Franciscan Healthcare CEO outlines reasons Winneshiek Medical Center might accept the Gundersen Lutheran Health Plan

Currently people who get their health insurance through Gundersen Lutheran Health Plan have to pay double the deductible to go to Winneshiek Medical Center than they do if they go to a Gundersen-Lutheran related hospital.  But the top administrator for Mayo Clinic Health System's Franciscan Healthcare in La Crosse says he can think of several reason the current situation could change.

Dr. Tim Johnson outlined three reason to members of the WMC Board on Wednesday--but also cautioned that there were risks involved.

Dr. Johnson said Winneshiek Medical Center might actually be able to negotiate for higher reimbursements from Gundersen than it presently has with Wellmark Blue Cross and Blue Shield.  Wellmark is Iowa's leading health insurance provider, but it sometimes uses its large size to drive hard bargains.  Johnson says higher reimbursement rates wouldn't matter, however, if there is a shift of patients away from Winneshiek Medical Center.

Secondly, Johnson noted there is "a lot of turmoil in the community" over Winneshiek Medical Center's decision not to name Gundersen as an in-network provieer.

Thirdly, Johnson said a contract with Gundersen could lead to increased usage at the hospital.  However, he also said there would be a "significant risk" that the opposite would be true without language in any contract with Gundersen that required Gundersen to use the hospital at a certain level.

Dr. Johnson concluded by saying Mayo Clinic Health Systems is ready to compete with Gundersen Clinic for the delivery of health care in Winneshiek County, "but we don't want to be disadvantaged."