Wisconsin has implemented a series of initiatives focused on improving healthcare. In 2017, the Agency for Healthcare Research and Quality ranked Wisconsin as the state with the best healthcare quality in the country based on 130 ranking measures. Contributing to better care coordination and quality, Wisconsin had the second highest number of physicians using electronic health records, as of 2017. Wisconsin has an all-payer claims database (APCD), voluntarily created in 2005 by members made up of providers, employers, payers and the state.
In 2019 Wisconsin formed the Health Care Coverage Partnership between the Department of Health Services and the Office of the Commissioner of Insurance to expand healthcare outreach, education and enrollment around the state. Though Wisconsin has yet to expand Medicaid, they did adopt a 1332 state innovation waiver for a reinsurance program in 2018, which has been credited with the average 3.2% decrease in premiums in the individual market in 2019. The state has undertaken other measures aimed at reducing healthcare costs: a 2018 law requires the Department of Health services to create a program to reimburse hospitals and healthcare systems for intensive care coordination services provided to Medical Assistance recipients.
However, Wisconsin has significantly high healthcare costs, particularly in urban areas – premiums for individuals were higher than the national average in Wisconsin in 2017 and premiums and deductibles for large group health plans have tripled since 2000. In addition, a 2016 Health Care Cost Institute comparison found significantly higher costs in five Wisconsin cities than the national average and wide price variation between the five cities. A 2019 Health Affairs Blog lays out how Medicaid expansion would lower premiums in the private health insurance marketplace and improve coverage in Wisconsin. Medicaid expansion has been shown to reduce uncompensated care costs (totaling $1.1 billion for Wisconsin hospitals in 2017), while Medicaid work requirements are likely to lead to coverage losses, increasing costs for consumers and hospitals. In addition, Wisconsin is expected to face a shortage of primary care physicians by 2035, many of them in rural areas which are already experiencing shortages of mental health providers and pharmacists.
Wisconsin ranked 19 out of 47 states plus DC, with a score of 37.5 out of 80 possible points in the Hub's 2021 Healthcare Affordability State Policy Scorecard.
The Dane County Health Council, the Foundation for Black Women’s Wellness and numerous community health partners have launched ConnectRx Wisconsin, reports Madison365. The initiative is a new care coordination system supporting Black pregnant birthing persons to improve access to healthcare and stabilizing resources, such as food, financial assistance, housing, employment and transportation. The aim is to reduce the occurrence of low birthweight infants and improve birth outcomes for Black birthing persons and babies in the county. Advocates note that in Dane County, babies born to Black mothers are twice as likely to have low birthweight than those born to white mothers. They also note that by providing care coordination and solutions for social needs, they may improve the health of both infants and parents, and hopefully eliminate health disparities.
The Wisconsin Department of Health Services has announced the creation of a new branch to improve health outcomes of historically underrepresented groups—The Office of Health Equity—reports Spectrum News 1. The Office of Health Equity will conduct research and policy analysis to address the social determinants, or root causes, of health, including access to housing, stable income and healthcare. The new Office will coordinate existing and new efforts on equity and inclusion across the Department of Health Services, including implementing strategies to build an infrastructure and culture committed to equity and inclusion along with minimizing the impacts of health disparities in Wisconsin communities by evaluating and proposing changes to Department of Health Services policies and budget.
A previous Wisconsin Watch/WPR investigation found that hospitals statewide sued dozens of patients during the early weeks of the pandemic, despite several hospitals pledging to pause or at least slow down aggressive debt collection during the public health crisis, reports Wisconsin Watch. However, one of those hospitals, Froedtert South, filed 314 lawsuits in small claims court against debtors in 2020. The lawsuits collectively sought to recoup about $1.1 million in alleged debt, ranging from $555 to $9,970 per lawsuit – at least eight defendants in 2020 filed for bankruptcy. Other Wisconsin healthcare providers have sued over debt in recent months, court records show, although Froedtert South stands out in volume.
