Psychiatrist John J. Wernert, M.D., was elected and planned to become the next ISMA president, but in June 2014 Gov. Pence tapped him to head the Indiana Family and Social Services Administration (FSSA). After six months at the FSSA, Dr. Wernert wants his ISMA colleagues to know, “This is a new day. We have a governor who is committed to improving Hoosier health and willing to change things, but we need your help with solutions.”
Dr. Wernert shares what he’s learned about the agency, as well as his goals and thoughts about how the ISMA and its members can help improve Medicaid and social supports for all. Your input is welcome in this new era when the first physician serves as FSSA secretary.
“The biggest surprise since coming here is seeing the high quality of the executive team and staff. They truly have a servant’s heart and are interested in doing what’s best to help people in need. The agency is not as bureaucratic and immovable as I was led to believe. You really can institute change and get some things done in a relatively short period.
|The son of a physician and nurse, who has medicine "in his blood," John J. Wernert, M.D., had often thought of running for state office, like his Kentucky kinfolks. Under Gov. Mitch Daniels, he considered the FSSA position, but the time was not right – until now.
Goals and priorities
“My first priority is to ensure patients and families are at the center of what we do at FSSA. We directly touch the lives of 30 percent of our citizens, and our agency is 43 percent of state government spending.
In such a large agency, programs and functions can get siloed. For example, the Division of Mental Health is concerned about the mental health of citizens, and the Division of Aging works with the elderly. These divisions must work in concert, coordinating services for maximal impact.
“In medicine, we moved to the primary medical home model. In a similar way, I see opportunities to gain efficiencies and improve coordination in FSSA. Integrated care is how we practice medicine now, so it’s not a big jump to come to state government and say we need to help our fellow citizens in need – rescuing families, restoring lives and giving folks a hand up, not a hand out.
“Doctors need to know more about Indiana FSSA. We have a $12.5 billion total budget per year, and 94 percent of it goes to providers. Historically, there has been a contentious relationship between FSSA and providers, and we’re trying to make it a more positive, collaborative partnership. That’s a priority for Gov. Pence. He wants me to spend as much time as possible mending fences and working with provider groups.
“We opened up our processes across the agency, in strategic planning and determinations of payment policies, by bringing in end-users, the doctors, prescribers and providers at all levels who are impacted by these policies – giving them a chance to collaborate and give input.
Forms and papers
“We are trying to simplify the administrative burden and make sure Medicaid aligns with federal rules, so doctors have only one set of rules to follow. We assembled a team to look at unnecessary forms and paperwork; some of these forms are 20-30 years old and no longer useful. We want to become electronic and paperless to leverage the investment physicians have made in their electronic medical record systems.
Changes with HIP 2.0
“A big priority is expanding access to medical care for patients, not just providing insurance coverage. To expand access and get physicians on board, we must have an increase in the Medicaid fee schedule. Indiana Medicaid has paid 67 percent of the Medicare rate. With the HIP 2.0 approval, doctors will get a significant raise when treating current and future Medicaid patients. Indiana doctors have not had a raise in Medicaid pay since 1994, other than the temporary pay raise from the Affordable Care Act.
“The key point in the HIP 2.0 announcement should be that HIP replaces traditional Medicaid and is a much different and enhanced benefit structure. I believe that with the reimbursement increase, most doctors and medical groups in the state will consider taking on new Medicaid patients."
To learn the details about HIP 2.0 reimbursement rate increases, see this IHCP bulletin.
“With these reimbursement increases, we’re putting substantial new dollars into the system, a significant improvement in reimbursement that will entice providers to take on new enrollees.
How to help
“Legislators want to hear from doctors. Why? They all have doctors; our profession touches all lives. As physicians, we need to improve our advocacy and interactions with state agencies like FSSA, Department of Child Services and the Indiana State Department of Health. We must not just complain about the perceived problems in the bureaucracy, but truly engage and help devise solutions.
“I promise you my door is open, and my team at FSSA wants to hear from you. Remember: This is a new day!”