February 21, 2018
Volume 6-Issue 4
Governor Discusses Premium Stabilization Plan, State Waivers with WHA Board
Borgerding Shares 2018 WHA Goals; ”WHA goes where its members are”
Gov. Scott Walker makes no apologies – he brags about Wisconsin’s health care.
“In the State of the State address, we listed off the great things about Wisconsin…and we pointed out that we are literally the best state in the nation for the quality of our health care system,” Walker told the WHA Board at its February 8 meeting in Madison. “We brag about Wisconsin health care and talk about not just how it attracts economic development, but how it attracts talent and adds to the overall quality of life.”
Walker acknowledged the health care systems in the state for providing good health care, but he also recognized hospitals are an asset to the community and another reason people want to live in Wisconsin.
In a statement released following the WHA Board meeting, Walker praised the work of the state’s health care leaders and WHA in helping Wisconsin achieve and sustain its high-quality health care. “Wisconsin is a national leader in health care quality in large part because of the work of the Wisconsin Hospital Association,” Walker said in the statement.
The Governor also wants to make sure that all residents have access to affordable care by holding the line on premium increases. Walker described his proposal, which relies on a waiver process contained in the ACA, to create a reinsurance program that would help stabilize the individual market. He said about 220,000 people purchase insurance in the marketplace, which this year saw a 36 percent increase in premiums and is now down to 11 plans participating across the state.
“If you look at premiums in the group insurance market, those are increasing at around five percent,” Walker said. “I asked the Office of the Commissioner of Insurance to craft an approach to make the premium increases for individual coverage align closer with increases in the group plans.”
The Governor’s reinsurance program is estimated to cost $200 million annually, with roughly three-fourths derived from redirected Obamacare dollars already coming to Wisconsin. The rest would come from the state, generated for 2019 by savings from the suspension of the ACA’s health insurance tax. Walker believes if the program is successful, it can keep premium increases low and attract new insurers or bring those back who have left the market.
“With Congress looking increasingly unable to repeal and replace the ACA, standing by and watching it fail is not an acceptable Plan B,” said WHA President/CEO Eric Borgerding. “For some time we have advocated that the state take matters into its own hands, craft our own solutions. We commend the Governor for using the tools available under the ACA, which is still the law, to put forward a plan aimed at stabilizing premiums, increasing competition in the insurance market and sustaining coverage gains. WHA supports this proposal and will work to see it become law.”
Well before Obamacare, Wisconsin took steps to address affordability of insurance by minimizing the impact of high-cost claims, Walker noted in a reference to the state’s defunct Health Insurance Risk Sharing Program (HIRSP). While Walker’s 1332 waiver is a different approach, and avoids assessments on insurance companies or fee schedules on providers for its funding as under HIRSP, the risk mitigating concept is not new to Wisconsin.
Getting more people into the workforce has been a priority for Walker. He cited the investments that have been included in the state budget to increase training opportunities, across all occupations. He thanked hospitals and health systems for supporting the SEARCH program, which provides training and jobs to people with disabilities.
The Governor also discussed how he is using another type of waiver (a “1115 waiver”) to implement eligibility and cost-sharing changes to the Medicaid program. The waivers can be complimentary in an overall strategy aimed at moving more people into the workforce and self-sufficiency, according to the Governor.
“We think inherently most people want to work, and we are willing to try some new things to help them transition over to work, to keep them out of your ERs and reduce uncompensated care,” the Governor said. “I recognize the concerns. The goal is still to help those who are able to get into the workforce—employer-based insurance coverage or access to a better individual market—that is our game plan on workforce.”
Some of the proposals in the 1115 waiver have drawn concern from WHA, which has twice submitted comments to CMS seeking changes to the proposal.