The Wisconsin Department of Health Services (DHS) has announced grants totaling more than $3.1 million to increase access to care and enhance quality in rural Wisconsin. According to a press release by DHS, the grants support education and training to assist rural hospitals and clinics in filling “high-need, high-demand” positions. The grants also seek to grow Wisconsin’s rural physician workforce by prioritizing individuals with Wisconsin ties for new resident positions
The federal Health Resources & Services Administration (HRSA) has ranked Wisconsin the third best state in the nation for the quality and performance efforts of its Critical Access Hospitals, reports Aspirus. HRSA’s measures are from its Medicare Beneficiary Quality Improvement Project, which includes more than 1,350 hospitals across 45 states. The program is intended to reduce hospital closures in rural areas, promote a process for improving rural healthcare and focus on community needs
Nearly half of Wisconsin residents in a federal survey say that they have put off medical care because of the COVID-19 pandemic, reports the Wisconsin Examiner. In addition, more than one in five are concerned about someone in their household losing a job or having their hours cut, according to the U.S. Census Bureau’s weekly survey. The impacts of the COVID-19 crisis have impacted not just access to healthcare, but also housing and employment security.
A new resource, WisCovered.com, aims to guide consumers seeking health insurance, reports the Wisconsin Examiner. The site is starting up as hundreds of thousands of Wisconsin residents have lost their jobs and potentially their health insurance, as well. Set up by the Office of the Commissioner of Insurance, WisCovered.com includes links to a variety of resources to help users learn about their insurance options, including free telephone counseling on health insurance alternatives through the nonprofit Covering Wisconsin or the United Way's 211 service.
Wisconsin has issued two emergency orders that suspend some administrative rules for the Wisconsin Department of Health Services to help maximize the state’s healthcare workforce while ensuring patients continue to get the care they need, according to WeAreGreenBay.com. The executive order adjusts training and license renewal deadlines, as well as paramedic-level ambulance staffing levels for emergency medical services. It suspends staff orientations at home health agencies and hospices, adjusts nurse aide training hours, relaxes criteria for resident care staff at community-based residential facilities and adult family homes and ensures nursing homes cannot discharge patients who are unable to pay. The law allows healthcare provider licenses that would have expired during the public health emergency to remain valid until 30 days after the emergency is over and gives providers who are licensed in other states, but assisting in Wisconsin, time to apply for a Wisconsin license.
Froedtert Memorial Lutheran Hospital, Inc. has sued at least 46 people in small claims court since March 12, though a hospital spokesperson says they have suspended filing in small claims court as of March 18 in response to COVID-19, reports Kaiser Health News and Wisconsin Public Radio. Indeed, court records show at least 18 lawsuits filed on the hospital’s behalf since then, including 15 filed on March 31 alone, and that at least six additional health systems have also sued patients during the pandemic. ABC for Health, a nonprofit public-interest law firm in Madison, explains that facing a medical debt lawsuit is stressful under normal circumstances and is much more so given that many people have lost their jobs and health insurance during the pandemic.
One in four direct caregiver positions at Wisconsin’s nursing homes and assisted-living facilities are vacant, up from one in five two years ago, reports the Wisconsin State Journal. A 2020 survey revealed that as many as 20,655 jobs are open at long-term care facilities, compared to 16,500 in 2018. Citing these alarming statistics, experts have called for expanding a state program aimed at increasing the number of nurse aides and reducing required training for certified nursing assistants from 120 hours to 75 hours.
The Froedtert & Medical College of Wisconsin health system implemented an AI-driven virtual triage tool that has, so far, redirected 30% of patients who initially sought high-cost forms of care to lower, condition-appropriate forms of care, according to Healthcare IT News. The system introduced this tool to better meet the needs of patients and staff, and report that 70% of people who engaged with the online assistant completed a full interview.
In 2018, Texas had about 54 primary care physicians per 100,000 people—one of the lowest ratios in the country, far below the national ratio of 76 per 100,000. More than a quarter of Texans live in an underserved county, according to the Texas Observer. As a result, Texans often have to travel for hours to get care, which ultimately leads to poorer outcomes and higher mortality.
