Valued Voice

WHA President and CEO Kyle O’Brien joined Wisconsin Public Radio’s (WPR) Rob Ferrett during Wisconsin Today on Nov. 14 to discuss the current financial landscape for Wisconsin hospitals and health systems and the challenges that could impact patients in the year ahead.

WHA President and CEO Kyle O’Brien (right) with Rob Ferrett at the Wisconsin Public Radio studio.

During the interview, O'Brien emphasized that Medicaid reimbursement continues to fall short of the actual cost of delivering care. 

“Hospitals lose about $1.6 billion a year in serving patients on Medicaid,” O’Brien said, adding that the program “reimburses hospitals approximately two-thirds of the cost to deliver that product, that service.”

The focus of the conversation then turned to the shift occurring in the Medicare Advantage marketplace. O’Brien said WHA is seeing “a tightening of the marketplace,” noting that some Medicare Advantage plans are “dropping hospitals out of their network,” while in other cases hospitals are leaving networks because “the commercial insurance burdens like prior authorization... have become too difficult and too time consuming for our providers.”

This means patients may find that their preferred hospital is no longer in-network in 2026—even if it was covered previously. 

“Patients need to make choices right now about what Medicare Advantage plan they’re going to choose, or even in some instances, going back to traditional Medicare with maybe a supplement plan,” O’Brien said.

His advice for Wisconsinites during open enrollment is direct: “They should contact their local hospital or provider and ask them about the Medicare Advantage plans that are in their network.”

O’Brien also discussed the potential impact if Affordable Care Act marketplace subsidies are not renewed, noting that hospitals worry “anytime there's a risk that somebody could lose coverage,” especially because hospitals must remain open and care for all patients regardless of ability to pay.

Before ending the interview, Ferrett asked O'Brien about the current state of Wisconsin's health care workforce. While WHA’s most recent workforce report shows modest improvement in vacancy rates across critical health care occupations, approximately one in ten Wisconsin hospital positions remains unfilled. Hospitals continue to invest heavily in salaries, benefits and “grow-your-own” workforce development programs to meet patient needs—particularly in rural and underserved communities.

Listen to the full interview, The financial state of Wisconsin hospitals, here.