing a sales strategy.

2. Trace referral patterns and identify network leakage

Tracing referral patterns is an easy way to highlight relationships between hospitals and other local healthcare providers like long-term care centers or, in this case, rehabilitation facilities. Users can leverage this information to learn about how specific facilities refer their patients and where they may be receiving other patient referrals from.

On the DHC Visuals dashboard, outbound referrals are represented by either a blue or orange line—denoting either in-network or out-of-network referral—connecting the originating hospital to the destination facility. The strength of the line illustrates the number of outbound referrals, with bolder lines representing the highest referral volumes.

2022 AdventHealth Orlando outbound CHF referrals

Fig. 3 CHF outbound referrals featured on the DHC Visuals Hospital Therapy Area Analytics dashboard for Congestive Heart Failure. Using medical claims data from multiple clearinghouses for the 2018 claims year.

In 2022, AdventHealth Orlando referred a minimum of 10 congestive heart failure patients to 12 different in-network and out-of-network providers. With 226 CHF patient referrals, Orlando Health Orlando Regional Medical Center saw the greatest total number of outbound referrals from AdventHealth Orlando.

This map highlights another important fact: AdventHealth Orlando’s top seven referral destination hospitals are out-of-network providers. Out-of-network referrals reflect network leakage and might also indicate potential revenue loss.

What does this mean for you? Identifying network leakage can be a strategic way to cater your sales approach to fit the specific pain points of a given hospital or facility.

3. Discover new patient and provider insights

Using data visualization technology, stakeholders can access advanced healthcare intelligence in a snap. Tools like the Atlas All-Payor Claims dataset unify hospital, physician, and medical claims data to deliver comprehensive industry insights.

The Definitive Healthcare platform puts your patient cohort data into an actionable context. With this tool, you can build customized patient cohorts to discover a hyper-targeted set of providers with the greatest number of treatment-ready patients.

Our platform not only helps you identify your total addressable market by region, but also helps you discover patterns in shared patient comorbidities, physician referrals, prescription use, and treatment histories—giving you the insight to turn data into action.

Learn more

Interested in learning more about how you can leverage data analytics to shape your next sales strategy? We’re here to help. Sign up for a free trial today and discover how healthcare commercial intelligence from Definitive Healthcare can help you understand the patients, providers, facilities, and technologies that define the healthcare landscape.

Alex Card

About the Author

Alex Card

Alex Card is a Senior Content Writer at Definitive Healthcare. His work has been cited in Becker's Hospital Review, Forrester Research, HealthTech, Insider Intelligence, and…

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