April 21, 2017
Volume 61, Issue 16


1,000 Hospital Supporters Attend WHA Advocacy Day; 600 Meet with Legislators
"You are a powerful voice for your community hospital and patients"

It was an impressive gathering as more than 1,000 hospital supporters converged upon Madison April 19 to attend the WHA Advocacy Day 2017 event at Monona Terrace for a morning of education and networking. And, for the first time in the history of WHA’s Advocacy Day, every available meeting room in the state capitol was booked as more than 600 hospital supporters flocked to the capitol in the afternoon to meet with their local legislators.

In his welcome, WHA President/CEO Eric Borgerding was clearly impressed with the sea of supporters he saw before him.

"This is just a tremendous showing," Borgerding said. "You are a powerful voice for your community hospital and the patients you serve."

Borgerding noted that since 2005, more than 10,000 people have attended Advocacy Day, and of those, 6,500 have gone over to the state capitol and lobbied their legislators.

With the support of citizen lobbyists, WHA and its member hospitals and health systems are effective advocates for sound health care policy, not just in Madison, but also in the nation’s capital. A brief video (see www.wha.org/advocacy-day.aspx) highlighted the multiple in-district meetings and roundtables hosted by WHA members that bring policymakers into their organizations to see health care delivery on the front lines. Borgerding said Advocacy Day is powerful for the fact it brings hospitals together throughout Wisconsin and provides an education and advocacy forum for supporters.

"We gather to learn more about the activities at the state and federal level that affect our hospitals so we can take that knowledge to our state capitol and tell our legislators to help all of us keep our hospitals strong for our patients and our communities," Borgerding said. "Today we have more than 600 people going to the capitol to visit with legislators and their staff. Thank you for your commitment to this event, but more, thanks for your commitment to grassroots advocacy on behalf of your community hospitals. That truly inspires us all."



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600 Citizen Lobbyists Tell Their Legislators to Support Hospitals

It was an impressive sight to behold as more than 600 hospital supporters from all parts of the state boarded buses or walked down Martin Luther King Boulevard toward the State Capitol to meet with their local legislator. Their message was unified and clear: Support good public policy that supports our state’s hospitals. Many had personal stories to share with their legislator. Stories like the 12-year-old boy who travelled to Madison to attend Advocacy Day with his mom to speak with his legislator and advocate in favor of important health care issues.

"High-quality, high-value and accessible health care is a hallmark of Wisconsin. Our ability to sustain our progress and achieve new standards of excellence are dependent upon sound public policy that supports innovation and brings some stability to what has been a highly uncertain reimbursement and regulatory environment," according to WHA President/CEO Eric Borgerding. "We appreciate the individuals who support WHA’s grassroots network across the state that mobilizes to tell not just Madison, but also our representatives in Washington, the impact their decisions will have on local health care providers, and most importantly, on the patients they serve."

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In Today’s Political Environment, Walter’s Advice is "Embrace Uncertainty"

The health care industry was steeped in uncertainty even before the passage of the ACA, but now with the failed attempt to repeal and replace Obamacare along with all the other changes in reimbursement and regulations, the roadmap to the future is even more unclear.

Health care is not the only environment where change and uncertainty are the norm, political insider Amy Walter told more than 1,000 people gathered for WHA Advocacy Day 2017. She advised the only way to survive the constant drama playing out in the media every day is to embrace uncertainty.

"You have to learn to accept uncertainty to be able to understand the world we are in right now," according to Walter, the national editor of the Cook Political Report and former political director of ABC News.

"2017 has been quite a year, and we are not even halfway through it. It feels like it has been 300 days (since President Donald Trump’s inauguration), not just 90," she said. "It feels a little overwhelming. You wake up every day to lots of drama in our country and in our world. It is exhausting just keeping up with the headlines and the news."

Walter said there are many new faces in Congress, with two thirds of the Republicans serving in the Senate never having served under a Republican President or having a chance to work with their own party.

