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With more than 3,000 workers, Gundersen Health System is La Crosse County's biggest employer.

A new report labeling the former Gundersen Lutheran Medical Center in La Crosse as the most profitable hospital in the country needs an asterisk before it goes into the record books — because statistics don’t always tell the whole story.

The study of 3,000 hospitals in the United States in 2013, when “Lutheran” still was part of the name of what now is Gundersen Health System, chronicled the hospital’s profit as $302.5 million — an eye-popping $4,241 a patient.

But a state hospital association official and a Gundersen representative questioned the findings Monday, saying the calculations don’t factor in the full gamut of Gundersen’s expenses.

The research from the Johns Hopkins Bloomberg School of Public Health in Baltimore, Md., and Washington and Lee University in Lexington, Va., was released Monday, as reported in the May issue of the journal Health Affairs.

The report posed questions without answering them, as well as providing a head-scratcher for Brian Potter, senior vice president of finance for the Wisconsin Hospital Association.

“I don’t quite understand” the calculations in the study, Potter said during a phone interview Monday. “The numbers for Gundersen look kinda crazy.”

The figures appear to be a mash-up of statistics from the hospitals, clinics and other services the La Crosse-based Gundersen system provides in the 19 counties where it operates in Wisconsin, Minnesota and Iowa, then applied only to the system’s main campus in La Crosse.

“I’m pretty skeptical of the figures,” Potter said. “I know that, in 2013, the (profit) margin for Gundersen was about 5 percent.”

The WHA does hospital finance analyses that differentiate between how figures are computed for multi-facility systems as opposed to single-hospital entities, he said.

The calculations in the research study don’t take into account systemwide administrative expenses and other costs such as home health services, which skews the tallies, Potter said.

“A lot of expenses for a hospital might go through the system,” while income would appear on the hospital’s ledger, making it look like it is making a lot more money than it is, he said.

The report casts aspersions not only on Gundersen but also the six other nonprofits in the study’s top 10, Potter said.

“A small subset of nonprofit hospitals are earning substantial profits,” said study leader Gerard Anderson, a professor in the Health Policy and Management Department at the Bloomberg School.

“Either they’re doing something right or they are taking advantage of a flawed payment system,” Anderson said in the press release. “Perhaps the most important question is what are they doing with all of that money?”

Gundersen Chief Financial Officer Dara Bartels can answer that, saying that, in part, the money goes to provide other services not only in La Crosse but also throughout the Gundersen network.

“This article does not reflect our costs — as an integrated health system — for the care we provide in a multi-state, largely rural region with a high Medicare patient mix, and does not analyze data on quality of care,” Bartels said.

The authors analyzed finances of about 3,000 acute-care hospitals, of which 59 percent were nonprofit, 25 percent were for-profit and 16 percent were public. Overall, their research found that more than half of all hospitals incurred small losses from patient care services, with a median loss of $82 a patient.

The findings “show that, while the majority of U.S. hospitals lost money caring for patients, a small percentage earned large profits,” according to a press release on the study.

“The results raise questions about whether peculiarities in the payment systems or some other factors are creating these outsized winners,” the release said.

While the study acknowledges that hospitals that are part of a hospital system are more profitable, it suggested the reason as being that they “use their weight to negotiate higher prices from insurers” rather than noting the income-vs.-expense gap.

Study co-author Ge Bai, an assistant accounting professor at Washington and Lee University in Lexington, Va., said, “All hospitals should make a little profit, but some hospitals are obtaining outrageous profits.”

Bartels disputed the insinuation, saying, “The portion of the cost report the authors used excludes administrative and shared costs per Medicare rules, with results varying between organizations. We would rank much differently if these costs were considered.”

Bartels likened the study’s methodology to analyzing a family’s income based only on the breadwinner’s salary without factoring in the broader scope of the family’s expenses, such as the mortgage, utilities, college costs and other bills.

The overall income appears larger when the full bill doesn’t include such expenses, she said.

Bartels cited Gundersen’s multi-year pattern of keeping annual rate increases as low as possible, in the 3 percent to 4 percent range for the past several years.

The devil is in the details, Bartels indicated, saying, “Analyzing Medicare cost reports of a single care center may have been relevant 20 years ago, but using the same methodology now for an integrated health system network isn’t constructive.”

That echoed a similar assessment from Potter, representing a neutral perspective.

Bartels also referred to a Dartmouth Atlas analysis tabbing Gundersen as the market leader in a region that has the lowest cost of care per Medicare beneficiary in the nation.

