Health Reform – What it Means for WI

WHPRMS

March 18, 2013Steve Brenton

Wisconsin Hospital Association

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“There are known knowns; things we know that we know.

There are known unknowns; things that, we now know we don't know.

But there are also unknown unknowns; things we do not know, we don't know.

Donald Rumsfeld

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Quality/Value Agenda

WI State Budget

•Medicaid

Physician Workforce

“No Fireworks This Year”Gov. Scott

Walker

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Medicaid

WHA - 133% FPL above 133% -

Exchange

Walker - 100% FPL above 100% -

Exchange

100 – 133% - 100,000 5

WHA Position

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2/1/13 – WHA publicly announces position:"Above all, our hospital and health system members are looking for stability, especially when it comes to covering our most vulnerable populations, and we believe WHA’s position is a measured approach that makes good fiscal and policy sense. There will be much debate on this issue with valid opinions on both sides, but at the end of the day, in this time of uncertainty, we cannot have fewer people with coverage and more uncompensated care."

• Strategy shifts away from Governor to Legislature and influential interest groups

“Hospitals back Medicaid expansion” – WI Health News

“WI Hospital Association endorses Medicaid expansion” – Milwaukee Journal Sentinel

“WHA urges Walker to OK Medicaid expansion” – Milwaukee Business Journal

“A broad coalition backs expansion, includes … Wisconsin Hospital Association” – San Francisco Chronicle

“Walker should expand Medicaid” – LaCrosse Tribune editorial (quotes WHA)

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Physician Workforce Agenda

• Governor’s Announcement & Package Details“Improving Rural Access to Health Care”

• Medical College of Wisconsin– Family Medicine Residencies - $1.75 million to expand the MCW family residency

program by 12 slots– Provide $7.4 million in bonding for new MCW campuses in Green Bay & Wausau

• UW School of Medicine and Public Health– Provide $3 million to expand the WARM & TRIUMPH programs for needs-based

scholarships

• Hospitals– Provide $4 million to create Graduate Medical Education consortium programs.– Provide $1 million in grants to hospitals to offset the cost of certain PCP residency slots

• Governor Announces Package – 2/11/13– Prairie du Chien Memorial– Mayo Clinic – Eau Claire– Ministry – Rhinelander– St. Norbert - Future MCW Site

• WHA Organized Joint Finance Member Visit in Green Bay– February 22nd, 2013– The coalition will meet with Finance Co-Chairman John

Nygren (R) and Finance Member Rep. John Klenke (R).– Participants include Dr. Ashok Rai of Prevea and Dr. Allen

Last of the UW Fox Valley Family Medicine Residency Program.• WHA Organized WCMEW Washington, DC Fly-In

Quality/Value Agenda

• Fixing Jandre decision• Regulatory Reform• HIPAA laws

Fiscal Cliffs, Debt Ceilings, Deficit Reduction…

Where Are We? & What’s Next

Does Congress Face a Cliff in 2013?

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Hospitals have become the

Medicare Piñata

ACA Cuts

SGR “fix” 2012

SGR 2013

Sequester 2013

Grand Bargain 2013?

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Protect Hospital Care

• WHA’s comprehensive, multi-pronged advocacy campaign against federal payment cuts

• “Protect” campaign runs until Congress acts

• Dozens of strategies to educate, mobilize advocates and to demonstrate to WI Congressional Members the impact of cuts on WI hospitals

• “Protect” webpage

• Multiple trips to DC

• Meetings w/congressional candidates

• Regular WHA communication

• And more…..

Protect” Strategies Deployed

“There’s no more money that we can take from hospitals.” Cong. Reid Ribble

“You don’t bend the cost curve down by increasing taxes on providers.” Sen. Ron Johnson

“From my perspective, I believe health care providers were at the

table during health care reform, you contributed your pound of flesh. To

keep going back to you now for more contributions, for more

reductions in funding is unfair….”

Cong. Ron Kind during WHA’s Telephone Town Hall

“…you have a pretty powerful group of

representatives, Democrats and Republicans, who come

together and know the importance of our Critical

Access Hospitals …” Cong. Sean Duffy during

WHA’s Telephone Town Hall

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What we do know …• Dollars are shrinking, driving

and necessitating health care “reform”

• Election didn’t change any of this

• Health care must retool/refocus to do better with the same or less• Integration/alignment• Population health• Transparency• Payment reform• Commitment to improvement• Quality, efficiency, VALUE

• Wisconsin is leading the way …

• “Advocacy” now means enabling superior performance

QUESTIONS

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