“We understand and support the goal of promoting self-reliance. We ascribe to the notion that the best Medicaid reform is a good job with good benefits, but we also know that this is a very challenged and at-risk population,” Borgerding said. “When implementing premiums and co-pays, those challenges become most evident. The concern is both affordability for this very low-income population and how these types of cost-sharing strategies will be implemented. Hospitals must continue serving everyone who comes through their doors, even if they are disenrolled from Medicaid for not paying a premium to the state or cannot make a copayment.”
Among other things, in its comments to CMS and lawmakers, WHA has consistently advocated for copayments for Medicaid be made payable to and collected by the state rather than hospitals.
“(WHA) have been good partners. When you raised concerns about Medicaid expansion we partnered to make our approach work, and I think you would agree that it’s been a success,” the Governor said. “We want the same thing with this proposal. We want to be innovative. Washington is hungry for states that want to be innovative as long as we can deliver tangible results, they might work with us.”
On behalf of the Board and WHA’s members, Borgerding thanked the Governor for his ongoing commitment to health care access in Wisconsin, noting the $2.7 billion in new state funding that has been injected into Medicaid, creation of the Disproportionate Share Hospital Program and the millions of dollars in new state funding for medical education programs since the Governor took office.
Borgerding Presents WHA 2018 Strategic Goals and Initiatives
WHA President/CEO Eric Borgerding presented WHA’s 2018 goals. He highlighted several key advocacy items, including Medicaid, which remains a top priority. Borgerding said WHA will reconvene the Medicaid Work Group this summer, noting that this group helps set WHA’s Medicaid agenda for the next state budget. He indicated WHA again will set several reimbursement priorities that are not confined to within the walls of the hospital and that support the continuum of care.
“We are not only looking forward, but we are realigning, evolving and growing to craft and deliver an agenda that reaches far beyond the hospital walls,” Borgerding told Board members. “As one of our member leaders recently said, ‘WHA goes to where its members are.’ That was a great compliment to our team.”
Workforce will continue to be a major area of focus in 2018 on major issues related to licensure, payment, and regulation, including advanced practice clinicians and physicians. Borgerding said WHA is planning a conference for members to understand the laws and regulations that enable the better use of APCs and advanced practice registered nurses (APRNs) in health care settings, a move he said is a “good example of not only passing but implementing legislation.”
The Behavioral Health Task Force will also be reconvened in 2018 to set a broader long-term agenda. Integrated physician and clinic engagement continues to be an important space to WHA, as physician practices evolve.
“Our physician agenda is evolving in an advocacy perspective,” Borgerding said. “We want to start working to address regulatory burdens at the state and federal level that limit physicians from also practicing at the top of their license.”
The work of the Post-Acute Care group and Special Needs Dental Work Groups will both continue in 2018. Borgerding said both efforts are great examples of how WHA is “going where its members are.”
Borgerding referenced the challenge in the Supreme Court to the non-economic damage caps in the Goals. Oral arguments are April 19. WHA filed an amicus brief with the Court of Appeals and the Wisconsin Supreme Court. This is the first serious legal challenge to the current caps, and WHA is monitoring the case very closely. If the caps are struck down this year, a legislative fix would not be possible until the Legislature convenes in 2019.
The goals are aggressive and targeted, but keenly focused on advocating for WHA members to enable high-quality, high-value care for employers and the people who live in our state.
“Our agenda, our work in Madison and in Washington, our focus on quality health care, is driven by, informed by our members,” Borgerding said. “What we focus on must be meaningful, must move the needle. We have to go where our members are. That’s what keeps WHA highly relevant and what delivers value for our members across the state.”
Dan Boston: What to Expect from Washington D.C.
On the heels of the Senate announcing they had reached a budget deal, Dan Boston, president, Health Policy Source, Inc. and WHA’s lobbyist in the nation’s Capitol, discussed what Wisconsin health care leaders could expect from Washington, D.C. in 2018. The deal that was reached in the Senate, according to Boston, included several important health care provisions, including funding for CHIP, FQHCs and other key WHA priorities like the Medicare Dependent Hospital program and the Low Volume Adjustment. What remains unaddressed is restoration of cuts to the 340B drug program. Several pieces of legislation, both good and bad, are still pending as AHA continues pursuing a legal strategy to the block cuts.
