Wednesday, October 01, 2014 - HFM Competitively Priced According to WHA Report

Wisconsin was one of the first states to offer consumers online health care price information. The Wisconsin Hospital Association (WHA) Information Center released the first version of PricePoint in 2004, and its new version went live August 21. It is designed to be more accessible and easier to navigate. The Wisconsin Hospital Association listened to feedback about its PricePoint website, and their new and improved tool is certain to be valuable to the state’s health care consumers. 

As co-pays and deductibles increase, the interest among consumers for price information also rises. PricePoint facilitates price comparisons among Wisconsin hospitals and health systems for a large number of services and procedures. New with the recent release is the addition of costs associated with the top 20 principal diagnoses treated in observation care in Wisconsin. The new PricePoint website makes it easier for consumers to directly compare Manitowoc County facilities. Leaders at Holy Family Memorial are confident that people will see that HFM is competitively priced. HFM welcomes all efforts to provide price transparency to its patients.

According to Mark Herzog, Holy Family Memorial’s President and CEO, HFM is doing their part to keep healthcare costs down. Over the last decade, after factoring the rate for inflation, HFM has achieved a reduction in total annual adjusted hospital charges from 2001 to 2012 of 29%. Today, it is hospital costs and the care of severely ill patients with chronic conditions that drive much of the cost in the healthcare system. “By reducing the need for inpatient hospital stays by 47% and holding hospital outpatient visits to a small increase of only 2%, HFM has been able to keep care safe, convenient and accessible,” said Herzog. “We achieved this through constant adoption of best practices; innovations allowing high quality, safe care to move to outpatient or home settings; and by incorporating cutting edge standards in our physician offices that keep patients from needing expensive, complicated hospital stays and treatments. With the advent of high deductible health plans, which have become very common- place in the Manitowoc market, the reduction of inpatient or other more costly procedural care has a very positive impact to those with high deduct- ible health plans. This is a demonstration of HFM’s commitment to help reduce the financial risk of those with high deductibles.”

PricePoint is based on charges, often compared to “sticker price” of a car. It is a starting point for research. Health plans and insurers negotiate a rate with hospitals that is not published and not available. However, there are graphics in PricePoint that show the average discount (across all services) that a hospital gives insurers, and the percent of how much a hospital charges that Medicare and Medicaid pays.

There are many factors that go into a patient’s decision about where to receive health care – provider, insurance, quality, cost and convenience to name a few – and no single one should be the sole determinant of care. Yet hospital leaders recognize that as health insurance deductibles increase, some consumers will place a higher emphasis on cost. 

HFM focuses on driving down costs related to over-using expensive resources while maintaining high-quality service through its “Right Care” core beliefs. The dramatic shift in inpatient volumes in Manitowoc County with a modest increase in outpatient care is indicative of early adoption of health reform.

Primarily through HFM’s focus on Right Care, the rate of growth in hospital charges in Manitowoc County over the past decade have remained 34% below neighboring Outagamie County and 97% below Brown County. Major disease mortality rates in Manitowoc are down 16% from 2002 – 2010, and the local care delivery system ranks in the top 20% in Wisconsin. The dramatic shift away from inpatient care has been accomplished with excep- tional quality and safety and only a moderate growth in outpatient volumes, yet HFM’s operating margins have generally been 3-5% range, an appropriate level for long-term sustainability of the organization.

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