“We are also a national leader in providing care in the last two years of life by spending less per patient episode of care, shortening patients’ length of stay in the hospital, having fewer patient complications and making fewer patient safety errors,” she said.

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Reporter

Mike Tighe is the Tribune newsroom's senior citizen. That said, he don't get no respect from the cub reporters as he goes about his duly-appointed rounds on the health, religion and whatever-else-lands-in-his-inbox beats. Call him at 608-791-8446.

(66) comments

Redwall

How predictable of the Fibune.

The story of the Johns Hopkins study was printed by every newspaper in the country (see Milwaukee Journal) except the La Crosse Fibune, which instead only printed Gundersen's repudiation of the study.

Fearless journalism. Not.

oldhomey

I repeat, if this report is seriously in error in regard to Gundersen, the hospital better get jumping on finding a way to get the actual facts publicized and the ratings institution taken to task. Dawgstyle on here appears to be somebody from the hospital p.r. department who is accusing critics of not knowing what they're talking about, which probably is true, but that is understandable, because what the public is given to work with is a lot of complex statistical studies and comparisons, and lay people are not going to be able to understand them without good, non-partisan interpretation, which perhaps the Tribune could provide by finding help in stripping this down for average readers. But the real onus now is on Gundersen to start explaining itself in the context of this report and showing the community that it an erroneous report, if it is in fact is erroneous. Having Mr. or Ms. Dawgstyle trying to reassure in these posts that its actual profit is only $40 million without doing anything to back up that statement isn't going to cut it.

Maybe You're Wrong

I would agree with your assessment of dawgstyle. In my experience, Gundersen does their best to hide what they're really charging. Given the X-Ray example from my previous posts, I had one X-Ray but the cost was spread over two bills and EOBs along with a bunch of other things. I had to ask for a detailed bill from Gundersen because they give you a statement that doesn't detail charges. Two months later, it arrived. My single X-Ray (a single view) was split into 6 line items on that bill which were all labeled simply 'RADIOLOGY'. On that basis, I called them and suggested I was over-billed.

I received the same attitude from those people on the phone as dawgstyle offers up here; i.e. "You don't know what you're talking about. You just don't understand the bill." No sh*t! It took the lady on the phone 20 minutes to untangle the mess. She first said my single Xray and the services of the radiologist should be two line items. I told her, "I agree. There are six here." Ultimately, she decided it was easier just to blow me off.

Since Gundersen and Gundersen Health Plan are ultimately two pockets in the same pair of pants, they don't care. I care! Mayo/Franciscan do the same sort of thing with Health Traditions. When we're over-billed, that is the basis insurance companies use to justify rate increases. Why is this allowed?

Dawgstyle tries to make something like an X-Ray seem more complex than it is by lumping MRI and open heart surgery offered by a "health system" and suggests I couldn't possibly understand this unless I'm in healthcare. No, dawgstyle, it's really simple. I needed an X-Ray (one view). Gundersen billed insurance over $1000 for a this X-Ray and radiologist's service. Another provider offers the same services for $125 cash. THAT, in a nutshell, is the problem.

CJ

One of the issues in medical is all the people you deal with or that you employ by having an appointment. Think about it, you call for an appointment someone answers and sets it or directs you to the right area, someone checks you in at the reception desk, another person takes you back checks vitals etc, finally there's the Dr or specialist, next you go to the checkout & possibly set a follow up appt or simply checkout. Once home you eventually get a billing statement and if you do snail mail with a check you send that in and someone else processes that......there are a lot of moving parts and no easy way there to cut overhead really. The cash practice local health clinics do a terrific job and you can actually get some care without the Dr treating you like a # worried they spend to much time and have to rush to the next room.....

dawgstyle

It is pretty simple at this point. You don't know the difference between a copay and co insurance, you are in so far over your head you can't breathe.

Just stop trying, it's borderline childish at this point.

CJ

How any people do you think really understand their bills Dawg? I haven't read any recent studies but medical error billing alone is a drag on personal spending also. The vast public is uneducated in multiple areas of any insurance program and with the ACA having people going to the exchanges on their own it hasn't improved from people I deal with and I am licensed to market on the exchange. While they may not appreciate it, the last two years of public schooling should have a minimum of a class a day on every area of finance and insurances to prep kids for real life instead of memorizing stats & history to pass a few tests for a piece of paper......colleges should be even more intense in this area.

dawgstyle

I 100% agree with you on this. Very little if anyone outside the industry understands how it all works. It's very sad and unfortunate. But one shouldn't use ignorance as an excuse to attack an organization that does a ton to help out the community.

