THE VALUED VOICE

Vol. 65, Issue 26
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Thursday, July 1, 2021

   

WHA Board Receives Annual Goals Update and Advocacy Report in June Meeting

Guest speaker WCHQ CEO Gabrielle Rude highlights collaboration opportunities

WHA’s June board meeting featured in-person attendance for the first time in 18 months, while remote participants experienced upgraded technology WHA has deployed to maximize virtual engagement.

WHA on Track to Fulfill Annual Goals

WHA President and CEO Eric Borgerding reviewed the documented goals the Association laid for 2021, highlighting progress made on strategic initiatives related to strengthening the state’s health care funding and infrastructure; expanding access and coverage; improving health care quality and affordability; ensuring an adequate health care workforce; maximizing the value of data and information; and achieving performance excellence.

Borgerding emphasized WHA’s progress toward its top priority for the current state budget cycle—reauthorization of Disproportionate Share Hospital (DSH) funding for hospitals, which is included in a budget bill expected to be sent to Gov. Evers for signature soon.

While highlighting successful WHA advocacy initiatives, Borgerding also noted that the Association continues to monitor national industry trends in order to keep ahead of “bad ideas” surfacing elsewhere.

Prairie Ridge Health President and CEO John Russell and Burnett Medical Center CEO Gordon Lewis shared key takeaways from the most recent American Hospital Association Region 5 board meeting. Lewis noted that of the issues discussed, Wisconsin is “leading on many fronts,” adding, “It’s great to be on the rocket and have a great team behind you.”

Among the threats on the horizon discussed by board members prior to WHA’s advocacy report were what one member referred to as the “skyrocketing of denials” by insurance companies, as well as aggressive and inaccurate reporting on collections activities by hospitals during the pandemic. Borgerding noted that WHA’s messaging in support of hospitals has included pushback on inaccurate media reports, a steady stream of positive social media activity and the publication of authoritative, data-based reports demonstrating the importance of Wisconsin’s hospitals to the health and economic vibrancy of the communities they serve.

WHA Advocacy Advances Budget Priorities, Shines Spotlight on Payer Abuses

WHA Senior Vice President of Government Relations Kyle O’Brien recapped the Association’s involvement in ongoing state budget discussions with elected officials to ensure understanding and support of policies and investments crucial to maintaining the strength of the state’s health care system, including reauthorization and permanent DSH funding. Support for and participation in these discussions by WHA members, O’Brien noted, has been critical to protecting WHA-led budget provisions. O’Brien thanked members for signing a joint letter asking lawmakers to reauthorize DSH funding and for testifying at Joint Finance Committee (JFC) listening sessions in their markets.

Through this coordinated action between WHA and its members, the JFC approved the following health care funding:

  • $517.5 million general purpose revenue (GPR) for cost-to-continue state Medicaid program;
  • Permanent reauthorization of additional$104 million all-funds for Medicaid DSH program;
  • $10 million GPR for regional crisis response system;
  • Extension of post-partum Medicaid coverage for an additional 30 days;
  • Additional $30 million all-funds into the Wisconsin Healthcare Stability Plan, reducing premiums for the individual market; and
  • $170 million GPR for long-term care, including nursing homes, personal care workers and various other direct care workforce.

Other issues WHA’s advocacy team continues to focus on in support of its members include behavioral health and telehealth policies, broadband investment and expansion, advanced practice providers, post-acute care-related issues and insurance trends.

On the latter point, WHA Senior Vice President of Public Policy Joanne Alig highlighted disturbing new payer practices in which insurers are making unilateral and dangerous changes to contracts which they frame as “policy changes” with very short notice and minimal communication. These include insurers retroactively denying emergency department claims, the establishment of “designated diagnostic providers” and “white bagging,” a policy in which insurers stipulate that failure to use a designated network for specialty pharmacy medications administered in the outpatient hospital setting will result in claim denials.

WHA is actively monitoring and responding as appropriate to these and other insurance issues on the horizon, working with the Wisconsin Office of the Commissioner of Insurance and partnering with the Rural Wisconsin Health Cooperative to coordinate effective advocacy representative of all state hospitals and health systems.

Quality Partnerships

Wisconsin Collaborative for Healthcare Quality (WCHQ) President and CEO Gabrielle Rude joined the WHA board meeting to share her vision for WCHQ, having taken the organization’s helm in November 2020.

Noting that 70% of WCHQ’s members are primary care providers, Rude shared her desire to increase membership among free and charitable clinics as well as Federally Qualified Health Care (FQHC) and tribal providers.

WCHQ’s mission has remained unchanged since its founding in 2003—to publicly report and bring meaning to information, in turn improving health. The organization’s core competencies include developing and publicly reporting quality measures; creating and disseminating improvement strategies; and facilitating collaboration.

Overcoming health disparities and improving health care value, Rude noted, are top priorities for WCHQ, both of which require input and engagement among a wide range of stakeholders.

WCHQ studies draw upon data from its members, and the Collaborative makes 40 quality measures publicly available wchq.org. WCHQ shares quality improvement toolkits with members even if their data was not included in its analysis.

Noting the voluntary relationship WCHQ has with its members, Rude observed, “When members come to us, they are focused on quality.” Among the benefits of WCHQ participation, according to Rude, is the fact that “Members start improving when they start reporting.”

In thanking Rude for her remarks, WHA President and CEO Eric Borgerding underscored the importance of collaboration in health care. “We look forward to expanding the dialogue with WCHQ and looking for opportunities to partner around health care quality, safety and access.”