Boston also said it’s uncertain whether the ACA is imploding or just slowly fizzling out, but despite the CSRs remaining unfunded, a shortened enrollment period and the individual mandate being repealed in 2019, sign ups remained nearly identical to last year. While a full repeal of the ACA remains unlikely, he said Congress could potentially revise the rules for essential benefits, enrollment periods, and age bands, while increasing the use of 1332 waivers. He indicated House Republicans are not expected to make another attempt to repeal/replace Obamacare before the 2018 election cycle.
Boston, who has been named by The Hill as one of D.C.’s top lobbyists for 14 of the last 15 years, has worked with WHA for over two years. Via teleconference from Washington, DC, he was making his first appearance at a WHA Board meeting.
“Dan and his team at HPS are a tremendous WHA partner asset for us and our members,” Borgerding told the Board. “They will be an increasingly important part of our D.C. strategy going forward.”
State advocacy update: ACA enrollment, 1332 waiver, workers comp and legislative issues
WHA’s Joanne Alig updated the Board on the status of Wisconsin’s 1332 waiver and provided the current state of the insurance exchange.
Enrollment on the insurance exchange in Wisconsin was down about seven percent, less than was anticipated, according to Alig. Nationally, enrollment was down about five percent.
While Wisconsin has more insurers participating in the exchange than other states, Alig noted there are several counties that now have only one insurer, and overall Wisconsin has fewer insurers participating across the state compared to 2017. Alig also noted the average premium increase for the individual market in 2018 was 36 percent.
“It’s not a crisis yet, but we are moving toward more market instability,” Alig said. “The individual mandate is effectively gone in 2019. Estimates are that premiums would go up about 10 percent, according to the CBO.”
Alig said states are using the 1332 waiver to stabilize the market. The state Legislature would need to pass legislation to enact the provisions in the waivers.
When the Governor introduced his reinsurance plan, WHA released a statement that supported the state in its decision to “strike its own path and take steps to stabilize the market, using the tools available to all states under the ACA.”
Alig summarized the reinsurance proposal, which if approved at the state and federal levels would be in place for benefit year 2019. Alig also noted that the Insurance Commissioner’s office is analyzing other options for stabilizing the markets for benefit year 2020 and beyond and will be working on these options through the coming calendar year.
WHA will continue to be actively engaged with OCI as it reaches out to stakeholders for feedback and comment on the 1332 waiver proposals.
WHA Senior Vice President Kyle O’Brien briefed Board members on the status of a proposed bill that will add a fee schedule for medical care provided to injured workers through the state’s worker’s compensation program. WHA, along with the Association’s members and coalition partners, have been lobbying against the change for months and have met with lawmakers across the state, asking them to oppose the proposal. O’Brien reported that the Senate Labor Committee chairman has stated this bill will not move out of his Committee if it includes a medical fee schedule and no lawmaker in the Assembly is even interested in formally introducing the bill in that house.
O’Brien said WHA has been working with Rep. Joe Sanfelippo, Sen. Alberta Darling and Rep. Jessie Rodriguez on legislation that would provide $1.5 million annually to reimburse hospitals and health systems for care coordination programs. He said floor action in both houses is expected as early as February 15 on this legislation, designed to better manage care for Medicaid enrollees who frequent hospital emergency departments. In 2016, over 10,000 Medicaid enrollees presented to a hospital emergency department seven or more times. The bills have been introduced as Assembly Bill 871 and Senate Bill 742.
Work continues on emergency detention reform legislation that would align Wisconsin’s emergency detention statutes with the obligations that currently exist for hospitals and health care providers under federal law. In addition, this legislation provides necessary clarification and liability protection to health care providers when they feel an obligation to warn about someone they believe is a harm to themselves or others. Assembly Bill 538 passed out of the state Assembly unanimously in November 2017 and was unanimously approved by the Senate Health Committee February 7, 2018. WHA expects this bill to be available for scheduling on the Senate floor as soon as February 20.
