February 6, 2015
Volume 58, Issue 5

Walker Introduces State Budget, Reauthorizes DSH
Borgerding tells WisEye: WHA focus on Medicaid improvements for hospitals, doctors

Governor Scott Walker delivered his third budget address to a joint session of the Wisconsin Legislature February 3, the first step of a long journey to the final budget expected in June.

As announced January 28, the Governor included the reauthorization of the Disproportionate Share Hospital (DSH) program in his budget, and reauthorized $30 million in state GPR dollars for the 2015-2017 biennium. The DSH program was created in the 2013-15 budget Act to improve Medicaid reimbursement and help those hospitals that serve a large number of Medicaid patients. The DSH program was slated to end on June 30, 2015.

"We are very pleased that Governor Walker continues to recognize how critically important hospitals are to ensuring access to care for all Wisconsinites, including the growing number of Medicaid patients," said WHA President/CEO Eric Borgerding. "This is welcome, ongoing acknowledgment of the challenges that confront Wisconsinís hospitals, where care is provided to all who walk through their doors, every minute of every day of every year."

WHA staff has begun reviewing the 1,839 page budget proposal, which includes the following provisions relating to health care payment, workforce and operations:

WHA members can expect to receive additional information over the coming weeks as WHA staff continues to analyze the budget provisions. The stateís Legislative Fiscal Bureau analysis of the budget proposal is expected within the next few weeks as well. The Department of Administrationís brief of the Governorís budget can be found at: www.doa.state.wi.us/Divisions/Budget-and-Finance/Biennial-Budget/201517-Executive-Budget.

Over the coming months, the Legislatureís Joint Committee on Finance will review the budget provisions and have the opportunity to accept, reject or amend the provisions included in the bill. The bill then must be approved by both houses of the Legislature and will ultimately be sent back to the Governor for any final vetoes. The biennial budget bill is typically signed into law in early July.

Borgerding Tells WisEye: WHA Focus on Medicaid Improvements for Hospitals, Doctors

In a February 4 post-budget discussion with Wisconsin Eye host Steve Walters, WHA President/CEO Eric Borgerding made it clear that advocating for Medicaid payments to hospitals and physicians is a top priority for the Association in the 2015-1027 state budget. Borgerding reiterated how pleased the Association was that Gov. Scott Walker reauthorized the Disproportionate Share Hospital (DSH) program in the budget he submitted February 3 to the Legislature.

"Governor Walker and the Legislature created a new reimbursement program for hospitals in the last state budget that was scheduled to end June 30, 2015. We look at the Governorís budget as holding the ground we gained in the last budget with the creation of DSH program in addressing the hidden health care tax," Borgerding said. "If he had not reauthorized DSH, it would have amounted to a $75 million cut to hospitals, particularly those safety net hospitals that serve a lot of Medicaid patients."

Borgerding pointed out that when government programs fail to pay the cost of caring for the patients who depend on them, hospitals provide the care, but it creates a shortfall that the Wisconsin Manufacturers and Commerce (WMC) dubbed the "hidden health care tax." In Wisconsin, the amount of the cost shift is $960 million, which is about equal to the corporate income tax.

"We hope to work with the business community that ultimately bears the brunt of the hidden health care tax, to not only hold on to the progress that has been made, but to continue to move forward to increase DSH and make it permanent," according to Borgerding. "Almost every other state in the country has a more robust DSH program. We have one of the smallest. We need to continue to make progress in reducing the hidden health care tax."

Borgerding told Walters that WHA would also advocate for improvements in reimbursement for primary care physicians who serve a lot of Medicaid patients. WHA will also continue to support investments that improve access to behavioral health services.

Responding to Walters question on how hospitals will respond to increasing Medicaid utilization and low reimbursement, Borgerding cited the leadership skills of Wisconsin hospital executives.

"We have tremendous hospital and health system leaders who are committed to serving every person who walks in their doors. They are making investments in primary care and are coordinating care to alleviate pressure on their emergency departments," Borgerding said.

Watch the full Wisconsin Eye interview with WHA President/CEO Eric Borgerding at: www.wiseye.org/videoplayer/vp.html?sid=12316 

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President Obama Proposes Medicare Cuts in FY 2016 Budget
WHA meets with Members of Congress, Ways & Means staff

As President Barack Obama released his proposed FY 2016 federal budget February 2, the Wisconsin Hospital Association and Rural Wisconsin Health Cooperative were in Washington, D.C. to meet with Members of Congress on key rural hospital issues. Among those were the importance of rural and critical access hospital (CAH) designation, which the Presidentís budget again targeted. Individuals also discussed rural graduate medical education and the need for more flexibility from the Centers for Medicare & Medicaid Services.

Later that same week, WHA leadership met with Members of Congress and Committee on Ways & Means staff to discuss priority issues the Committee will tackle this Congressional session.

"WHA was pleased to be able to speak personally with Ways & Means Committee Chair Paul Ryan about issues like how Wisconsin will be impacted by the U.S. Supreme Courtís decision in King v. Burwell, for example," said Eric Borgerding, WHA president/CEO. "We were also fortunate to spend considerable time with his key committee staff and discussed issues such as ICD-10 and structural changes to the Medicare program."

