North Central Health Care preps for changes to Medicaid

North Central Health Care will likely have to treat more patients for free in the future after significant changes were made to Medicaid eligibility at the federal level, according to Jason Hake, NCHC’s deputy director.

“We do think our biggest challenge is going to be individuals losing coverage,” he told Marathon County supervisors last week. “I think we’re going to see an increase in charity care, and I think that’s going to be our biggest challenge in the future.”

When asked about the impacts of the “One Big Beautiful Bill” at a recent meeting of Marathon County’s Human Resources, Finance and Capital Committee, Hake said NCHC is not anticipating a big decrease in Medicaid reimbursement rates next year, but he expects those rates to stagnate over time. Medicaid is one of NCHC’s biggest sources of revenue, he noted.

Hake joined Gary Olson, executive director of NCHC, to give an overview of the center’s updated fee schedule for next year, which covers everything from outpatient mental health services to aquatic therapy and nursing home services.

The money NCHC receives for the services it provides is often well below the fees it charges because of the caps set by Medicaid and private insurers, Hake said, and a certain amount of that is written off as charity care so that no patients are turned away. “Our mission is to serve everyone in the community,” he said. NCHC is jointly owned and operated by Marathon, Lincoln and Langlade counties, with Marathon County currently providing about $5.9 million in annual funding. A majority of that money goes toward the operation of Mount View Care Center, a 160-bed skilling nursing home in Wausau. Hake said NCHC is not requesting a increase in the county subsidy for next year.

Until recently, NCHC also ran the Pine Crest nursing home in Merrill, but in June, the Lincoln County Board of Supervisors voted to sell it for $9.5 million. When asked about the impact of the sale, Olson said he “would have to run some numbers” to provide a full answer at a later date.

“We’ll have a better picture next year after we’ve gone through a year without Pine Crest,” he said.

Hake said an estimated $1.2 million in “indirect costs” associated with running Pine Crest will have to be covered elsewhere within NCHC, which will also need to absorb a $500,000 annual loss in revenue from the facility. Overall, though, Hake said NCHC has done “very well” financially in 2025.

The presentation by Olson and Hake was part of a larger discussion about raising fees for county services in order to keep up with increasing costs and minimal tax increases.

County administrator Lance Leonhard said he was about halfway through his meetings with department heads to discuss next year’s budget, and he plans on presenting a proposal to increase fees wherever possible. As an example, he said county clerk Kim Trueblood has compared the county’s marriage licenses, which currently cost $100 per couple, with other counties and is recommending a substantial increase to match the market.

“We’re having those conversations at every budget meeting, with the general presumption to be that market increase,” he said. “My goal is to bring forward a document that, where we aren’t increasing fees at that market rate, we at least have that noted and can provide an explanation as to why.”

Other business

■ The HRFC approved a total of four new or expanded positions for 2026, including a Veterans Service employee going to full time; a full-time health coordinator to focus on homelessness, replacing a nursing position; a full-time HVAC specialist for Facilities Management, replacing a building maintenance technician; and a business management partner for Human Resources, making a limited-term employee into a permanent based on the need to run the Workplace payroll system.

These positions will all need to be approved as part of the 2026 budget.

■ The committee recommended the designation of the stone gate at East Gate Hall in Wausau as a historical site to the Wausau Historic Preservation Commission.

■ The committee authorized the county to sell an unused building at 527 McClellan St., Wausau, an old group home that had previously been transferred to NCHC. The building will be auctioned off on Wisconsin Surplus, with the proceeds going to help NCHC make its annual debt payment to the county.

■ In her final report as human resources director, Molly Adzic said her department has assisted in the hiring of 179 employees this year, along with 176 “separations.” Of those 176, 99 were people quitting or retiring, six were terminations and the rest were seasonal or limited-term employees whose term came to an end. Adzic, who has accepted a job in the private sector, said she is working on a departure plan before she leaves county employment.