I wish high schools and colleges would do a better job educating people on their benefits. Employers too.

HolmenPackerFan

So, this commenter used the term copay instead of coinsurance. Of everything presented, this is what you choose as a point to debate?

Explain why Gundersen billed Maybe You're Wrong $1000 for an Xray he/she could have gotten somewhere else for $125.

You speak about an $8 cheeseburger and use it to claim he doesn't understand how business works. Let's run with that comparison for a second. The Barrel Inn down the street from Gundersen has a great cheeseburger for $7.50. You can add fries for $1.00. Your check comes and you pay $8.50 and maybe leave a $2 tip. ...$10.50 cash, right?

If Gundersen were a competing eatery, they'd bill the insurance company $68 for that burger and fries. The insurance company would agree to pay 80% of that claim and you'd be responsible for the other 20% co-insurance (better make sure I use the right terminology) amount of $13.60. By your logic this is OK????

It is pretty clear you work for Gundersen.

Maybe You're Wrong

I appreciate the questions offered by Mr. Shark because it shows someone is questioning the report rather than accepting it as many of the commenters here. The reality is there is no way little old Gundersen had $302.5 million in PROFIT in a single year. The fact Gundersen stands out from the others and this number is so large should be a reason to suspect the data they used is incomplete or flawed.

That said, I have to go along with the report and generally agree that Gundersen is making WAY more money than they'd like anyone to know. Where does it go?

There are many people who have commented here who obviously hate Gundersen. I go there for my healthcare and I have reason to hate them when the bill comes too. I think they could charge much less than they do for the services they provide. Officially, they defend the things they do like the methane power station in Onalaska, the cow poop digester in Dane County and the windmill in Cashton as responsible eco-stewardship. Who can argue? They're building a hotel. They offer lots of good reasons for this. The bottom line, unfortunately, is they are a healthcare provider, not energy providers or a hotel chain. The money they 'invest' in these things comes from fees collected from patient care. It is my opinion the money dedicated to these other 'distractions' should be directed at lowering the cost of patient care.

Among the other things people may not know is Gundersen owns a health insurance company, Degen Berglund pharmacies, Tri-State Ambulance, and who knows how many other things. It's curious that if you need respiratory supplies, their insurance will only cover them if you buy from Degen Berglnd or another approved provider for about double the price you can buy them elsewhere. In many cases, the out of pocket amount we pay after insurance for things like CPAP machines or nebulizers is the same or more we'd pay in cash buying it online. Of course, if we choose the cheaper online route, Gundersen insurance will not pay for it. Why have insurance???

Example: I needed an X-Ray (outpatient) and have Gundersen insurance. My out of pocket cost/co-pay for this service was $201.56 for the X-Ray and the radiologist's fee to interpret it.

Another local provider which doesn't accept insurance charges $125 for the X-Ray and interpretation. (http://mynfclinics.com/services-pricing/) It is unreal that I pay premiums to Gundersen for insurance, I go to Gundersen for the X-Ray and I end up paying MORE money out of pocket than I would have paid to this other clinic if I had no insurance at all and paid them cash.

Offer all the explanations you like, Gundersen. You're pocketing my insurance premiums PLUS charging so much for the 'covered' services that the co-pay is more than if I simply pay cash.

Despite the great care provided by Gundersen, this nonsense is what makes people angry.

dawgstyle

Here is where you are missing things in your example. Gundersen has more overhead than the other local provider. Is your local provider going to perform an MRI? No. Is he going to perform open heart surgery? No. Does he have to staff hundreds of people to file your insurance claims to get them paid because your insurance doesn't want to pay your claims? No.

If you work in healthcare, you'd know that you can't compare an integrated health system that spans dozens of counties and three states, to a local provider than performs simple xrays and checkups. They are not the same thing.

Your statement about a covered service and a copay makes no sense, since a copay is a static value.

You note the Hotel. You might want to do a little research and learn more about it. Gundersen isn't getting into the hotel business. They are providing the land for a company to have a hotel here for patients to utilize. It will NOT be owned by the health system.

