In a combined presentation at this year’s Wisconsin Hospital Association (WHA) Rural Wisconsin Health Conference, the leaders of WHA and the Rural Wisconsin Health Cooperative (RWHC) underscored the strong relationship between the two organizations and the shared priorities driving their advocacy efforts for hospitals and health systems throughout the state.
WHA President and CEO Eric Borgerding began his remarks by reflecting on the “long road” that Wisconsin hospitals and health systems have traveled since the 2019 Wisconsin Health Conference—the last time the event was held before COVID surfaced in the state. “We’ve been through a lot together—WHA and RWHC. One thing that has not changed, and has probably even been strengthened, is the partnership between our two organizations.”
Borgerding highlighted the history of COVID and its effects on the state’s health care system, drawing upon data provided by the Wisconsin Hospital Association Information Center (WHAIC) and shared in real time for the past 14 months in a
COVID 19 situational awareness dashboard on WHA’s website. Citing the dramatic rise of COVID cases and hospitalizations in Wisconsin the fall of 2020, followed by an equally precipitous fall of these measures through the spring of 2021, Borgerding noted, “That is a testament to you all.” He referenced the
all-time low hospitalization figure—186—the state registered on Memorial Day as cause for cautious celebration.
Borgerding outlined the three ongoing priorities driving WHA’s COVID-related work: advocating for hospital/provider resources, regulatory reform and payer reform; educating the media and decision-makers about the impact and status of COVID; and slowing the spread of the virus.
Recent legislation signed by Governor Evers included three important WHA-supported policies: out-of-state licensure reforms; acute hospital care at home; and payment for skilled nursing home-level care in hospitals. WHA continues to focus on additional issues affecting hospitals and health systems, Borgerding said, including behavioral health; telehealth policy; broadband investment and expansion; and advanced practice providers/top-of-license practice.
The effects of COVID on the state’s hospitals and their patients, including $2.5 billion in losses resulting from a federally mandated shutdown of non-emergent services in March 2020, are detailed in a WHAIC report entitled,
COVID-19 Effects on Wisconsin Hospitals, Health Systems and Patient Care. Ramping regular care back up throughout the state has been and continues to be a WHA priority, Borgerding noted.
Building upon the success of the WHA-led “Stop the COVID-Spread!” coalition, an influential group of the state’s leading advocacy organizations formed in October 2020 to combat the growing health crisis, the multi-industry partnership, which includes RWHC, will shift its focus to overcoming vaccine hesitancy, Borgerding said.
RWHC Executive Director Tim Size seconded Borgerding’s reference to the strong partnership between RWHC and WHA. “I value the partnership equally if not more so than Eric’s kind words,” he related as he began his presentation focused largely on
“For most of us, 2020 was the most challenging year we’ve faced. We survived the pandemic. What I’m going to talk about is, can we survive health insurers not willing to support local health care?,” said Size, noting that health insurers recorded record profits in 2020. “It’s a mystery to many of us why some insurers are choosing this time to come down heavy on rural health care,” he continued.
Size outlined a set of expectations his co-op members have established for insurers, which will drive RWHC’s advocacy work going forward. He underscored the important role that hospitals play not only in providing care to their patients, but also in helping insurers fulfill their missions. Rural hospitals assist patients in accessing the care they need and help them understand how their health insurance will help pay for it, Size observed before enumerating “behaviors” RWHC would like to see health insurers adopt. These include the following:
- Support network adequacy
- Assure equitable credentialing
- Avoid steerage from rural hospitals
- Recognize actual cost of efficient rural care
- Utilize relevant quality measures
- Engage in good faith contracting
- Assure consistency throughout the plan year
- Offer appropriate employer/subscriber education
- Inform subscribers of all local options
- Assure responsiveness and transparency
- Approve necessary care by qualified providers
- Engage in community/population health
- Acknowledge the economic impact of local care
Size concluded his remarks by citing data by the Center for Healthcare Quality and Payment Reform which shows that across the U.S. more than 800 hospitals—40% of all rural hospitals—are either at immediate or high risk of closure. It would be foolish, he noted, for Wisconsin to assume we are immune from these trends. “The future of rural hospitals is up to all of us,” he said, referencing planned activities that will be kicked-off with renewed energy and in partnership with WHA in the June RWHC meeting.
See a wrap-up of the 2021 Wisconsin Rural Health Conference in photos here.