June 7

(Madison) - State officials are leaning on a request-for-proposals (RFP) process to support a state consultant's recommendation to self-fund the 250,000-enrollee State Group Health Program. Wisconsin's community-based health plans believe an RFP won't be enough to adequately consider the impact of self-funding, and one state official apparently agrees.

The Walker Administration and the Group Insurance Board have maintained that issuing an RFP is the only way to obtain the data needed to evaluate the pros and cons of self-funding the State Program. Wisconsin's community-based health plans believe self-funding the State Program and other recommendations from the state's consultant will increase the state's medical costs and financial risk, reduce choices and local competition, disrupt patient care and negatively impact the competitive health insurance market and local communities.

While an RFP can provide vendors' administrative cost projections, the broader impact of self-funding cannot be determined through an RFP. Department of Employee Trust Funds Strategic Health Policy Director Lisa Ellinger made that point in a June 7 Wisconsin Health News panel discussion, when she said the impact of self-funding on the broader Wisconsin market is outside the scope of the self-funding RFP.

The full impact of self-funding the State Group Health Program touches many significant issues, as the state's consultant, Segal, said, "A likely outcome of such a significant project will change the healthcare landscape in the State."

While the RFP will be released soon, it is equally important for the Administration to devote sufficient energy and resources to assessing the issues outside the scope of the RFP. That should include, in Segal's words, "gaining consensus and coming to logical, supportable, market and data driven recommendations."

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