O’Brien also reported to the Board on several bills that WHA publicly opposed, including legislation mandating the use of cameras in hospital operating rooms and legislation that would prohibit hospitals from using specialty/board certification as a condition for receiving medical staff privileges. O’Brien said he expects neither bill will move forward this legislative session.
Top of page (2/9/18)
Budget Committee Passes Gov. Walker’s Reinsurance Legislation
WHA lobbies Budget Committee to remove $80 million Medicaid lapse in bill
A core component of Gov. Scott Walker’s health care stability plan moved forward February 12 by passing out of the state Legislature’s Budget Committee on a 13-3 vote, garnering support from all Republicans on the Committee as well as Democratic Rep.Katrina Shankland (D-Stevens Point). The bill, known as Senate bill 770 and Assembly bill 885, was introduced at the request of Gov. Scott Walker and uses the federal 1332 State Innovation Waiver authority to establish a $200 million reinsurance program for health insurance sold on the individual market in Wisconsin.
Wisconsin Hospital Association President/CEO Eric Borgerding provided written testimony to the Committee, stating “it is clear that we cannot rely on solutions or answers from the nation’s capital and should take action at the state level to mitigate premium increases and ensure choice and affordability for the individual market. This is why we support
AB 885 and SB 770, and the steps they set in motion to sustain coverage expansion through a reinsurance program.”
Wisconsin’s Deputy Insurance Commissioner, JP Wieske, in written comments to the Joint Finance Committee (JFC), stated insurance rates will be 13 percent lower with the reinsurance program in place than they would otherwise be without the reinsurance program. Similarly, in 2020, rates would be 12 percent lower than they would be if the reinsurance program were not established. Borgerding and Wieske both cited significant rate and premium increases from 2017 to 2018, resulting in average premium increases of 38 percent in the current plan year and insurers exiting the marketplace.
The Governor’s reinsurance program is funded through federal and state resources, with about 75 percent of this funding coming from federal savings resulting from lower premium increases, resulting in subsidy savings to the federal treasury that can be used to fund the reinsurance program. The original bill provided between $50 and $80 million in state funding through a mandatory lapse from the Medicaid program.
WHA successfully lobbied the JFC to remove this mandatory Medicaid lapse from the proposed bill. The non-partisan Legislative Fiscal Bureau stated the Department of Health Services had few ways to achieve these proposed savings necessitated by a mandatory lapse, but could resort to provider reimbursement cuts to find additional revenue to meet the lapse requirements.
“WHA appreciates the budget committee’s concern with the impact of a mandatory lapse in our state’s Medicaid program and their action to remove this provision from the bill,” said Borgerding following committee action on the legislation.
Top of page (2/16/18)
Make plans now to make an impact in Madison on March 21. Join WHA for Advocacy Day 2018, one of the best ways hospital employees, trustees and volunteers can make an important, visible impact in the state capitol.
Register yourself and your team today.
As always, Advocacy Day 2018 will have a great line-up of speakers, including morning keynote Mara Liasson, national political correspondent for NPR. In addition, Gov. Scott Walker has been invited to offer the luncheon address. The day will also include a legislative panel and an issues briefing for those planning to talk with their state legislators.
The afternoon of Advocacy Day is always a highlight as hundreds of attendees take what they’ve learned and meet with their legislators in the state capitol. Speaking up on behalf of your hospital by meeting with your legislators during Advocacy Day is essential to help educate legislators on your hospital and health care issues.
Make plans now to join over 1,000 of your peers from across the state at Advocacy Day 2018 March 21. More information and online registration are available at www.whareg4.org/2018AdvocacyDay.
For Advocacy Day registration questions, contact Kayla Chatterton at firstname.lastname@example.org or 608-274-1820.
