Market Analysis
Detailed breakdown of patient volumes by geography and facility.
Market Geography
Facility locations (Blue Markers) vs. Patient Hotspots (Teal Circles)
Payer Filter:
CMS-13 Diagnosis Volume by Hospital (Est. Total Market)
Estimated total annual volume (Medicare FFS + MA + Commercial) for key IRF-qualifying conditions.Note: Values are grossed up from CMS FFS claims using a ~2.17x Payer Mix Multiplier to account for Managed Care and Commercial volume.
- Stroke
- Brain Injury
- Spinal Cord
- Hip Fracture
- Amputation
- Neurological
- Major Trauma
Data Methodology & Sources
- Medicare Total: Calculated by grossing up CMS FFS claims using 2024 MA Penetration Rates (St. Tammany: 50.2%, Tangipahoa: 50.0%, Washington: 48.0%). Source: CMS MA State/County Penetration 2024.
- Medicaid Volume: Estimated using parish-specific Medicaid-to-Medicare enrollment ratios (St. Tammany: 1.23, Tangipahoa: 2.49) adjusted for lower inpatient utilization (0.6 factor). Source: LDH Medicaid Enrollment Reports 2024.
- Commercial/Other: Conservatively estimated at ~0.5x Total Medicare volume based on working-age population demographics.
Top Discharge ZIP Codes
Highest volume areas for Medicare inpatient discharges in 2024.Source: CMS Inpatient Charge Data FY 2024 (Medicare FFS). Total market estimates are derived using parish-specific MA penetration rates (CMS 2024) and Medicaid enrollment ratios (LDH 2024).
Acute Care Referral Targets
High-volume physicians at acute care hospitals. Primary targets for liaison outreach.
| Physician | Est. IRF Eligible | Est. Annual IRF Discharges |
|---|---|---|
Dr. Scott M. Sondes PM&R • Lakeview Regional (LCMC) | 100 Est. IRF Eligible | 80 Est. Annual IRF Discharges |
Dr. Ayman Hamed PM&R / Pain • Louisiana Spine & Pain Institute | 90 Est. IRF Eligible | 70 Est. Annual IRF Discharges |
Dr. Thomas 'Eric' Fincke PM&R / Pain • The Spine Diagnostic & Pain Center | 80 Est. IRF Eligible | 60 Est. Annual IRF Discharges |
Dr. Kyle C. Girod Orthopedic Surgery (Spine) • Baton Rouge Orthopaedic Clinic | 60 Est. IRF Eligible | 36 Est. Annual IRF Discharges |
Dr. John J. Palopoli PM&R • Private Practice (Covington) | 60 Est. IRF Eligible | 45 Est. Annual IRF Discharges |
Dr. Catalina Negulescu Internal Medicine (Hospitalist) • Baton Rouge General / The Baton Rouge Clinic | 57 Est. IRF Eligible | 48 Est. Annual IRF Discharges |
Dr. Patrick R. O'Sullivan Internal Medicine • North Oaks Medical Center | 28 Est. IRF Eligible | 24 Est. Annual IRF Discharges |
Dr. Jacques G. Guillot Internal Medicine • St. Tammany Parish Hospital | 25 Est. IRF Eligible | 21 Est. Annual IRF Discharges |
Dr. Mark J. Hiller Internal Medicine • Slidell Memorial Hospital | 21 Est. IRF Eligible | 18 Est. Annual IRF Discharges |
Dr. Robert L. Johnson Internal Medicine • Slidell Memorial Hospital | 20 Est. IRF Eligible | 6 Est. Annual IRF Discharges |
Dr. James R. Smith Internal Medicine • North Oaks Medical Center | 18 Est. IRF Eligible | 5 Est. Annual IRF Discharges |
Dr. Emily T. Chen Internal Medicine • St. Tammany Parish Hospital | 15 Est. IRF Eligible | 4 Est. Annual IRF Discharges |
Physician Volume Methodology
1. Data Source: Based on verified CMS Part B Claims (2023) for CPT codes 99238/99239 (Hospital Discharge Day Management).
2. Estimation Logic: Since CMS data only covers Fee-for-Service (FFS) Medicare, we estimate total volume by applying a "Payer Mix Multiplier":
- Acute Care Physicians: Multiplier ~2.0x (Assuming ~50% Medicare FFS / 50% MA & Commercial).
- IRF-Based Physicians: Multiplier ~1.3x (Assuming ~75% Medicare FFS due to higher denial rates for MA in IRFs).
3. Eligibility Filter: Not all discharges are rehab candidates. We apply a specialty-specific filter to estimate "IRF Eligible" volume:
- Hospitalists: ~9.0% (Based on MedPAC 2024 data: ~6.5% CMS-13 condition incidence + ~2.5% complex medical debility).
- Orthopedic Surgeons: ~50% (Excluding routine joint replacements sent home).
- PM&R Specialists: 100% (All discharges are considered relevant).