Buoyed by the promise of better care and lower costs, health organizations are increasingly flocking to care coordination models. But they are not always easy to organize in today’s disjointed healthcare system and current payment structures often don’t reward the effort. Also, coordination among different programs is lacking.

A panel of experts will share their experiences from the field. Find out what’s working, what’s not and what they see as the future of care coordination. Panelists: 

• Joy Tapper, Executive Director, Milwaukee Health Care Partnership 
  
• Tom Lutzow, CEO, Independent Care Health Plan
  
• Jane Pirsig-Anderson, Director, Aurora Health Care Family Service
  

The event is Tuesday, April 4 from 11:30am – 1pm at the Wisconsin Club in Milwaukee (900 West Wisconsin Avenue). Register now.

February 24, Wisconsin Health News

The Wisconsin Department of Justice has reached an agreement with Adapt Pharma to offer an anti-overdose nasal spray at a discounted rate when bought in bulk by police, first responders and state or local government agencies.

Narcan Nasal Spray can reverse some of the effects of an opioid or heroin overdose. Under the agreement, approved entities that purchase the nasal spray in quantities of greater than 48 units can receive a 40 percent discount. 

That reduces the price from $125 to $75 for two 4mg doses. The rate is set until Feb. 15, 2018. 

Schimel earlier in February renewed an agreement with Amphastar Pharmaceuticals that established a rebate program for each of its naloxone syringe purchased by public entities in Wisconsin through Feb. 1, 2018.

February 20, Wisconsin Health News

More than 12,000 doctors and other prescribers have registered for the state's Enhanced Prescription Drug Monitoring Program, Department of Safety and Professional Services staff told the Medical Examining Board last week.

That's about a third of the total number of expected eventual participants, said Andrea Magermans, PDMP analyst. More than 5,000 delegate users, which act on behalf of prescribers, have signed up too, she told board members last Wednesday.

The registration process is different than under the older program, which has posed a challenge, she said.

"There have been some customer service type of issues," she said. "We've been addressing them as they've come up."

Magermans noted that getting used to the new format has posed a challenge for users as well. But once they're used to it, "it seems to be going well," she said. They've received positive feedback about the changes.

Effective April 1, those prescribing controlled substances will have to review a patient's records before writing a prescription. Prescribers will also have to update the PDMP by end of the next business day after dispensing a controlled substance in most cases.

Magermans said they hope to create a new category in the PDMP for medical directors by April 1, which will allow those overseeing prescribers to review their prescribing methods. By the start of April, DSPS also plans to add a component to the program so prescribers can review their own prescribing history. 

DSPS is also in talks with health systems, including Aurora Health Care, Gundersen Health System, Marshfield Clinic Health System, ProHealthcare and UW Health, about pilot projects allowing health systems to integrate their electronic health records with the ePDMP, she said.  

At least one pilot organization will be working on it prior to April 1, but Magermans didn't know how far they would be in the process.  

Gov. Scott Walker's 2017-'19 state budget, released earlier this month, recommends $1 million to fund five positions "for the continued improvement" of the PDMP. Dr. Tim Westlake, vice chair of the Medical Examining Board, said the new positions should help with the rollout.

But he said that a concern they should have is whether the board has the resources to prosecute the cases, in case there's a spike.

"We want to make sure we have enough investigative resources to be able to prosecute the cases," he said. "If we get an extra 20, 30 or 50 opioid prescribing cases that can bog the whole system down."

Join Wisconsin Health News for a Newsmaker Event with Department of Health Services Secretary Linda Seemeyer, who will outline Gov. Scott Walker's 2017-19 budget and discuss department priorities.

The event is being held March 21st from 11:30 am to 1:00 pm at the Madison Club, 5 E. Wilson St, Madison WI 53703.  Register now.

February 15, Wisconsin Health News

Group Insurance Board members sent a letter last week to lawmakers, revealing more information on the process they used when deciding to self-fund and regionalize the health plan for state employees.

Their plan, approved last week, would shift the state away from a fully insured model, which involves 18 companies, to a model with six vendors. They estimate the move could save more than $60 million in the 2017-'19 state budget from reduced administrative and insurer risk fees as well as improved discounts. Department of Employee Trust Funds spokesman Mark Lamkins did not provide a further breakdown of the savings.

Any self-insurance contract is subject to approval by the Legislature's Joint Finance Committee.

The board selected Compcare Health Services Insurance Corp. to offer a statewide option as well as a regional option. The other companies serving regions would be Dean Health Plan, HealthPartners Administrators, Network Health Administrative Services, Security Administrative Services and Quartz, which is affiliated with Unity Health Insurance and Gundersen Health Plan. 

In a letter sent Friday to JFC co-chairs, GIB Chair Mike Farrell and board member Stacey Rolston, who is a deputy administrator in the Division of Personnel Management at the Department of Administration, wrote that those participating in the state employee health plan will have greater access to providers than are currently available to most members under a proposed move to self-insurance because CompCare has a broader network.

