Governor Walker Signs State Budget into Law with Health Care Investments

Biennial Budget Act Includes Medicaid DSH, GME and Rural Health Care Investments

September 22, 2017

During a bill signing ceremony at a Neenah elementary school September 21, Gov. Scott Walker signed into law Wisconsin’s 2017-19 biennial state budget, which lays out the state’s $76 billion spending plan through June 30, 2019. The budget bill Walker signed includes nearly all of WHA’s budget priorities this session, including a significant increase in the state’s Medicaid Disproportionate Share Hospital (DSH) program and investments for our state’s rural health care workforce.

“We are pleased the budget that Governor Walker signed today advances several of WHA’s priorities aimed at ensuring Wisconsin’s citizens will continue to have access to some of the highest quality care in the nation,” said WHA President/CEO Eric Borgerding, who attended the bill signing ceremony.

In May, the Joint Finance Committee (JFC) increased Wisconsin’s Medicaid DSH program by over $60 million, taking Wisconsin’s total Medicaid DSH program up to $134 million over the two-year budget. Just three budgets ago, Wisconsin did not have a Medicaid DSH program. In addition, the JFC recognized rural hospitals who do not qualify for DSH because of a federal law criteria which requires the hospital to provide OB services. The JFC provided $1.2 million to support these rural hospitals who treat the same level of Medicaid patients as Medicaid DSH hospitals.

The final budget also includes several WHA priorities to strengthen our state’s physician, advanced practice clinician and allied health professional workforce. The budget bill provides $1.5 million to increase the state’s graduate medical education matching grant program and another $1 million annually for newly created matching grant programs to support hospitals looking to offer new training sites and experiences for advanced practice nurses, physician assistants and allied health professionals.

Wisconsin’s governor has strong partial veto authority to strike specific items from an appropriation bill while enacting the rest of the bill into law. The governor used this power 99 times in this budget and used it to strike one provision WHA lobbied for that created a pilot program for intensive care coordination services provided to Medicaid beneficiaries by hospitals and health systems.

These care coordination services are designed to better manage patients who are high utilizers of hospital emergency department services, which has proven to provide better care for patients and lower overall costs for the Medicaid program. In a letter supporting the provision from Sen. Alberta Darling, Senate co-chair of the JFC, and Assembly Health Committee Chairman Joe Sanfelippo, the two lawmakers stated the provision would “encourage” and “replicate” successful provider-based intensive care coordination programs. The lawmakers stated “hospital-level interventions not only dramatically reduce utilization, but give patients with the highest needs the knowledge and skill to be informed health care consumers.”

Since learning of the veto, WHA has already been in communication with Walker’s senior staff about the need to continue discussing the role hospitals and health systems can and should have in better managing care for patients who are significant utilizers of hospital emergency departments.

“We also look forward to continuing discussions with Governor Walker, DHS Secretary Seemeyer and the Legislature around innovative strategies and partnerships that will deliver better managed and better coordinated care for the state’s most costly Medicaid patients,” said Borgerding in a statement following the budget bill signing ceremony.

This story originally appeared in the September 22, 2017 edition of WHA Newsletter