E1 · DEMAND
Model demand by clinical need, not observed utilization
HRSA counts how many visits people do use today. We switch to how many visits they should use per clinical guidelines. Primary care demand rises ~2.5×, behavioral health ~4×.
→ Borsky et al., Health Affairs (2018)“Only 8% of US adults receive all high-priority USPSTF preventive services.”
How we derived this default
Primary Care 2.5× default = USPSTF high-priority services delivered at 8% of recommended rate (Borsky 2018) → ~3× gap tempered to 2.5× after accounting for acuity triage. Behavioral Health 4× = NSDUH 22.8% prevalence × 77% untreated share. Oral Health 1.8× = ADA preventive dental visit benchmark of 2/yr vs observed 1.1/yr.
Per-profession-group multiplier applied to demand. See evidence walk for derivation.