Wisconsin Implementing Health Care Efficiencies Project to Contain Medicaid Costs


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The goal of the BHCG is to enable southeast Wisconsin to become a premier community for health care, recognized for its ability to provide low cost, high quality health care services and promote employee well being. The idea was that providing family planning services to individuals not otherwise eligible for Medicaid could avoid state costs to cover pregnant women and their babies due to unplanned pregnancies. Rural Health and Critical Access Hospitals: Benefits include improved access to health care, more higher education options, improved public safety, and a stronger infrastructure. In the past year, WCHQ has:. Identifies multiple barriers to accessing SUD treatment in rural and remote areas of Wisconsin. The BHCG maintains organizational memberships with key health care groups whose strategies are aligned with our own.

Working together Algoma residents have created an alternative school, called Pathfinder, out of an old bank, built the Algoma Community Wellness Center, made connections between local industries and schools to create new learning opportunities for students, and more. Robert Wood Johnson Foundation view details. Map is search able by level of rurality, service license level, service type, county, and region trauma regions.

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Wisconsin's Medicaid and BadgerCare Programs. A Tour of Research Medicaid / BadgerCare Projects. • Enrollment RWJF SHARE: ▫ Adult Coverage – Affects on Utilization, Cost . Implementation We have both pre- and post- enrollment medical claims for “Efficiency” Effect: access to primary and specialty care. BadgerCare Plus — a combined Medicaid/CHIP health coverage program. She also oversees the UW's Evidence-Based Health Policy Project. Ms. Friedsam has director and planning director of the Wisconsin Department of Health and. Social Services .. costs in all areas of the state “While there is no question that.

Wisconsin Department of Health Services view details. Regulating Network Adequacy for Rural Populations: Perspectives of Five States Policy brief describing a study exploring how California, Kentucky, Montana, Texas, and Wisconsin define insurance network adequacy and how much consideration is given to rural issues in regulating their networks.

Features statistics including these states' rural population, rural percent of total population, rural area in square miles, number of marketplace networks, and percent that are narrow networks. Rural Wisconsin Health Report of Wisconsin rural health outcomes and factors, including health behaviors, clinical care, social and economic factors, and the built and physical environment.

Rural, urban, and statewide data provided. Rural-Urban Differences Analyzes social participation among older adults and if the relationships between social participation and health differ between rural and urban settings in Wisconsin.

Medicaid Waivers Should Further Program Objectives, Not Impose Barriers to Coverage and Care

Includes study population statistics on current and past self-report health status, marital status, employment, age, income, social participation, and rurality. Safetyweb Network Provides an overview of the Safetyweb Network through an interview with network director, Mike Rust. The Safetyweb Network is a Balsam Lake, Wisconsin based network that focuses primarily on providing health benefits counseling services to residents in Polk County, Wisconsin.

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Interview topics include network characteristics, lessons learned, accomplishments, and challenges. National Rural Health Resource Center view details. Population Health Strategies of Critical Access Hospitals Provides examples of population health strategies developed by Critical Access Hospitals CAHs from 8 different rural communities that have significantly contributed to the improvement of population health and the health of their community. Flex Monitoring Team view details. The discussion focuses on how Advanced Practice Nurse Prescriber Hospitalists can help to sustain rural hospitals as a solution to workforce challenges.

A video promoting the strengths and benefits of rural hospitals in the state, including interviews with hospital CEOs and managers. Originally presented at the Wisconsin Rural Health Conference. State Variations in the Rural Obstetric Workforce Illustrates the challenges affecting the obstetric workforce in Critical Access Hospitals and other rural hospitals having at least 10 births in using data derived from a telephone survey conducted in 9 states. Peiyin Hung, Katy B. Wisconsin Divided Six Ways: A Review of Rural-Urban Classification Systems A report looking at Wisconsin through the lens of maps, methodology descriptions, and demographic data to illustrate the differences in metropolitan, micropolitan, and rural classifications and how they affect policy and programming on a state level.

Includes core, county-based, census tract, and ZIP code data and statistics. Closing Gaps in Native American Health Health issue brief describing health disparities between Wisconsin Native Americans and their white peers, with discussion of how new Medicaid policies could result in increased access to health services, improved care coordination for tribal health patients, and additional support for Indian Health Service providers.

Features statistics including infant mortality rates, age-adjusted mortality rate, diabetes and cancer age-adjusted mortality rates, suicide rates, and average age of death. Wisconsin Council on Children and Families view details. Includes a brief description of the program and preliminary program results. Administration for Children and Families view details. Enrollment and Coverage Trends Chartpack Overview of the impact of federal health reform and Medicaid reform on Wisconsin residents.

Provides data on health insurance coverage and costs, including comparative information for rural, suburban, and urban areas. Also provides county-level data.

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University of Wisconsin Population Health Institute view details. Wisconsin Primary Care Physician Retirement Provides data on Wisconsin's primary care physicians related to future retirement, including information on physicians by age. Offers retirement projections by rural and urban service area.

