HOW - State Employees
Wisconsin provides its employees with benefits including healthcare insurance. Healthcare of Wisconsin [HOW] is a new Wisconsin statute and a better way to provide state employees with healthcare because it 1) deals directly healthcare providers and 2) eliminates insurance companies and pharmacy benefit managers. HOW is neither a governmental single payer “Medicare for All” plan nor a self-insurance plan. Wisconsin would not assume the tasks customarily assigned to a healthcare insurance company.
State employees keep the healthcare providers they love and lose the insurance companies they don't.
HOW – Trust Fund
HOW uses current state organizations and policies to provide healthcare to state employees. HOW creates a joint venture of healthcare providers, licensed in Wisconsin. Instead of paying premiums to healthcare insurance companies, HOW reallocates these taxpayer dollars and establishes a trust fund [FUND] including the requisite initial capitalization and reserves.
The FUND covers the payments to healthcare providers for their goods and services supplied to state employees. The State of Wisconsin Investment Board manages the FUND. HOW achieves the lowest costs for taxpayers.
HOW - Joint Venture
HOW creates a joint venture [JV] of healthcare providers, licensed in Wisconsin. Healthcare providers manage themselves. They set their prices for goods and services. They set procedures for referrals, prior authorizations, patients’ appeals, payments, services utilization, etc. They appoint JV as their agent to negotiate a healthcare-requirements contract with Wisconsin for state employees.
HOW – What Does It Buy
HOW pays for hospitalizations, medical coverage, ambulatory patient, urgency, emergency, pregnancy, maternity, newborn care, mental health, substance abuse disorder, rehabilitative and habilitative care and devices, laboratory, preventative and wellness care, pediatric care, pediatric and adult oral and vision care, medical management programs and prescription drugs.
HOW - State Agencies
The Wisconsin Department of Health Services manages HOW operations and and negotiates with JV on behalf of state employees. Wisconsin Employee Trust Funds manages processes and pays the claims from the sale of healthcare goods and services to state employees.
HOW has its costs too, including additional personnel to Wisc
HOW - State Agencies
The Wisconsin Department of Health Services manages HOW operations and and negotiates with JV on behalf of state employees. Wisconsin Employee Trust Funds manages processes and pays the claims from the sale of healthcare goods and services to state employees.
HOW has its costs too, including additional personnel to Wisconsin Departments of Health Services, Employee Trust Funds and the State of Wisconsin Investment Board.