Two WI Health Care Organizations Awarded about $7 Million to Pilot Cost-saving Initiatives

The federal health care reform law (aka the Affordable Care Act) includes many components that are designed to help improve the efficiency of the health care system and reduce costs. Among those parts of the law is funding for grants to test innovative ways of lowering costs and improving care.

Last week the Center for Medicare and Medicaid Innovation awarded a total of $772 million of grants to 81 organizations across the country, including two grants for 3-year pilot programs in Wisconsin:

• Children's Hospital of Wisconsin is receiving a $2.8 million grant to help families in its 45,000 member Medicaid HMO find health homes and reduce avoidable hospital visits. 
• The Pharmacy Society of Wisconsin will receive a grant of $4.1 million grant to expand across the whole state to a pilot program now in Dane County that pays pharmacists to advise patients about their medications.

The Children’s Hospital HMO – Children's Community Health Plan – will hire a nurse and six "navigators" to work with higher risk members to assist them in getting the care they needed and to ensure they are aware of resources available in the community. They will focus on those who in the past six months have either had two emergency room visits or have asthma and have had one hospitalization or emergency room visit.

This pilot project will test a promising approach for controlling costs, while also improving outcomes. It’s a marked contrast to the changes to BadgerCare that the state is making in July, which don’t save money or improve outcomes; instead they will decrease access to cost-effective care and shift costs from the state to hospitals’ uncompensated care.

Read more about both of the new grants in the Journal Sentinel article by Guy Boulton, and check the federal website regarding all the innovation grants. Please also note that last week WCCF began a series of blog posts on a “top ten” list of ways that the health care reform law is already helping Wisconsinites. We will add to it each day as we approach the ruling on the law’s constitutionality, which the Supreme Court is expected to issue later this month.

Jon Peacock