Addressing the Healthcare Affordability Crisis in Milwaukee

Delivering Better Health Through Affordable Care

The people of Milwaukee are facing unprecedented economic challenges – no one has been spared from rising grocery bills, increased rent and utility bills, and even higher costs for car insurance. Combined with rising healthcare costs in Milwaukee, people are faced with tough decisions. Families are delaying or skipping care because of cost concerns – a trend that impacts community health, workforce productivity, and the local economy. It’s time to address the healthcare affordability challenge head on.

Why Healthcare Costs Keep Climbing

 

The first step in addressing the healthcare affordability crisis in Milwaukee is to recognize why it’s happening. Premiums are a direct reflection of local healthcare costs, and Wisconsin has some of the highest healthcare costs in the country. These are some of the biggest factors driving cost:

 

  • Aging population – More older adults need more complex and costly care.
  • Chronic conditions – Obesity, diabetes, and heart disease are examples of conditions that are becoming more common AND more expensive to treat.
  • Drug costs – including specialty drugs – They continue to rise, with prices of existing drugs increasing at rates faster than inflation and new drugs starting at record-high prices.
  • Provider consolidation – When healthcare providers merge, it often leads to higher prices and fewer choices.
  • Fraud, waste, and abuse – The complexity of our system makes it easier to abuse the system.
  • Legislation – Recent policy changes continue to mean added costs in the system – year after year.

 

See our recent article in the Milwaukee Business Journal about what we're doing, and keep reading below.

Who Can Make a Difference

 

 

Addressing the multi-factor contributors to healthcare affordability requires all members of the healthcare system to act. Payors, hospitals and health systems, healthcare providers, pharmaceutical companies, lawmakers, and individuals all need to take a seat at the table.

 

Healthcare providers must focus on value, not volume, leaning into value-based care models that incentivize positive healthcare outcomes. Lawmakers must work to better understand the impact of legislation being proposed and passed with each session, factoring in the true cost of the affordability crisis. Individuals must engage in their healthcare journey, investing time to understand their healthcare coverage and benefits so they can use the tools, programs and resources available, knowing that there is support to help navigate options and costs.

How We're Making Healthcare More Affordable

 

At Anthem Blue Cross and Blue Shield, we’re working toward solutions to address affordability on behalf of our members in Milwaukee. Affordability is central to improving health outcomes and driving economic resilience. Rising costs ripple through businesses and communities, affecting productivity and long-term well-being. That’s why we are committed to solutions that go beyond traditional cost control measures.

 

Given the contributing factors to the affordability crisis, here are some of the things we’re doing to make healthcare more affordable in Milwaukee:

 

  • Helping seniors manage complex care so they avoid unnecessary hospital stays.
  • Offering disease management programs that help members better control chronic conditions.
  • Negotiating lower prices for prescription drugs, especially expensive specialty drugs.
  • Working with providers to pay them based on the quality of care they deliver, not the number of services they provide.
  • Giving members rewards through programs like SmartShopper when they use our tools to compare prices (please note that this program is only available to members enrolled in certain plans).
  • Using AI to improve administrative efficiencies and the member experience.
  • Advocating for policies at both the state and federal levels that support affordability and access.

 

Our strategy blends proven tools with fresh thinking: expanding access to high-quality care, simplifying benefit design, preventing fraud and waste, and addressing the full spectrum of health – physical, behavioral, and social drivers of health.

Looking Ahead

 

Historically, health plans focused on paying for care and controlling costs. Today, we recognize that most factors influencing health occur outside medical settings. Social drivers like housing, nutrition, and behavioral health play a critical role – and overlooking them only compounds costs higher. This is why it is so important that stakeholders across Milwaukee come together to address it.


By working together – we can build a more affordable, accessible, and effective healthcare system for every family in Milwaukee.