By State Representative Patrick Snyder (R-Schofield)

One of the most pressing concerns facing families across Wisconsin is the cost of health care. Undergoing treatment for a medical condition can already be a very stressful time for patients and their families. Unfortunately, hat stress can skyrocket once the bill comes due.

Most health insurance plans include cost-sharing arrangements such as copayments, coinsurance, and deductibles. These out-of-pocket costs, which have increased in recent years, are not only a financial burden on patients, but also an administrative burden on the providers who must collect them.

Guidance from the US Department of Health and Human Services’ Office of Inspector General allows providers across the country to provide “prompt-pay” discounts for copayments and deductibles under certain circumstances if the bill is paid promptly. These discounts offer relief to patient’s wallets and simplify the collections process for providers.

However, due to differing interpretations of Wisconsin state law, providers that offer these discounts in other states are hesitant to give these same discounts to patients in Wisconsin. That’s why Senator Dan Feyen and I introduced Assembly Bill 571. This bill clarifies that prompt-pay discounts are permissible in Wisconsin allowing patients and providers to take advantage of this practice that is common elsewhere in the country.

A similar bill was passed unanimously by the state Assembly last session, but unfortunately “died” in the Senate after senators abruptly ended the session due to the COVID-19 pandemic. The proposal was re-introduced this fall, I look forward to it moving through the legislative process so Wisconsinites can finally take advantage on a nationwide industry norm that helps lower health care costs.

By Hoven Consulting – WiAHC’s Government Affairs Firm

The state’s Medicaid program will carry forward many of the temporary telehealth provisions it put in place at the start of the COVID-19 pandemic in a permanent policy that will take effect January 1, 2021.

“What you see right now is in many cases the same rule that you’re going to see in the future, with I think some improvements actually,” Medicaid Director Jim Jones said at a Wisconsin Health News virtual panel in September.

Jones said improvements include paying originating sites, like a pharmacy or medical office, to provide a place for Medicaid members to receive telehealth. They’re also looking at expanding tele-dentistry and doctor-to-doctor teleconsultation. 

Other changes like covering asynchronous telehealth, where patients, for instance, send a photo to their provider, are still being developed. 

A state law enacted in November 2019 requires that the Department of Health Services to treat telehealth the same as in-person care and mandates that Medicaid reimburse the same telehealth services that Medicare covers. The Department of Health Services initially anticipated taking six to nine months to roll out the law. 

But when the pandemic struck in March 2020, DHS “ripped the Band-Aid off” and moved quickly to set up a temporary policy to ensure members could still get access to services, Jones said. They've spent the time since working on a permanent rule.

Rep. Amy Loudenbeck, R-Clinton, who wrote the law, said it helped plant “the seed of what telehealth could be,” particularly in how it could boost access to mental healthcare. 

“This test period that we’re in has been really helpful and will inform rule-making,” she said. 

She’s now working on legislation that would apply the Medicaid definition for telehealth to the state occupational licensing law.

Jim Castellano, telehealth and virtual care manager at Marshfield Clinic Health System, said state and federal flexibilities boosted their ability to provide telehealth.

“In some ways, I think this was a unique opportunity for everybody to just really get down and dirty with the technology and see what it’s capable of,” said Dr. John Schneider, chief medical officer at the Milwaukee County Behavioral Health Division. 

He said telehealth has helped them reach more people, including easing the pivot from at-home visits to telecalls. He said there could be challenges with reimbursement in the future. 

John Nygren, Wisconsin Association of Health Plans executive director, said their members have embraced the use of telehealth, calling it the “one of the best things” that has come out of the pandemic. 

The Long Term Care Advisory Council (LTCAC) is tasked with providing advice to the Wisconsin Department of Health Services (DHS), as outlined in the council charter. DHS aims to have a diverse council, consisting of individuals from rural and urban areas, varied ethnicities, and different experiences with the various long term care programs in Wisconsin. Members of the LTCAC are appointed by DHS Secretary-designee Karen Timberlake. LTCAC members serve three-year terms that begin in January and run through the end of December.

At the end of 2021, there will be one seat up for renewal and we are also looking to fill the current vacancies. Current membership and vacancies are listed on the LTCAC webpage. The Department is specifically looking for individuals that represent either consumer or advocate groups.

Individuals interested in being considered for LTCAC membership should send a letter of interest describing a little bit about themselves, their background, and why they are interested in serving on the council. It is encouraged that applicants include information in their letter of interest describing how they will provide diversity to the council. Letters can be emailed to Suzanne Ziehr.

