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Physician Edition

08-16-2017


August 16, 2017

Volume 5-Issue 15


Market Uncertainty Causing Insurer Exits, Possible Premium Increases in WI

As federal efforts to repeal and replace the ACA stall, and amid discussions about defunding cost sharing reductions (CSRs), this week Molina announced it will no longer offer health plans on the Wisconsin insurance exchange and preliminary premium rate increases show many benefit plans with double digit increases over 2017.

Molina announced August 2 that it planned to exit the exchange market in Wisconsin beginning in 2018.This comes after two other insurers in Wisconsin - Anthem and Health Tradition Health Plan – decided earlier this year to discontinue offering individual market plans in 2018. Molina currently sells exchange plans in 30 counties, and Anthem offers plans in 34 counties. Importantly, however, these two insurers’ offerings overlap in 23 counties in Wisconsin. bsent other carriers stepping in to fill the gap, these departures mean that one county – Menominee – will have no insurer offering coverage in the exchange in 2018, and 10 Wisconsin counties will have only one insurer participating. See the table and heatmaps for a summary of possible changes by county for 2018.

Even with these announcements, however, Wisconsin still has one of the most competitive insurance markets in the country. he fact that residents in most counties will still have a choice between two or more insurers is positive, and far different from many of Wisconsin's neighbors. Iowa for example, is seeing the possibility of no insurers across the state participating in the exchange. Most, if not all, of the 11 remaining insurers in Wisconsin are more local or regional community based plans, many of which originated in the state.

However, there are other signs that the markets are at risk. This week, the Centers for Medicaid and Medicare Services (CMS) released the preliminary rate filings for health plans for 2018. While these are preliminary, the rate filings for Wisconsin insurers participating in the exchange indicate premium increases could range from 0 up to nearly 50 percent, depending on age and geography. Many of the health insurers cited various market dynamics as rationale for the increases including: market uncertainty, risk, defunding the CSRs, lack of enforcement of the individual mandate; and the reinstatement of premium tax. Some also pointed to a modification in the age rating curve published by the federal government last September which results in higher premiums for individuals under the age of 20 beginning with the 2018 benefit year.

Adding to uncertainty is the question over whether the Trump Administration or Congress will continue funding CSRs. About 125,000 people in Wisconsin enrolled in exchange coverage currently qualify for these subsidies. The effect of defunding the cost sharing subsidies, however, does not fall only on these individuals. Rather, because insurers would still be required to pay for the cost sharing subsidies without federal funding, insurers have signaled they will either have to raise premiums or choose to exit the market. Thus, the immediate impact of the federal government withholding funding for CSRs is on the overall stability of the market which could jeopardize coverage for all exchange enrollees. This in turn, has a broader impact on overall coverage expansion in Wisconsin.

In a statement released today, WHA President/CEO Eric Borgerding said WHA agrees with the National Governors Association Health Committee, who urged urged the Administration to ‘fully fund cost sharing reductions (CSRs) for the remainder of calendar year 2017 through 2018. This is a necessary step to stabilize the individual marketplaces in the short term as Congress and the Administration address long-term reform efforts.

According to Borgerding, “One of the primary reasons Wisconsin rejected Obamacare Medicaid expansion and disenrolled some 60,000 from the program was the existence of subsidized coverage on the exchange. That affordable coverage is a fundamental and intentional component of Wisconsin’s unique approach to coverage expansion. As go the cost sharing subsidies, so goes the viability of Wisconsin's exchange and that part and parcel component of the Wisconsin coverage model. Under the Wisconsin Model, our uninsured rate has been cut nearly in half since 2014. We have much at stake in what comes next, and something must come next. Inaction is not an option nor is intentionally allowing failure of insurance markets an acceptable strategy or outcome.

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This was released to the statewide media August 3, 2017.

Job Opportunities Abound in Wisconsin Hospitals, Health Systems

Entry-level positions offer advancement to higher-paying careers

As summer winds down and students find their way back to the classroom to prepare for future employment, the decision on what type of career or job path to choose begins.

Thousands of jobs are posted on the state'sJob Center websiteand on WHA's Job Bulletin, but Ann Zenk, RN BSN MHA, WHA vice president, workforce and clinical practice, encourages students and job seekers to consider a career with a Wisconsin hospital or health system. "Health care is a rewarding field,” said Zenk. “Whether you work in direct patient care or in a support role, health care is a meaningful career for those with a passion for helping others.”

