April 1, 2016
Volume 60, Issue 13
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Walker Tells Hospital Supporters: Health Care Supports Economic Development
Governor Scott Walker has never been shy about touting the value of Wisconsin’s health care. And he did not disappoint the more than 1,000 people gathered for his keynote luncheon address at WHA’s Advocacy Day event March 30.
“I appreciate all of you. Thank you for what you do for your hospitals and health care systems and for your community, and collectively, what that means to the state of Wisconsin,” Walker said.
“When you talk about infrastructure, people think about the obvious—good transportation, access to reliable power, clean water, and especially in the rural parts of the state, access to broadband,” Walker said. “But I contend right at the top of the list is access to quality health care. That is why I am pleased to say we ranked second in the country based on the quality of health care in our state.”
That is important, according to Walker, not only for quality of life but it is an important factor when an employer thinks about locating here, or anyplace in the world or the country. The Governor said you can do business anywhere in the world, but clearly for those who need to attract and keep top talent, health care is one of the top things they want to know about.
“You can go anywhere in the state, from the most urban areas, to rural—if you have access to good quality health care, people will want to come and do business in your community,” Walker said.
Health care is not just about quality of health in our state, it is also about the impact it has on the economy. Walker pointed out that with the “ripple effect,” hospitals and health systems are major job creators in the state. The challenge, he said, is ensuring that whether the jobs are created in health care or other sectors, there is a trained workforce in place to take those jobs.
“How can we work together to address workforce issues? As you know with your own systems and other partners in the community, as employment goes up, that is a good thing. But it is also a challenge because our workforce needs go up,” he said.
Walker has been extremely supportive of expanding the medical schools and funding graduate medical education in all parts of the state, a fact that WHA President/CEO Eric Borgerding noted in his introduction of the Governor. The Governor said he was pleased to support Wisconsin’s participation in the Interstate Medical Licensure Compact, a move that will help ease the physician shortage here by speeding up the licensure process for physicians.
He also pointed to the success of Project Search. Several Wisconsin health systems participate in the program, which has provided the training necessary to create employment opportunities for young adults with intellectual and physical disabilities.
“The future of the state is not in just filling jobs, but in creating career opportunities,” Walker said.
The Governor thanked Wisconsin hospitals and health systems for their support of the Heroin and Opioid Prevention and Education program. He asked hospitals and health systems to reinforce this issue in their communities.
“We can pass all the laws in the world, but unless we are willing to have a discussion with our co-workers, friends, and community about what is going on with this epidemic it will only get bigger,” he said. “It is preventable, but it will take a whole lot more conversation.”
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WHA Legislative Panelists Debate Medicaid, but Agree Health Care is an Asset
One of the most anticipated sessions of WHA’s Advocacy Day is the legislative panel. Moderated by WHA President/CEO Eric Borgerding, the four invited legislators traded friendly jabs, but they were just as quick to point out the vast majority of bills that were passed this last legislative session were bipartisan. So in spite of claims to the contrary, Wisconsin legislators do work well together, especially on issues related to health care.
Legislators participating on the panel were Sens. Leah Vukmir (R-Brookfield) and Jon Erpenbach (D-Middleton), and Reps. Jim Steineke (R-Kaukauna) and Peter Barca (D-Kenosha).
Borgerding started by sharing the results of a survey of 300 of the state’s employers where they ranked access to high-quality health care second only to education in terms of importance when they consider a site location. Borgerding asked them if they think health care is a key economic driver in Wisconsin, and secondly, what the role of legislators is in making health care an important component of our economy.
“I know people are driven to the great quality health care system we have here in Wisconsin,” Vukmir said. “Payments from out-of-state patients total about $1 billion to hospitals, and $1.3 billion to the economy when the multipliers are applied. On the second question, I think the biggest thing we can do to help health care is to stay out of your way from a regulatory perspective.”
Erpenbach said he believes a strong economy is directly tied to high-quality health care.
“As businesses look to relocate, they consider schools, health care, transportation….all of it gets to the quality of life in Wisconsin,” according to Erpenbach. “Wisconsin could be doing so much better in health care and health insurance through the Affordable Care Act if we would take the Medicaid [expansion], and use our reimbursement on Medicaid rates.”
Steinke said health care is an important issue every citizen in the state faces. “We are fortunate we have great quality health care in our communities,” he said. “Providing good health care to employees is extremely important.”