The Wisconsin Office of the Commissioner of Insurance reports that people in Wisconsin who purchase health insurance on the ACA exchange will have more choices in 2020, according to the Milwaukee Journal Sentinel. The number of insurers selling health plans will increase to five, up from three in 2017. Officials believe that the increased competition on the exchange will keep price increases in check and could even lead to price decreases for the following year.
A rural safety net hospital and the only hospital serving Clark County, Wisconsin, managed to remain open by contacting city hall for help getting a loan, according to AP News, but other hospitals in other rural states are not as lucky. While 155 rural hospitals have closed in the past 15 years. However, as of 2017, 16 of Wisconsin’s 76 rural hospitals are operating on a financial deficit as their unpaid medical bills climb. Advocates and hospital administrators worry that Wisconsin may end up mirroring other states that have seen numerous rural hospital closures.
The Wisconsin Collaborative for Healthcare Quality issued a report identifying where gaps in health outcomes and care exist within the state. The report highlighted widespread racial and ethnic disparities, with American Indian/Alaskan Native children experiencing much lower childhood vacination rates, Asian/Pacific Islander adults having much lower rates of breast and colorectal cancer screenings and Black adults with diabetes or heart disease being much less likely to be tobacco-free. The report also highlighted payer disparities, noting that those with Medicare had much lower cervical cancer screening rates. Finally, the report noted limited rural/urban disparities, but that these ay have been related to the use of only two categories to describe rural and urban areas, potentialy masking disparities in these areas.
A recent report by the Wisconsin Collaborative for Healthcare Quality revealed wide variation in how people in the state experience health outcomes and care, which is influenced by many factors. The report found substantial disparities across several measures. For example, the data show that Black Wisconsinites experience substantial disparities (defined as 10 percent lower than the best performing group) for childhood vaccinations, weight management, blood pressure control, tobacco use, and diabetes or heart disease prevalence. Many outcomes were stratified by race and payers or insurers. For instance, those who were uninsured or have Medicaid experienced similar and substantial disparities in nearly every measure compared to those with commercial or Medicare coverage. The Wisconsin Collaborative for Healthcare Quality hopes this data will be used to increase health equity within the state.
The Governor of Wisconsin, through an executive order, created a task force focused on reducing prescription drug prices in Wisconsin, according to WEAU News. The Governor's Task Force on Reducing Prescription Drug Prices is charged with gathering and analyzing data on development, pricing, distribution and purchasing of prescription drugs, analyzing other states' strategies in reducing prescription drug prices and identifying opportunities to work with other states and the federal government. The Task force is also charges with making recommendations for reducing prescription drug prices in Wisconsin.
A 10-year project of the University of Wisconsin-Madison Population Health Institute and the Robert Wood Johnson Foundation shows the health disparities among populations in Wisconsin, according to The Milwaukee Independent. The interactive tool displays different health measures for the different counties in Wisconsin, from air pollution-particular matter to income inequality to ratio of population to primary care physicians.
Wisconsin Medicaid’s 2014 coverage expansion had a tremendous impact on making antidiabetic drugs more affordable for childless, low-income adults, according to the University of Wisconsin-Madison News. The study, published in Health Affairs, revealed that before the expansion, this population was covered by the BadgerCare Plus Core Plan, which covered fewer medications and had higher copays for generic and brand-name drugs. The expanded coverage was also correlated with a 4 percent increase in childless adults using antidiabetic medications, such as insulin and oral medications.
Obesity rates in Wisconsin vary four-fold among adults and six-fold among children, with rural residents more likely to carry excess weights, according to the Lacrosse Tribune. This obesity map, broken down by zip code, found that 41.2 percent of adults and 14.8 percent of children were obese in 2015-2016. Thw map demonstrated that where we live has a tremendous impact on the risk for being obesity: Rural areas generally had higher obesity rates than urban or suburban areas, which could reflect less access to healthcare and affordable healthy food. The Wisconsin Obesity Prevention Initiative started in 2015 is funded by $9.7 million over five years from the UW School of Medicine and Public Health’s Wisconsin Partnership programs.