 

 

 

 

 

 

 

 















“Hospitals and health systems have a variety of positions, from entry level that require a high school or limited technical school training, to those that require an advanced degree,” Zenk said. “No matter where you start there is a pathway to a higher-paying, challenging career in our hospitals. Health care occupations are among the fastest growing in the U.S., and positions are available; the door will be open to all who wish to enter the health care field.”

Hospitals and health systems desire and support advancement to in-demand roles, such as nursing assistant, physical therapist, nurse or nurse practitioner. Zenk noted “a hard-working, dedicated person can start in an entry-level position and with educational assistance that is often paid for by their employer, supported by a flexible work schedule, can train for the next level of employment, even advancing to a master’s degree, while continuing to work in progressively better-paying roles.

Recruiting to rural areas can pose unique challenges. That is why WHA is a strong supporter of the Rural Wisconsin Initiative, a legislative package that provides matching grant funding for the training of advanced practice clinicians and allied health professionals in rural Wisconsin hospitals

The Rural Wisconsin Initiative bolsters our state’s health care infrastructure by ensuring we have a workforce in place to care for our residents by creating in-state opportunities for health care professionals to complete their education and training,” WHA President/CEO Eric Borgerding said. “We want to do everything we can to ensure we have the workforce necessary to deliver high-quality, high-value care in all of our communities.

Wisconsin hospitals employ more than 100,000 people, making it one of the state’s largest industries and among the most stable in an economic downturn.

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Pharmacy Interns Now Able to Immunize Kids

A new law, Act 42, signed into law August 2, 2017, allows pharmacy interns who have completed at least two years of pharmacy school to immunize persons over six years of age with the supervision of a licensed pharmacist.   According to Sen. Patrick Teslin, co-author with Rep. Mike Rohrkaste, pharmacy students “will have access to the full gamut of experiential training.”  Previous law prohibited pharmacy students from immunizing anyone under age 18, but allowed pharmacists to administer vaccines to persons older than six. 

“Training consistent with expectations in the workplace is essential to a well prepared and effective health care workforce. This new law provides pharmacists better preparation for practice,” according to Ann Zenk, WHA vice president workforce and clinical practice.

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WHA Offers Fall and Injury Prevention Workshop Oct. 11

WHA is pleased to announce the return of Patricia Quigley, Ph.D. October 11 for a “Re-energizing Fall and Injury Prevention Practices Workshop.” This one-day conference will help participants better understand and apply the state of the science specific to fall and injury prevention, regulatory guidelines and essential programmatic components, shifts in clinical practice for individualized care management as well as population-based approaches. The workshop will also cover patient engagement and autonomy and redesigns post-fall management practices. Conference participants will create action plans that incorporate small tests of change to accelerate patient safety capacity and accountability.

The workshop is open to all Hospital Improvement Innovation Network (HIIN) hospitals, and through the support of the Wisconsin Office of Rural Health, critical access and small rural hospitals that are eligible for Flex grant funding are welcome to attend.

The workshop will be at Glacier Canyon Conference Center, Wisconsin Dells, October 11, 2017.

Registration information is here:  www.cvent.com/d/05qghd

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WCMEW Conference Tackles Care Delivery through Expert Panels

Designing and supporting a health care workforce that meets the needs of Wisconsin patients can be a challenge for hospital administrators, teaching institutions and policymakers. How do systems ensure they hire and retain the appropriate mix of providers? Can implementing team-based care shift the current roles of clinicians and reduce projected workforce shortages? How should tomorrow’s health care professionals be trained to effectively deliver care in an environment that is constantly evolving?

These questions, among others, will be discussed by expert panelists and through small-group breakout sessions at a statewide conference this fall. The Future Landscape of Wisconsin’s Health Care Workforce, hosted by the Wisconsin Council on Medical Education and Workforce (WCMEW), will take place in Wisconsin Dells September 27. The full-day conference aims to deliver on several of the recommendations from WCMEW’s 2016 Report, “A Work in Progress: Building Wisconsin’s Future Physician Workforce.”  The report advocates for statewide discussion of health care workforce challenges, engaging stakeholders from across sectors and disciplines to approach projected shortages collaboratively. “Promoting transformation of care delivery” is a key area of opportunity for Wisconsin to address provider gaps across the state, according to the report.

To deliver on its recommendations from the 2016 Report, WCMEW will bring together expert speakers from a variety of sectors to discuss reforming care delivery and potential workforce effects. They include representatives from training institutions, hospital systems and membership associations. Peter Sanderson, MD, medical director, informatics and ambulatory regulation, Ascension Wisconsin, will lead a breakout session on future workforce models in both planning and implementation contexts. Shishir Sheth, MD, clinical vice president, specialty care, Ascension Medical Group, with co-presenter Eric Elliot, president, Wisconsin Academy of Physician Assistants, will present approaches to leveraging physician assistants to maximize patient care. Matthew Swedlund, MD, clinical assistant professor, UW School of Medicine and Public Health, will also provide conference attendees with concrete models for adapting high-functioning teams in primary care settings, emphasizing the need for reforms in care delivery.