Prior to responding to the question, Barca recognized the WHA advocacy team and remarked that in spending time with them, he knows WHA has a “very strategic agenda, and they think carefully about the issues and know where the field is going, which is vitally important.”
To the point of the question, Barca said, “Wisconsin has had good success with businesses expanding. Health care and education are by far the two major issues that come up. From an economic standpoint, health care brings wealth into the state. People drive in from Illinois to get care here.”
Barca identified workforce training and development as one of the biggest issues facing economic development in Wisconsin.
“We can’t get enough psychiatrists, for example,” he said. “We need to take a look and analyze these areas where there are steps we can take that would make a difference.”
Vukmir and Erpenbach agreed the economic impact of health care is huge, but Erpenbach added he feels quality is even more important than the economic benefits. Borgerding said comments have been made that health care is simply “recycling dollars” in the economy; however, according to a University of Wisconsin study, people coming into the state to receive health care injected more than $3 billion into the economy and supported more than 6,500 jobs. That is directly related to having access to high-quality care. Erpenbach took strong exception to the idea that health care “recycles dollars” in the economy. “That doesn’t happen. I see it every day. There is out-of-state money coming in because of health care.”
One factor that impacts the cost of care in Wisconsin, according to Borgerding, is Medicaid reimbursement. He pointed out that the Greater Milwaukee Business Foundation on Health found underpayments from Medicare and Medicaid increases health care costs to southeastern Wisconsin health systems between 25 to 30 percent.
Barca responded to the statement by starting with the basic premise of “what is more important than health care?”
“Whenever you talk about Medicaid reimbursement, monies have to be identified to address that issue,” Barca said. “Take the federal money. It is a huge mistake not to take the money because there is
$5 billion we could recover over a 10-year period that we are leaving on the table. If we take the money, we could take a substantial portion and put it back into Medicaid rates.”
On the issue of addressing Medicaid reimbursement, Vukmir said that is why during the last legislative session she and others advocated so strongly for Medicaid disproportionate share hospital payments.
Borgerding asked the panelists for their opinions on self-funding the state employee health insurance program. He said the Group Insurance Board is moving forward with gathering data and information on self-funding, which is a big shift from the current system that provides choice among 17 health plans across the state.
“I don’t think we can rule anything out. As legislators, we need to look at the RFPs when they come back and see if the savings are there, but I am not convinced self-insured is the way to go,” Steineke said.
Vukmir said she is keeping an open mind amidst conflicting reports on whether there will be savings, but the issue requires a “serious discussion with the input of health providers.”
The facts are necessary and the discussion around how much money would need to be set aside to self-fund would have to part of that discussion, according to Erpenbach.
“Self-insurance is great if you have young employees, but it is an absolute train wreck for companies that have an older workforce,” according to Barca, who worked in a business that transitioned from self-funding back to a health plan. “This has to be studied very carefully.”
Borgerding commented that a move to self-funding has to be made with caution and with a good understanding of what is in place now, and what the trend has been with the current program.
“If the savings don’t materialize, the Joint Finance Committee will be left with a very big hole to fill in the state budget,” Borgerding cautioned.
Behavioral health has been a high priority issue for WHA over the past couple of years. Borgerding said over the last session, some very positive steps were taken in this area, but Wisconsin continues to struggle to find enough psychiatrists to meet the demand for care. According to the Department of Health Services (DHS), Wisconsin needs an additional 270 psychiatrists to meet current patient demand. He asked the legislators to provide their view on what steps can be taken to expand the supply and how we can ensure they practice here.
Barca said it is a huge problem in the Kenosha-Racine area, especially in acute care settings. “We need to look at incentives to have them practice here, consider telemedicine and look at more creative ways to use technology to address this issue.”
Mental health from an economic standpoint is costing the state and employers a lot of money, according to Erpenbach. “No matter where you live, you encounter people who are struggling with mental health issues. We have a critical shortage of psychiatrists in Wisconsin. We can provide incentive programs, but to attract people to our state, we can’t just look at financial incentives, we have to consider the overall quality of life.”
“We have the behavioral health pilots, and we made great strides. It will take awhile for those accomplishments to get on the radar screens for those in residency programs, but we can attract them to residencies and keep them in practice here,” Vukmir said.
Steineke pointed to the WHA-backed package of mental health reforms, which were the most substantive in recent memory.