Top of page (2/16/18)
This week’s President’s Column is a reprint of WHA President/CEO Eric Borgerding’s February 12 testimony supporting legislation creating a reinsurance program aimed at stabilizing individual insurance rates in Wisconsin. For more information about this legislation, including adoption of WHA-advocated amendments, see story above.
Testimony in Support of AB 885 and SB 770
Joint Committee on Finance
February 12, 2018
Good Afternoon Chairpersons Darling and Nygren and members of the Joint Committee on Finance. Thank you for holding this hearing and the opportunity to testify. My name is Eric Borgerding, and I am pleased to comment on behalf of the Wisconsin Hospital Association in support of AB 885 and SB 770, a reinsurance proposal intended to help stabilize the individual health insurance market in Wisconsin and sustain the substantial coverage gains we have achieved over the past four years.
As you know, Wisconsin’s hospitals and health systems are on the front lines of providing high-quality care every day, from our large urban communities to small rural areas so vital to our state, and everywhere in between. In 2013, as the nation was gearing up for the implementation of the health insurance exchange and the significant changes to the health care markets as a result of the Affordable Care Act (ACA), Wisconsin’s hospitals and health systems stepped up as well. We worked with the Insurance Commissioner’s Office, the Department of Health Services, Governor Walker and with many of you to help our Wisconsin residents sign up for health care coverage through either the insurance exchange or Wisconsin’s version of Medicaid expansion.
Regardless of ideology, Wisconsinites are united in the belief that everyone should have access to high-quality, affordable health care coverage. Indeed, Wisconsin’s uninsured rate has been cut by 42 percent since then—a laudable achievement for which we should all be proud.
Now, nearly five years later, we are seeing troubling signs in the individual market, including premiums increasing on average 36 percent from 2017 to 2018. We are seeing insurers exiting the market, and for the first time since the insurance exchange went live, enrollment has dropped. WHA not only watched, but vigorously engaged with our federal elected officials over the past year as debate about the repeal and replacement of the ACA ebbed and flowed in Washington, D.C. Along with a large and diverse coalition of Wisconsin business and health care organizations, WHA weighed-in as the individual market became more unstable, and we were disappointed and frustrated when nothing was done to address states’ concerns.
Like five years ago, we still believe everyone should have access to high-quality, affordable health care coverage. To make this an ongoing reality, it is clear that we cannot rely on solutions or answers from the nation’s capital and should take action at the state level to mitigate premium increases and ensure choice and affordability for the individual market. This is why we support AB 885 and SB 770, and the steps they set in motion to sustain coverage expansion through a reinsurance program.
Frankly, when it comes to the proposal before you, it should not matter what one’s disposition is toward the ACA. I say this for two reasons:
First, for most opponents of the ACA, even its repeal is not a stand-alone proposition. The idea of repealing Obamacare is almost always, and should be, followed by the desire, if not the imperative, to replace Obamacare. The inability to legislatively accomplish either should not leave Wisconsin powerless and inactive, nor should we stand by and watch the administrative, piecemeal deconstruction of Obamacare leave us with fewer insured or the erosion of the gains we have achieved in coverage. If Washington cannot act, then let us use the tools given to states in the ACA to do better. One can be both an opponent of Obamacare and a pragmatist on health care policy, and that is exactly the approach AB 885 and SB 770 take.
In the case of AB 885 and SB 770, we commend Gov. Walker, and stand with Obamacare’s opponents and supporters alike who are committed to working together to sustain the coverage gains we have achieved in Wisconsin.