"The Republicans are used to saying no, but they are finding that getting to yes is very different. Governing is hard," she said.

Walter said we have to accept the fact we are living in uncertain times, and not just here in the U.S.

"The whole world is feeling upheaval. The post-world war era progress is being upended. The surprise was it took this long to happen, 20-30 years to come to a head given the demographics in our country," according to Walter. "Think about the generation over 55 years of age. That generation is overwhelmingly white—80 percent—compared to the kids under five years old now where the majority are not white. Just in the course of one lifetime we have seen a complete change in the demographic makeup of this country."

Walters is a regular panelist on NBC’s Meet the Press, PBS’ Washington Week, and Fox News’ Special Report with Bret Baier, and can also be seen on Face the Nation and Fox News Sunday. She also provides political analysis every Monday evening for the PBS NewsHour.

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Walker a "Valued Partner" with Wisconsin Hospitals, Health Systems and WHA

Gov. Scott Walker was a strong supporter of good health care policy even before he took office in 2010, as WHA President/CEO Eric Borgerding noted in his introduction of Walker before an audience of over 1,000 hospital advocates April 19 in Madison.

In his time serving on the Assembly Health Committee, then Rep. Scott Walker laid the groundwork for what is one of the most stable medical malpractice environments in the country. As Milwaukee County Executive, Walker worked with WHA on the General Assistance Medical Program.

"Today, we can look back on his term as Governor and point to numerous examples of his leadership on health care, but also to his partnership with WHA and our members," Borgerding said.

Wisconsin has been at the forefront in the ongoing debate over repealing and replacing the ACA, working together to preserve and strengthen and be rewarded for the Wisconsin model of coverage expansion that has delivered a 38 percent reduction in the state’s uninsured rate.

"Wisconsin has been a leader in transforming health care, enabled by good public policy," Borgerding said. "There is much more to do in both Madison and Washington. Our partnerships with our elected officials are more important today than ever before."

Walker Touts Health Care as Wisconsin Asset: Accessible, Affordable and High Quality

The Governor felt right at home before the Advocacy Day crowd on what was his sixth appearance before the group. He began by saying he appreciates working with the WHA staff and Board of Directors and with all the hospitals and health systems across the state. He also recognized the dedication of the health care advocates and members of hospital boards who were in attendance.

"Health care, in general, is about three core things: quality, access and affordability," Walker said. "Hopefully in this state, we have shown how to do that in a way that is effective for the rest of the country." He thanked hospitals and health systems for their commitment to quality and mentioned that Wisconsin consistently ranks in the top three states in the nation based on quality.

Walker said since 2011, his Administration has put $3.25 billion worth of new state GPR into the Medicaid program to make sure that it was accounting for not just the people hospitals serve, but make sure that it is not "dished off to everybody else, which becomes a hidden tax on employers."

"When a state does not fully or adequately fund Medicaid, it just becomes a hidden tax on other employers and individuals who have health care plans. They have to pick up the difference, and you have to raise more money to compensate for uncompensated care," according to Walker.

Referencing his days in the Legislature, Walker said ensuring liability protections, not just individually for health care professionals, but also for hospitals and health systems, is important to ensure they are protected from unnecessary liability burdens. Good regulations that ensure public health and safety, which are not obsessively beyond that which place an unnecessary burden on providers, also allow providers to focus on improving quality and increasing access.

"Health care is not only good for quality of life, it has a tremendous economic impact. I say that when you think about it logically it makes sense. We, particularly in government, talk about things in silos. Health care here, taxes there, education over there. It’s interrelated," he said. "When an employer looks to bring a business into a community, or tries to hire talent they need to serve a particular position, they look at a variety of things. It’s good to have reasonable taxes, a good regulatory environment and a limited lawsuit environment, but there are core things they need—access to a great workforce, a good education system and right at the top of the list is a good health care system. No matter how much they pay you, if there is not access to good health care and education system, it is not worth it. It has a direct impact. It’s not just quality—we rank third—but affordability and access are tied together to economic vitality and growth."

