By Tom Still
MADISON, Wis. – Healthcare delivery systems in Wisconsin and across the nation are changing – and rapidly, in many cases. Recovery from the COVID-19 emergency, higher costs and workforce concerns are among issues compelling medical systems and hospitals to merge with or acquire other systems.
The trick is changing while not sacrificing quality, which Wisconsin’s 34 health systems and 158 hospitals appear to be doing thus far.
Consolidation has been apparent in Wisconsin health care in recent years, with mergers or acquisitions involving such familiar names as Froedtert Health, ThedaCare, Gundersen Health System, Bellin Health, Advocate Aurora Health, Atrium Health, Marshfield Clinic and Duluth-based Essentia Health. It’s only human nature to wonder if such mergers can ensure quality care or just lead to “bigger over better.”
A recent report from The Centers of Medicare and Medicaid Services, a federal agency that oversees major parts of health care delivery in the United States, suggests “better” is still the case in Wisconsin. That’s a selling point for people who live here – and those who might consider moving to the state.
The CMS scores most hospitals each year through a “five-star” rating system that captures 46 measures across five major categories: mortality, safety of care, readmissions, patient experience, and timely and effective care. Wisconsin ranked among the nation’s top four states with Utah, South Dakota and Montana.
Better than three out of four Wisconsin hospitals of all sizes (77%) scored at the five-star or four-state level, which was a 15% improvement over 2022. Nationwide, 16% of all hospitals received a five-star rating from CMS and 26% earned a four-star rating. In Wisconsin, those figures were 38% and 39%, respectively.
Among its Midwest neighbors, Wisconsin stood out with 29 hospitals earning five stars. Ohio, Illinois and Michigan, all much larger states, stood at 26, 14 and 21, respectively. Minnesota (16 five-star hospitals) and Indiana (14) have roughly the same number of people as Wisconsin, and Iowa recorded eight five-star ranked hospitals.
It’s true many people rank the quality of care they receive in a hyper-personal way. If a doctor, nurse or clinician fixes what ails them, people tend to give good marks. If the health problem persists without a good explanation as to why, a more critical view emerges. Right or wrong, that’s human nature.
That’s why data points help tell a better story. They encompass larger populations, examine relative differences between states and health systems, and consider other measurable factors.
The CMS rating is one among many, but it coincided with findings released in March 2023 through “Taking the Pulse: How Quality Health Care Builds a Better Economy.”
Produced by the Wisconsin Technology Council using two-dozen sources, that report examined mortality tied to health care, Medicare 30-readmissions, hospitals penalized for rules and regulatory infractions, and average hospital length of stay. It also reported Wisconsin ranked among the top 11 states overall based on data from the federal Agency for Healthcare Research and Quality. The report also looked at various cost metrics, and Wisconsin health care ranked in the middle to slightly above average.
What are possible reasons why Wisconsin hospital quality stands out statistically among the states?
- Rural Wisconsin hospitals are alive and mostly well, which isn’t the case in some states.
- Strong partnerships exist between higher education institutions and delivery systems. That’s evident at private and public colleges and universities that are working to produce skilled workers to meet industry standards.
- Wisconsin has a world-class medical industry that provides innovative products and services, both near and far. Epic, Promega, Exact Sciences, Accuray and others are examples. In the case of Epic, its birth and growth in Wisconsin has led to a greater penetration of digital health tools for home-state patients and providers alike.
- The Wisconsin Hospital Association, which represents most hospitals in the state, has operated its voluntary “CheckPoint” quality reporting system for nearly 20 years. It’s publicly available at https://www.wha.org/Quality-Patient-Safety/CheckPoint
Change is rippling through Wisconsin health care administration and delivery at a pace not seen in years, but there are data-driven reasons to believe quality won’t suffer as a result.
Still is president of the Wisconsin Technology Council. He can be reached at firstname.lastname@example.org.