The Presidentís budget included $350 billion in Medicare cuts to providers over 10 years. Several of his proposed cuts are ones hospitals have seen (and fought) before, including:

Several other provisions target post-acute care payments, including:

"WHA continues to oppose flawed Medicare payment reductions, especially since Wisconsin providers are national leaders on quality and cost efficiency, both of which create value for the Medicare program," according to WHA President/CEO Eric Borgerding.

On the positive side, the Presidentís budget would extend funding for the Childrenís Health Insurance Program through 2019 and extend Medicare rates for primary care physicians under Medicaid, but do so in a budget-neutral manner.

Access the Presidentís budget proposal at: www.whitehouse.gov/sites/default/files/omb/budget/fy2016/assets/budget.pdf.

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2015 WHA Advocacy Day Opens Opportunity to Advocate for Medicaid
Register now for April 28 event at Monona Terrace

It is not too early to gather a contingency of hospital supporters and make plans to be in Madison April 28 for WHA Advocacy Day. Every year, the event grows both in the number of attendees and in the impact made on our legislators in Madison. Advocacy Day is one of the best ways your hospital employees, trustees and volunteers can make an important, visible impact in the State Capitol. Registration is now open at http://events.SignUp4.net/15AdvocacyDay0428.

Tucker Carlson, a nationally-recognized veteran journalist and political commentator, will share an insiderís view on Washington, D.C. and a look ahead to the 2016 elections. Carlson co-hosts FOX and Friends Weekend and is editor-in-chief of The Daily Caller. Prior to joining FOX in 2009, Carlson hosted several nightly programs on MSNBC and he co-hosted Crossfire on CNN and a weekly public affairs program on PBS. A longtime writer, Carlson has reported from around the world and has been a columnist for New York magazine and Readerís Digest. He currently writes for Esquire and The New York Times Magazine. His most recent book is entitled Politicians, Partisans and Parasites: My Adventures in Cable News.

The most popular feature of the dayóthe legislator panelóshould be a lively debate on the state budget and other legislative issues, followed by a luncheon keynote address from Governor Scott Walker (invited).

The highlight of Advocacy Day is always the hundreds of attendees who take what theyíve learned during the day and then meet with their legislators in the State Capitol in the afternoon. The Legislature will be in the midst of determining the Stateís biennial budget bill, so you wonít want to miss the opportunity to make your voice heard with your legislators on important issues like Medicaid.

"WHAís Advocacy Day continues to be a powerhouse event in Wisconsinís State Capitol each year because of the commitment to this day of our hospital leaders, staff, trustees and volunteers to this day," said WHA President/CEO Eric Borgerding. "This yearís event is perfectly timed for attendees to have an impact on state budget issues like Medicaid reimbursement. We need every one of you to speak up for your community hospitals."

WHA schedules all meetings, provides transportation to the State Capitol two blocks away, and prepares attendees for their visits. In addition to an issue briefing at Advocacy Day, WHA offers an optional webinar on legislative visits prior to Advocacy Day.

Join 900 of your peers from across the state at Advocacy Day 2015 on April 28. A complete program and online registration are available at http://events.SignUp4.net/15AdvocacyDay0428.

For Advocacy Day questions, contact Jenny Boese at 608-268-1816 or jboese@wha.org. For registration questions, contact Jenna Hanson at jenna.hanson@wha.org or 608-274-1820.

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CHNA Implementation, Evaluation Grants Available

The Wisconsin Partnership Program is seeking applications for its new Community Opportunity Grants Program, which supports implementation and/or evaluation strategies that address priorities identified in a Community Health Needs Assessment (CHNA) implementation plan or a Community Health Improvement Plan (CHIP).

Community Opportunity Grants seek to enhance collaboration among public health departments, nonprofit organizations, hospitals, clinics, health care systems, schools, businesses and government leaders on community-identified health priorities.

Wisconsin-based organizations that are tax-exempt under the Internal Revenue Code Section 501(c)(3) and state, tribal or local government agencies are eligible. Individual awards will be up to $50,000 for a maximum of 24 months. Ten to 12 grants will be awarded annually.

Applicants must submit a Notice of Intent (NOI) to apply by noon, March 6. Applicants also must discuss the proposed project with a program officer from the Wisconsin Partnership Program before submitting a full proposal, which is due by noon April 10. Details and a link to the NOI are online at www.med.wisc.edu/wisconsin-partnership-program/community-opportunity-grants-program/44947.

Interested applicants are encouraged to attend a grant information session in Madison on February 13,

in Wausau on February 17 or in Milwaukee on February 20. Each two-hour session will focus on the new Community Opportunity Grants Program as well as the Partnership Programís mission, vision and grant programs. Click here (www.med.wisc.edu/wisconsin-partnership-program/grant-information-sessions/45046) for details and to register. A webcast also will be available to assist potential applicants.

Announcement of award recipients is expected July 1.

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