On extending Wisconsin Works for Everyone to other programs, including Medicaid, the Governor said people with physical and intellectual disabilities are sometimes hesitant to work for fear they will lose their benefits. He said his plan is to "spread that time out, make the transition longer" so people who are receiving state benefits, such as Medicaid, do not "fall off a cliff." He said his plan, for example, is if an individual’s income reaches 200 percent FPL, for every $3 you make over that, you pay $1 more in copay for child care.

On the Medicaid waiver, he said Wisconsin will ask the federal government if it can charge a premium even at low income levels, at $1 a month.

"Skeptics in the capitol have asked me why you would do that when it costs more to collect that dollar. It is not about saving money," Walker said. "As they churn people off Medicaid, we are getting people ready for the workforce."

Everyone pays some kind of premium for health insurance, according to the Governor; starting to pay even a small premium reduces the shock of paying one. He said the state will also request to put filters in place that allow the state to screen for addiction. Along with that, the Governor put money into the state budget for rehabilitation.

"We didn’t do this to create more uncompensated care. We have more people who are not on Medicaid because they can pay for their individual plan," he said.

On the ACA, Walker said the discussions are all over the board, and there is much work to do. However, he said when he is in Washington he consistently tells people, "If you want to make a change, make a change that goes along with what we did in Wisconsin."

Wisconsin has a better rate of coverage than 43 other states, he said.

"The discussion earlier this year was around reimbursement, but the talk needs to be around not just the cost of health care and reimbursement, but what are we doing to make health care better, and what are we doing to help our constituents live healthier, better lives," Walker said.

Employment and jobs have always been a key priority for Walker. The unemployment rate in Wisconsin has hit an all-time low, 3.7 percent. Good news for job seekers, but not so positive for employers. The Job Center of Wisconsin now has more than 95,000 job openings posted. Walker said workforce shortages are a huge challenge, but if Wisconsin can "connect the dots between skills, education and the qualifications to match the positions," there will be endless opportunities for family-supporting jobs.

Walker’s support for graduate medical education has helped create residencies in rural areas, while Fast Forward grants are encouraging health systems to partner with the state to match those who are looking for employment with the training they need to be successful.

"It is a moral imperative they have access to education or it can be an economic impairment," Walker said. "The biggest barrier to creating more jobs going forward is this one thing: workforce.

The Governor pointed to Project SEARCH as a great example of getting people with disabilities into the workforce. He acknowledged that of the 27 Project SEARCH job sites across the state, all but a couple are sponsored by health systems.

"I was just out in your hospitals on a tour. There is nothing more fulfilling that visiting a Project SEARCH site," he said. "The inspiration they provide makes people want to work harder themselves. When I have 95,000 job openings, I can’t afford to have anyone on the sidelines. We have to have everyone working."

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Legislative Leaders Diverge on Policy Issues, but Agree Health Care is an Asset

Four of Wisconsin’s legislative leaders participated in a panel discussion at WHA Advocacy Day 2017. This is part one of a two-part series featuring that dialogue. The second article in this series will be in the April 28 issue of The Valued Voice.

It is the most highly anticipated and popular session at WHA’s Advocacy Day, and this year the state legislators participating in the panel discussion moderated by WHA President/CEO Eric Borgerding did not disappoint the audience.

Legislators participating on the panel included: Senate Majority Leader Scott Fitzgerald (R-Juneau); Senate Minority Leader, Jennifer Shilling (D-La Crosse); Assembly Speaker Robin Vos (R-Rochester); and, Assembly Minority Leader Peter Barca (D-Kenosha).

Borgerding kicked the conversation off by asking Barca for his thoughts about the importance of hospitals and health systems to economic development.

"Health care is an important asset in our state. A WHA survey of 300 employers showed they ranked quality health care second in importance only to education," Barca said. "You are making our regions more economically vibrant. We need to do what we can to support your efforts and provide you with the tools to succeed."