In closing, Borgerding pointed out there can be divisiveness on many issues in health care, but behavioral health is one that brings legislators together.
“We are not going to educate 270 psychiatrists in this state, but integrating other providers into care delivery, removing some of the barriers that were addressed in the behavioral health package, and allowing Medicaid reimbursement to primary care physicians who are coordinating care will all allow our practitioners to deliver even better patient care,” Borgerding said. “That is our goal in Wisconsin. To deliver the highest quality, best care in the nation. And with the support of our policymakers, we will do just that.”
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WHA Hails Signing of Health Care Data Modernization Act
Governor signs bipartisan bill at WHA event before more than 1,000 hospital and health system supporters; Act will help support population and community health needs assessments
The Wisconsin Hospital Association (WHA) applauds Gov. Scott Walker for signing into law the bipartisan Health Care Data Modernization Act March 30 at WHA’s 2016 Advocacy Day in Madison with more than 1,000 hospital supporters in attendance.
The Act will improve data tools used by health care providers to assess population and community health care needs, target scarce health care resources within Wisconsin communities and help streamline Wisconsin’s hospital and ambulatory surgery center data collection program.
“The hospital and ambulatory surgery center information collected and analyzed by the WHA Information Center has served as a resource to public policymakers, public health officials, health care providers and health care consumers for more than a decade,” said WHA President/CEO Eric Borgerding. “This Act will help ensure the WHA Information Center can provide more timely and precise data to health care providers as they develop innovative strategies to improve population health in Wisconsin.”
Borgerding acknowledged the commitment of the bill’s bipartisan lead authors, which included Sens. Howard Marklein and Jon Erpenbach and Reps. Dale Kooyenga, Daniel Riemer, and Joe Sanfelippo. Marklein, Kooyenga and Riemer participated in the bill signing ceremony.
The bipartisan Health Care Data Modernization Act was unanimously approved by the Assembly and Senate in February and had 39 co-sponsors.
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Kolste Receives WHA 2016 Health Care Advocate Award
State Rep. Debra Kolste (D-Janesville) received the Wisconsin Hospital Association (WHA) Health Care Advocate of the Year Award March 30 at WHA’s Advocacy Day in Madison. Kerry Swanson, president/CEO, St. Mary’s Janesville Hospital, presented this year’s award to Kolste in recognition of her collaborative efforts with hospitals and health care systems on several key WHA priority issues.
“Deb has been a valued partner with WHA,” Swanson said. Swanson said Kolste’s bipartisan accomplishments over the past two legislative session have supported the efforts of Wisconsin’s hospitals and health systems to deliver better care for patients.
Swanson noted Kolste’s work as a co-lead author on Act 153, bipartisan legislation that provides over $2 million in funding to test alternate payment models in the state Medicaid program to encourage mental health care coordination within an integrated health system and promote psychiatric consultations between providers.
Swanson highlighted Kolste’s efforts to address physician workforce needs in Wisconsin through her strong support of the bipartisan Interstate Medical Licensure Compact Act—which will enable many physicians who come to Wisconsin to begin serving patients more quickly through an expedited licensure process—and for a bipartisan increase in graduate medical education funding that is helping to increase the number of physicians trained in Wisconsin.
“Representative Kolste has been an important voice in the Legislature on several of WHA’s priority issues,” according to WHA President/CEO Eric Borgerding. “Deb’s knowledge, insight and passion for health care has helped advance bipartisan health care legislation ranging from supporting behavioral health care coordination to addressing Wisconsin’s physician workforce needs to enabling modern population health analyses.”
Kolste represents Wisconsin’s 44th Assembly District, and was first elected in 2012. Among other committees, Kolste serves on the Assembly Committee on Health, the Committee on Workforce Development and on the Speaker’s Task Force on Alzheimer’s and Dementia.
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Hospital Sisters Health System Receives WHA 2016 Advocacy All-Star Award
Hospital Sisters Health System (HSHS) received the Wisconsin Hospital Association (WHA) 2016 Advocacy All-Star Award at the Association’s annual Advocacy Day in Madison March 30.
Therese Pandl, HSHS Eastern Wisconsin Division CEO, and Julie Manas, HSHS Western Wisconsin Division CEO, accepted the award before more than 1,000 hospital supporters participating in the day’s activities. The award is presented to one hospital or health care system each year that exemplifies dedication to grassroots advocacy.
