CITY OF PEWAUKEE - ProHealth Care, which
operates Waukesha Memorial Hospital and Oconomowoc Memorial
Hospital, lags behind the four other main health care providers in
the Milwaukee area in its pricing.
That was the conclusion of a report released Friday by City of
Pewaukee-based consulting firm The Benefit Services Group Inc.
The organization analyzed claims paid by insurers, self-funded
plans, workers’ compensation, health maintenance organizations and
other commercial payment systems.
In the report, BSG said it tried to account for factors that tend
to skew a provider’s costs: the degree of sickness experienced by
the patients they treat and the amount of payment they receive from
Medicare and Medicaid, which often reimburse hospitals at a lower
rate than private insurers. Its objective, therefore, was to
determine what different hospital groups would actually charge if
serving the same patient.