Wisconsin gets pitch for flexibility in health benefits

Groups representing Wisconsin small businesses, hospitals, and health plans floated a proposal last month aimed at reforming the state's health care system, including lowering costs and granting employers more flexibility in providing benefits.

The plan, called "Wisconsin's Healthier Choices for Affordable Health Care," suggests, among other things, that the state allow employers to design their own coverage instead of being forced to include a long list of state-mandated provisions.

The proposal could affect physicians as small employers, even though Wisconsin has a greater proportion of physicians in large groups than many states. Critics of the state's current system say the mandates force small employers to either pay for an extensive plan or decide they can't afford any coverage.

"We're not proposing the elimination of state mandates," said Phil Dougherty, deputy director of the Wisconsin Assn. of Health Plans. "We want the flexibility if buyers want a plan without some mandates. We want the ability to serve somewhere in the middle as well."

While they applauded the effort to address rising health care costs, physicians weren't completely supportive of the proposal. The Wisconsin Medical Society had concerns about important mandated provisions being left out of some plans.

"On one hand, we're careful of unfunded mandates," said Paul Wertsch, MD, a family physician in Madison and medical society president. "On the other hand, there are concerns about what happens if you get rid of a bunch of mandates."

Last year, the medical society updated a plan originally proposed in 1992 to address health care costs. The new proposal calls for the development of a standardized benefits package for state residents and encourages comparison of pricing systems based on current procedural terminology and ICD-9 codes.

The plan was just one of several from state groups trying to tackle the same issue, which is a pressing one in Wisconsin. A study conducted last year by Mercer Human Resources Consulting reported Milwaukee-area health costs were 55% higher than those in other metropolitan areas.

The latest proposal not only calls for more leeway in developing benefits packages for employees, but it also encourages the further development of consumer-driven health care and calls on the state to streamline the process of graduating qualified professionals to help ease a shortage of candidates for health care jobs.