By Tom Still
MADISON, Wis. – In the same week when Wisconsin’s overall health-care quality was ranked No. 1 in the nation by the federal agency that tracks such data, the state Worker’s Compensation Advisory Council came up with a solution in search of a problem.
The council agreed with the state’s largest business lobby that companies are being overcharged by providers and hospitals for treating injured employees – and that adding a set fee schedule for medical procedures would keep costs down.
The recommendation, which may reach the Wisconsin Legislature in bill form, should be examined as part of a much larger issue: Employers who invest in high-quality health care for their workers get measurable returns on their investment.
The Worker’s Compensation issue has been a source of friction between Wisconsin Manufacturers and Commerce and the state’s medical community for years. The business lobby has argued that companies get charged too much for treating workers injured on the job. The medical community has countered by touting its record of fixing what ails those workers, cutting down on return trips to the hospital, and quickly returning healthier workers to their jobs and productivity.
While there will always be anecdotal examples to the contrary, the quality of health care in Wisconsin compares favorably to what can be found in any state. Moreover, employers who contribute to providing health coverage for their workers are paying somewhere in the mainstream of what companies in other states pay. Here are recent examples of quality scores.
- The federal Agency for Healthcare Research and Quality reported in late August that Wisconsin ranked No. 1 among the states in overall quality of health care, as measured by 200 statistical measures used by the agency to evaluate performance. Wisconsin historically ranks high in the federal study but cracked into the top spot this year, followed closely by Massachusetts and Pennsylvania.
- The AHRQ ranking follows on the heels of a No. 1 ranking for the state’s “critical access” hospitals by the federal Health Resources and Services Administration. Critical access hospitals are smaller facilities that provide essential services in rural areas; Wisconsin has 58 such hospitals. Maine, Utah and Minnesota were next in the federal ratings.
If Wisconsin has high-quality health care, are employers paying through the nose to get it? While there can be striking regional differences on employer costs, the answer is a qualified “no.”
A recent study by the state of Oregon specifically targeted to Worker’s Compensation costs in all 50 states ranked Wisconsin’s premiums 12th highest in the nation and at 112 percent of the national median. However, other rankings of overall employer costs are a bit more favorable.
In a report released Aug. 24, the Henry J. Kaiser calculated that employers in Wisconsin pay an average premium of $4,985 per employee for single health insurance coverage. That ranked 13th highest in the nation and within a few dollars of eight other states that ranked lower in employer costs.
In early 2017, the Huffington Post ranked Wisconsin 11th best in the country in terms of overall health insurance costs. In October 2016, the Commonwealth Fund reported that premiums and deductibles for employer health insurance have risen more slowly in Wisconsin and nationally since 2010, when the Affordable Care Act was adopted. About 55 percent of Wisconsin residents are insured through employers.
That’s not to say businesses shouldn’t be concerned about rising health-care costs – the trend lines remain up – but quality care can accrue benefits that go straight to the bottom line.
The often-asked question, “How much does this health plan cost?” can be answered in ways that go far beyond insurance premiums. It also includes sick days, sick wages and worker productivity.
The failure to prevent serious complications, such as a hospital-acquired infection, may cost the patient his or her life, prolonged disability and thousands of dollars in treatment. Avoidable surgical complications may prolong hospitalization, result in disability or death, and cause great expense and repeated procedures.
More than 30 studies have been conducted over time on the links between health risks, medical costs and workplace productivity. The studies provide compelling evidence that investing in employees’ good health pays off in measurable ways.
High-quality health care is also a business advantage worth touting. At a time when Wisconsin businesses are working to attract and retain workers, they should be pointing to quality metrics and working with health providers to do more.
Setting fee schedules and procedure rates may have a short-term effect, but weighing health care costs against quality and productivity is a better long-term strategy.