Health Care Reform
Implementing Federal Reform in Wisconsin: WHA will effectively communicate, educate and advocate health reform related initiatives that will be phased in over the next 3 years, culminating with significant coverage additions slated for implementation in 2014. Priorities will include: rational and fiscally sound Medicaid-based Coverage Expansions; piloting Payment Reform (including commercial payment reform via the Wisconsin Payment Reform Initiative); Medicare Pay for Performance Initiatives; designing a workable Wisconsin Insurance Exchange; and advancing the Pay for Value theme through continued support and involvement in the national Healthcare Quality Coalition. (www.qualitycoalition.net)
Board Sets Health Reform Implementation Priorities
The WHA Board-approved Access, Coverage and Cost Principles adopted four years are still extremely relevant in the current environment and will continue to serve as a road map for WHA priorities. On October 20, the Board approved five health reform implementation themes that the Board agreed upon:
1. Accelerate performance improvement on clinical quality, safety, and cost
Through participation with the Wisconsin Health Information Organization (WHIO), the Wisconsin Collaborative for Health Care Quality (WCHQ), and in collaboration with the state Medicaid staff and other stakeholders, WHA will remain committed to measurable, focused, and coordinated performance improvement initiatives.
2. Pursue Value Agenda
Wisconsin has been at the forefront nationally of the movement to harness the power of transparency, delivery integration, and health information technology to achieve value…the sum of high quality and costs. Those advocacy efforts have been directed through the Health Care Quality Coalition, a group of organizations committed to ensuring that health reform implementation features a strong commitment to paying and providing incentives for high value. WHA will maintain that focus through its involvement in the Quality Care Coalition.
3. Advance Payment and Delivery System Reform
Board members agreed that delivery system and payment reforms will remain important dynamics in the coming year and successful hospitals and health systems will need to align with physicians in order to either lead or accommodate anticipated new public and commercial payment strategies aimed at improving outcomes with static or declining resources.
4. Medicare Payment Cuts
The Accountable Care Act (ACA) pays for coverage expansions by reducing Medicare payment to hospitals. WHA advocacy efforts must focus on minimizing further Medicare payment cuts associated with reforming Medicare, reducing the federal deficit, or fixing the physician payment formula (sustainable growth rate or SGR).
5. Wisconsin Insurance Exchange
WHA will collaborate with state officials and the Wisconsin Legislature to align WHA’s health insurance exchange principles with the implementation of the Wisconsin Office of Free Market Health Care. WHA’s highest priority will be to support a pluralistic insurance marketplace with accountable governance that minimizes the erosion of employer-based coverage in Wisconsin.
Health Care Reform Video: Presentation by Steve Brenton, WHA President
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