Finally, you say that Gundersen is making more money than they would like anyone to know. It is a non profit, all their records are public record, which is where this report came from. They aren't hiding anything, you are just ignorant to the facts.

tower

Ok, lets say the report is off 50%. That still puts GL in the top 10. You seem to think the people at Johns Hopkins went out of their way to nail GL. They used the same figure combinations for everyone. You also seem to be making the argument that the patient mix for GL is so out of the ordinary from the rest of the 3000 hospitals as to slant the results. Come on, get real.
If you want an MRI you can drive to Eau Claire and get one at a free standing clinic. Face it, Mayo and GL have a corner on the market in La Crosse and this study reflects that.

dawgstyle

I have already stated its not off 50%. Its off by 750%. The actual profit of the health system was 40 million.

Maybe You're Wrong

"Gundersen has more overhead than the other local provider. Is your local provider going to perform an MRI? No. Is he going to perform open heart surgery? No."

You're being willfully obtuse here, dawgstyle. I needed and received an X-Ray from Gundersen. I didn't need an MRI. I didn't need open heart surgery. I needed an X-Ray and the services of a radiologist to read it.

"Does he have to staff hundreds of people to file your insurance claims to get them paid because your insurance doesn't want to pay your claims? No."

That must be why Gundersen give insurance companies a discounted rate which isn't available to people who pay cash. If I pay cash at this alternate provider and submit the claim directly to Gundersen Health Plan, why won't they pay it? After all, I'm saving them a pile of money.

"If you work in healthcare, you'd know that you can't compare an integrated health system that spans dozens of counties and three states, to a local provider than performs simple xrays and checkups. They are not the same thing."

Clearly, they are not the same. I discovered this other provider staffed with MDs, nurses and PAs with lab services which charges far less for those services than Gundersen only after I got my bill from Gundersen. This other provider would certainly refer me to another provider if I needed heart surgery or an MRI.

"Your statement about a covered service and a copay makes no sense, since a copay is a static value."

Co-pay is not a static value. My insurance is 80/20. I pay 20% of the costs up to the deductible amount. My out of pocket cost after insurance has paid the first 80% of the claim was MORE than what I would have paid for an X-Ray and radiologist at the provider whose prices I listed. My cash price for the whole thing would have been $125. Gundersen billed about $1000 of which I had to pay just over $200 even though I have insurance. You're right. It doesn't make sense. I pay an insurance premium to cover my healthcare costs then end up paying more out of pocket than if I had no insurance at all.

I will give you another example. I was discussing this issue with a friend who needs B12 injections every two weeks. Gundersen charges his insurance $120 for an intramuscular B12 shot at the clinic according to his EOB. He walks in, gets his shot and leaves. This other provider (we checked the price list) charges $10. (That's ten bucks!) Should he or his insurance company be gouged an extra $110 every two weeks because he might need an MRI or a cardiothoracic surgeon someday? He said he has to pay $20 according to the terms of his insurance policy. So, even with insurance, he pays twice as much. On top of this, since Gundersen Health Plan recorded a $120 claim, they'll undoubtedly use this as an excuse to raise rates.

You seem to be going out of your way to defend Gundersen here. Is your real name, Dara Bartels?

"They are providing the land for a company to have a hotel here for patients to utilize."

There are already plenty of hotels here for patients to utilize. I maintain Gundersen has no business doing this. They are a HEALTHCARE SYSTEM as you like to point out, not a hotel system.

"It is a non profit, all their records are public record, which is where this report came from. They aren't hiding anything, you are just ignorant to the facts."

So this report is 100% accurate based on the public record? Is this why Gundersen officials are objecting?

I've offered nothing but facts here with actual numbers related to my own personal experience taken from my bills, EOB and an itemized statement which I had to request.

dawgstyle

"That must be why Gundersen give insurance companies a discounted rate which isn't available to people who pay cash. If I pay cash at this alternate provider and submit the claim directly to Gundersen Health Plan, why won't they pay it? After all, I'm saving them a pile of money."

The discounted rate for uninsured people is great than that for people with health insurance. FACT.

"Co-pay is not a static value. My insurance is 80/20. I pay 20% of the costs up to the deductible amount."

"Copays are static values, 80/20 is co insurance. As I said before, you don't know what you are talking about.

You're being willfully obtuse here, dawgstyle. I needed and received an X-Ray from Gundersen. I didn't need an MRI. I didn't need open heart surgery. I needed an X-Ray and the services of a radiologist to read it."

You clearly don't understand how a business operates. When I go to a bar and order a cheeseburger, I don't need the bartender or the 4 other waitresses, I only need a cook and my waitress. The cost for them to place my order and cook it is less than $8, but the business still has to pay for its costs on everything in the bar, not just what I use. That is how business works.

