Medical services cost 81% more in Wisconsin, study finds

health care system

Only Alaskans pay more for medical services than Wisconsinites, according to claims data for three of the nation’s largest insurance companies.

The Health Care Cost Institute, a Washington D.C.-based nonprofit that researches and analyzes insurance claims data, studied price variations in 41 states based on claims from Aetna, Humana and UnitedHealthcare. The study found costs for 235 common treatments and examinations, referred to as “care bundles,” for commercially insured patients under the age of 65 were 81 percent higher in Wisconsin than the national average.

“In New Hampshire and Wisconsin, over 20 percent of health care services are twice the national average price,” the study reads.

In descending order, Alaska, Wisconsin, North Dakota, New Hampshire and Minnesota were the most expensive states to receive health care services, according to the study. The least expensive were Florida, Arizona, Maryland, Tennessee and Nevada.

HCCI Executive Director David Newman said that that many price variations between states are the result of justifiable market conditions. The cost of doing business in Alaska, for example, is higher across the board — the state’s distance from suppliers and relatively sparse population make shipping more expensive and limit access, which drives up prices. His organization is advocating transparency in health care industry pricing, he said.

“All we’re trying to do is suggest that where there are high prices, that people ask, ‘why,'” Newman said. “And understand that, in some circumstances, they will be justified … but when they’re high and unjustified, that is good reason for people to ask, ‘why.'”

Aetna, Humana and UnitedHealthcare only account for about a third of the state’s commercially insured, so the results of the study are not exhaustive.

Here are a few examples of how much more Wisconsinites are shelling out, on average, for their health care, according to guroo.com, which uses Health Care Cost institute’s claims data from Aetna, Humana and UnitedHealthcare.

  • The national average cost of a Childbirth “care bundle,” which includes routine prenatal care, lab tests, ultrasounds, delivery of and routine postnatal care, is $12,485. The average price in Wisconsin is $16,181, slightly lower than the Milwaukee area average of $16,750.
  • Knee replacement surgery costs on average $35,543 nationally, $43,301 in Wisconsin and $41,822 in the Milwaukee area.
  • Nationally, tonsil and adenoid removal costs $5,195 on average. In Wisconsin, the average cost is $7,916 and in the Milwaukee area the average coast is $6,976.

A representative from the Wisconsin Hospital Association was not immediately available for comment.

Sign up for BizTimes Daily Alerts

Stay up-to-date on the people, companies and issues that impact business in Milwaukee and Southeast Wisconsin

Ben Stanley, former BizTimes Milwaukee reporter.

No posts to display