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(e) Federal databases, including those of the health care financing administration.
(2) Contents. The consumer guide shall contain information on all of the following:
(a) How to find and choose a doctor, hospital, health care plan, nursing home or other health care provider.
(b) How to get health insurance or enroll in medicare, medical assistance, badgercare or family care and where to go with health care coverage or payment questions or problems.
(c) Where to learn about specific conditions, illnesses or injuries.
(d) Other websites and related information sources that provide information on health care questions.
(3) Report dissemination. The department shall make available from the department’s website an electronic version of the consumer guide at no charge. The department shall distribute a paper, summary version of the consumer guide at no charge to the governor, the legislature and a board-approved list of individuals and agencies. The department shall make the paper, summary version of the consumer guide available for purchase by others.
(4) Suggested use of the consumer guide. Some suggestions for using the report are as follows:
(a) Health care plan. If available to the department, the following types of data for individual health care plans shall be contained in the consumer guide and may supplement consumers’ age, health status, mobility and financial resources as important factors consumers should consider when selecting a health care plan:
1. Health plan costs, such as premium per member.
2. Affiliations of specific physicians, clinics or hospitals.
3. Satisfaction of enrollees with access to providers.
4. Satisfaction of enrollees with service locations.
5. Measures of financial strength, such as profit margins and administrative versus medical costs.
6. Clinical process and outcome measures, such as those required for accreditation by the national committee for quality assurance or participation in the Wisconsin medical assistance program.
7. History and trend information on complaints and grievances.
8. Consumer satisfaction core measures from the consumer assessment of health plans or other satisfaction surveys.
9. Accreditation status.
10. Years of operating experience.
11. Location of plans, service area of plan by county.
12. Health plan product lines.
(b) Health care provider.
1. If available to the department, the following information about a physician and a health care provider specified in s. DHS 120.15 (1) shall be contained in the consumer guide and may supplement other factors such as the consumer’s age, health status, mobility and financial resources as important factors consumers might consider when selecting a health care provider:
a. Active status information.
b. License or certification status, if applicable, including date of initial licensure or certification, credential suspensions or revocations.
c. Medical education and training information.
d. Specialty, board certification and recertification information.
e. Practice information including name of practice, location, telephone number and hours spent at location.
f. Whether the provider renders services to patients insured through medicare or medical assistance.
g. Whether the provider accepts medicare assignment.
h. The names and addresses of facilities at which the provider has been granted privileges, if applicable.
i. Usual and customary charges for office visits, routine tests and diagnostic work-ups, preventive measures and frequently occurring procedures.
j. Health plan affiliations, if applicable.
k. Volume of surgical procedures for those specific procedures where the department has determined, based on existing scientific evidence, that surgical outcomes are related to volume of procedures performed, if applicable.
L. Types of conditions treated.
2. The department shall provide consumers with information regarding how to assess the information specified in subd. 1. and what additional questions consumers may want to ask the health care provider.
(c) Health care facility.
1. If available to the department, the following information about a health care facility shall be contained in the consumer guide and may supplement other factors such as the consumer’s age, health status, mobility and financial resources as important factors in selecting a hospital, nursing home, hospice or other health care facility:
a. Facility type.
b. Location.
c. Ownership.
d. Medicare and medical assistance participation.
e. Number and type of medical professionals on staff.
f. Number of staffed beds.
g. Services provided.
h. Accreditation status.
i. Date of last inspection by the department.
j. Degree of compliance with medicare and medical assistance regulations.
k. Evaluation by consumers.
L. Membership in professional organizations.
m. If applicable, performance measures such as complication rates, volume of procedures, patient satisfaction and last report of facility surveys of care delivered.
n. Years of operation.
o. Costs.
p. Satisfaction of clients.
q. Measures of financial strength.
r. Affiliations with specific physicians, clinics or hospitals.
2. The department shall provide consumers with information regarding how to assess the information specified in subd. 1. and what additional questions consumers may want to ask the health care facility.
History: Cr. Register, December, 2000, No. 540, eff. 1-1-01.
DHS 120.24 Hospital rate increase report.
(1) Data sources. The hospital rate increase report shall be based on notarized copies of notices placed in newspapers and submitted to the department by hospitals.
(2) Contents.
(a) The hospital rate increase report shall contain all of the following information:
1. For each hospital that publishes a notice as specified under s. DHS 120.09 (2), the report shall list all of the following:
a. The name of the hospital and the city in which the hospital is located.
b. The date the increase will be effective.
c. The resulting annualized percentage increase.
d. The geographic area of analysis in which the hospital is located.
2. A list of hospitals that have closed since 1993.
(3) Report dissemination. The department shall make the report available from the department’s website at no charge.
(4) Suggested use of report. Some suggestions for using the report are as follows:
(a) To understand changes in hospital rates.
(b) To compare rates across hospitals within and across state regions or statewide.
(c) To project expected costs of hospitalizations.
History: Cr. Register, December, 2000, No. 540, eff. 1-1-01.
DHS 120.25 Uncompensated health care services report.
(1) Data sources. The uncompensated health care services report shall be based on data derived from all of the following sources:
(a) Annual hospital plans for the provision of uncompensated health care submitted to the department by hospitals.
(b) Fiscal surveys of hospitals conducted by the department.
(2) Contents. The uncompensated health care services report shall contain all of the following information:
(a) For each hospital, the report shall list all of the following:
1. The city in which the hospital is located.
2. The type of the hospital.
3. The dollar amount of charity care provided for the most recent fiscal year.
4. The proportion of total annual gross patient revenue that constitutes the charity care.
5. The annual amount of bad debt.
6. The proportion of total annual gross patient revenue that constitutes the bad debt.
7. The total annual dollar amount of charity care and bad debt.
8. The proportion of total annual gross patient revenue that constitutes both charity care and bad debt.
9. The proportion of total nongovernmental patient revenue that constitutes the charity care.
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.