Phil Hauck's TEC Blog

Sunday, August 14, 2011

State Cost and Quality Reports by Provider

While Co-op members have access to Humana claims information, that isn't the only cost reporting source available to us ... though it's probably the best.
The Wisconsin Collaborative for Health Care Quality has great information, too at
It confirms again that Green Bay is a higher cost area than are other areas of the state, heading south.
For instance, looking at knee replacements, I can learn the following ... altho the data isn't that recent (2009):
Prevea/St. Mary's and Prevea/St. Vincent's are about $39,000, but Bellin was at $31,000.
But going elsewhere, here's what I would pay:
In Appleton, both Theda Clark and Appleton Medical Center would charge about $24,000.
University of Wisconsin Hospital, Madison, is $29,600.
Milwaukee is equal or higher than Green Bay, but Racine isn't: Wheaton Franciscan is at $27,000.

How about baby deliveries (normal vaginal deliveries):
Bellin is $4200, Prevea/St. Mary's $4600 and Prevea/St. Vincent's $5100.
But in Appleton, both Theda Clark and Appleton Medical Center are about $3500.
Milwaukee and Madison are equal to Green Bay or much higher.

Bellin is $13,000, Prevea/St. Mary's $14,000 and Prevea/St. Vincent's $17,000.
In Appleton, Appleton Medical Center is $10,000 and Theda Clark is $12,000.
The rest of the state is higher.

There are about 50 other QUALITY measures as well.

There's an important reason to ask for public disclosure of these Quality and Cost performances: Studies show that when public disclosure occurs, provider systems are much more aggressive in instituting systems that will improve quality and lower cost. Seems intuitive ... but without public disclosure, it doesn't happen!

Is public disclosure new to health provider systems? Hardly. For great examples, go to Norton Healthcare, Kentucky's largest health system (, and Integris Health, Okahoma's largest (

No comments:

Post a Comment