Wisconsin has the second highest number of physicians using electronic medical records, according to a report from a federal agency, according to the Wisconsin State Journal. The Office of National Coordinator for Health Information Technology (ONC) said 92 percent of Wisconsin's office-based doctors use electronic health records, compared to a 60 percent average across the country.
Wisconsin's growing worker shortage presents a particularly difficult challenge for the health care industry, especially in rural areas and at facilities that care for the elderly and disabled. According to the Wisconsin State Journal, Wisconsin's baby boomers retire in greater numbers over the coming decades and live longer than previous generations; therefore, there will be more consumers of health care while the working-age population that provides those services is projected to stay about the same.
A recent federal report is ranking the health care at Wisconsin’s rural hospitals as one of the best, according to WKBT News. The report, from the Federal Health Resources and Services Administration, refers to the 58 rural hospitals with 25 beds or less. Hospital officials cite patient outcomes and communication with larger hospitals as contributing factors.
UW Health and the Marshfield Clinic Health System withdrew their membership in AboutHealth on Dec. 31, 2016, according to the La Crosse Tribune. AboutHealth was founded two-and-a-half years ago in a quest to improve healthcare and rein in costs. The alliance of Wisconsin provider groups will continue to exist with six members - Gundersen, Aspirus, Aurora Health Care, Bellin Health, ThedaCare and ProHealth Care.
Bills for commercial insurers in southeast Wisconsin increased at half the rate as the national average, according to Milwaukee Business Journal. It has been suggested that lower increases can be attributed to the competitive market of six healthcare systems at the time of the study.
A joint investigation by the Wisconsin Center for Investigative Journalism, Wisconsin Health News and Wisconsin Public Radio found that the costs of seven widely prescribed antibiotics, cancer drugs, arthritis medications and other prescriptions have escalated between 29 percent and 5,241 percent in recent years, according to the Cap Times. The price increases, which continue to mount, place economic and emotional pressure on patients and their families, squeeze the budgets of health care providers and raise costs for taxpayers in Wisconsin and nationwide.
Healthcare in Wisconsin is dramatically more expensive compared to Minnesota. Wisconsin's costs are inflating faster as well, according to a report by Citizen Action of Wisconsin. Deductibles stayed stagnant in Minnesota but increased by 46 percent in Wisconsin in 2016. The report calls for increased rate review authority, expanding Medicaid to enhance Medicaid funds, and end the sale of substandard non-Affordable Care Act-compliant health plans.
The state’s 1115 waiver in 2014 that reduced eligibility limits for Medicaid resulted in approximately 80,000 people losing coverage, according to the Commonwealth Fund. Independent evaluators will be looking into the impact of this policy on those who maintained as well as those who lost coverage.
Healthcare hyperinflation is a long term trend within the state, according to a report by Citizen Action of Wisconsin. Large group health insurance premiums and deductibles have tripled since 2000, with regional rates of inflation ranging from 170% in Madison to 365% in Green Bay, and the major variations in relative cost within regions for different types of insurance suggest the numbers measure underlying medical costs and distortions in the insurance market.
Green Bay Press Gazette: A program in Green Bay, called the Parks Prescription Program aims to promote healthier lifestyles through physical activity, raise awareness of the dangers of childhood obesity and increase use of city parks in partnership with children's healthcare providers. Doctors that participate in the program screen patients ages 6 to 13 for excessive weight and will write “prescriptions" for those who could benefit from more activity to participate in the Green Bay Parks Department's free, 10-week Summer Playground Program.
Cost variations exists across the state, especially in the small group market, according to report by Citizen Action of Wisconsin. Other key points includes the lack of correlation between quality and health insurance costs and cost rankings of premiums by city.
Milwaukee Journal Sentinel: Six of the largest health systems in Wisconsin created a partnership with the goal of improving healthcare quality and lowering costs. The six health systems are to share best practices for improving quality and eliminating waste. The new partnership hopes to contract with health insurers, and the statewide network could appeal to national and government employers. The six health systems now belong to the narrow networks of Anthem Blue Cross and Blue Shield in Wisconsin.