Manas and Pandl said they were honored to accept the award on behalf of the entire system that includes six hospitals in Wisconsin: HSHS Sacred Heart (Eau Claire); HSHS St. Joseph’s (Chippewa Falls); HSHS St. Mary’s (Green Bay); HSHS St. Vincent (Green Bay); HSHS St. Nicholas (Sheboygan); and, HSHS St. Clare (Oconto Falls).
“Advocacy is central to our mission,” according to Pandl. “Every day we advocate for policies that will enable us to continue to provide high-quality, accessible health care to the people living in our communities. We are very proud to receive this award as we continue to make our voices heard in Madison and Washington, DC.”
Over the past year, the hospital’s advocates have regularly contacted, hosted and met with their elected officials to discuss important health care issues, including advocating for improvements in Wisconsin’s Medicaid program. They have worked to educate elected officials on how public policy impacts area hospitals, communities and patients. They have even traveled to Washington, DC multiple times with WHA to make certain Wisconsin’s Members of Congress understand how federal issues impact local hospitals and communities.
“HSHS is a true partner with the Wisconsin Hospital Association and takes serious its mission to serve,” said Jenny Boese, WHA vice president, federal affairs & advocacy. “It has been a privilege to work alongside their entire team, and they are well deserving of this award.”
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Following Briefing, Over 500 “Citizen Lobbyists” Head to State Capitol to Meet with Legislators
Hospital advocates thank legislators for their support of key WHA priorities
More than 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 March 30 in Madison.
The state capitol was filled with “citizen lobbyists” from across the state advocating for policies that enable and protect high-quality, high-value health care in their communities.
O’Brien recapped the 2015-2016 legislative session for the group, emphasizing the power of speaking with “one voice” on key issues.
“Last year, your Advocacy Day legislative visits were an important part of accomplishing WHA’s legislative agenda this past session,” O’Brien said. “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.”
WHA was successful this session by building on the momentum created by the “citizen lobbyists” at last year’s advocacy day—enacting the Interstate Medical Licensure Compact and making the disproportionate share hospital program an ongoing appropriation. This year, O’Brien said it is time to thank legislators for acting on our “asks” and for their commitment to protecting high-quality, high-value health care.
O’Brien not only asked hospital advocates to thank their legislators for their past support, but to also cut Wisconsin’s hidden health care tax by increasing Medicaid reimbursement for services provided by hospitals. Medicaid pays roughly 65 percent of the cost of care and that results in a $900 million annual “hidden health care tax” on Wisconsin families and employers.
O’Brien also asked the advocates to remind their legislators that Wisconsin health care is among the best in the nation, but changes to the state employee health insurance program that are being discussed could have implications on access to that high-quality health care.
“Ask your legislator to consider innovative ideas to reduce costs and enhance access to care in the state employee health insurance program that build on Wisconsin’s health care market attributes,” O’Brien said.
For more photos and coverage of the legislative visits, go to the WHA 2016 Advocacy Day In Review.
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WCMEW to Host GME Summit May 25
Highlighting work done to expand graduate medical education (GME) in Wisconsin, the Wisconsin Council on Medical Education and Workforce (WCMEW) will host a one-day event that will showcase efforts to expand and optimize GME programs in Wisconsin and in other parts of the country. “Getting It Done: Status Report on Expanding GME in Wisconsin” will be held May 25 at the Glacier Canyon Lodge in Wisconsin Dells.
The Summit will begin with keynotes by Shelley Nuss, MD, campus dean for graduate medical education and designated institutional official, GRU/UGA Medical Partnership, speaking on “The Georgia GME Initiative”; and Ted Epperly, MD, president and CEO, Family Medicine Residency of Idaho, presenting “Building GME in Rural Idaho.”
Afternoon sessions start with a panel discussion on Wisconsin’s state-funded GME Grant Programs. Following will be breakout sessions including community engagement in GME, rural training tracks as vehicles to expand GME in rural areas, use of distance learning and technology in GME, and “What You Need to Know about DHS and WRPRAP Grants.”
Registration is now open for this event. For information, including the day’s agenda, visit: https://events.signup4.net/WCMEWPostGrad0525 or review the conference brochure included in this week’s packet. Registration questions can be directed to Kayla Chatterton at email@example.com or at 608-274-1820.