My name is not Dara Bartels. I am not going out of my way to defend Gundersen, I am going out of my way to educate you on a subject you don't know anything about, but just want to complain about. I don't know what it takes to run a auto dealership, and service and repairs seem really expensive when I have to fix my car, but I don't complain about their profits because I don't understand their business. I am certainly not about to go car and driver for a few months and then claim I do.

"There are already plenty of hotels here for patients to utilize. I maintain Gundersen has no business doing this. They are a HEALTHCARE SYSTEM as you like to point out, not a hotel system."

They still will not be a hotel system. A third party is going to own a hotel next to the hospital, why is that a bad thing? Are you worried they will but Marriott out of business?

"So this report is 100% accurate based on the public record? Is this why Gundersen officials are objecting?"

The report is based on the hospitals profit. It doesn't take into account the costs of running the countless regional clinics around the tri state area. Those costs and profits are filed separately. As is said in the article. its like looking at someones salary and assuming all that money is available to spend without taking into their costs like a mortgage or a car payment.

You may have provided nothing but facts and actual numbers for some of your post, but the majority of it is incorrect, I pointed one of those out with your copay statement.

Face it, you are just bitter because you think healthcare is too expensive.

tower

I agree with you. Now that cash for service provider is really the only private MD left in La Crosse. There are several reasons for that, that we don't need to get into, but the end result is a monopoly. GL like to point out all the rural area they cover but no more that the Mayo system. I wonder if this whole result of the study is a shading of the facts, not by Johns Hopkins ( who could care less about GL) but by GL to make themselves more saleable? Been hearing those rumors for years.

tower

mrshark, Medicare is the basis of health payments. The reason is that the Feds have medical billing information dating back to 1967. They have an excellent handle on medical costs. Their payments are are based on costs plus 10% profit. The profit amount is a good return on the practices provided and hardly will drive hospitals and providers out of business. Maybe you can answer why if Medicare is so bad why providers go out of their way to get as many Medicare patients as possible?

dawgstyle

Can you show ANYTHING that shows providers go out of their way to get as many Medicare patients as possible?

tower

Next time you are in FL, the epicenter of Medicare patients, take a look at all the ads on newspapers, billboards, etc. The providers are advertising all the time. Local we don't have the same attempt. Now you before you tell La Crosse is so much different than FL I have to say I disagree when it comes to the economic forces at play.

dawgstyle

Tower, your ignorance on this topic is astounding. You read a couple of magazines and you think that makes you knowledgeable. I read a couple of articles on a great many things, that doesn't mean I am qualified to discuss the topic.

dawgstyle

How many of these Florida providers work for an integrated health system covering hundreds of miles of rural areas spanning 3 states? The answer is none. Because it IS DIFFERENT HERE.

mrsharkb8

Read the article people. Then apply some rational thought. Here are my comments:
Footnote 2.:
We focused on operating profit in
this study because that is generated
from hospitals’ core business—patient
care—and thus is more comparable
across hospitals than the
overall profit is. For example, an
excluded item—donation revenue—
is a more important revenue source
for nonprofit hospitals than for
public and for-profit hospitals.
From the start of the article they, in fine print, acknowledge they do not consider the overall profitability.
Footnote 11.:
Hospital-reported patient care cost,
not Medicare-allowable cost, was
used to derive the net income from
patient care services.
I am not exactly sure what this means, but it sounds like they didn’t use what Medicare actually paid GHS to determine net income. So if GHS reported care costs are high and the allowable costs are low, wouldn’t using the higher reported cost figure actually return a false high net income?
Page 3.:
Because the proportion
of low-income patients treated by a hospital
is not publicly available, we used as a proxy
the estimated proportion of uninsured people in
the county where a hospital is located.
So they estimated “uninsured people” in LaCrosse County rather than considering low-income. Not only are their figures based on an estimate of a group of people, but it assumes low income are uninsured. This is a faulty assumption. This demonstrates also the weakness in not considering the entire system. GHS services a considerable number of counties with higher levels of low-income patients. By only considering the county with, arguably, the lowest portion of our low-income patients, the net result will naturally show a higher profit. Classic example of “garbage in, garbage out” mathematics.
Then they spend an entire section claiming that have more uninsured patients in the county has an association with lower profitability. So, why not consider the entire region served?
Okay, last point.
Page 8.:
We found that factors largely beyond hospitals’
control—location, patient mix, and the relative
market power of private insurers—were associated
with hospital profitability. Factors within
hospitals’ control—markup and consolidation—
also play important roles.
“Factors beyond hospitals’ control” affect profitability. If the factors are beyond control, how can you hold the hospital accountable for those profits? How would you propose those factors be regulated? “Mark up” is the ratio between GHS gross charges to Medicare allowable costs. One of their sources for this definition is Anderson GF “Soak the rich to soak the poor: recent trends in hospital pricing.” This article sought to propose policy changes to ensure the uninsured and self-pay patients were not charged significantly higher rates than other payers, including Medicare. Since when should we consider Medicare rates as the base line appropriate rate? If Medicare rates became the standard, all hospitals would operate in the red on be out of business.

