Hospital service areas and Medicaid access in Maryland

The study defines a service area (rather than a market area) of an individual hospital. Based on patient origin data, algorithms have been developed to select zip codes on the basis of their contributions to a hospital's discharges, and their ability to fulfill a contiguity principle along with a dependence criterion. The service area concept is also used to evaluate the performances of hospitals in terms of the access to care for Medicaid patients. The analysis shows that the hospital's performance in serving Medicaid patients does not significantly depend on its location, nor does it matter whether it is the only hospital in its jurisdiction.