This story originally appeared in the July 01, 2021 edition of WHA Newsletter

WHA Logo
Thursday, July 1, 2021

WHA Board Receives Annual Goals Update and Advocacy Report in June Meeting

Guest speaker WCHQ CEO Gabrielle Rude highlights collaboration opportunities

WHA’s June board meeting featured in-person attendance for the first time in 18 months, while remote participants experienced upgraded technology WHA has deployed to maximize virtual engagement.

WHA on Track to Fulfill Annual Goals

WHA President and CEO Eric Borgerding reviewed the documented goals the Association laid for 2021, highlighting progress made on strategic initiatives related to strengthening the state’s health care funding and infrastructure; expanding access and coverage; improving health care quality and affordability; ensuring an adequate health care workforce; maximizing the value of data and information; and achieving performance excellence.

Borgerding emphasized WHA’s progress toward its top priority for the current state budget cycle—reauthorization of Disproportionate Share Hospital (DSH) funding for hospitals, which is included in a budget bill expected to be sent to Gov. Evers for signature soon.

While highlighting successful WHA advocacy initiatives, Borgerding also noted that the Association continues to monitor national industry trends in order to keep ahead of “bad ideas” surfacing elsewhere.

Prairie Ridge Health President and CEO John Russell and Burnett Medical Center CEO Gordon Lewis shared key takeaways from the most recent American Hospital Association Region 5 board meeting. Lewis noted that of the issues discussed, Wisconsin is “leading on many fronts,” adding, “It’s great to be on the rocket and have a great team behind you.”

Among the threats on the horizon discussed by board members prior to WHA’s advocacy report were what one member referred to as the “skyrocketing of denials” by insurance companies, as well as aggressive and inaccurate reporting on collections activities by hospitals during the pandemic. Borgerding noted that WHA’s messaging in support of hospitals has included pushback on inaccurate media reports, a steady stream of positive social media activity and the publication of authoritative, data-based reports demonstrating the importance of Wisconsin’s hospitals to the health and economic vibrancy of the communities they serve.

WHA Advocacy Advances Budget Priorities, Shines Spotlight on Payer Abuses

WHA Senior Vice President of Government Relations Kyle O’Brien recapped the Association’s involvement in ongoing state budget discussions with elected officials to ensure understanding and support of policies and investments crucial to maintaining the strength of the state’s health care system, including reauthorization and permanent DSH funding. Support for and participation in these discussions by WHA members, O’Brien noted, has been critical to protecting WHA-led budget provisions. O’Brien thanked members for signing a joint letter asking lawmakers to reauthorize DSH funding and for testifying at Joint Finance Committee (JFC) listening sessions in their markets.

Through this coordinated action between WHA and its members, the JFC approved the following health care funding:

  • $517.5 million general purpose revenue (GPR) for cost-to-continue state Medicaid program;
  • Permanent reauthorization of additional$104 million all-funds for Medicaid DSH program;
  • $10 million GPR for regional crisis response system;
  • Extension of post-partum Medicaid coverage for an additional 30 days;
  • Additional $30 million all-funds into the Wisconsin Healthcare Stability Plan, reducing premiums for the individual market; and
  • $170 million GPR for long-term care, including nursing homes, personal care workers and various other direct care workforce.

Other issues WHA’s advocacy team continues to focus on in support of its members include behavioral health and telehealth policies, broadband investment and expansion, advanced practice providers, post-acute care-related issues and insurance trends.

On the latter point, WHA Senior Vice President of Public Policy Joanne Alig highlighted disturbing new payer practices in which insurers are making unilateral and dangerous changes to contracts which they frame as “policy changes” with very short notice and minimal communication. These include insurers retroactively denying emergency department claims, the establishment of “designated diagnostic providers” and “white bagging,” a policy in which insurers stipulate that failure to use a designated network for specialty pharmacy medications administered in the outpatient hospital setting will result in claim denials.

WHA is actively monitoring and responding as appropriate to these and other insurance issues on the horizon, working with the Wisconsin Office of the Commissioner of Insurance and partnering with the Rural Wisconsin Health Cooperative to coordinate effective advocacy representative of all state hospitals and health systems.

Quality Partnerships

Wisconsin Collaborative for Healthcare Quality (WCHQ) President and CEO Gabrielle Rude joined the WHA board meeting to share her vision for WCHQ, having taken the organization’s helm in November 2020.

Noting that 70% of WCHQ’s members are primary care providers, Rude shared her desire to increase membership among free and charitable clinics as well as Federally Qualified Health Care (FQHC) and tribal providers.

WCHQ’s mission has remained unchanged since its founding in 2003—to publicly report and bring meaning to information, in turn improving health. The organization’s core competencies include developing and publicly reporting quality measures; creating and disseminating improvement strategies; and facilitating collaboration.

Overcoming health disparities and improving health care value, Rude noted, are top priorities for WCHQ, both of which require input and engagement among a wide range of stakeholders.

WCHQ studies draw upon data from its members, and the Collaborative makes 40 quality measures publicly available wchq.org. WCHQ shares quality improvement toolkits with members even if their data was not included in its analysis.

Noting the voluntary relationship WCHQ has with its members, Rude observed, “When members come to us, they are focused on quality.” Among the benefits of WCHQ participation, according to Rude, is the fact that “Members start improving when they start reporting.”

In thanking Rude for her remarks, WHA President and CEO Eric Borgerding underscored the importance of collaboration in health care. “We look forward to expanding the dialogue with WCHQ and looking for opportunities to partner around health care quality, safety and access.”

This story originally appeared in the July 01, 2021 edition of WHA Newsletter