The Wisconsin Health Information Organization (WHIO) is a voluntary non-profit organization dedicated to improving the quality, affordability, safety and efficiency of health care in Wisconsin. The WHIO has been designated a Qualified Entity (QE) by the Centers for Medicare and Medicaid Services (CMS). As a Qualified Entity, WHIO is permitted to receive Medicare claims data from CMS and combine it with other claims data received from our voluntarily participating commercial and Wisconsin Medicaid insurers for the purpose of producing public reports to evaluate the performance of Wisconsin’s health care delivery system.
This report was created from data provided by CMS through the QE Certification Program, and claims data from 16 commercial health plans and Wisconsin’s Medicaid program. The information represents health care information on over 4.8 million people. The measurement period of this report is October 1, 2013 through September 30, 2014.
The WHIO’s vision is to be an indispensable asset to those who work to improve the healthcare value of Wisconsin. We strive to:
Aggregate health care data to create comprehensive, reliable information to
decrease unwarranted variations in care and cost;
Improve the quality, cost, safety and efficiency of health care in Wisconsin by partnering with providers, purchasers and payers; and
Support consumer decision making by publishing usable information.
The report that follows has been developed to help Wisconsin and the CMS improve the quality and reduce the cost of Medicare services.
Provides the Recommended Care for your Healthcare Issue at the Right Time
This is a rating of how the providers in a Wisconsin county compare to an expected result based on their statewide peer group in delivering evidence-based care to their patients. The ratings in this report are displayed as green, yellow, and red arrows that represent Better than Average, Average, or Worse than Average performance. To learn more about the quality measures in this rating, see Quality Measures at the end of this report.
Makes Good Use of Your Healthcare Dollars
This is an efficiency rating of how the providers in a Wisconsin county compare to an expected result based on the statewide peer group in the efficient use of health care dollars when treating their patients. The ratings in this report are displayed as green, yellow, and red arrows that represent Better than Average, Average, or Worse than Average performance.
Explanation of the Ratings:
If a county’s providers had better performance compared to their statewide peers AND the result was statistically significant, then the county’s provider rating will display a green arrow, indicating Better than Average performance. If a county’s providers had lower performance compared to their statewide peers AND the result was statistically significant, then the county’s provider rating will display a red arrow, indicating Worse than Average performance. If the performance result was not statistically different from the average, then the county’s provider rating will display a yellow arrow, indicating Average performance. If there was not enough information to be rated, the county’s provider rating will display a gray circle.
This report provides ratings of primary care practices aggregated at the county level for Wisconsin’s Family Medicine, Internal Medicine and Pediatric physicians. The state of Wisconsin has been divided into healthcare regions that include the counties below.
The ratings include a measure for overall quality labeled “Provides the Recommended Care for Your Healthcare Issue at the Right Time” and a measure for efficiency labeled “Makes Good Use of Your Healthcare Dollars.” In counties where there was not enough information, the county result indicates “Not Rated.”