To ensure consideration for membership beginning 2022, please submit a letter of interest by October 15, 2021.

Grassroots advocacy is the most powerful tool WiAHC has at its disposal to shape public policy and building relationships with lawmakers is the most important aspect of advocacy. In effort to capitalize on our greatest advocacy resource – our membership – WiAHC has unveiled our Coffee Conversations with Legislators advocacy program.

The initiative is designed to help connect members with their local legislators. Under the program, the WiAHC Government Affairs Team will set-up in-district meetings between WiAHC members and state lawmakers who represent them in the Legislature. These meetings, which can be located at your facility, or a local coffee shop provides a tremendous opportunity for WiAHC members to build or strengthen their relationships with local legislators and to educate them on home health care and on policy issues important to home health care professionals and their patients.

Please click here for more information on the program.

Wisconsin Governor Tony Evers and the Wisconsin Department of Health Services (DHS) earlier this month announced $58.4 million in funding for local and tribal health departments to continue their work responding to the COVID-19 pandemic and build a strong recovery. The funding comes from the Coronavirus State Fiscal Recovery Funding and Coronavirus Local Fiscal Recovery Fund established by the American Rescue Plan Act (ARPA) and adds to the $106.5 million the Evers Administration has already allocated to local and tribal health departments for COVID-19 response activities in 2021.

“We’ve worked hard this past year to put our state in the best position to recover from this pandemic, and this funding will help support our local partners in this effort to help build a robust and equitable state and ensure our continued economic recovery,” said Gov. Evers.

The funding will provide resources to meet the public health needs that continue to emerge from the COVID-19 pandemic, or to address those needs that have been exacerbated by the pandemic and the associated economic downturn. Potential uses for the funding include: measures to stop the spread of COVID-19 such as testing, contact tracing, and vaccination programs; staffing for public health and safety; enhancing public health programs through improvements like technology infrastructure or data analysis; addressing disparities in health outcomes, including services that connect residents with resources; and supporting healthy living environments and healthy childhood environments.

“As vital partners in our COVID-19 response, local and tribal health departments have gone above and beyond, and this funding from ARPA will help them continue to respond to the pandemic while also improving systems and building capacity in their communities,” said DHS Secretary-designee Karen Timberlake. “Activities and resources like the ones funded by this investment are the building blocks of Wisconsin’s recovery, and we look forward to continuing to partner with our local and tribal health departments in this effort.”

The $58.4 million in ARPA funding is applicable to expenses that local and tribal health departments incurred from March 3, 2021 through December 31, 2024, and has been allocated to departments based on a formula that includes a base amount of funding with additional funding based on population size.

Earlier this month, former DHS Deputy Secretary Julie Willems Van Dijk, who was a highly visible part of the Evers’ Administration’s COVID-19 response efforts, announced her retirement. Van Dijk, whose last day in her role at DHS was Sept. 10, was replaced by Deb Standridge as the new DHS Deputy Secretary.

“Having spent 40 years dedicated to public good and the health and safety of folks in this state, Julie is the embodiment of public service. It has been a privilege to work alongside her on a near-daily basis over the past year and a half. I want to thank Julie for her career in public service and her family for their many years of support as well. Julie will be greatly missed, and I wish her all of the best in her retirement,” said Gov. Tony Evers.

Standridge previously served as executive director of the state’s alternate care facility at State Fair Park. She has spent her career working in healthcare systems, most recently serving as Regional President of the North Region of Ascension Wisconsin. Her professional focus has been on the strategic direction and operational management of hospitals in a diversity of communities, including her work at Wheaton Franciscan Healthcare’s North Market. She has also served on the Board of Directors for the Wisconsin Hospital Association.

“I want to thank Governor Evers and Secretary-designee Timberlake for this opportunity to serve our state. I know we have both challenges and opportunities ahead of us, and I am ready to get to work serving the people of Wisconsin in this new role,” said Deb Standridge. “I would also like to add my gratitude to the outgoing deputy secretary. Having worked closely with Julie when I ran the Alternate Care Facility, I’ve seen her dedication in action.”

Earlier this month, the National Association for Home Care & Hospice (NAHC) filed comments with the Centers for Medicare & Medicaid Services (CMS) on the proposed 2022 home health rule (CMS -1747-P), calling for no major changes to the Patient-Driven Groupings Model (PDGM) payment system, while also calling attention to the fact hospitals and skilled nursing facilities received payment boosts during the COVID-19 pandemic, while home health agencies did not.