This event is presented by the Wisconsin Council on Medical Education and Workforce (WCMEW). WCMEW is a multi-stakeholder organization whose purpose is to facilitate strategies to ensure an adequate supply of health care providers to meet the needs of Wisconsin citizens today and into the future.
WCMEW stakeholders include: Medical College of Wisconsin, Pharmacy Society of Wisconsin, Rural Wisconsin Health Cooperative, UW School of Medicine and Public Health, Wisconsin Academy of Family Physicians, Wisconsin Academy of Physician Assistants, Wisconsin Hospital Association, Association of Nurse Educators of Wisconsin, Wisconsin Medical Society, the State of Wisconsin, and the Wisconsin Nurses Association.
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In Memoriam: Dick Davidson Remembered
Dick Davidson, the American Hospital Association’s president emeritus, died March 28 at age 79. Davidson had retired on January 1, 2007, after serving 16 years in the AHA’s top leadership role and was the second longest-serving president in the Association’s 118-year history.
Rick Pollack, current AHA CEO and president, remembers Davidson as “an innovative and visionary leader, a consensus builder, and a friend and mentor to many throughout our field.” Davidson “believed deeply in the special role that hospitals play in the lives of the patients and communities they serve.”
Davidson led the Association through a period of significant change when many hospitals evolved into health systems with multiple sites and services. WHA Senior Advisor and former President Steve Brenton recalls that Davidson was among the very first health leaders to talk about what is now known as population health, and he paved the path for AHA’s push into performance improvement.
In 2007, Davidson received the AHA’s highest honor, the Distinguished Service Award, which recognizes significant lifetime contributions and service to the nation’s health care institutions and the association. The annual Dick Davidson Quality Milestone Award for Allied Association Leadership was established to recognize a state, regional or metropolitan hospital association that demonstrates exceptional organizational leadership and innovation in quality improvement and has made significant contributions to the measurable improvement of quality within its geographic area. The Wisconsin Hospital Association received the Davidson quality award in 2014.
Davidson also was the first president of the Maryland Hospital Association, serving from 1969 to 1991. Davidson was succeeded at the AHA by Rich Umbdenstock, who retired as CEO and president last fall, handing the reins to Pollack.
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Member News: Bellin Health Leadership Changes
Woleske named Bellin Health chief operating officer; Hieb named Oconto Hospital CEO
Chris Woleske has been named the health system’s chief operating officer, effective immediately.
Most recently, Woleske served as CEO of Bellin Health Oconto Hospital, a position she had held since 2005. She also was the health system’s executive vice president of clinical services at Bellin Hospital and Bellin Psychiatric Center in Green Bay.
“Chris Woleske has proven herself as a knowledgeable and insightful leader who is adept at leading in times of growth and change,” said George Kerwin, Bellin Health president and CEO. “She is the perfect person to revive the role of COO as Bellin continues to expand its efforts to make the people in our region the healthiest in the nation.”
The COO position was not a vacancy at Bellin. The role has not existed at the health system for about a decade but was resurrected to oversee all aspects of operations related to direct patient care—part of the health system’s push for greater integration and efficiency.
Woleske has been a member of Bellin’s senior leadership team since 1998. Prior to that, she practiced law at the law firm Liebmann, Conway, Olejniczak & Jerry.
Woleske is a member of the WHA Board and chairs the WHA DHS 124 Task Force. She is a fellow of the American College of Healthcare Executives. She earned her bachelor’s degree in health care administration from the University of Wisconsin-Eau Claire and her law degree from Marquette Law School. Woleske completed an executive program at Stanford Graduate School of Business.
Hieb Named Bellin Health Oconto Hospital CEO
Bellin Health Chief Nursing Officer (CNO) Laura Hieb is the new CEO of Bellin Health Oconto Hospital. She will retain her CNO role, which she has held since 2006. Hieb was team leader of Bellin’s Homecare Services from 1998-2006. She has been a registered nurse since 1989, when she started her career at Bellin.
“Laura Hieb has been an asset to Bellin Health for many years, and she will continue to bring her leadership, experience and know-how to bear in her new role,” according to Bellin Health President/CEO George Kerwin said. “Bellin Health Oconto Hospital is transitioning from one terrific leader to another.”
Hieb earned her Bachelor of Science in nursing degree from Bellin College and her Master of Business Administration-Health Care (executive focus) from Cardinal Stritch University. She is certified as a Nurse Executive through the American Nurses Credentialing Center.
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