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Health Reform – What it Means for WI WHPRMS

Health Reform – What it Means for WI WHPRMS. March 18, 2013 Steve Brenton Wisconsin Hospital Association. “There are known knowns ; things we know that we know. There are known unknowns; things that, we now know we don't know.

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Health Reform – What it Means for WI WHPRMS

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  1. Health Reform – What it Means for WI WHPRMS March 18, 2013 Steve Brenton Wisconsin Hospital Association

  2. “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

  3. WI State Budget • Medicaid Physician Workforce Quality/Value Agenda

  4. “No Fireworks This Year” Gov. Scott Walker

  5. Medicaid WHA - 133% FPL above 133% - Exchange Walker - 100% FPL above 100% - Exchange 100 – 133% - 100,000

  6. WHA Position 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." “Hospitals back Medicaid expansion” – WI Health News “Walker should expand Medicaid” – LaCrosse Tribune editorial (quotes WHA) “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 • Strategy shifts away from Governor to Legislature and influential interest groups

  7. Physician Workforce Agenda

  8. 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

  9. WHA Organized WCMEW Washington, DC Fly-In • 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.

  10. Quality/Value Agenda • Fixing Jandre decision • Regulatory Reform • HIPAA laws

  11. Fiscal Cliffs, Debt Ceilings, Deficit Reduction… Where Are We? & What’s Next

  12. Does Congress Face a Cliff in 2013?

  13. Hospitals have become the Medicare Piñata

  14. ACA Cuts • SGR “fix” 2012 • SGR 2013 • Sequester 2013 • Grand Bargain 2013?

  15. 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

  16. Protect” Strategies Deployed • “Protect” webpage • Multiple trips to DC • Meetings w/congressional candidates • Regular WHA communication • And more…..

  17. “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 “There’s no more money that we can take from hospitals.” Cong. Reid Ribble “…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 “You don’t bend the cost curve down by increasing taxes on providers.” Sen. Ron Johnson

  18. What we do know … • Dollars are shrinking, driving and necessitating health care “reform” • 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 • “Advocacy” now means enabling superior performance • Wisconsin is leading the way … • Election didn’t change any of this

  19. ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? QUESTIONS

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