The Healthcare Value Index (HCVI) to Enable Free and Transparent Markets: The Healthcare Administration Perspective
According to the Wisconsin Hospital Association (WHA) homepage, WI hospitals employ over 100,000 people (about 1.7% of state population of 5.7 million – WDHS, 2014) and generate nearly $30 billion (yes with “B”) in economic activity (2016). WHA also states that WI hospitals provided over 2.6 million inpatient days (2014) and 17.4 million outpatient days (2014). We have a significant number of people needing care here in Wisconsin. Who is going to help take care of the great Wisconsites? Why not us?
Two issues that are often discussed relate to retention and (healthcare) costs. With the first issue (retention) we have such talented people, students, professionals, and future employees who obtain some degree of education/experience here in Wisconsin and then leave to work in other states. Why not us?
How do we retain this talent? We have one of the most competitive healthcare markets in the country, two (soon to be three) premier pharmacy schools, two top tier medical schools and many well respected institutions of higher learning; yet many of these graduates will never work in Wisconsin, so Why not us? We are a hot-bed of healthcare activity and opportunity! Why not us?
Secondly, let’s take a look at cost for a moment. What do I mean? Let us take a knee scope for example, something that is by-in-large, a common procedure provided at many hospitals throughout the United States. I recently had to have a knee scope and used a resource (wipricepoint.org) to conduct a little research as a consumer. The data used on this website is public data provided from the Wisconsin Hospital Association (WHA) Information Center. This is an owned subsidiary of the Wisconsin Hospital Association (WHA) and has been evolving since around 2004 to provide some level of transparency to consumers; yet many are unaware of its existence.
When you go to this website you can search by outpatient services and then compare institutions by using a filter by city, county or state. For an example, specifically I recently had a knee arthroscopy with medial or lateral meniscectomy (ICD-10 code: 29881). Now when we do some quick comparisons you can quickly analyze data and see the cost differences (low, medium and high charges) and the number by institution; then you are also able to filter and compare. Take a look at Table 1 below.
In a day where consumers are cost conscience, but still want high quality care a tool like this may be the beginning to how consumers play a role in the organic forming of centers of excellence, create costs controls, and work to increase quality outcomes; all by their own consumerism as work.
Of these three institutions to compare the same procedure (29881) during the same time-frame (April 2015-March 2016), it is interesting to see that the Ortho. Hospital of Wisconsin provides the highest number of these procedures at 480 yet has a slightly lower cost than that of Aurora St. Luke’s. On the contrary Aurora St. Luke’s and the Froedtert Surgery Center LLC have a similar (N) with 91 and 97, respectively; yet, have a significant cost difference AND Froedtert Surgery Center LLC has the same charge across the board (maybe suggesting a flat rate).
For someone like myself this brings forth a lot of questions. For an institution with a lower “N” I begin to wonder the level of quality they provide that allows them to not conduct as many procedures but have a significantly lower cost. I think about how many surgeons they have and how many each conduct, is this all they do or just a small part of their scope of practice. Would you want someone who does this a few times a year or someone where this is all they do all year long is this procedure?
Now, allow me to change the focus a little to understand how this might play a role moving forward in our national/state healthcare conversations. We are in this state of transition from a Fee For Service (FFS) model that provides a payment model where services are unbundled (separate – or a la carte) and paid separately. In general terms, the more you provide the more you get paid; as this model looks more at quantity versus quality. Now, what has hit the orthopedic world and is shortly about to hit many other like cardiac and oncology is the value-based model of payment. This model of payment [really driven from the Centers for Medicare and Medicaid Services (CMS)]; where institutions are incentivized to provide higher quality and not paid based on volume/quantity.
What if there was a way to use/apply a cost-accounting method using this public data to create a Health-Care Value Index (HVI or HCVI) that would create a score (index – way to measure) where the best value (highest quality at the lowest cost) is provided? Would that provide consumers with the power to choose? To impact quality? Over-charging? Inefficiencies? And maybe, begin to disrupt the norm and the way our health “systems” have been operating to truly get to that value-based care using an evidence-based approach. Why not us?
Healthcare is a competitive market and for those in healthcare looking to advance their career or aspiring to get into healthcare you do not need to look much further than right here in WI for the opportunity. Why not us?
Another one of those opportunities is through Concordia’s MBA program (Healthcare Administration). With a main campus in Mequon (and Ann Arbor); as well as eight (8) other centers in Wisconsin (and one in St. Louis); Concordia is positioned to accommodate both working and non-working professionals all over the state (and beyond).
Concordia is a place with a rich history, one that brings in a different approach and by different I mean faith. Some may stray from that but many flock to a place where you can openly discuss faith and from all over the world. Students come here because of our strong community feel where students here are names not numbers. Concordia is a place where healthcare related programs are what we do. Some of our CUW alumni are key leaders in many of the health systems in Wisconsin, but they need your help. We want to keep that talent in WI to provide care, direction and really lead our nation in the way we deliver care to our friends, family and neighbors.
So why not us?
Wisconsin Hospital Association, Inc. (2016). Quick Facts. Retrieved on 6/14/17 from:
Wisconsin Pricepoint. (2017). Outpatient Surgery. Retrieved on 6/14/17 from: