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Monroe Clinic's rates rise about 7.5 percent
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MONROE - Rates for services at Monroe Clinic are increasing by an average of 7.5 percent in 2009. How that increase compares to some other Wisconsin hospitals depends on what you're looking at.

Hospitals are required to publish rate increases in accordance to Wisconsin State Statutes (sec.153.08) and the Wisconsin Administration Code (Sec. HSS 120.26). The Monroe Clinic's 2009 rate increases were published Dec. 2 in The Monroe Times.

An informal survey compared rate increases and several element charges in six Wisconsin hospitals, which have published rate increases in the past three months. Those hospitals were: Monroe Clinic, Monroe; Baldwin Area Medical Center, Baldwin; Aurora Medical Center of Washington County Inc., Hartford; Westfields Hospital, New Richland; St. Joseph's Community Hospital, West Bend; and River Falls Area Hospital, River Falls.

Baldwin (pop. 2,667) and New Richmond (pop. 6,310) are located near River Falls (pop. 12,560), which lies east of St. Paul, Minn.

Hartford (pop. 10,905) and West Bend (pop. 28,152) lie northwest of Milwaukee.

The increase in rates this year for the six hospitals ranged from 5 percent in West Bend to 9.5 percent in Baldwin. Last year, the same hospitals increased rates 4.9 to 10 percent. Monroe Clinic's rates increased an average of 9.9 percent in 2008.

While only the Baldwin hospital had higher overall rate increases for 2009 than Monroe Clinic among those surveyed, neither Baldwin nor Monroe is showing the highest charges among the six hospitals.

Increases in individual elements, selected for publication, range from 0 to 29 percent.

The highest rate increase was in Baldwin for a newborn nursery room, which will go up 29 percent to $439 next year.

But that charge remains low among the six hospitals. River Falls will charge $780. Monroe Clinic's $541 charge falls between Hartford and West Bend hospital charges for the same element.

Baldwin's Labor and Delivery charge also increases 25 percent, to $727. That charge towers over New Richmond's $300, up 7.1 percent, and Monroe's $560, up 10 percent; but all three still are far below Hartford's $1,200 and River Falls' $1,800 charges.

Baldwin also takes a whopping 22 percent increase in charges for medical and surgical room and board for $734, and yet remains below all the other hospitals except West Bend at $545. Monroe's semi-private room will cost $888.

River Falls is taking its room charge up 6.7 percent to $1,275 and New Richmond's is up 7.4 percent to $1,020.

So the population of a community is not a good indicator of its hospital rates.

The largest range of prices for a procedure published with the rate increases is for circumcisions. River Falls will charge $1,030 next year, while West Bend will do the procedure for $81. Monroe is second lowest among the six, at $129, even with a 10 percent increase.

Monroe Clinic also is the second lowest of the group for emergency room visits, $144 after a 7.5 percent increase. Baldwin, with $124 after a 9.5 percent increase, and River Falls, with $536 after an 8.2 percent increase, has the lowest and highest charges for the same visit.

Fall Rivers did publish a decrease in two charges: a complete blood count, down 33 percent, from $171 to $115, and a CT scan, down 23 percent from $814 to $624.

But River Falls' mammography screening charge will go up 26 percent to $178, and telemetry/cardiac nursing went from $520 to $625, a 20 percent increase.

Neighboring hospitals that Monroe area residents may use - Memorial Hospital of Lafayette County in Darlington, Mercy Health System Corporation in Janesville, and St. Mary's Hospital Medical Center in Madison - were compared with Monroe Clinic.

Three procedures, a vaginal birth without complications, a knee replacement and a transurethral prostatectomy, were chosen to compare the costs. Price differences were compared with the use of Wisconsin Hospital Association's Price Point Web site.

For a delivery, Monroe Clinic's and St. Mary's charges were close to the state average of $6,285, and both fell between Darlington's lower $4,500 and Janesville's higher $7,850 charges.

A $28,000 knee replacement at Monroe, Darlington or St. Mary's was about $4,000 less than the state average, and about $20,000 less than in Janesville.

But when it comes to transurethral prostatectomy, without any cancer complications, Darlington, as did four of the other hospitals surveyed, fell off the chart for information.

Monroe and Janesville had the highest charge, $3,000 above the state average of $12,600. St. Mary's shows the procedure at $8,000.

Many things can cause a difference in charges between facilities, the mix of payment from government programs and insurances, new technology, intensity of care, staffing costs, range of services provided and service frequency, differences in coding, the amount of debt and depreciation a facility carries. The published rate increases show an increase of 5 to 9.5 percent of total patient revenues on an annualized basis.

Some selected charges Monroe Clinic published show a 10 percent and more increase. Those increases are in obstetrics and delivery charges, 10 percent each; circumcision 10.3 percent, and newborn room rate, 12 percent.