Before answering his first question, Vos made a point of dispelling any notion that Wisconsin legislators do not "get along."

"We are fortunate to have four leaders who get along. While we don’t agree on all the public policy points, we know we have good people in our state, and we are lucky that our economy is doing better," according to Vos.

On the point of the importance of good quality health care to the state, Vos noted there is a budget surplus of "almost a half billion dollars."

"That is why in this budget we can make significant investments to improve our business environment. As a business owner, I need access to high-quality health care and a great education system…and it’s important that we fix transportation," Vos said. "This is a time to be proud that we have leaders who work together addressing problems that are really important that keep our economy growing."

Shilling noted she has good access to quality health care in all areas of her district and because of that, she is seeing employers and health systems partner to provide on-site clinics and wellness programs to employees.

"It’s a cost savings. They realize if their employees are healthy, they are more productive," she said. "As we recognize the important role that health care has on our economy, in many communities it is the nursing home, hospital and school district that are the largest employers. But, as we look at Medicaid and uncompensated care, we know we still have work to do."

Shilling said much of the work that has been done in the Legislature on the opioid problem, mental health and telemedicine has been on a bipartisan basis. "Urban and rural, Democrat and Republican, we have worked together on these issues," she said.

Fitzgerald said it is frustrating that so much of health care is driven by the federal system.

"We understand the importance of health care in every community we represent. For us, it is frustrating that so much of health care is driven by the federal government," he said. "We have to look for waivers to implement stuff related to Medicaid. I am hopeful that some of the action we are seeing in Washington results in more flexibility in the state. If there is any place to manage health care, anything that reaches out and touches a hospital, it should be handled at the state level. We have a bipartisan relationship to accomplish things. If a block grant came down, this is where we could do good with that."

Fitzgerald said he appreciates the community programs that hospitals sponsor because it moves them to a prevention model, and that is why "hospitals are so important to mid-sized and small communities."

Moving to the topic of workforce, Borgerding asked the panelists if there is a role for the state of Wisconsin to help meet the demand for health care professionals in hospitals and health systems.

Vos said this is a really critical topic not just for hospitals, but for all employers.

"If you draw a line from Eau Claire to Green Bay, the region north of that line is one of the oldest in the entire United States. That is why we focus so much effort to ensure we have great schools in Wisconsin; the entire community depends on that," Vos said. "We have done some things to encourage people to go into different career fields. We have the patient’s compensation fund to make sure doctors come here and to know we value their services. But it’s a real challenge. Health care is no different than other fields, except you are a 24/7 business, and you cannot stop a line or fill in with a substitute. We need to attract more people to our state and into better careers."

Shilling said career exposure is occurring at younger ages. Students need to know about the career opportunities available in their own town. She said a new rural legislative initiative should help.

"There is a rural health care package that offers incentives and targets some of our rural communities. It has matching grant programs for newly created clinicians and incentives such as loan forgiveness for professionals to practice in remote areas," according to Shilling. "If they practice in those rural areas, they are more likely to stay. I think working together in a bipartisan fashion will help us address these issues."

There are big picture issues to consider, according to Fitzgerald. It is a matter of once they have the right education, to attract and keep them in the community.

"If you open a facility, say with 100 jobs and offer a good wage, but there is not an infrastructure to support having restaurants and adequate housing, those kids won’t want to live in that size of a community," he said. "The hospital is the one place that brings professionals together and there is a real effort to attract physicians, nurses and other clinicians. If there is any place this hits hard, it is hospitals because you need all those professionals in one place."

Borgerding agreed the hospital really is a hub, and we must find ways to keep our kids here. The blueprint is in place, he said, which is graduate medical education (GME).

"We know if a Wisconsin student attends medical school here and completes a residency here, we have an 86 percent chance they will practice here," according to Borgerding. "The Rural Wisconsin Initiative is the exact model we want to follow with allied health professionals to create opportunities for them to stay in our communities and enter post grad training."