Second, Wisconsin has already supported and successfully implemented the strategy of using public policy to address high-risk, high-cost claims in the private individual insurance market. The Health Insurance Risk Sharing Program, or HIRSP, used public policy to address high-risk/high-cost insurance well before Obamacare and 1332 waivers existed. While the reinsurance mechanism envisioned in this legislation is different than the insurance plan set up and maintained under HIRSP, the purpose and concepts are very similar. One major difference between this these bills and HIRSP is that a reinsurance program, via a 1332 waiver, would tap into federal dollars that Wisconsin is currently accessing, and entitled to access, under Obamacare. Securing Wisconsin’s fair share of federal dollars under the ACA has long been a priority for WHA that we, joined by the co-chairs of this Committee, strongly advocated for during the repeal and replace debate. We would like to see Wisconsin go even further, and secure full federal matching funding for the Medicaid expansion we so clearly did achieve—but that is a discussion for a different day.
Our only concern with this legislation is its reliance on an up to $80 million lapse from Medicaid in this biennium. According to the Legislative Fiscal Bureau, “… since no reinsurance payments would be made in 2018-19 biennium, a lapse from MA would not be necessary in the 2017-19 biennium solely for the purpose of funding the reinsurance program.” We agree, and given the current projected general fund balance, we believe a lapse from this source and of this magnitude is unnecessary.
Over the past several years this Committee has shown its commitment to the Medicaid program through its ongoing support for sustainable funding. We applaud those efforts and encourage you to ensure other sources of ongoing funding for the reinsurance program without tapping into scarce Medicaid resources.
With Congress looking increasingly unable to replace or repair the ACA, standing by and watching insurance markets fail is not a sound strategy. For some time we have advocated that the state take matters into its own hands, craft our own solutions. We support using the tools available under the ACA to put forward a plan aimed at stabilizing premiums, increasing competition in the insurance market and sustaining coverage gains for the foreseeable future or until the ACA is actually repaired or replaced.
Therefore, we respectfully ask you to take this step for Wisconsin and support AB 885 and SB 770.
Top of page (2/16/18)
Health Care Providers Express Opposition to Worker’s Compensation Fee Schedule
During a hearing that lasted nearly six hours February 14, the health care community stood united in opposition to government-set price controls imposed unilaterally on hospitals, physicians, physical therapists, chiropractors and other practitioners who provide care to injured workers. The Senate Committee on Labor and Regulatory Reform held a public hearing on Senate bill 665, the biennial worker’s compensation bill sent to the Legislature by the labor and management members of the Worker’s Compensation Advisory Council.
Among other provisions, the bill would require the Department of Workforce Development (DWD) to come up with and impose a fee schedule that approximates the prices paid by group health insurers. Sen. Steve Nass, chairperson of the Committee, at times expressed frustration with the process, noting there are some other good policies in the bill, including the bill’s provisions regarding the use of opioids. “The opioid is a classic example, but there are other things in the bill. But because the rates came over, the whole bill may very well die along with everything else that’s good,” he said.
Health care providers described many of the positive outcomes in the worker’s compensation system, including that workers get back to work three weeks faster on average compared to other states; that overall costs per claim are lower compared to other states; that workers are very satisfied with their care; and importantly, that premiums in the worker’s compensation program have gone down the last two years in a row, and DWD has estimated savings of $170 million to the program.
Despite the negative rhetoric about health care providers from supporters of government price setting, health care practitioners and provider representatives from across the state also shared their experiences and the work being done by health care providers in helping to prevent and treat injured workers. Sen. Van Wanggaard, vice-chairperson of the Committee, shared his own experiences as an injured worker, and praised the terrific health care he received.
Health care providers encouraged the legislators to protect Wisconsin’s excellent worker’s compensation system by rejecting government price controls and, instead, reduce costs by making the program more efficient and less administratively burdensome.
Joanne Alig, policy advisor for WHA, referred to a new report completed by the Benefit Services Group (BSG) and HC Trends (see full story below). Alig described some of the key differences between group health and worker’s compensation, including that worker’s compensation insurers are exempt from health care requirements such as HIPAA and ICD-10, which only adds to the administrative burden for health care providers. Alig noted that a fee schedule does nothing to reduce the underlying costs of the program.
