WHA Continues to Make Progress on 2017 Goals as New Projects, Issues Arise

Board discusses worker’s comp fee schedule, state legislative agenda, health reform

October 20, 2017

When WHA launched their newly redesigned pricing website, WiPricePoint.org October 10, it included changes recommended by the Board earlier in the summer and incorporated feedback from consumers.

“We released PricePoint with some great changes, as suggested by the Board, consumers and our own staff,” WHA President/CEO Eric Borgerding told the WHA Board at their October 23 meeting. “PricePoint has evolved to an increasingly consumer-facing resource that helps them ask the right questions and connects them to the answers, including facilitating communication with their insurance provider.”

Borgerding said PricePoint and WHA’s quality public reporting site, WiCheckPoint.org, have helped keep Wisconsin at the forefront of health care transparency.

WHA has been promoting the recent accolades and rankings. Wisconsin’s health care delivery system and its hospitals have been recognized as the best in the country based on quality by the federal Agency for Health Care Quality (AHRQ) and Wisconsin’s critical access hospitals were the best in their class for quality improvement and public reporting. WHA purchased newspaper ads , radio ads and digital ads to promote the fact that Wisconsin’s health care is the best in the country. Elected officials are also picking up on the message, including Gov. Scott Walker who consistently touts Wisconsin’s high-quality care as an asset.

Borgerding said more than 50 legislators and their staff attended a recent WHA-sponsored briefing at the state capitol. The briefing focused on the value Wisconsin’s high-quality care has for not only the health of the state’s residents, but also to the health of our communities. The work of several WHA members related to care coordination was also showcased at the briefing. Rep. Joe Sanfelippo presented the welcome at that event.

WHA’s 2017 Workforce Report will be released later in October. Borgerding said the report garners a lot of media attention, but more importantly, it serves as WHA’s primary guidebook to its workforce agenda.

“We comment a lot about what we are seeing in the health care workforce in the report, which also serves as our primary agenda-setting tool,” Borgerding said. 

The workforce report from prior years drove the team-based care regulatory reform package. Most recently, WHA has been working on legislation that will update Medicaid regulations related to co-signatures required for orders made by other providers. The workforce report was also used to document the importance of passing the enhanced Nurse Licensure Compact and supporting the Rural Wisconsin Initiative that can be used to fund clinical training for advanced practice clinicians and allied health professionals.

Borgerding said WHA staff, with help from members, are making excellent progress in meeting the 2017 goals. As is the case with nearly every other year, some of the goals will carry over into 2018 because of how the legislative session is scheduled, but also because many are perennial issues.

Another issue that is new to the goals document but not novel to WHA members is working on issues related to dental access for people with special needs. Behavioral health issues are also evolving, and that workgroup will begin meeting again soon.

Immediately following the President’s report, WHA COO Brian Potter presented the WHA 2018 budget, which the Board approved, with no dues increase.

Borgerding announced that Debbie Rickelman, former vice president of the WHA Information Center, passed away October 12. She is greatly missed by staff and members alike. A memorium to Debbie can be found below.

Borgerding said Kelly Court, WHA chief quality officer, is retiring soon (see story), and he introduced her successor, Beth Dibbert, to the Board. 

WHA joins coalition to oppose medical fee schedule in worker’s comp program
The push to enact government price controls for medical care delivered to injured workers is facing strong opposition from a coalition armed with the facts. And the facts do not support the allegations that are being used to support the latest effort to reduce provider rates in the worker’s compensation program, according to WHA Senior Vice President Kyle O’Brien.

O’Brien said a coalition comprised of WHA, along with the Wisconsin Chiropractic Association, Wisconsin Medical Society and the Wisconsin Physical Therapy Association, have joined publicly to highlight the fact that effective October 1, Wisconsin employers experienced a significant reduction in worker’s compensation premiums for the following year, all without implementing a government fee schedule for health care services.

“Worker’s comp is an asset in Wisconsin for job creation, not a liability,” according to O’Brien. “Workers injured on the job in Wisconsin receive some of the highest quality care in the nation. Because of that, they use fewer medical services, are more satisfied with their care, initiate fewer litigated claims and return to work faster than every other state in the nation. Wisconsin’s health care providers are delivering value to our work comp program.”

The State Budget and Fall Session
In his report, O’Brien said Gov. Scott Walker signed into law Wisconsin’s 2017-19 biennial state budget September 21, 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.

Wisconsin’s Medicaid DSH program was increased by over $60 million, taking Wisconsin’s total Medicaid DSH program up to $134 million over the two-year budget. In addition, the Joint Finance Committee (JFC) recognized rural hospitals who do not qualify for DSH because of a federal law criteria that 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.

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 the 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. 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.

WHA activities supporting members’ integrated physician enterprise
The Board discussed and approved an assessment of how WHA can best support its members’ integrated physician and clinic enterprise now and in the future. The assessment was a culmination of work by the WHA Physician Leaders Council and the Board at its July planning session.

“As WHA’s members’ focus has evolved beyond the traditional ‘walls’ of the hospital to a presence as local and regional integrated health systems, WHA’s focus has similarly evolved,” said WHA Chief Medical Officer Chuck Shabino, MD. “This assessment does not represent a new space for WHA, but the assessment brings WHA’s integrated physician and clinic-focused efforts and initiatives into a single summary and guiding document.”

Mark Thompson, MD, chief medical officer, physician integration, SSM Health–Wisconsin Region and at-large physician leader WHA Board member, praised the assessment. “We need leaders, physicians and CEOs to work to support our physicians,” said Thompson.  “The right people are in this room to support that work.”

Federal Update: Repeal and Replace
Joanne Alig, WHA senior vice president, policy and research, reviewed the latest developments on federal efforts around health care reform. Alig emphasized WHA’s top priorities continue to be sustaining coverage and market stabilization. Alig said WHA supported the provisions in the Graham/Cassidy/Heller/Johnson bill in late September that recognized Wisconsin’s partial expansion, and by various estimates would have provided added funding to Wisconsin for health care. She noted, though, some concerns about the bill, including sustainability of Medicaid funding and overall HHS authority versus state flexibility. 

Alig also provided an overview of the Murray-Alexander efforts this week, which would fund the cost sharing reduction subsidies for another two years, among other provisions to help stabilize the market in the short term. She noted the exchange open enrollment period starts November 1 and ends December 15 for benefits for the 2018 calendar year. As reported in The Valued Voice last week (see story), premiums overall are higher, in part to make up for the anticipated loss of the CSRs, and there are fewer insurers in the exchanges in 2018. Alig also noted some challenges with enrollment this year, including a shorter enrollment period, system outages for maintenance and lack of federal outreach. As some in Congress are seeking stability through legislative proposals, Alig said WHA encourages the Walker administration and the state Legislature to seek ways to improve and stabilize the markets at the state level as necessary. 

WHA State PAC & Conduit Report
WHA Advocacy Committee Chair Mike Wallace, president/CEO, Fort HealthCare, informed the Board that during the first three quarters of the year, fundraising for the Wisconsin Hospitals State PAC & Conduit is at 83 percent of its 2017 goal of raising $312,500. The campaign hit the $258,000 mark this week with contributions from 270 individuals. (See full article..)

This story originally appeared in the October 20, 2017 edition of WHA Newsletter