January 29, 2016
Volume 60, Issue 4


Assembly Committee Hears Agreed-To Work Comp Legislation
Management Representative: “Best set of policy recommendations in over 20 years”


On January 27, the Assembly Committee on State Affairs and Government Operations heard this session’s version of agreed-to legislation recommended by the Worker’s Compensation Advisory Council (WCAC), made up of five labor representatives and five management representatives. The legislation was formally introduced as Assembly Bill 724 and Senate Bill 536 by Sen. Steve Nass (R-Whitewater) and Rep. John Spiros (R-Marshfield).

Nearly mirroring a Senate Committee hearing held two weeks earlier, Labor and Management lead negotiators Stephanie Bloomingdale and Jeff Beiriger testified together in support of the legislation along with Worker’s Compensation Division Administrator B.J. Dernbach.

Management representative Beiriger noted the proposed legislation does not include a controversial policy that had been part of the previous session’s WCAC agreed-to legislation relating to a medical fee schedule for health care services provided to injured workers, and that was the key reason previous legislation failed to pass. Beiriger commented that the Council felt they would risk losing significant reforms included in AB 724 and SB 536 by including a similar fee schedule provision in this session’s agreed-to legislation. 

“The clear message from the people involved in the management side of this was, the last time we did an agreed bill there were a number of very positive changes that were taking place with the system and if we move forward again and lose all of those changes, yet again, then we will have not moved the ball forward at all over the course of four years,” said Beiriger at the hearing.

Beiriger closed his testimony by saying, “what [the WCAC] have offered here in AB 724 is the best set of policy recommendations that I have been involved with for more than 20 years.”

Representatives from Wisconsin Manufacturers and Commerce also testified in favor of the bill, commenting that the proposed legislation contained “some really good reforms” and is the “best package to come out of the Council process in years.”

For more information on the Senate hearing and provisions in the agreed-to bill, see the January 15 article in The Valued Voice.


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WHA to Federal Delegation: Fix HOPD Payment Prohibition 
CMS announces guidance released later this year


On January 26, WHA President/CEO Eric Borgerding sent a letter to Wisconsin’s Congressional Delegation reiterating the need to fix a provision included in the Bipartisan Budget Act of 2015 (BBA 2015) that prohibits hospitals from using an entire Medicare payment system, the Outpatient Prospective Payment System (OPPS), in certain situations.

“The abrupt inclusion of this 'site neutral' policy—without input from our hospitals on this policy’s impact on care access, finances or operations—inappropriately upends local health care decisions made by Wisconsin hospitals and health systems,” said Borgerding in the letter. 

This site neutral policy was put into law November 2, 2015 and impacted a variety of hospitals and health systems across the country and in Wisconsin. 

“Within eight days, the site neutral policy was released, voted on by Congress and signed into law by the President,” continued the letter. “WHA believes it is inappropriate for the President and the Congress to change Medicare reimbursement law within the span of eight days when our hospitals and health systems have been planning, in some cases for years, certain projects based on current law.” 

Of particular concern with abrupt enactment of the policy is its immediate impact on projects under development as well as its longer-term impact on current grandfathered provider-based hospital outpatient departments (HOPD) that may need to relocate, among other scenarios. 

“WHA and our impacted hospitals and health systems are asking for your support and leadership to address these situations,” continued the letter. “We believe this is a targeted but fair approach for correcting an extremely unfortunate law. We look forward to working with the entire Congressional Delegation on this solution. We trust that the Congress and the Administration will work to quickly address this issue.”

In related news, on a Centers for Medicare & Medicaid (CMS) Hospital Open Door Forum call held January 26, CMS stated that policy guidance implementing this provision, Section 603 of the BBA 2015, will be included in the forthcoming FY 2017 Outpatient Prospective Payment System rule. The OPPS proposed rule is generally released in late summer and will not be finalized until the fall. 

WHA believes that delaying CMS guidance on Section 603 until the fall means Congress must act this spring in order to provide stability for organizations with projects under development, among other situations. WHA continues to ask Wisconsin Members of Congress to champion a quick legislative solution.

Read WHA’s letter at: www.wha.org/pdf/2016WHASiteNeutralLetter1-26.pdf.

