Tracking Medicaid Fund Performance Wisconsin

The law makers and administering public entity will be pushing to advance implementation to improve activity directly tied to Medicaid fund performance.  The transformative structure involves the Family Care IRIS 2.0 and the Dementia Care Redesign going statewide.  These transitions move Medicaid funded delivery to a value based practice designed to improve outcomes while diminishing the outflow of money. 

This top down approach has changed the supply/demand outlook.  Existing community providers struggling to forge a practice that will meet the populations needs are becoming absent.  The State wide delivery will present with larger pockets of hard to serve areas. 

The performance of the Medicaid fund is dependent upon administering entities (Integrated Health Agencies) being able to contract with lower cost community providers who can help the individual who is eligible for reimbursed service.

The State of Wisconsin's Department of Health Services will be required to demonstrate efforts to educate the existing population of community providers to be able to better participate in this new value based model.  Community providers will need to align their delivery to better serve the entire system.

Wisconsin's Home Care Path has applied change to their delivery process when helping families with an elder experiencing the undesired symptoms of dementia.  These changes bring value to families who care for an elder with symptoms of dementia by delivering an early phase response- with an affordable service.  Home Care Path brings value to payers by initiating early engagement designed to prevent scary crisis dementia events.  Home Care Path brings value for primary medical providers by collaborating to achieve the care continuum tasks proven most beneficial for attaining the dementia redesign listed outcomes.

Each community provider will be challenged to adjust their process as the public programming that is funded by Medicaid evolves to achieve a value based delivery.  The performance of the Medicaid fund will be closely and thoroughly examined to assure greater value is being experienced by these new initiatives.

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