Wisconsin State Rep. Karen Hurd (R-Fall Creek) discussed her concerns with the recent closures of two hospitals in the Chippewa Valley with WHA’s Public Policy Council during its March 13, 2024 meeting.
“Payer mix was a primary problem,” said Hurd. She stated the need for long-term solutions to the challenges faced by Wisconsin hospitals to ensure what occurred in the Chippewa Valley doesn’t happen in other communities across the state.
Council members reinforced payer-mix concerns, as labor, supply and service costs continue to increase for Wisconsin hospitals while reimbursement from government and commercial insurers isn’t keeping pace. President and CEO Door County Medical Center Brian Stephens said “everyone around the table is evaluating services” for financial viability, with labor and delivery being a top consideration, especially in rural communities.
“I will be a formidable champion and advocate for what comes next,” said Hurd, as she described the need for legislative action to protect the existing hospital safety-net in Wisconsin. “I need your ideas.”
Hurd discussed her partnership with WHA in this past session, specifically her work passing legislation that directs the Wisconsin Medicaid program to pursue a waiver of the federal Institute for Mental Disease (IMD) exclusion. Currently, patients on Medicaid fee-for-service (non-HMO Medicaid coverage) are not eligible to have inpatient stays reimbursement by Medicaid if the admission is in a standalone psychiatric facility with 16 or more inpatient beds.
Hurd gave a historical overview of how the federal IMD exclusion policy came into place with the creation of Medicaid and Medicare. Hurd stated that the policy was created because of a public perception of psychiatric hospitals that is very different than it is today. Gov. Tony Evers is scheduled to sign this bill into law on March 22.
“With this legislation, we are going to make nearly 1,000 psychiatric hospital beds in Wisconsin available to patients who need care,” said Hurd.
The signing of Assembly Bill 616 is just the first step in the process of Wisconsin applying for and receiving a waiver of the federal IMD exclusion. WHA will continue to engage with our members and DHS officials as the waiver moves forward.