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Assembly Lawmakers Release Rural Initiative, Residency Funding
The Rural Wisconsin Initiative provides additional support to WRPRAP


State Rep. Ed Brooks (R-Reedsburg) and Sen. Tom Tiffany (R-Hazelhurst) recently introduced legislation to provide additional funding to the Wisconsin Rural Physician Residency Assistance Program (WRPRAP). The bill, introduced as Assembly Bill 797, would provide $250,000 in general fund dollars in addition to funding already allocated to WRPRAP from the Critical Access Hospital (CAH) Assessment. 

Currently, the CAH Assessment funds an annual appropriation to WRPRAP of $750,000. The additional funding would only be provided for one fiscal year, beginning July 1, 2016. 

During the 2013-15 biennial budget, Gov. Scott Walker and the state Legislature made an unprecedented state commitment to graduate medical education (GME) funding. The budget included a WHA-led initiative to invest $5 million in additional GME

 training opportunities. This example of a partnership between the State of Wisconsin and WHA member hospitals has led to impressive results. In a little more than two years, the program has already provided funding to establish seven new residency programs serving 34 Wisconsin counties and training 73 new physicians.

The authors of AB 797 said the $250,000 in one-time funding would provide more opportunities for physicians to train in rural communities, especially in specialties of need like obstetrics and gynecology. Reps. Kathy Bernier (R-Chippewa Falls), Romaine Quinn (R-Rice Lake) and Travis Tranel (R-Cuba City) are also lead sponsors of the bill.

WHA has registered in support of the legislation. The bill has been referred to the Assembly Committee on Mining and Rural Development and awaits a public hearing in that Committee. 

For more information on The Rural Wisconsin Initiative, go to http://legis.wisconsin.gov/assembly/republicans/ruralwisconsininitiative.

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Feb. 25 WHA Webinar Focuses on Leader’s Role in Tackling Opioid Abuse

Recognizing that Wisconsin hospitals have an important role in addressing the growing public health issue of the misuse and abuse of opioids, in December 2015 the WHA Board of Directors unanimously passed a resolution recognizing the issue and encouraging hospitals to develop specific strategies to address it while creating a culture of change responsive to this growing epidemic. To support the efforts of WHA members, WHA is offering a series of webinars in 2016.

This first, complimentary WHA Member Forum webinar, scheduled February 25, will focus on the importance of hospital leaders vocalizing the gravity of this issue and leading the culture change among their prescribers to examine their own prescribing habits. During this webinar, participants will hear from Peter Holden, president/CEO of Beth Israel Deaconess Hospital in Plymouth, Massachusetts, as he shares his experience in addressing the issue and culture change within his own organization, as well as championing the effort in hospitals throughout Massachusetts in his role as chair of the Massachusetts Hospital Association. In addition, this webinar will include information on WHA’s efforts to assist hospital leaders with tackling this issue and resources and next steps WHA will take.

There is no fee for WHA hospital and corporate members to participate, but pre-registration is required. More information and online registration are available at http://events.SignUp4.net/HospitalLeaderRole-Opioids. For more information, contact Jennifer Frank at jfrank@wha.org or 608-274-1820.

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Register Now for WHA 2016 Advocacy Day Scheduled March 30 

Each year, the WHA Advocacy Day event grows both in the number of attendees and in the impact it makes on our legislators in Madison. Advocacy Day is one of the best ways hospital employees, trustees and volunteers can have an important, visible impact in the State Capitol. Help make the 2016 event a great success by assembling your hospital contingent for 2016 Advocacy Day, set for March 30 at the Monona Terrace in Madison. Register at http://events.SignUp4.net/16AdvocacyDay0330.

As always, Advocacy Day 2016 will have a great lineup of speakers, including morning keynote Rick Pollack. Pollack is the president and CEO of the American Hospital Association (AHA). He’s been a member of AHA’s advocacy team for the past 33 years and will share his Washington DC insider’s view of federal political activities during this presidential election year. Our legislative panel discussion will round out the morning session, followed by a luncheon keynote address from Gov. Scott Walker (invited).

The highlight of Advocacy Day is always the hundreds of attendees who take what they’ve learned during the day and then meet with their legislators in the State Capitol in the afternoon. In fact, over 650 visits were made last year that directly impacted the outcomes of priority legislation.

“WHA’s Advocacy Day continues to be a powerhouse event in Wisconsin’s State Capitol each year,” said WHA President/CEO Eric Borgerding. “Last year, we had 1,100 hospital advocates travel to Madison because they care deeply about their hospitals and local communities. There is no substitute for this level of engagement.”

Join over 1,000 of your peers from across the state at Advocacy Day 2016 on March 30. The day’s agenda and online registration are available at http://events.SignUp4.net/16AdvocacyDay0330.

For Advocacy Day questions, contact Jenny Boese at 608-268-1816 or jboese@wha.org. For registration questions, contact Jenna Hanson at jenna.hanson@wha.org or 608-274-1820.

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CDC Issues Zika Guidelines; WHA Creates Resource Page

Many people are hearing about the Zika virus for the first time. To help our members respond to requests for information, WHA has dedicated a page to Zika at www.wha.org/zika.aspx in its emergency preparedness resources at WHA.org. Among the resources posted there is a PowerPoint presentation created by John Temte, MD, PhD, that health care professionals will find helpful. Temte is a professor of family medicine at the University of Wisconsin School of Medicine and Public Health, and he serves on the U. S. Advisory Committee on Immunization Practices. 

WHA is actively monitoring the media and posting links on the resource page to outside news sources that we believe will be helpful in keeping our members informed on this emerging public health issue.

WHA has also posted the Centers for Disease Control and Prevention (CDC) interim guidelines for U.S. health care providers caring for infants born to mothers who traveled or lived in an area with Zika virus transmission during their pregnancy. In addition, the agency has issued interim guidelines for U.S. health care providers caring for pregnant women who recently traveled to impacted areas. Among other actions, the CDC recommends testing pregnant women for the virus if they report at least two related symptoms within two weeks of travel to affected areas, or have ultrasound findings of fetal microcephaly or intracranial calcifications. 

A marked increase in infants born with microcephaly, a birth defect resulting in smaller than normal head size, has been reported in the Zika outbreak in Brazil. It is not known how many of the cases are associated with the virus. Only about one in five people infected with the mosquito-borne virus will get sick, and their illness is usually mild. The most common symptoms are fever, rash, joint pain or conjunctivitis (red eyes). There have been 31 detected cases in the continental U.S., all in individuals who had traveled to the affected areas, and 20 confirmed cases in the U.S. territories – 19 in Puerto Rico and one in the U.S. Virgin Islands. 

The Wisconsin Department of Health also has a resource page at www.dhs.wisconsin.gov/arboviral/zika.htm.

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Member News: Burch Named CEO of Aspirus Riverview

Todd Burch has been named chief executive officer (CEO) of Aspirus Riverview Hospital and Clinics in Wisconsin Rapids. Burch joined Aspirus Riverview January 4.

Burch has 14 years of health care leadership experience. He served as chief operating officer of Marshalltown Medical Center and Surgical Center, a 125-bed community hospital serving two counties in central Iowa. Prior to Marshalltown, Burch served as CEO of Greeley County Health Services, which included a critical access hospital, long-term care facility, home health agency and rural health clinics. He has also served as a health care consultant, assisting hospitals improve operations and performance.

Burch holds a Master of Science in Healthcare Administration from the University of Texas at Arlington and a Bachelor of Business Administration from Southwestern Oklahoma State University. He is a member of the American College of Healthcare Executives and has served on numerous local and state health care committees.

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Member News: ThedaCare Receives National Recognition for Community Service

In recognition of its broad-based efforts to improve the lives of the most vulnerable members of its community, ThedaCare has been named one of four national finalists for the prestigious 2015 Foster G. McGaw Prize, one of health care’s most prestigious honors for excellence in community service. As a finalist, ThedaCare will receive $10,000 to be used to support their community health initiatives.

The Foster G. McGaw Prize is sponsored by The Baxter International Foundation, the American Hospital Association (AHA) and Health Research & Educational Trust. This year marks the award’s 30th anniversary. ThedaCare also was a finalist for the 2008 Foster G. McGaw Prize.

“ThedaCare has established a sustainable model of community health improvement that focuses on facilitating an inclusive community process,” said John O’Brien, chair of the Foster G. McGaw Prize Committee.

“We see our role in improving community health as that of a convener and facilitator,” said Dean Gruner, MD, ThedaCare president/CEO. “We know that systemic health issues in our community cannot be solved by our health care system alone. We’ve engaged with a variety of our stakeholders, including many community members who are most affected and informed about a problem, because we understand that they will have the most energy and passion to develop truly innovative, effective solutions to some of our community’s most significant health concerns. While ThedaCare gets the credit, this has actually been a community process. It’s truly a community award.”

SAVE THE DATE:
WHA Community Benefit/Population Health Summit
May 5, 2016
The Sheraton Hotel, Madison 
More information available soon

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