Despite a $6.6 billion two-year budget deficit, Wisconsin is going ahead with plans to expand its BadgerCare Plus program to childless adults. And, because the budget calls for state health officials to find $500 million in budget savings in the coming years, it's a fair bet that the state will be looking to expand managed care and other cost-saving mechanisms in its health programs.
Wisconsin Medicaid is saving money through its carve-out of pharmacy services, joining the multi-state pool known as TOP$. It's also moving toward greater use of medical homes.
Wisconsin employers are experimenting with more on-site medical clinics, many of which have a pharmacy component and a wellness component.
The state's health plans are adopting value-based drug benefit design to varying degrees, trying to balance their formulary decisions with both price and clinical value. Meanwhile, Dean Health Plan is expanding the reach of its pharmacy benefit manager, Navitus Health Solutions, which touts a different business model than the PBM giants.