More specifically, NAHC recommended the following modifications to the proposed rule in their comments to CMS:

• The structure and design of PDGM should be maintained for 2022.
• Withdraw the proposal to recalibrate PDGM case mix weights based on 2020 care utilization data, given the fact it’s unreasonable to assume health care utilization in 2020 is an appropriate basis for 2022.
• Replace the suggested methodology for assessing whether behavioral changes of home health agencies resulted in PDGM achieved budget neutrality in comparison to the HHPPS HHRG payment model with a methodology that focuses on behavioral changes, not change in average case mix weight. 
• Reconsider the decision to apply the new OMB geographic designations for core-based statistical areas (CBSAs) in the annual wage index. Instead, CMS should treat all provider types equally in the transition to an updated wage index as it has done for inpatient hospitals.
• Establish a process and methodology to modify HHA payment systems and rates during a Public Health Emergency.

CLICK HERE to read the full text of NAHC’s comments to CMS.

Nominate a yourself or a colleague to serve on the WiAHC Board of Directors today!

WiAHC is run by a volunteer Board of Directors. Board members are elected annually to staggered three-year terms. Board members develop and manage the affairs of the Association and are supported by Committee Chairs and staff.

Positions serve a three-year term, starting January 2022.

To be eligible, a nominee's home health agency must be a current member of WiAHC.

How to Nominate

Nominating is easy, quick and simple!

Submit a nomination by completing the call for nominations form here.

The deadline to submit nominations is October 1, 2021.

Grassroots advocacy is the most powerful tool WiAHC has at its disposal to shape public policy, and building relationships with lawmakers is the most important aspect of advocacy. In effort to capitalize on our greatest advocacy resource – our membership – WiAHC has unveiled our Coffee Conversations with Legislators advocacy program.

The initiative is designed  to help connect members with their local legislators. Under the program, the WiAHC Government Affairs Team will set-up in-district meetings between WiAHC members and state lawmakers who represent them in the Legislature. These meetings, which can be located at your facility or a local coffee shop provides a tremendous opportunity for WiAHC members to build or strengthen their relationships with local legislators and to educate them on home health care and on policy issues important to home health care professionals and their patients.

Please click here for more information on the program.

Gov. Tony Evers and the Wisconsin Department of Health Services (DHS) announced today that six million doses of COVID-19 vaccine have been administered in the state of Wisconsin. Over half of all Wisconsinites have already completed their COVID-19 vaccine series.

“Wisconsin’s vaccine providers have worked tirelessly to get shots in arms,” said Gov. Evers. “This is a tremendous milestone, and we couldn’t have gotten here without the hard work and dedication of everyone involved. Whether you’re administering shots, scheduling appointments, answering phones, or sanitizing workstations, thank you. I encourage every eligible Wisconsinite who has not done so already to roll up their sleeves and get vaccinated to help protect themselves and their loved ones.”

Since Wisconsin began administering COVID-19 vaccine in mid-December of last year, over 3.1 million Wisconsinites have received at least one dose. The state continues to make deliberate choices to reduce barriers to accessing the COVID-19 vaccine and provide much-needed relief to communities that have withstood the worst of the pandemic. Since the start of the COVID-19 Vaccination Program in Wisconsin and thanks to countless partners, the state has launched a number of successful vaccine initiatives. Through the Vaccine Equity and Outreach grant program, DHS has helped support 100 organizations to serve as trusted vaccine messengers, increase vaccine confidence, and promote vaccine equity in racially and geographically diverse communities across Wisconsin.

Earlier this month, over 600 people got their COVID-19 vaccine at the Wisconsin State Fair, and in the process, a voucher for a free cream puff. Wisconsin also recently announced its $100 COVID-19 Vaccine Reward Program, which offers a $100 Visa gift card to anyone who receives their first dose of COVID-19 vaccine between August 20 and September 6.

Data continue to show that COVID-19 vaccines do their job by preventing severe illness, hospitalization, and death. In July, people who were not fully vaccinated were nearly three times more likely to test positive for COVID-19, and 3.7 times more likely to be hospitalized for COVID-19-related illnesses. The COVID-19 vaccines remain one of the best ways to protect yourself, your family, and your community from COVID-19 and the highly infectious Delta variant.

“It is important that we continue to vaccinate everyone who is eligible for the COVID-19 vaccine, especially as cases continue to rise, driven by the Delta variant,” said DHS Secretary-designee Karen Timberlake. “Layering protection by getting vaccinated and wearing masks in schools and in public, indoor settings is critical to stopping the spread of the Delta variant.”