“If the goal is to reduce costs in the system above the $170 million in savings already achieved, fee schedule proponents should work to remove the underlying costs to the system,” she said.
Echoing that sentiment, Connie Kinsella emphasized that “fee schedules are not reform.” Kinsella retired as vice president of revenue cycle for UW Health four years ago after having spent her career working on reducing health care costs. Kinsella described in some detail what she called the most “archaic, costly and cumbersome practices of any third party in health care.” She said worker’s comp carriers can negotiate on policies such as prompt payment, and they can bring to the table ways to improve administrative efficiency. “Fee schedules turn a blind eye to quality and efficiency,” she added.
Also testifying were representatives from Ascension Wisconsin, Aurora Health Care, Gundersen Health System, Marshfield Clinic Health System and Prevea Health. Each of these experts provided excellent examples of the work they do every day and their frustrations with the administrative hassles involved in the system.
In the end, the legislators on the Committee expressed surprise at the level of paperwork still involved in worker’s compensation claims processing.
“You have got to be kidding me—that is just amazing…stone tablets,” said Wanggaard.
Legislators also continued to articulate their frustration with the process
“We quite frankly will be, if we do which is doubtful of course, voting to move something forward that we, quite frankly don’t know the impact of the formula, and that can be dangerous,” said Nass.
Top of page (2/16/18)
Senate Health Committee Approves WHA-Led Medicaid, Mental Health Priorities
Bills would fund provider care coordination and reform emergency detention processes to align with EMTALA
In one of their last actions of the legislative session, the Senate Health and Human Services Committee met February 6 to take up a variety of appointments and legislation, including two bills that are key WHA priorities.
The Committee heard Senate Bill 742, legislation that would authorize a grant program to reimburse hospitals and health systems for services provided to high utilizers of Wisconsin emergency departments. The goal of this legislation is to incentivize the creation of provider-based care coordination programs in hospitals throughout Wisconsin and expand programs that exist today. The Committee received testimony from Ascension-Wisconsin’s Cheryl Taylor and Aurora’s Jane Pirsig-Anderson, both of whom work with their respective organization’s intensive care management programs.
As mentioned in testimony by the lead authors of this legislation, Sen. Alberta Darling (R-River Hills), Rep. Jessie Rodriguez (R-Oak Creek) and Rep. Joe Sanfelippo (R-New Berlin), the Ascension and Aurora programs have shown strong results and promise in the idea of provider-based care coordination.
“We need to meet these patients where they are, not where we think they should be,” said Taylor. “We help patients navigate the system by helping the doctor understand what the patient is saying and help the patient understand what the doctor is saying.”
Pirsig-Anderson said the legislation will “bridge a care coordination gap for Medicaid patients who have not responded to traditional case management” and said Aurora’s program has already demonstrated a significant reduction in high-utilizers presenting at the emergency department, with a 39 percent reduction at Aurora Sinai and a 68 percent decrease in utilization at Aurora St. Luke’s.
Senate Bill 742 was approved by the Senate Health and Human Services Committee unanimously February 8. The bill’s Assembly counterpart, Assembly Bill 871, was approved unanimously by the Assembly Health Committee February 1. Both bills are expected to be ready for floor action in the Senate and Assembly yet this month.
In addition, the Senate Committee heard Assembly Bill 538 which would align Wisconsin’s emergency detention statutes with the obligations that currently exist for hospitals and health care providers under federal law. In addition, this legislation provides necessary clarification and liability protection to health care providers when they feel an obligation to warn about someone they believe is a harm to themselves or others.
This legislation was a key recommendation of WHA’s Behavioral Health Task Force. The bipartisan bill, which was approved unanimously by the full Assembly in November, was also unanimously supported by the Senate Health and Human Services Committee February 8. WHA expects the legislation to be ready for a Senate floor calendar February 20.