Barca is concerned about the shortage of mental health professionals and psychiatrists. He believes the state could do more to attract these professionals to Wisconsin.

"I think getting our education institutions to open more nursing slots is important, but we are asking people to have more post-graduate opportunities, too," Barca said. "We have an aging workforce. We have to do much better at keeping people here and attracting them to Wisconsin. We have to make sure that people want to stay here. We need to do better to support entrepreneurs…refinance their education debt… and in health care it means greater partnerships with WHA and the Medical Society."

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Children’s Hospital of Wisconsin Receives WHA 2017 Advocacy All-Star Award

Children’s Hospital of Wisconsin received the Wisconsin Hospital Association (WHA) 2017 Advocacy All-Star Award at the Association’s annual Advocacy Day in Madison April 19.

Peggy Troy, president/CEO of Children’s Health System, accepted the award before more than 1,000 hospital supporters participating in the day’s activities. WHA recognizes one hospital or health care system each year that exemplifies dedication to grassroots advocacy.

"Kids don’t vote; they sometimes get lost in the debate on many issues," began Troy. "When we talk to legislators, we are the voice on behalf of kids and hospitals all across the state of Wisconsin. That is why I am so grateful to all of our advocates, the thousands who email, write, call and meet with their elected officials."

"I am also proud to partner with so many other hospitals in the room today and with the Wisconsin Hospital Association," Troy said. "We are so honored by this award. It means the world to us."

In presenting the award, Jenny Boese, WHA vice president, federal affairs and advocacy, said Children’s Hospital has been a great partner and advocate on health care issues and has raised the bar on grassroots engagement. For example, Boese said Children’s has had more than 100 of their supporters attend WHA’s Advocacy Day for several years in a row and has been strongly committed to engaging on key issues like Medicaid funding in the state budget.

"Children’s is a true partner with the Wisconsin Hospital Association, and they are deeply committed to their mission to serve," Boese said. "It has been a privilege to work alongside their entire team, and they are well-deserving of this award."



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Sanfelippo Receives WHA 2017 Health Care Advocate Award

State Rep. Joe Sanfelippo (R-New Berlin) received the Wisconsin Hospital Association (WHA) Health Care Advocate of the Year Award April 19 at WHA’s Advocacy Day event in Madison. Kyle O’Brien, WHA senior vice president, government relations, presented this year’s award to Sanfelippo in recognition of his partnership with WHA in supporting issues that enable the delivery of high-quality, high-value health care in Wisconsin.

In accepting the award, Sanfelippo said he was proud to be in a state that has some of the best hospitals and health care systems in the country, and he recognized the dedicated efforts health care professionals bring to their work 24 hours a day, 365 days a year.

"We have great health care, and you are all at the forefront of providing that care," according to Sanfelippo. "As we go forward, we will work on ideas that we can bring here to Wisconsin that are working in other states, and build upon the collaboration of working with WHA and their members."

O’Brien said Sanfelippo has been a partner with WHA since he was first elected to the state Legislature in 2012, quickly rising to be one of the Assembly’s top health care policy leaders. In 2014, Sanfelippo was appointed by Speaker Robin Vos to chair the Assembly Committee on Health, a position he has now held for two terms.

"Representative Sanfelippo has worked closely with WHA and member hospitals to enact public policy that protects and strengthens high-quality, high-value health care in Wisconsin," according to O’Brien. "Sanfelippo’s accomplishments during his time in the Legislature include mental health care reform, legislation to give health care providers additional population health tools and encouraging additional investments in our state Medicaid program like the Disproportionate Share Hospital (DSH) program."

O’Brien said Sanfelippo understands the impact of Wisconsin’s Medicaid reimbursement on hospitals, health care providers and private payers of health care—especially employers—and has supported efforts to mitigate Medicaid losses for Wisconsin hospitals, recognizing roles for hospitals to better coordinate care for Medicaid patients.

