Wisconsin expects to see system changes that drive community hospitals to aggressively fund raise to maintain operation. Systems are changing to create an unsustainable period for community hospitals who deliver care on a very tight budget.
Wisconsin regulations for eligibility for Medicaid as a pay source for hospital services are embedded with requirements that disrupt the hospital process for seeking reimbursement for treatment claims. Wisconsin Counties are reporting heroin, opiates, and meth addiction numbers are at an all time high.
Greater State control of the Medicaid benefit results in implementing compliance tasks to assure continuous access. Addicted individuals need help and are not compliant with regulations that only reimburse on a drug free beneficiary.
These addictions are served by the higher cost emergent urgent medical treatment delivered through the community hospital. Expect to hear community hospital administrators alerting County committees of the increasing number of non-paid community hospital stays.
Non- paid hospital stays are escalating and the numbers are expected to soar with the transition period from the Affordable Care Act to the Legislative Replacement Bill. Community hospitals struggle to manage the increasing difficulties with a changing claims process with the level of staffing the tight budget allows.
Community hospitals will be looking to the foundation gifts as a means to continue operation through this uncertain environment. This internal shift of funds will feel very uncomfortable to some working to keep the doors open.
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