Wisconsin Primary Care Physicians: Distribution, Demographics, Hours of Work, Population to Provider Ratios Provides detailed information on the Wisconsin primary care physician workforce.

Rural Health Information Hub

Includes information for urban and rural service areas. Provides details on hours worked in different settings, population to primary care physician ratios, and medical school attended. Rural Health in Wisconsin: Slides from a Wisconsin Rural Health Conference presentation. Presentation Slides Sponsoring organization: Always Moving Forward in the Face of Chaos An overview of the history of the Baraboo rural training track RTT family medicine residency program, provided by its program director for the period from Includes a particular focus on the people involved and how they contributed to the success of this RTT program.

Recording of a presentation at the RTT Collaborative annual meeting.

Cost, Quality, and Value of Public Health Services | Public Health Services and Systems Research

States have numerous options to customize their Medicaid programs to suit their needs. Section authority is broad, but there are limits to the changes states can make. States must show that their proposed waivers are necessary to carry out a demonstration project that not only is experimental in nature, but will promote the objectives of Medicaid, such as expanding coverage or access to care. To allow states to implement their demonstration projects, the law gives the HHS Secretary authority to waive provisions in section of the Social Security Act, which lists the requirements states must follow to qualify for federal Medicaid matching funds.

In other words, state demonstrations cannot cost the federal government more than it would spend without the waiver. Waivers can initially be approved for a five-year period and are often extended for additional three-year increments. Both the state and federal government must post proposals for public comment before approval.

Under these criteria, a demonstration project must:. The Trump Administration has not revised the criteria for approval of demonstration projects, but the letter that Secretary Price and CMS Administrator Verma sent to governors earlier this year suggests that it will favorably consider work requirements and enforceable premiums for people with incomes below the poverty line, despite past disapprovals of such measures. In response, some states have proposed or are considering work requirements and enforceable premiums for people with incomes below the poverty line, as well as waivers that go beyond the areas highlighted in the Price-Verma letter:.

As explained, section authority is limited to waivers that are necessary to implement experimental projects intended to promote the objectives of Medicaid. They should not cause fewer people to get or retain coverage or make it harder to obtain necessary health care. All the proposals described would have those harmful impacts.

Some states are also proposing to change how Medicaid works, using policies that have proved unsuccessful and sometimes harmful to beneficiaries. For more information about WHIO, please visit their web site at www. By aggregating data from multiple payers representing a majority of claims in the state, the WHIO data mart creates a robust data set that providers and other interested parties can use to improve care. Providers having access to aggregate data from multiple sources obtain a more complete picture of their practice.

Ultimately, WHIO also plans to publicly report its data, thereby adding to health care cost and quality transparency. WHIO holds a rolling 27 months of claims data that comprises the experiences of more than 3. A total of It will likely be able to publish this additional data in the late spring or early summer WHIO is targeting December 1, to begin public reporting of primary care performance Family Practice, Internal Medicine and Pediatrics at the clinic site level where criteria for a minimum number of encounters is met.

It is expected that data for approximately clinic sites will be publicly reported initially. The Statewide Value Committee SVC was formed in to develop a consistent approach to measuring health care value and to determine the focus that will accelerate improvement in value. One of the key initiatives of the SVC is the development of agreed upon measures of value across all stakeholders in the state of Wisconsin. However, as a group, they have not had a set of agreed upon measures for health care value.

In addition, provider organizations must contend with ever-increasing requests for performance measurement data from a number of sources — the federal government, health plans and health care purchasers among others — that divide their focus and resources. This work group, made up of health plans, public agencies and private purchasers, was charged with gaining consensus regarding a set of value metrics. The group has built a consensus around 16 measures that represent health care value. Examples include measures such as hospital readmissions and diabetes control A1-C.

Through collaboration, a common set of data requirements that will meet the needs of all stakeholders, providers, purchasers and consumers alike has been defined. This is only a beginning; the SVC will need to continue to improve this initial set of value metrics. They will also need to determine how these metrics will be used to drive benefit plan changes, changes in how providers are paid and changes in how care is delivered.

There is much work to be done, but in Wisconsin health care leaders are not fighting with each other, rather they are cooperating to solve problems together. Improving health care value is too big of an undertaking for any one stakeholder to solve.

Section 1 — What is the Business Health Care Group?

The Business Health Care Group plays a key role in bringing these stakeholders together to improve health care value and deliver true health care reform. WISHIN, an independent nonprofit organization incorporated in late , is charged with bringing the benefits of widespread, secure and interoperable health information technology to patients and caregivers throughout Wisconsin. WISHIN plans to build a statewide health information network to connect physicians, clinics, hospitals, pharmacies, clinical laboratories and others across Wisconsin, regardless of the electronic medical record system they use.

A statewide electronic health information exchange offers the promise of timely, relevant information that can lead to better clinical decisions and outcomes, less duplication, more effective transitions of care and reduced administrative costs.