Report: Health Care Costs Vary Across Country, State

Health Care Cost Institute Study Looks At Prices For Doctors, Hospitals, Outpatient Services

Bill Feig/AP Photo

The Health Care Cost Institute looked at five cities in Wisconsin: Appleton, Sheboygan, Green Bay, Racine and Milwaukee. Physician prices were high in all the communities, but there was wide variation.

In Green Bay, doctors charged 56 percent higher than the national average but in Sheboygan, doctor prices were 10 percent below average.

Eric Barrette, director of research at the institute, co-authored the report.

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“If physician prices are high but inpatient prices aren’t, policy solutions targeting the hospital industry might not have any effect,” Barrette said.

Barrette said he hopes the report and online comparison tool will prompt communities to find out what’s driving up the cost of health care. He said the report is just a starting point for the 61 metro areas they looked at across the United States

“For us to do in-depth study of 61 metro areas is just not feasible,” he said. “But we can produce these high-level statistics that are still relevant and insightful.”

The report examines prices for physician, inpatient and outpatient services. The institute analyzed claims data of employee-sponsored health plans from 2012 to 2014 from four major national health care providers.

Wisconsin has only three of the four: United Health Care, Humana and to a lesser extent Aetna, said Dana Richardson, CEO of Wisconsin Health Information Organization.

“There are other states where the major carriers like United or Blue Cross or Humana have a significant presence,” she said. “But that’s just not the way our state health insurance market is set up. So it’s probably not as useful for us as perhaps some of the other data sources that we have right here in our state.”

But she said studies on the cost of health care are increasingly important.

“As we see more and more consumers now through their high deductible plans having to pay more of the price — or more of the cost of care — what we’re working towards here (at Wisconsin Health Information Organization) is how we can provide that information to consumers,” Richardson said.

Tracking doctor or hospital prices only give part of the picture, she said. There’s also medication, rehabilitation and other health services. Not to mention utilization: how often patients are using health care services.

“Our goal is to be able to get to both utilization and price so that we can begin to help consumers better understand, you know, what does it cost to have, for example, open heart surgery. Not just the surgery, but rehab and medication and doctor visits. Of that, what is the amount the consumer themselves would have to pay out of pocket,” Richardson said.

Barrette hopes others will build on the work in the report to learn more about what is driving up health care costs.

“If there’s low prices but lots of people using the services, you still have high spending. And that implies a different type of solution.”