How the U.S. Census Results Affect Your Healthcare Organization
On August 12, the U.S. Census Bureau released detailed 2020 census results. Because the data publication was delayed by several months due to the COVID-19 pandemic, the release sets off a nationwide race for state legislatures to complete redistricting ahead of the November 2021 election cycle. Furthermore, the new information will become the basis for significant portions of the nearly $1.5 trillion in annual federal budgetary spending.
A summary of key observations is highlighted in the graphics below.
Overall U.S. population increased from approximately 308.7 million in 2010 to 331.4 million in 2020, a 7.35 percent increase. A significant percentage of the increase occurred in the South and West, with six of the top 10 fastest-growing counties by population located in Texas, three in Florida, and one in Georgia.
The rise of urban living continued. Census data showed that 312 of the 384 U.S. metro areas gained population between 2010 and 2020. Phoenix, Arizona, paced the nation among the largest cities, surpassing Philadelphia, Pennsylvania, to become the fifth-largest city in the United States.
The population migration to warmer, urban areas also affected apportionment of seats in the U.S. House of Representatives. Thirteen states will see either a gain or loss in Congress, with Texas leading after a pickup of two seats. Fluctuations in apportionment not only have the potential to change near-term party dynamics in Washington, D.C., but also will affect the Electoral College mathematics during the 2024 and 2028 U.S. presidential races.
The Diversity Index, a measure of the overall population’s racial and ethnic diversity, increased from 54.9 percent in 2010 to 61.1 percent in 2020. Hispanic and Asian population flow to areas such as California and Texas contributed the most to this rise.
What Does This Mean for Healthcare?
Because so much of a healthcare organization’s business is dependent on population in a localized geographical area, statistically significant increases or decreases can have far-reaching implications. Before beginning large-scale projects, especially those that require substantial investment of capital and/or onboarding of high-level clinicians or specialists, management teams should first review census data for insights into the viability of the potential return on investment or volume sustainability for new providers. Comparing trends by analyzing the 2000, 2010, and 2020 census information allows for ZIP code-level analysis of how population changed during a 20-year period. A similar review of patterns in population age also is salient to any projection around expected volume. Sizable initiatives have failed not because of payor mix, clinical quality, or poor execution but because there were not enough people in the area to yield the necessary number of services to support the new venture.
With the country diversifying, healthcare entities should evaluate how well their existing infrastructure supports racial and ethnic minorities in their primary and secondary service areas. If trends indicate a dramatic increase in population flow in the immediate vicinity of the facility for a particular category, organizations can evaluate how well their infrastructure supports the provision of services to the growing segment. This strategy could help maintain a competitive advantage over other healthcare providers in your service area. Your organization can capitalize on a growing demographic by cultivating new or expanded services to meet their healthcare needs. The same can be said for other demographics within a particular service area, e.g., increases in elder populations could indicate a possible expansion of home health and long-term care services or changing gender demographics could result in strategic planning of women’s health services.
The redistricting process and change in congressional seats will likely affect future legislative agendas up and down the ballot. Furthermore, the tabulation of census tract data (see Figure 2-1 below) will subsequently flow into updated core-based statistical areas (CBSA), a critical component of Medicare Wage Index calculations.
Even with the rise of telehealth services during the pandemic, physical location of the U.S. population remains one of the most important contributors to a healthcare entity’s financial health. Entities now have a window to perform detailed evaluations of this data before it begins to age and should consider incorporating this into any strategic discussion about future plans to expand or evaluation of staffing needs, services offered, and clinician utilization. The public use files are available for use here.
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