Top of page (2/9/18)
Ellinger, Hofer Join WHA Government Relations Team
WHA is adding two new members to its government relations team. Lisa Ellinger will serve as the new vice president, public policy and Kari Hofer will be WHA’s new vice president, advocacy.
“The deep knowledge and experience Lisa and Kari bring to WHA will have an immediate impact on our robust policy and advocacy program,” said WHA President/CEO Eric Borgerding. “We are very pleased to welcome these highly regarded professionals to the talented WHA team. Along with their new colleagues and WHA’s members, they will help craft, grow and deliver a WHA agenda that enables Wisconsin’s hospitals and health systems to continue delivering some of the best quality of care in the country.”
Ellinger joins WHA from the Wisconsin Department of Employee Trust Funds (DETF) where she has served as director of the Office of Strategic Health Policy since 2011, responsible for policy development and implementation of the health, life, disability, and long-term care insurance programs for state and local government employees across the state of Wisconsin. Prior to joining DETF in 2008, Ellinger served as the assistant director of the Wisconsin Health Project and worked as a policy advisor for the Milwaukee-based New Hope Project. Ellinger also served on Governor Jim Doyle’s staff as the Health and Human Services Policy Advisor and worked in the state Legislature as a legislative research assistant in both the state Senate and state Assembly. Ellinger has a B.S. in journalism and political science from UW-Madison and a master’s degree from the UW-Madison LaFollette School of Public Affairs.
“I am excited to be joining a leading, mission-driven organization focused on providing quality health care across Wisconsin,” Ellinger said. “WHA’s policy and advocacy work helps drive the health care agenda in Wisconsin, and I look forward to being a part of this great team.”
Hofer comes to WHA from the Wisconsin Manufacturers & Commerce (WMC) where she has led the WMC Foundation as executive director since November 2016, responsible for all fundraising efforts needed to implement the WMC Foundation’s programs and annual events, including corporate sponsorships and corporate and private foundation grants. Hofer also has an extensive background in political fundraising, including serving as the Wisconsin finance director for U.S. Senator Ron Johnson’s successful 2016 re-election campaign, the deputy finance director for the Linda Lingle U.S. Senate Committee, finance director for the Republican Party of Wisconsin and the Hawaii Republican Party. Hofer graduated from UW-Madison with a B.A. in communication arts and political science, earned her MBA from the University of Wisconsin in 2015 and is a member of the Association of Fundraising Professionals – Madison Chapter.
“I am thrilled to be taking on this new role and joining the WHA team. WHA has a strong, engaged advocacy network that empowers the success of their policy initiatives,” Hofer said. “I look forward to continuing this approach and giving voice to the Wisconsin hospitals and communities these issues impact most.”
Both Ellinger and Hofer will join the WHA team this month.
Top of page (2/16/18)
Conflict Resolution and Principles of High Reliability Focus of 2018 Physician Leader Conference
On March 9-10, WHA will host its annual Physician Leadership Development Conference at The American Club in Kohler. This year’s Friday agenda will focus on strategies for physician leaders to resolve conflict utilizing effective feedback and the skills needed to make conflict productive. In addition, the Saturday morning session will focus on the physician leader’s role in shaping performance culture, discussing the principles of high reliability, and demonstrating various skills physician leaders can use to shape culture.
Sessions will be presented by Allison Linney and Craig Clapper, both nationally-recognized faculty from the American Association for Physician Leadership (AAPL), and both will discuss important and practical leadership skills that help physician leaders to move beyond their clinical training and take a new approach to managerial decision-making and problem solving.
Over the past 12 years, WHA has hosted nearly 1,800 physician leaders at the annual WHA Physician Leadership Development Conference, in an effort to assist members in providing the necessary education to new physician leaders and those identified as having leadership potential. Make sure your new physician leaders have the opportunity to attend by registering them today at www.cvent.com/d/ktql9j.
For questions about the annual Physician Leadership Development Conference, contact Jennifer Frank at email@example.com or 608-274-1820.