They also wrote that providers that are part of Group Health Cooperative of South Central Wisconsin, which did not respond to an RFP on administering the program, will be included via other third party administrators. In addition, Physicians Plus, which responded to the RFP but wasn't selected as a vendor, is exploring a partnership with Unity and Gundersen, according to the letter.

According to GIB, nine companies responded to the RFP. That also included Mayo Clinic Health Solutions, the self-insurance business unit of Health Traditions Health Plan, which wasn't chosen. WEA Trust also participated in the process and did not receive an offer. 

GIB noted that many of the plans with minimal participant enrollment in the program chose not to respond, including Arise, Group Health Cooperative - Eau Claire, MercyCare Health Plans and Medical Associates.

But Patrick Cranley, MercyCare chief operating officer, said GIB's characterization was "a little bit disingenuous."

"We could not respond to the RFP because the RFP required that respondents be able to serve an entire region defined by the RFP," Cranley said. He called it "a conscious decision to limit the number" of plans participating in the state program.

Cranley called the board's decision an "unfortunate choice" for the wider market as it eliminates a number of high quality community health plans from participation in the health plan.

"I think it does long-term damage to the competitive insurance market in the state of Wisconsin," he said. "You're essentially perhaps even crippling some of the plans that are smaller plans that provide important competition in the markets in which they participate."

Cranley said MercyCare serves 1,400 members in Jefferson, Rock and Walworth Counties through the state plan. That's out of 48,000 total members for his plan.

"I would prefer to continue to serve these folks and let them have access to our health plan," he added. 

ETF often pursues an "aggressive education campaign" to ensure participants understand their choices under the program, according to the letter. The communication strategy for 2018 "will be unprecedented," Farrell and Rolston wrote.

The board plans to finish contract negotiations by the end of March.

Read the letter.

The Wisconsin Department of Safety and Professional Services (DSPS) launched the new Wisconsin Enhanced Prescription Drug Monitoring Program (ePDMP) on January 17, replacing the former program.

2015 Act 266 requires physicians and other prescribers to review patient information from the ePDMP before issuing a prescription for any controlled substance beginning April 1, 2017. (More information, including exceptions to the requirement to consult the PDMP, in this nonpartisan Legislative Council memo.)

Be ready with the following information in order to register for the ePDMP, and note that prior login credentials no longer work.

• Last name.
• Last four digits of your social security number.
• License number.
• License type (profession).
• Specialty or primary area of practice.
• DEA number.

 The ePDMP supports current browsers and two previous versions, except it only supports the current and previous version of Internet Explorer. If you experience issues, DSPS suggests that you update your browser.

Once the registration process is complete, users can begin looking up patients and managing delegates. The multistate search function will be available to both prescribers and their delegates as soon as their accounts are established. Training materials, including brief tutorial videos and information about creating and maintaining delegates are available at pdmp.wi.gov.

If you have questions or experience problems with the registration process, contact pdmp@wisconsin.gov.

In response to a national crisis relating to a 2012 outbreak of fungal meningitis linked to contaminated compound drugs sourced from a New England Compounding Center, ASPS published an issue brief on In-House Compounding. View brief. 

The Assembly Committee on Health and the Senate Committee on Health and Human Services for the 2017-18 Session have been set. Committee membership is as follows:

Assembly Committee on Health

• Representative Joe Sanfelippo, R- New Berlin (Chair)
  
• Representative Kathy Bernier, R – Chippewa Falls (Vice-Chair)
  
• Representative James Edming, R – Glen Flora
  
• Representative Ken Skowronski, R - Franklin
  
• Representative Jesse Kremer, R - Kewaskum
  
• Representative Chuck Wichgers, R - Muskego
  
• Representative Dave Murphy, R - Greenville
  
• Representative Andre Jacque, R – De Pere
  
• Representative Deb Kolste, D Janesville
  
• Representative JoCasta Zamarripa, D – Milwaukee
  
• Representative Lisa Subeck, D - Madison
  
• Representative Chris Taylor, D - Madison
  

Senate Committee on Health and Human Services

• Senator Leah Vukmir, R – Brookfield (Chair)
  
• Senator Terry Moulton, R – Chippewa Falls (Vice-Chair)
  
• Senator Devin LeMahieu, R - Oostburg
  
• Senator Jon Erpenbach, D - Middleton
  
• Senator LaTonya Johnson, D - Milwaukee

January 6, Wisconsin Health News

Gov. Scott Walker called for a special session of the Legislature Thursday to consider 11 bills that aim to combat the heroin and opioid epidemic.

The bills are based on recommendations from a task force that Walker convened last year, chaired by Lt. Gov. Rebecca Kleefisch and Rep. John Nygren, R-Marinette.