Sanfelippo has also been a leading state voice to federal policymakers as well, as demonstrated by a recent statement with Joint Finance Committee Co-Chairman Rep. John Nygren encouraging Wisconsin’s Congressional delegation to treat Wisconsin "equitably" on health care reform and to provide additional Medicaid resources to the Badger State.

Sanfelippo represents Wisconsin’s 15th Assembly District and was first elected in 2012. Among other committees, Sanfelippo chairs the Assembly Committee on Health and serves on the mental health reform and transportation committees.

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After WHA Briefing, Citizen Lobbyists Head to Capitol to Meet with Legislators

More than 600 hospital supporters made their way to the state capitol to meet with their local legislators following an issues briefing by WHA Senior Vice President Kyle O’Brien at WHA Advocacy Day April 19 in Madison.

The state capitol was filled with hospital supporters from across the state advocating for policies that enable and protect high-quality, high-value health care in their communities.

O’Brien summarized the current political issues in Madison, explained how legislative appointments work and documented how effective the meetings are in educating and motivating legislators to support policies that support hospitals.

"Last year, at this very same event, we witnessed the Governor signing a bill into law that you, our hospital supporters, had advocated for the year before during your Advocacy Day visits," O’Brien said. "Your Advocacy Day legislative visits were an important part of accomplishing WHA’s legislative agenda this past session. Lawmakers hear from WHA’s government relations team on a regular basis, but Advocacy Day serves as the best opportunity to hear directly from you—their constituents—about protecting high-quality, high-value health care in your local communities."

O’Brien asked supporters to make three main points to legislators during their visit: describe the important role that great local health care has in attracting new economic development and keeping people healthy; ask legislators to use one-tenth of the Medicaid surplus to fund health care reimbursement increases; and, emphasize how essential it is to invest in graduate medical education to maintain an adequate health care workforce in Wisconsin.

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U.S. Rep. Duffy Meets with Hospital/System Leaders, Discusses Health Reform

During the Congressional recess, area health care leaders from Ascension Wisconsin, Aspirus and Hospital Sisters Health System met with U.S. Rep. Sean Duffy at his district office in Wausau. The only topic of discussion during the meeting was health care repeal/replace legislation known as the American Health Care Act (AHCA).

Hospital/system leaders highlighted concerns with any legislation that does not recognize Wisconsin’s unique and successful model for reducing the state’s uninsured rate. This Wisconsin Model provides Medicaid coverage to everyone in poverty and then affordable insurance, through federal cost-sharing subsidies and premium assistance on the federal exchange, to those over the poverty level. Leaders expressed the need for Rep. Duffy and Congress to provide Wisconsin with funding parity under the AHCA with respect to Wisconsin’s "partial Medicaid expansion" and to ensure lower-income individuals on the federal exchange can afford coverage going forward.

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Member News: ThedaCare Names Imran Andrabi, MD New President and CEO

ThedaCare named Imran Andrabi, MD, as the new president and chief executive officer. Andrabi will join ThedaCare June 19, 2017, following the retirement of Dean Gruner, MD, who has led the system for nine years.

Andrabi comes to ThedaCare from Mercy Health, a non-profit Catholic health care ministry serving Ohio and Kentucky. He began with Mercy Health (formerly Catholic Healthcare Partners) as an intern and medical resident 25 years ago and steadily advanced to become regional president and chief executive officer of the Toledo region in 2015.

Gruner leaves ThedaCare after serving as president and CEO since 2008. Under his direction, ThedaCare has continued to grow as the largest health care provider in Northeast Wisconsin and the largest locally based employer with 6,700 employees, seven hospitals, 32 clinics and other health care services across nine counties.

Andrabi received his medical degree from King Edward Medical College in Lahore, Pakistan, and is certified by the American Board of Family Practice. With an interest in helping others in the health care field advance, Andrabi has been actively involved in teaching medical students as teaching faculty at the Medical College of Ohio and the Ohio University College of Osteopathic Medicine. In addition, he serves on numerous boards and committees to improve the health and economic status of the Toledo community.

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