Sorry for the rant.

chucker

How can a so called Non-profit make that much profit ??? this is total B.S. !!!

dbnelson

GL only has one HIGH deductible. THE employees have no choice but to take it!!! Interesting that most of the businesses in La crosse offer GL insurance plans that have better coverage than GL employees.

dawgstyle

High deductible? Single GL employee is 1000 deductible.

tower

MR, I agree but that is still the point, people voted with their feet no matter what name was on the door.

james know better

I think they could spend some of that $$ providing better health insurance to their employees. RIght now they have a very high deductible and their out of pocket costs are so high that their staff cannot afford to go to the doctor. Ask anyone you know who works there in direct care and see what they say. So when you go into their hospital your care giver might not be feeling their best but cannot afford to go to the doctor. One would think they would want the healthiest staff caring for their patients....evidently not.

CJ

Employees there have more than decent insurance coverage from what I have seen. If someone picks a high deductible that is on them unfortunately.....

Gundersen La Crescent

We do not get to choose between plans - we are offered one plan, with high deductible, especially the family insurance plan deductible.

dawgstyle

$2500 for a family deductible is not a high deductible plan. If you think it is, you don't know anything about health insurance.

CJ

Anyone complaining about deductibles that work for GL go look on healthcare.gov or simply GL insurance site and see what patients pay for premiums. Throw some of your income into an FSA or HSA and enjoy the perks of lower cost coverage all around compared to I would say 75% of working families today. We hear often how people choose jobs based on benefits, go try working for yourself and get some real math on what life really cost outside of the shelter of a "good job" with benefits some of you whine about......When I go to a medical provider or chiropractor I don't need it to feel like I'm walking into a spa for a massage, like many simple adequate service, diagnosis & treatment if needed without all the fluff......

CJ

So what do you consider a high deductible? Single & family I'd be enlightened to know.....add in the fact on $10-15 copays for what some see $200-250 bill and hit a deductible of anywhere from $5,000 on up before insurance pays.

dawgstyle

In this day and age? High deductible is $5000 and above. The days of no deductibles and $500 plans are all but extinct. $1000 for a single and $2500 for a family is far better than the average plan these days.

dbnelson

As a former employee of GL I also believe that the institution provides excellent care for their patients and I believe that they offer the best of providers. After one of my children was diagnosed with a chronic disease I really found out how terrible the insurance was that they provided for their employees. We typically paid out $500-$700 every 3 months for appointments & labs. Deductibles, co-insurance & Co-pays were extra. They have a "cost share" fund that's supposed to pay half of the bills & and it sounds good but employees still have to pay a ton out of pocket. I had no choice but to find other employment because of their insurance. I believe that they are taking good care of their patients but not their employees. I agree with one of the authors on this page who said that GL takes great care of the "brass" but If you are just an employee then you are not so lucky. I thank the neighborhood family clinic everytime we go there for charging an "appropriate" amount of money for their services.

badboy

Let's see, they created a position for Arndt and he hires a bunch of his good ol boys from Trane. That's a few mill there they needed to recoup.

Even if those reported numbers are off by as much as 50% it still means Gundersen Health System is gouging the consumers by $2100 per patient. Have they no shame?

dawgstyle

They are off by more than 50%. Actual profit was about 40 million, not 300 million

badboy

I was referring to the $4200 per patient.

dawgstyle

If they are down by that much on the profit, they are off by FAR more than 50% on the per patient profit. The two go hand in hand.

yourewrong

Lets see here, if there profit was $40 million (which is the actual correct number once expenses are figured in), and they made $4200 per patient, that means between all of their locations, they are seeing 26 patients per day

dawgstyle

well 300 is 7.5 times that of the actual number of 40. so if you divide 4200 by 7.5 you get $560. $560 per patient seems more than reasonable to me.

oldhomey

I would say that this report represents the most serious challenge that Gundersen has ever faced, because it totally undermines their community reputation. It is one reason why we have law suits, and I think the hospital would be well-advised, if it cannot get the ratings institution to re-visit its work here, to sue them so that everybody, the public included, can get to the bottom of what is being alleged by this report.