The task force released an interim report Thursday. Even though it hasn't finished its work, the opioid and heroin epidemic are "such a crisis to deal with, we need to start acting now," Walker said.

"We need to tackle this issue head on," Walker told attendees of a Wisconsin Bankers Association event in Madison Thursday. "Not because it's a quality of life, not because it's a public health issue, but because it's a key part of our workforce."

Among the proposals the Legislature will consider are bills that would in the 2017-'19 biennium provide $2 million to support new medically assisted treatment centers, $1 million for consultation services helping medical professionals connect with addiction medicine specialists and $126,000 to the rural hospital graduate training program.

Another bill would provide money to the Department of Justice to fund criminal investigation agents focused on drug trafficking. And another would expand the Screening, Brief Intervention and Referral to Treatment training program offered by the Department of Public Instruction.

"All of us know someone personally affected by a heroin overdose or drug death," Kleefisch said in a statement. "Together, we're going to continue this initiative as we look for new ideas and evaluate the impact of the policies we've adopted the past several years."

An additional proposal would allow school personnel that can administer life-saving drugs like EpiPens to use the anti-overdose drug Naloxone. And two more would require schedule V substances that contain codeine like some cough syrups by dispensed with a prescription and extend limited immunity from prosecution to overdose victims.

Other bills include permitting the University of Wisconsin System to open a recovery school for students who need in-patient care and allowing relatives to commit a drug-addicted family member in the same way as is currently allowed for alcoholism.

Walker's order doesn't include all the recommendations made in the report, such as providing $2 million over the next biennium for Wisconsin hospitals to hire in-house recovery coaches. His spokesman said the bills are in the final stages of draft form and will be released when introduced.

Another order signed by Walker Thursday directs state agencies to pursue a number of different initiatives to curb opioid abuse, including having the Office of the Commissioner of Insurance conduct a survey of opioid addiction treatment coverage for major insurers in Wisconsin. 

"The recommendations included in this report are not the silver bullet," said Nygren, who's authored 17 laws fighting drug abuse though his Heroin, Opioid Prevention and Education Agenda. "I look forward to continuing the fight."  

Wisconsin Hospital Association CEO Eric Borgerding noted that the interim report includes recommendations they suggested, like providing investments in fellowship training for addiction medicine and streamlining regulations for healthcare providers that are trying to expand access to substance abuse treatment.

Wisconsin Medical Society Chief Medical Officer Dr. Donn Dexter called the package of bills "ambitious, which is exactly what dealing with this crisis demands." The Pharmacy Society of Wisconsin said the proposals aim to increase access to treatments and prevent new addictions.

"We're especially excited about the investments to increase the number of providers available and in telemedicine," Bernie Sherry, senior vice president and Ministry market executive for Ascension Wisconsin, said in a statement. "This is a good day for Wisconsin." 

Myranda Tanck, a spokeswoman for Senate Majority Leader Scott Fitzgerald, R-Juneau, said they'll likely maintain their current session calendar for when the full body meets. 

Kit Beyer, a spokeswoman for Assembly Speaker Robin Vos, R-Rochester, said they hope to have the bills ready for committee hearings by the end of the month.

Assembly Democratic Leader Peter Barca, D-Kenosha, said the urgency of the special session is warranted.  

"The opioid epidemic in our state is a very serious issue that requires a very aggressive response," Barca said in a statement. "I hope the committees will collect input from those who know this issue firsthand -from law enforcement, to educators, to medical professionals - as this will help us address this crisis in the most comprehensive manner possible."

Walker also signed an order directing the Department of Health Services to apply for funding available through the 21st Century Cures Act, which was approved by the federal government last year. The act makes $7.6 million per year available for two years to Wisconsin. His order directs the department to apply for the grants by Feb. 17.   

Sen. Tammy Baldwin, D-Wis, said she helped lead the effort in Congress to include $1 billion in the act for the opioid epidemic. 

"The opioid epidemic is not a partisan issue, and a strong partnership between the federal government and our state is essential to an effective response," she said in a statement. "This is a significant step forward for communities fighting the opioid epidemic across Wisconsin."

The Wisconsin Department of Safety and Professional Services (DSPS) plans to launch the new Wisconsin Enhanced Prescription Drug Monitoring Program (ePDMP) on Tuesday, Jan. 17.

2015 Act 266 requires physicians and other prescribers to check patient information from the ePDMP before issuing a prescription for any controlled substance beginning April 1, 2017. (More information, including exceptions to the requirement to consult the PDMP, in this nonpartisan Legislative Council memo).

All prescribers will have to register to use the ePDMP—even if they are registered with and use the current system, which is being replaced and will not be available after Jan. 17.

The new ePDMP is designed to promote streamlined workflow integrations and improved data quality using analytics and visualizations to draw user’s attention to the most relevant and possibly concerning data in each report.

Questions about the ePDMP can be directed to pdmp@wisconsin.gov.