THE VALUED VOICE

The Wisconsin Hospital Association’s (WHA’s) Public Policy Council met on Feb. 26, ten days after the release of Governor Evers’ proposed state budget. The virtual meeting included guest presentations from co-chairs of the state’s powerful budget-writing Joint Finance Committee, Sen. Howard Marklein (R-Spring Green) and Rep. Mark Born (R-Beaver Dam).
 
Born related that the state is in a good position to fund certain priorities and noted that he realizes that funding for the Disproportionate Share Hospital (DSH) program is important to WHA and its members. He also stated that the governor’s proposed budget contained policy recommendations that should be addressed outside of the budget process. Legislators, Born noted, are prepared to move some of these provisions as standalone bills through the legislative process.
 
Sen. Marklein underscored his strong relationship both with WHA and with local hospitals in his area before reviewing the state’s fiscal standing, stating that discipline and restraint is still needed to protect the budget surplus Wisconsin ended with last year. Marklein noted that the budget process would include agency briefings and public hearings before potential passage by the end of June.
 
Hospital and health system leaders on the council as well as invited hospital leaders from Sen. Marklein’s and Rep. Born’s districts provided the two lawmakers with their perspectives on the challenges that continue to face our state’s hospitals and a reminder of everything hospitals have done to support the state and local government’s COVID-19 response. Hospital leaders concluded their remarks with a unanimous appeal to the lawmakers to help permanently reauthorize hospital funding in the next state budget.
 
Bob Van Meeteren, president and CEO of Reedsburg Area Medical Center in Sen. Marklein’s district, advised the lawmakers that federal aid to hospitals was not enough, as Reedsburg Area Medical Center used millions of dollars in cash to make up for losses that were not covered by federal aid. “We will be digging out of this financially for years,” said Van Meeteren.
 
Van Meeteren stated that his hospital, as a Medicaid Disproportionate Share Hospital, would face a significant cut in reimbursement from the state if the Legislature does not permanently reauthorize the current Medicaid DSH program. Several other hospital representatives in attendance called attention to similar cuts their organizations would face if the budget bill doesn’t reauthorize funding.
 
Governor Evers’ proposed budget includes a permanent reauthorization of Medicaid Disproportionate Share funding for hospitals, which, if passed, avoids a cut in hospital reimbursement amounting to over $100 million during the next biennium. This increase in funding was previously approved by Governor Evers and by Republican majorities in the state Legislature during the last state budget.
 
According to hospital leaders participating in the meeting, now is not the time to reduce state support for hospitals. Several hospitals and health systems highlighted the services they provided to the community and local public health departments to fight the pandemic, including large-scale vaccination and testing infrastructure and personal protective equipment for schools and other community organizations, regardless of whether the service was reimbursable by federal, state or local governments.
 
“Hospitals have stepped in to provide a backstop to public health in the fight against COVID,” said Lisa Schnedler, president and CEO of Upland Hills Health in Dodgeville, also in Sen. Marklein’s district. She added, “We’ve conducted 90% of virus screening in our community and are now administering vaccines. Funding is needed to do what is asked of our hospital.”
 
Mike Schafer, CEO of Spooner Health and member of the Public Policy Council and WHA Board of Directors reminded lawmakers about the need to continue support for the Rural Critical Care Supplement, a Medicaid funding program for rural hospitals that also serve a higher number of Medicaid patients, especially as hospitals like Spooner Health are assisting the state with vaccination and testing that is largely unreimbursed.
 
Schafer also highlighted the work of Sen. Marklein in reforming state hospital regulations in 2014, thanking him for this important work and asking him to oppose additional mandates and regulatory requirements on hospitals proposed in the governor’s budget. Some of these provisions include new state regulatory requirements on hospitals qualifying for the federal 340B program and new mandates on hospitals when they discharge patients.
 
Marklein agreed with the need to seek more regulatory reform, rather than adding more regulations for hospitals, saying that COVID-19 exposed a long-standing need for health care regulatory reform. Marklein added that many temporary regulatory changes made to deal with the pandemic should be made permanent.
 
WHA President and CEO Eric Borgerding said that such regulatory relief would be an ongoing focus for WHA. He also shared data showing that hospital and health system billings were down statewide due to the pandemic and referenced continued hesitancy regarding health care. Borgerding reiterated the “never contemplated” role that health care providers fulfilled with respect to fighting COVID, including implementing new processes and protocols to provide COVID and non-COVID care, conducting testing and administering vaccines.
 
Borgerding highlighted WHA’s concern that the $100 million in DSH funding passed in the last state budget might be cut, citing this as the association’s primary budget priority.
 
Council members also received updates from WHA staff on the upcoming state budget; the work of a subcommittee of the Public Policy Council focused on public health; new recommendations from a coalition, which includes WHA, created by the Wisconsin Attorney General to tackle mental health crisis challenges; and recent federal action by Congress and the Centers for Medicaid & Medicare related to COVID-19 and surprise billing.