Presented toWisconsin Economic Association 2009 Conference

November 7, 2009

Andrew W. WeierDirector, Quality and Strategic Analysis

Saint Joseph’s HospitalMinistry Health Care

Marshfield, Wisconsin

Current Issues in Health Carefor Wisconsin: A Providers

Perspective

Older Persons Use More Services2007 Use of Hospital Services by Age

Central and Northern Regions

0.0

200.0

400.0

600.0

800.0

1000.0

1200.0

1400.0

1600.0

1800.0

2000.0

5 - 9

10 -

14

15 -

17

18 -

24

25 -

34

35 -

44

45 -

54

55 -

59

60 -

64

65 -

74

75 a

nd u

p

Age Groups

Ho

spit

al D

ays

/1,0

00

Po

pu

lati

on

Hospital Days based on WHA Data YE Q3 07 Population 2007 Estimate per DataBay

Age 45-642.1 X higher

than Age 5-44

Age 65 and up7.7 X higher

than Age 5-44

Age 5-44

Ashland17803

4

Adams21969

5.6 Marquette16035

6.5

Shawano44077

5.4

Burnett17329

5.8

Racine202404

4.8

Waukesha397922

6.1

Kenosha173624

9.9

Washington134255

8.6

Ozaukee89692

5.5

Juneau2863511.7

Green Lake19913

3.1

Barron48493

5.3

Bayfield16129

4.5

Brown259192

9.1Buffalo14640

4.1

Calumet50381

14

Chippewa62375

8

Clark36496

6.4

Columbia58135

6.8

Crawford18090

3.5 Dane503017

10.3

Dodge92842

5.3

Door30645

5.6

Douglas45532

3.5

Dunn45165

7.4Eau Claire

1046637.1

Florence54103.6

Fond du Lac105777

5.6

Forest10448

2.6

Grant51828

2.1 Green37259

6.7

Iowa25127

6.8

Iron6785-0.8

Jackson20851

5.8

Jefferson85178

7.8

Kewaunee21909

5.5

La Crosse115538

4.7

Lafayette16631

2.6

Langlade21986

3.9

Lincoln30885

2.9

Manitowoc88055

4.1

Marathon138836

6.6

Marinette45024

2.6

Menominee52219.8

Milwaukee993969

3.9

Monroe46353

8.4

Oconto41385

9.7

Oneida38846

3.5

Outagamie189556

10.9

Pepin841810.3

Pierce41190

7.8

Polk47842

9.7

Portage73911

5.3

Price15791

0

Richland18702

3.2

Rock165354

5.5

Rusk15996

2.8

St. Croix8796721.5

Sauk63520

9.3

Sawyer18133

7.2

Sheboygan122921

5.9

Taylor20254

2.3

Trempealeau28969

4.8

Vernon31359

7.7

Vilas22240

3.3

Walworth106588

10.8

Washburn17634

5.8

Waupaca55297

4.3

Waushara27228

6

Winnebago171369

5.7

Wood78393

2.6

Rate of Change2005 - 2015

21.5 to 21.512.5 to 1510 to 12.5

7.5 to 105 to 7.52.5 to 5

-0.8 to 2.5

Projected Population in 2015Figures show 2015 projected population

and percent change between 2005 and 2015Areas outlined in white make up

Mhc and Affinity current service areas.

March 2006

Projected Change in Wisconsin Population by County

% of Population 65+ in Northern & Central Region2000 Census to 2030

33.1

%

30.0

%

25.0

% 30.6

%

32.4

%

35.8

%

17.7

%

21.2

%

21.7

% 25.6

%

26.8

%

17.9

%

17.2

%

19.4

%

20.8

%

0.0%5.0%

10.0%

15.0%20.0%25.0%30.0%

35.0%40.0%

For

est

Lang

lade

Linc

oln

One

ida

Pric

e

Vila

s

Cla

rk

Mar

atho

n

Por

tage

Tay

lor

Woo

d

Cal

umet

Out

agam

ie

Win

neba

go

Sta

te o

f WI

2000 Census

2005

2010

2015

2020

2025

2030

Central & Northern Region Area Population Age 65+

The 65+ population will increase significantly by 2030 and at a much higher rate than the state of WI average.

Larger concentration of older population in Northern WI counties – 2005 vs 2025

Central & Northern Region Counties are poorer than average

• The bulk of lower-income Wisconsinites reside in rural counties that are typically either dominated by farming or by tourism, forests, and lakes.

• While the Wisconsin median stands at 26.6%, these rural counties are experiencing poverty rates in the mid to upper 30s%.

• Forest 35.6%• Langlade 32.9%• Lincoln 25.2%• Oneida 26.6%• Price 30.0%• Vilas 30.1%

• Clark 35.2%• Marathon 21.1%• Portage 24.7%• Taylor 27.7%• Wood 22.6%

MHC Northern Region

MHC Central Region

WI Discharges by Top HospitalsFY 2008

32,098

23,817

24,351

21,091

21,532

19,222

18,540

18,320

19,353

17,521

454,402

St. Luke's - Milwaukee

Froedtert

St. Mary's - Madison

UW

Meriter - Madison

St. Joseph's - Marshfield

Waukesha Memorial

All Saints-Racine

St. Joseph - Milw

Aspirus - Wausau

All Other WI Hsp

Top 10 yield 33% of All WI discharges (excludes normal newborn)Source Data Bay, WHA, Oct, 2007 - Sep, 2008

Payer Mix, Top WI Hospitals

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

St. Luke's - Milwaukee

St. Joseph - Milw

St. Joseph's - Marshfield

All Saints-Racine

Aspirus - Wausau

Froedtert

St. Mary's - Madison

Waukesha Memorial

UW

Meriter - Madison

Commercial Government Self

Source Data Bay, WHA, Oct, 2007 - Sep, 2008

Commercial Payer TrendSelect WI Hospitals, FY’04 – FY’08

0%

10%

20%

30%

40%

50%

60%

70%

FY04 FY05 FY06 FY07 FY08

UW St. Joseph's - Mfld St. Joseph - Milw All WI Hsp

Source Data Bay, WHA, Oct, 2007 - Sep, 2008

Saint Joseph’s HospitalPayer Discounts, FY ‘08

Source: Internal data, do not cite or quote

SJH Specific DischargeMS-DRG 470 Major Joint Replacement or Reattachment

of Lower Extremity without Major Complication or Mortality

Source: Internal data, do not cite or quote