GrandpaS

Gundersen is a great medical facility and we are lucky to have them in the area, except for the outrageous bills they come up with, pretty much like every other hospital. A few years ago, they did some significant remodeling. Maybe that was necessary, but the entry lobby that looks like a New York Hilton certainly wasn't. They have a grand piano in there , and sometimes someone there playing it. YOU pay for that every time you get services there. I don't know about you, but I don't want my medical fees covering a piano player in the lobby. I'm not too excited about paying for the construction, operating costs and maintenance of that waterfall that takes up one whole wall, either.
A few years ago they acquired Tri-State Ambulance. Now they're going to build their own hotel. And they want to buy and demolish several houses so they can build a parking lot, and then maybe convert it back into a neighborhood 5 years from now. I have news for ya, folks. Any company that can do all those things is making a ton of money. If they were trying to contain their costs, they wouldn't have that waterfall wall or need a grand piano in the lobby. You need to develop a conscience, GHS. If only Trane company were doing this well.

oldhomey

Amen, Gramps. I agree with all that you say. I think it is also applicable to the empire building in state universities that have skyrocketed costs and tuition while overloaded administrative staffs cut costs by hiring mostly part time faculty at slave wages and no benefits.

tower

MR, not really. Back in the 80's GL had a larger portion.

Melowese Richardson

But don't you think that this was caused by the Mayo purchase of St. Francis more than anything else?

chucker

"G" stands for "GREEDY " Gundersen , it's total BS when they charge $250 to $450 for 1st time 15 min visit !!! TRUMP will address this problem ???

CJ

I hadn't been to a medical doctor in a number of years until late 2012. I about passed out looking at the $200 plus bill for a brief office visit. The family health cash clinics locally going I hope can help more folks out compared to the gouge of a visit at GL for basic issues.

tower

What is also interesting is that GL is the smallest hospital of the 10 listed as the most expensive. By about 90 beds.

lookout

Well I'll have to say they have most of my money and lots of my insurance company's. When you get charges two hundred and fifty dollars for a 10 minute visit something is truly wrong with the system. And those visits were just to talk to someone. Look closely at your statements and tell them to itemize them so you know what your getting for your money. Watch very closely if you have to go often. I've been bille dfor time sI was never there. I've paid at the desk before and told I needed to pay that same bill. I sent them the reciets one time for that bill and they still said I owed them for that visit. My records with the paper they gave me didn't holed up to what their records showed so I still had pay them. They drove me nuts It had the same date on it and I didn't go to the same doctor twice in one day but I still had to pay to get them off my back. Now I never pay up front. I wait till they send the bill and write a check.

Alan Muller

I don't think a spokesperson for the Wisconsin Hospital Association, a trade association, should be described as having a "neutral" perspective.

Health care charges in Southeastern MN (= Mayo near monopoly) are reported to be twice those in Minneapolis/St. Paul, where there is active competition. I wonder if the same thing isn't happening with Gunderson. How to their charges compare to Mayo's?

spirit3

Got sum splain' to do, don't think GL will be getting anymore tax breaks...

leiniegal

I agree with most have said here. GHS likes to pay the top brass top dollar. They also demand 10% of your bill every month. For most people that is more than their house payments. Then they get their wages garnished to boot. They constantly tell employee to do more with less help and dept bossed to cut costs. Obviously, it's working. BIG PROFITS!! They can explain away however they'd like, they are great at messaging the truth and skewing numbers to look better. The truth is they compared many hospitals with the SAME set up and GHS out ranked them all. Now they are building a hotel as well to get MORE money from the patients. I am betting there won't be a generous medical rate or donated rooms. Anyone want to take that sucker's bet?

Mack

Not at all surprising. 30 years ago, Gundersen had the lowest rates in the country. Today Gundersen charges the highest rates in the country. Ask Jerry Arndt. Something drastically changed. If you've ever been over-charged and looked into their charges you will find the same. The rates Gundersen charges are the highest anywhere in the country. Medicine used to be a noble profession. Medicine for profit is not a noble profession. Medicine for extreme profit is a pathological disorder.

kim9602

Sure sounds like there's a big effort into avoiding letting the community (ie., CUSTOMERS) think Gundersen is "too" profitable, for the multitude of reasons it would make them look like what they are: A money-making machine.

