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Shared decision-making required for Wisconsin Employee Trust Fund (ETF) members

For State of Wisconsin Employee Trust Fund  (ETF) members, shared decision-making is required as part of the prior authorization process.  It will provide you with information about the surgery you're considering, including the risks and benefits, as well as alternatives to surgery.

The choice is yours

Shared decision-making will help you decide if surgery is right for you. The choice is up to you. In many cases, learning about the treatment options may help you choose a less invasive treatment for your condition. We believe when you have a say in planning your treatment, you'll be more satisfied with the care you receive.

ETF members are required to complete the shared decision-making process prior to receiving the following surgeries or specialty consults:

Learn more about shared decision-making

To help you better understand shared decision-making, we've prepared answers to commonly asked questions.

Why is shared decision-making only required for ETF members?
The State of Wisconsin Employee Trust Fund (ETF) group requires its members go through the shared decision-making process as it is a contractual obligation.

What is the purpose of shared decision-making?
Shared decision-making helps members understand all of their options, but more importantly, provides additional information to help members have a more educated conversation when talking with their provider.

Why is Security Health Plan interfering with my relationship with my provider?
That is not our intent at all. Shared decision-making is designed to enhance the communication and relationship you have with your provider.

If my doctor provides this information, why do I need shared decision-making?
The education shared decision-making provides is not designed to be better than the information you receive from your provider. It helps prepare you to have a more educated discussion about your care.

What are the medical qualifications of the Security Health Plan staff who are providing this education?
Security Health Plan staff who help you complete shared decision-making come from diverse medical backgrounds. Their education levels vary from certified medical assistant to registered nurse.

Is this just a way for Security Health Plan to save money?
No. In fact, in the long run it might cost us more. If you decide not to have knee replacement surgery today and choose an alternative treatment, three years from now you may change your mind and decide that knee replacement surgery is right for you.

What if I don't complete shared decision-making and go ahead with the referral or surgery?
Security Health Plan will have the right to deny payment for that service, and the liability will fall upon you.

If after I've completed shared decision-making and remain convinced the surgery is my best option, will Security Health Plan cancel my coverage or raise my insurance premiums?
No. While Security Health Plan requires you to complete shared decision-making, we are not telling you which option is the best for you. This is your decision.

Need more information?

If you have questions about shared decision-making, please call Customer Service at 1-800-472-2363. If you are hearing or speech impaired, call TTY 711.