Thursday, April 17, 2025

   

Guest Column: A State of Emergency: Why Wisconsin’s Healthcare System Must Adapt to Survive

By Nitesh Kumar, MD, MBA, Director of Business Development, Lakeview Specialty Hospital & Rehabilitation Center

Dr. Nitesh KumarDr. Nitesh Kumar

On April 9, 2025, the Wisconsin Hospital Association (WHA) convened its annual Advocacy Day at the State Capitol in Madison. More than 1,200 health care leaders, hospital staff, clinicians, trustees and volunteers representing 150 hospitals from across the state gathered with a unified purpose: to urge lawmakers to address the mounting challenges threatening the future of health care in Wisconsin.

The event opened with an engaging fireside chat between Green Bay Packers Head Coach Matt LaFleur and WHA President and CEO Eric Borgerding. Drawing parallels between the demands of professional football and the realities of health care, LaFleur emphasized the importance of adaptability, resilience and strategic response to high-pressure situations. His message, “Adapt or Die,” resonated powerfully—particularly in a health care landscape where outdated policies and insufficient funding are putting lives at risk.

The Financial Reality: A System Under Siege

Wisconsin’s health care system is confronting a growing financial crisis. For every dollar hospitals spend on Medicaid patients, they receive just 63 cents in reimbursement. This alarming gap has created a $1.6 billion Medicaid shortfall, forcing hospitals—particularly non-profit facilities that comprise 96% of Wisconsin’s health care system—to absorb the deficit. In 2025 alone, 10 hospitals have closed, a direct consequence of chronic underfunding and aggressive insurance denials (Ashley & Ashley, 2025).

These closures are not just institutional losses—they represent a decline in community health access, reduced economic vitality and increased strain on surviving hospitals. As facilities close or scale back, patients in rural and underserved regions are left with fewer options and longer wait times for critical care.

Legislative Gridlock: When Policy Delays Become Medical Emergencies

One of the most urgent concerns highlighted during Advocacy Day was the failure to pass Senate Bill 682. This bill proposed allowing a patient’s next of kin—spouse, child, or parent—to act as a surrogate health care decision-maker when the patient is incapacitated. Unlike most other states, Wisconsin does not automatically recognize next of kin, requiring instead that a legal guardian or power of attorney be formally appointed through the courts.

This process can delay essential care transitions by 60 to 90 days, needlessly prolonging hospital stays, tying up critical bed space, and placing an emotional and financial burden on families. Worse still, it often forces patients to seek care out of state. For instance, if a Wisconsin resident is airlifted to Illinois—a state that recognizes next of kin—and becomes mentally incapacitated due to a stroke or traumatic brain injury, they may be unable to return to Wisconsin until a legal process is completed. During that time, Medicare or Medicaid dollars flow to out-of-state providers, further depleting Wisconsin’s already strained health care funding.

Advocacy in Action: A Call for Urgency and Reform

Throughout the day, advocates met with lawmakers to stress the need for systemic reform—arguing that access to high-quality health care is not a luxury, but critical to local economies. They emphasized that solving these policy and funding challenges is not just about economics—it’s about survival.

Without intervention, Wisconsin’s health care infrastructure will continue to erode. The consequences are stark: higher mortality rates, economic stagnation in health care-dependent communities and the slow exodus of health care dollars to neighboring states.

WHA’s Advocacy Day served as both a rallying cry and a warning. The message to policymakers was clear: adaptability in health care is no longer optional—it’s a necessity. If we do not evolve our systems to meet today’s realities, we will face irreversible damage to our state’s health and future.

References:


Vol. 69, Issue 16
Thursday, April 17, 2025

Guest Column: A State of Emergency: Why Wisconsin’s Healthcare System Must Adapt to Survive

By Nitesh Kumar, MD, MBA, Director of Business Development, Lakeview Specialty Hospital & Rehabilitation Center

Dr. Nitesh KumarDr. Nitesh Kumar

On April 9, 2025, the Wisconsin Hospital Association (WHA) convened its annual Advocacy Day at the State Capitol in Madison. More than 1,200 health care leaders, hospital staff, clinicians, trustees and volunteers representing 150 hospitals from across the state gathered with a unified purpose: to urge lawmakers to address the mounting challenges threatening the future of health care in Wisconsin.

The event opened with an engaging fireside chat between Green Bay Packers Head Coach Matt LaFleur and WHA President and CEO Eric Borgerding. Drawing parallels between the demands of professional football and the realities of health care, LaFleur emphasized the importance of adaptability, resilience and strategic response to high-pressure situations. His message, “Adapt or Die,” resonated powerfully—particularly in a health care landscape where outdated policies and insufficient funding are putting lives at risk.

The Financial Reality: A System Under Siege

Wisconsin’s health care system is confronting a growing financial crisis. For every dollar hospitals spend on Medicaid patients, they receive just 63 cents in reimbursement. This alarming gap has created a $1.6 billion Medicaid shortfall, forcing hospitals—particularly non-profit facilities that comprise 96% of Wisconsin’s health care system—to absorb the deficit. In 2025 alone, 10 hospitals have closed, a direct consequence of chronic underfunding and aggressive insurance denials (Ashley & Ashley, 2025).

These closures are not just institutional losses—they represent a decline in community health access, reduced economic vitality and increased strain on surviving hospitals. As facilities close or scale back, patients in rural and underserved regions are left with fewer options and longer wait times for critical care.

Legislative Gridlock: When Policy Delays Become Medical Emergencies

One of the most urgent concerns highlighted during Advocacy Day was the failure to pass Senate Bill 682. This bill proposed allowing a patient’s next of kin—spouse, child, or parent—to act as a surrogate health care decision-maker when the patient is incapacitated. Unlike most other states, Wisconsin does not automatically recognize next of kin, requiring instead that a legal guardian or power of attorney be formally appointed through the courts.

This process can delay essential care transitions by 60 to 90 days, needlessly prolonging hospital stays, tying up critical bed space, and placing an emotional and financial burden on families. Worse still, it often forces patients to seek care out of state. For instance, if a Wisconsin resident is airlifted to Illinois—a state that recognizes next of kin—and becomes mentally incapacitated due to a stroke or traumatic brain injury, they may be unable to return to Wisconsin until a legal process is completed. During that time, Medicare or Medicaid dollars flow to out-of-state providers, further depleting Wisconsin’s already strained health care funding.

Advocacy in Action: A Call for Urgency and Reform

Throughout the day, advocates met with lawmakers to stress the need for systemic reform—arguing that access to high-quality health care is not a luxury, but critical to local economies. They emphasized that solving these policy and funding challenges is not just about economics—it’s about survival.

Without intervention, Wisconsin’s health care infrastructure will continue to erode. The consequences are stark: higher mortality rates, economic stagnation in health care-dependent communities and the slow exodus of health care dollars to neighboring states.

WHA’s Advocacy Day served as both a rallying cry and a warning. The message to policymakers was clear: adaptability in health care is no longer optional—it’s a necessity. If we do not evolve our systems to meet today’s realities, we will face irreversible damage to our state’s health and future.

References: