November 25, 2015
Volume 59, Issue 47


Wisconsin Hospitals’ Community Outreach Efforts Total $1.68 Billion
Hospitals provide $278 million in charity care; lose $900 million on Medicaid 


Wisconsin hospitals provided $1.68 billion in 2014 on programs and services that benefitted the community. These activities ranged from providing free care to those unable to pay their bills, to sponsoring health improvement activities, health education, free screenings and working with partners on complex socioeconomic issues in the community. 

Hospitals also reported they incurred $900 million in losses associated with caring for patients in the Medicaid program. Medicaid pays hospitals only about 65 percent of what it costs to care for this vulnerable, and often medically-complex, patient population.

The Wisconsin Hospital Association (WHA) surveys its 132 member hospitals and health systems annually and asks them to describe and quantify the programs, services and activities they provide at or below cost, solely because those programs fulfill a health need in the community. (See report: www.wha.org/pubarchive/special_reports/2015cbReport.pdf). Hospitals reported in 2014 they provided $1.68 billion in community benefits. Included in that total is $278 million in charity or free care (at cost), $70 million on activities aimed at improving community health and $217 million on education for health care professionals, up from $193 million in 2013. 

“Whether it is providing financial assistance to patients with limited resources through charity care programs, or improving access to essential or primary health care services by sponsoring free medical and dental clinics, Wisconsin hospitals provide a ‘safety net’ of care in the communities they serve,” according to WHA President/CEO Eric Borgerding. “Without that care in place, state and local government would have a much greater burden in trying to deliver these essential services to a vulnerable population.” 

While the amount of charity care reported dropped to $278 million in 2014 from the $328 million hospitals reported in 2013, the number of patient encounters that qualified for free care continues to track fairly closely to previous years. In 2014, the number of patient encounters that qualified for free care was 1.3 million, which was close to 2013 when hospitals reported 1.4 million instances of charity care, compared to 1.2 million in 2012. 

“Charity care can vary from year to year, depending on the types of cases that qualify,” according to WHA Senior Vice President/COO Brian Potter. “The fact that there were about the same number of cases, and the cost decreased may reflect the fact that more services are provided in the less costly outpatient setting than in the hospital, which is consistent with what we are seeing with all patient care.” 

In 2014, hospitals reported they were unable to collect $234 million, compared to $276 million in 2013. In 2013, hospitals reported a jump in bad debt of nearly $6 million over 2012 figures, in part due to increases in deductibles and co-pays.

“While more people may be gaining coverage, we still see many patients who struggle to meet their co-pays and deductibles,” Potter said. “That continues to be a real concern for hospitals.”

Hospitals Absorb Nearly $15 Million Loss Operating Nursing Homes 
Keeping those who are elderly or in need of rehabilitation services in the community is one of the most valued and necessary services requested by their families and friends. In some communities, hospitals are the sole providers of those services. In 2014, 16 of the 18 hospitals that operated nursing homes reported losses totaling $15 million, up from $13 million in 2013. Hospice care is also becoming increasingly more available because hospitals recognize the value of end-of-life services for their patients and families. Hospitals typically report hospice services are operated at a loss. 

Wisconsin hospitals offer multiple access points in their communities to services as wide ranging as medical care at a free or reduced-fee medical clinic to screenings at health fairs, schools and other public events. By offering free health screenings and other medical services closer to where people shop, work or play, hospitals live out their missions to raise the health status of people living in their communities. 

Hospitals Identify Community Health Needs, Develop and Implement Plans
In 2013, under a new requirement of the Affordable Care Act, hospitals were required to complete a formal community health needs assessment (CHNA) in partnership with public health and other community partners to assess, address and prioritize community health needs. While the formal process is new to some, the work is not. Improving the health of the entire community is at the heart of every hospital and health system’s mission.

While each hospital conducted a CHNA, the types of problems identified across the state shared some similarities. Most of the hospitals identified several of the following as issues in their community: access to care, mental health, alcohol and drug abuse, nutrition, obesity, physical activity and tobacco.

“Hospitals have never allowed the boundaries of their campus to restrict their engagement with the community,” according to Borgerding. “Hospitals use their human and financial resources to focus on factors that improve people’s health while creating a healthier environment that also makes our state a great place to live and work.” 

Visit www.wiServePoint.org to review the 2015 WHA Community Benefits Report. It also has patient stories and descriptions of free and reduced-cost services that hospitals provide in their communities.


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WHA Creates Online Opioid Education Resource for Hospital Staff

Feedback provided by WHA members indicated a need for an online source that would collect and organize existing information related to opioid use. In response, WHA added a new resource to WHA.ORG that is meant to be a dynamic and responsive site representing current best practices and provider toolkits. 

“WHA recognizes Wisconsin hospitals play an important role in addressing this public health issue and we support the efforts of both Rep. John Nygren and Attorney General Brad Schimel,” said WHA President/CEO Eric Borgerding. “We will continue to work with all our partners to develop tools and resources that will assist our hospitals in addressing issues related to opioid abuse.” 

The WHA opioid resource page is here: www.wha.org/opioid.aspx.

For more information, contact Steve Rush, WHA vice president, workforce and clinical practice, at 608-274-1820 or srush@wha.org.

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Guest Column: New WHA Report Documents Hospitals’ Commitment to Community
By Therese Pandl, 2015 Chair, Wisconsin Hospital Association and President/CEO, HSHS-Eastern WI Division, and Eric Borgerding, President/CEO, Wisconsin Hospital Association

Wisconsin hospitals and health systems are accountable to their communities and committed to transparency. That is why more than 10 years ago, WHA began surveying its members to collect and report community benefits. This year, 132 hospitals completed the Wisconsin Hospital Association (WHA) community benefits survey. We are one of a few states where 100 percent of the hospitals voluntarily report community benefits. The survey helps quantify the resources, but it does not explain the impact this commitment has on individuals living in our communities. 

The WHA 2015 Annual Community Benefits Report has more than 100 stories that help illustrate how hospitals and the health care professionals we employ are caring for patients and improving lives, both within and outside our walls. We invest in our communities by sponsoring education and outreach and increase access to care by supporting free or reduced-fee clinics. 

Even though we have one of the lowest uninsured rates in the country, it does not mean there are not people living in Wisconsin who need assistance with medical bills, or that everyone has equal access to health care. Wisconsin hospitals provided over $300 million in charity care while absorbing $900 million dollars in Medicaid shortfalls. In addition, hospitals invested more than $200 million educating health care professionals. 

Health care is changing, but the hospital mission remains the same: Improve the health of the people living in Wisconsin. New technology and advances in medical science are helping people live longer and live better. Telemedicine is bridging the distance among primary care doctors, specialists and the patient to speed diagnosis and treatment. These technologies and services come at a cost; that’s why Wisconsin hospitals are taking great care to carefully manage our resources so we can continue to make investments in the health of our communities.

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Central Wisconsin Hospitals Participate in Decon Training

Jim Monarski, project coordinator of the Region 2, North Central Wisconsin-Healthcare Emergency Readiness Coalition (NCW-HERC), recently teamed up with Ministry Good Samaritan Hospital, Merrill to conduct “first receivers awareness and operations” level decontamination training. For the last ten years, this free training has been offered to all fifteen Region 2 hospitals, all of which have taken advantage of the opportunity.

The training consists of an eight-hour class covering Occupational Safety and Health Administration (OSHA) hazardous waste operations and emergency response training and OSHA best practices for hospital-based first receivers. The class focuses on chemical, biological, radiological, nuclear, and explosive hazards and how to process patients through the hospital’s decontamination unit to the proper level of care. The first half of the class is classroom-based with a review of the hospital’s decontamination plan, and the rest of the day consists of hands-on training, including donning and doffing of personal protective equipment and setting up a decontamination tent. Many hospitals have received such equipment through the Wisconsin Healthcare Emergency Preparedness Program (WHEPP), a federally-funded grant program administered by DHS in partnership with WHA and other stakeholders.

Hospital personnel are also provided education on how all of the hospitals would work together as part of a “health care coalition” in a single- or mass-casualty event where contaminated individuals arrive at the hospital. On July 1, the Department of Health Services (DHS) formally inaugurated seven regional health care coalitions in order to provide for a more interdisciplinary, coordinated approach to preparing for and responding to health emergencies.

If you have questions regarding WHA’s role in emergency preparedness or health care coalitions, contact Andrew Brenton, WHA assistant general counsel at 608-274-1820 or abrenton@wha.org, or visit: www.wha.org/HealthcareCoalitions.aspx.

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Fast Facts from the WHA Information Center: November is National Pancreatic Cancer Awareness Month

The American Cancer Society’s most recent estimates for pancreatic cancer in the United States are for 2015:

According to the WHA Information Center, there were 1,783 inpatient admissions and 1,386 outpatient visits to Wisconsin hospitals between July 1 2014 - June 30 2015 for the primary treatment or evaluation of pancreatic cancer. Some risk factors for pancreatic cancer include tobacco use, being overweight, obesity and workplace exposure to certain chemicals. 

Data provided by the WHAIC (www.whainfocenter.com). The WHA Information Center is dedicated to collecting, analyzing and disseminating complete, accurate and timely data and reports about charges, utilization, quality and efficiency provided by Wisconsin hospitals, ambulatory surgery centers and other health care providers.

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