Registration for the full-day conference September 27 is available at www.cvent.com/d/85qxys. Contact George Quinn, WCMEW executive director, at gquinn@wcmew.org or 608-516-5189 with questions. See the full brochure for more information.

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Wisconsin Celebrates Rural Health Day, November 16

Join WI-ORH celebration by planning National Rural Health Day events in your community

Wisconsin’s rural communities are wonderful places to live, work and visit. They are also communities where health care providers deliver top-notch, innovative, affordable and holistic primary care—a model for the rest of the country as America transitions to a population, wellness-based system of health care.

While there is a great deal of innovation going on in rural health care, rural communities face unique challenges: provider shortages, an older population and lack of transportation. National Rural Health Day, November 16, 2017, is an opportunity to recognize the challenges and celebrate our successes.

Join the Wisconsin Office of Rural Health’s (WI-ORH) celebration by planning Rural Health Day events in your community. Download a menu of activities to choose from at http://worh.org/national-rural-health-day and put your own ideas into action.

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Why Contribute to the WI Hospitals PAC/Conduit in a Non-Election Year?

By: Mike Wallace, Chair, WHA Advocacy Committee

While hundreds of individuals contribute every year to the Wisconsin Hospitals State PAC & Conduit fundraising campaign, there may be some who think doing so is not important in a non-election year.

Consider this: As a health care leader, I prepare for the future by making plans now. So, too, do campaign committees who are already laying the groundwork for next year’s elections. This is an ongoing, year-round process, and one where you and I can offer support to Republican and Democrat campaign efforts alike as they prepare for 2018.

It is not unusual to hear about dozens and dozens of campaign fundraisers throughout the year, including annual golf outings which typically occur during the pleasant summer and fall weather. I am frequently invited to participate in these events and do so whenever I can. When I can participate, I contribute using my Wisconsin Hospitals Conduit account. This is why I contribute each year to the Wisconsin Hospitals Conduit. Doing so allows me to control which candidates and campaigns receive my support.

If you’re wondering whether the Wisconsin Hospitals Conduit or the Wisconsin Hospitals State PAC is the best choice for you, either is a great option. As I said, the Wisconsin Hospitals Conduit suits me perfectly, but for those who would prefer to simply contribute and have their dollars used where most needed, I would recommend the Wisconsin Hospitals State PAC. Regardless, either option helps support candidates who value the work you and I do every day. In the end, better candidates lead to better legislators who craft better laws.

If you have not yet contributed in 2017, I would challenge you to do so today. Become a part of this important effort by logging onto www.whconduit.com or by calling WHA’s Jenny Boese at 608-268-1816 or Nora Statsick at 608-239-4535.

WI Hospitals State PAC/Conduit Update: Campaign nears $200,000 mark, next contributor list August 18
The Wisconsin Hospitals State PAC & Conduit topped $197,000 this week, putting the 2017 fundraising effort at 63 percent of its $312,500 goal. Two hundred and eleven individuals have contributed to date an average of $934 each.

While the 2017 campaign is mirroring last year’s record-setting fundraising pace, it will need to pick up the pace over the next few months to achieve this year’s $312,500 goal. You can help. Contribute today. Contributors who give by August 17 will be included in the next contributor list to run in the August 18 edition of The Valued Voice.

Make your contribution at www.whconduit.com or call WHA’s Jenny Boese at 608-268-1816 or Nora Statsick at 608-239-4535.

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Updated Guidance for Zika Testing in Pregnant Women

The Centers for Disease Control (CDC) has recently updated its Zika virus testing recommendations for pregnant women, and the Wisconsin Division of Public Health has adopted these updated recommendations. See the memo outlining the details of this change at www.dhs.wisconsin.gov/dph/memos/communicable-diseases/bcd-2017-03.pdf. Share this memo with all appropriate health care providers, labs and health department staff.

For questions, contact: Rebecca Osborn, 608-261-6388, Rebecca.Osborn@dhs.wisconsin.gov; Christine Muganda, 608-266-6914, Christine.Muganda@dhs.wisconsin.gov; or Ryan Wozniak, 608-267-0249, Ryan.Wozniak@dhs.wisconsin.gov.

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