THE VALUED VOICE

Vol. 64, Issue 38
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Thursday, September 17, 2020

   

New Report Highlights Health Care Value in Wisconsin

A new report from HC Trends, a research affiliate of BSG Analytics (BSGA) finds Wisconsin continues to deliver access to high quality health care while keeping costs in line with the national average.
 
“As Wisconsin residents face the upcoming election amid the continued uncertainty surrounding the COVID-19 pandemic, health care and its associated costs are top of mind for residents of the Badger State,” said Eric Borgerding, WHA president and CEO. “We are fortunate, as this report confirms, that Wisconsin has a stable, high-quality, and accessible health care system that provides tremendous value to health care consumers.”
 
The new report found that while health care costs typically are comprised of utilization and unit price, no study has adequately analyzed both of these factors with a focus on Wisconsin’s unique health care markets. 
 
The report noted Wisconsin is unique in that it has a competitive health care environment with many regional health plans participating.  Wisconsin also has a unique history of providing team-based care, through which medical care is delivered in an integrated way, with all members of the team aligned to provide higher quality care.  The state’s integrated health systems have developed treatment protocols focused on best practices that improve patient outcomes and reduce the unnecessary duplication of testing and other medical services.   Focusing solely on unit price fails to consider these factors and could lead to less integrated and more fragmented care. 
 
The researchers at HC Trends and BSGA indicate that health care insurance premiums can be used as a proxy for cost because they reflect both utilization and unit price.  In reviewing Wisconsin premiums since 2008, the report shows that Wisconsin premiums are now in line with the national average.  With open enrollment in health insurance set to begin in November, this is good news for Wisconsin consumers. 
 
HC Trends also highlights that cost isn’t the only measure of overall value.  They noted that more advanced payers will look beyond the traditional measure of cost and will consider quality and access to care as well.  On both of these factors, Wisconsin excels, consistently achieving some of the highest quality care in the country. 
 
Finally, HC Trends and BSGA researchers reviewed numerous studies that draw various conclusions about health care costs and performance.  Some are credible studies that are based on data sources that appear valid.  However, many others appear more questionable in their data sources or methodologies. 
 
When reviewing any study, BSGA points out that health care data should be evaluated based on its accessibility and accuracy; whether it clearly defines the geographical area from which it is derived; and whether it can be segregated by payer mix.  Studies should also be evaluated as to whether they use a credible data source; whether the methodology is transparent and can be replicated; whether the sample size is appropriate; and how the health care payer mix is used. 
 
These principles will long serve to help further the discussion about health care in Wisconsin. 
 
The full study from HC Trends can be found at: www.hctrends.com

This story originally appeared in the September 17, 2020 edition of WHA Newsletter

WHA Logo
Thursday, September 17, 2020

New Report Highlights Health Care Value in Wisconsin

A new report from HC Trends, a research affiliate of BSG Analytics (BSGA) finds Wisconsin continues to deliver access to high quality health care while keeping costs in line with the national average.
 
“As Wisconsin residents face the upcoming election amid the continued uncertainty surrounding the COVID-19 pandemic, health care and its associated costs are top of mind for residents of the Badger State,” said Eric Borgerding, WHA president and CEO. “We are fortunate, as this report confirms, that Wisconsin has a stable, high-quality, and accessible health care system that provides tremendous value to health care consumers.”
 
The new report found that while health care costs typically are comprised of utilization and unit price, no study has adequately analyzed both of these factors with a focus on Wisconsin’s unique health care markets. 
 
The report noted Wisconsin is unique in that it has a competitive health care environment with many regional health plans participating.  Wisconsin also has a unique history of providing team-based care, through which medical care is delivered in an integrated way, with all members of the team aligned to provide higher quality care.  The state’s integrated health systems have developed treatment protocols focused on best practices that improve patient outcomes and reduce the unnecessary duplication of testing and other medical services.   Focusing solely on unit price fails to consider these factors and could lead to less integrated and more fragmented care. 
 
The researchers at HC Trends and BSGA indicate that health care insurance premiums can be used as a proxy for cost because they reflect both utilization and unit price.  In reviewing Wisconsin premiums since 2008, the report shows that Wisconsin premiums are now in line with the national average.  With open enrollment in health insurance set to begin in November, this is good news for Wisconsin consumers. 
 
HC Trends also highlights that cost isn’t the only measure of overall value.  They noted that more advanced payers will look beyond the traditional measure of cost and will consider quality and access to care as well.  On both of these factors, Wisconsin excels, consistently achieving some of the highest quality care in the country. 
 
Finally, HC Trends and BSGA researchers reviewed numerous studies that draw various conclusions about health care costs and performance.  Some are credible studies that are based on data sources that appear valid.  However, many others appear more questionable in their data sources or methodologies. 
 
When reviewing any study, BSGA points out that health care data should be evaluated based on its accessibility and accuracy; whether it clearly defines the geographical area from which it is derived; and whether it can be segregated by payer mix.  Studies should also be evaluated as to whether they use a credible data source; whether the methodology is transparent and can be replicated; whether the sample size is appropriate; and how the health care payer mix is used. 
 
These principles will long serve to help further the discussion about health care in Wisconsin. 
 
The full study from HC Trends can be found at: www.hctrends.com

This story originally appeared in the September 17, 2020 edition of WHA Newsletter