LAX

It's just plain a big money racket! Remember, the biggest cause of bankruptcy and financial disaster for Americans is medical costs. Remember how they told us that things like same day surgeries and new technologies and such were going to save us all huge money on our medical bills? What a scam...

Clarification

Not sure who Gunderson is trying to impress. Stockholders? If you found out that some car dealership is the most profitable, would you expect the best deal from them?

spirit3

Being a non-profit they cannot have anyone owning the company or have stockholders.

bobbobberson

I honestly cannot say I have gone through all of the details. I am sure most of us will not. You want to give them a small bit of credit......but

Certainly if specific costs were not reflected in the report, they were not accounted for in any of the institutions reviewed. They didn't account for them in Hospital X and leave them out for Hospital Y. We are talking about a study of 3,000 hospitals. Yes, 3000 so the sample group is quite large! Also keep in mind, Gundersen had $30 million more in profit than second place. Remember that this is a "not-for-profit" organization that gets immense tax breaks.

This has that "where there's smoke there's fire" feel to it. [scared]

"The study found that factors influencing surpluses include a hospital's market power, whether the hospital's market has a dominant insurer, retail price markup, prestige, teaching status, the mix of uninsured and Medicare patients, and for-profit or not-for profit ownership.

“Profits are going to be high when a hospital has a very dominant market share,” said Gerard Anderson, director of the Center for Hospital Finance and Management at the John Hopkins Bloomberg School of Public Health, who co-authored the study. “The Federal Trade Commission needs to take a look at whether there is unfair competition.”"

Gundersen has competition in the Mayo clinic. The Gundersen campus has continued to grow at a staggering rate. Many hospitals are. They are starting to look like 5 star resorts. The bottom line is that Gundersen needs to drop their profits by lowering costs and donate more to the community. The other option could be the government reviewing their not-for-profit exemption.

I don't think anyone feels short changed with their healthcare around here. Kudos to both Gundersen and Mayo in that regard but at what cost?

tower

So the answers Ms. Bartels gives are filled with nonsense to try and snow everyone. We aren't taking about Medicare only or quality of care. We are talking about money, period. I recommend people go on to goldstar.com and look at how GL try to confuse people. This website is for the reporting to the gov what non profits make. They list the salaries of major people in order. GL is listed as 5 or 6 different entities ranging from housekeeping to medical care. The bottom line is that GL says they make around $60M in profit. That is their figure as reported to the IRS. I would also state I don't believe Bartels when she says they have the lowest Medicare costs in the country. In 2006 GL was rated as one of the most expensive hospitals in the nation, right here in the Tribune, for Fed payments. So you are telling us that in a short 10 yrs you have gone from the worst to the best in Medicare payments? Excuse me but boulderdash. I know of at least 2 Medicare Part C providers who have pulled out of WI and Western WI due to high costs of HC. I suggest that GL spends a lot of money on top salaries and benefits for administrators. From other news sources a medical center of GL size pays their CEO around $1.1M.
I have also heard of a VP provided transportation and housing while she is in La Crosse but living in MI. Why, we don't have someone that is willing to live here to do the job? This is a problem I have with "non-profit" hospitals who love to go on community campaigns to fund raise for their projects but don't have a problem trying to confuse and deflect information about what they earn. This is all a shell game to try and confuse. I love the attempt at deflection by saying the former "Lutheran" hospital. Everyone knows perfectly well it is the same place run by the same people.

dawgstyle

Let's just be honest, you have no idea what you are talking about Tower. You haven't read the report nor have you reviewed the data they used. You just like to stir the pot.

tower

Doggie, I recognize cow manure when I read it. I read both the US News article and the Johns Hopkins article on the subject. Bartels is using smoke and mirrors to explain this away. So GL has a rural population, so what? They also get more Medicare reimbursements for their rural hospitals and it is a myth hospitals lose money on Medicare. Ask yourself, if that myth is true why do health systems go out of their way to get more Medicare patients?

chucker

They are charging way to much , Greedy jerks !!

Melowese Richardson

Feel free to show 'em who's the boss chucker. Just go elsewhere, that way it will be one less idiot that I might run into. [thumbup]

tower

Apparently a lot of idiots have voted with their feet as Mayo La Crosse and GL have roughly the same market share.

Melowese Richardson

And has this not always been the case, Tower?

jharrimjr

SmeloWhiteOlMan, and it will be for chucker one less idiot that HE'LL run into. [thumbup]

Melowese Richardson

Wrong, but nice try harassem.

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