Legislators want to keep local structure but adopt integration reforms
MacIver News Service | May 14, 2015
Joint Finance co-chairs John Nygren (R-Marinette) and Alberta Darling (R-River Hills) joined fellow committee members Dean Knudson (R-Hudson) and Leah Vukmir (R-Wauwatosa) in forwarding a modified plan for Wisconsin’s long-term health care programs. Members outlined a vision for a regional system with multiple “integrated health agencies” (IHA) in each region to ensure competition between providers and plans.
At a press briefing just before Thursday’s Joint Finance session, the four members said that the Governor’s plan to move to a statewide, integrated model simply did not have the input from stakeholders that was needed. They agreed with the governor’s basic goals of bending the cost curve and better integrating managed care services, but wants to continue Aging and Disability Resource Centers (ADRCs) that act as local gateways for long-term care services.
The plan would cement the availability of self-directed health plans that are a feature of Wisconsin’s IRIS program. Members also want the state to determine per member per month health care rates, or how much it should cost to take care of each participant, through an independent actuary.
If approved, the plan would require the Department of Health Services (DHS) to negotiate with the federal Center for Medicaid Services (CMS) to ensure that it passes federal muster.
The announcement puts some “meat on the bones” for the direction legislative leaders want to take Wisconsin’s costly long-term care system.