July 3, 2014
Volume 57, Issue 27


WHA Publishes Health Care Terminology Guide

The Wisconsin Hospital Association (WHA) has prepared a web-based guide entitled Health Care Acronyms and Terminology to help provide a basic understanding of various acronyms and terms used in health care. The guide contains definitions that apply to topics related to reimbursement, health reform, medicine, quality and workforce. It will be helpful to a variety of audiences, including hospital and health system employees, physicians and trustees.

The guide has been posted on www.wha.org in the Members Only section, under the "General" tab. If you are employed by a WHA member and have not registered for access to the Members Only section, go to http://members.wha.org.

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WHA Continues to Oppose Burdensome Policies in Comments on IPPS Rule

On June 30, WHA submitted comments (www.wha.org/pdf/WHAcomment_NPRM_IPPS2014.pdf) to the Centers for Medicare & Medicaid Services (CMS), expressing serious concerns with certain provisions of the 2015 Inpatient Prospective Payment System (IPPS) proposed rule. The rule itself touches on many issues of significance to WHA members for which WHA has long advocated.

Since 2011, WHA, along with several national colleagues, has opposed the application of a nationwide rural floor budget neutrality adjustment, resulting from an amendment that was slipped into the 2,000-page Patient Protection and Affordable Care Act (PPACA). The policy, sometimes referred to as the "Bay State Boondoggle," significantly benefits a small handful of states at the expense of hospitals nationwide. In 2015 alone, Massachusetts is estimated to reap an additional $157.8 million in increased reimbursements, and California, $196 million. That is why last year WHA joined 20 other state hospital associations to fight back against this provision.

Among other comments, WHA indicates that the two-midnight policy undermines the role of the physician’s judgment and describes its support for continuing CMS’ current enforcement delay, and also its opposition to the proposed payment reduction associated with the two-midnight policy. WHA also recognizes the redundancy and complexity of the Recovery Audit Contractors (RAC) Program, a program that causes significant administrative inefficiencies for hospitals.

WHA also comments on several other important policies including graduate medical education, flexibility for hospital price transparency, Medicare disproportionate share hospital (DSH) payments, and other payment adjustments. Finally, WHA expresses support for moving to greater value in the hospital value-based purchasing program, yet urges CMS to eliminate the overlap in measures for the hospital-acquired condition (HAC) and value-based purchasing programs, and develop more reliable and valid alternatives to the HAC program’s patient safety composite indicator (PSI 90).

The final IPPS rule is expected later this year. WHA will also review and comment on the proposed outpatient payment rule which is expected to be released shortly.

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Emergency Rule Adds Congenital Heart Disease to Newborn Screening

In a memo to providers (www.wha.org/pdf/DHS_CCHD7-2-14.pdf), the Wisconsin Department of Health Services (DHS) State Health Officer Karen McKeown notified hospitals that screening for critical congenital heart disease (CCHD) has been added to the newborn screening tests.

The memo states that DHS "has added, by emergency rule, screening for CCHD by pulse oximetry (POX) to the Wisconsin Newborn Screening Program’s panel of conditions." The emergency rule means that every infant born in or out of a hospital is required to have CCHD screening. Those infants born in a hospital will require the screening prior to discharge. This rule is expected to go into effect July 3, 2014.

"The vast majority of hospitals in Wisconsin were routinely screening for CCHD by pulse oximetry prior to the emergency rule," said Jodi Johnson, WHA vice president, workforce and clinical practice. "This rule now makes that a more formal requirement."

DHS is directing screeners and providers to visit the Wisconsin SHINE (Screening Hearts in Newborns) Project’s website at http://wisconsinshine.org for more information regarding screening newborns, including a screening toolkit.

The Wisconsin SHINE Project is a collaborative effort of the University of Wisconsin School of Medicine and Public Health, the Medical College of Wisconsin, Wisconsin DHS, and Wisconsin State Laboratory of Hygiene. For assistance or more information, contact the Wisconsin SHINE Project Hotline on-call personnel at 608-262-2122.

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WHA Webinars Focus on Improving Patient Experience, Service Excellence

Health care providers continue to move toward more concerted efforts of improving the patient experience and providing service excellence to each patient and their family with every encounter. In July and August, WHA is offering two webinars that focus on these topics.

Hospital staff who have the responsibility of focusing on improving the patient experience, patient relations, marketing or quality improvement will benefit from the July 22 webinar, "The Patient Experience Trifecta: Ignite the Passion, Change the Experience, Tell Your Story." This webinar will focus on word-of-mouth marketing, which can be a health care provider’s most strategic marketing weapon, and how it ties to patient experience. In addition, the session will discuss the "chief experience officer" model of managing patient experience and the three roles for that position. In addition, this webinar will share five strategies that mainstream companies use to identify and deploy customer ambassadors to tell their story. For more information and to register, go to: http://events.signup4.net/2014JulyWebinar.

On August 7, WHA is offering the webinar "Creating Service Excellence: Generate Enthusiasm to Improve Patient Relations." Service excellence is more than just "being nice" or saying yes to all patient requests. Also, service excellence does not happen by accident, but rather is the result of purposeful design by leaders who are committed to serving the patient and their family. This session will give a how-to guide to educate and engage your care team in service excellence, sharing practical tips to foster cooperation to achieve service excellence and ways to develop standard operating procedures to deliver consistent, exceptional service. For more information and to register, go to: http://events.signup4.net/2014AugustWebinar.

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Guest Column: Ending the Cycle of Poverty and Poor Health
By Cathy Jacobson and Joy Tapper | Milwaukee Journal Sentinel | June 30, 2014

Health disparities in our community are undeniable.

The Milwaukee Journal Sentinel’s "Poor Health" series of special reports highlights the complex economic and social factors that influence health care delivery and determine health outcomes—especially for low-income individuals and people of color. Indeed, research and our community’s experience have shown that there is a direct link between poverty, racism and poor health.

Since the Milwaukee Health Care Partnership’s formation as a public/private consortium in 2007, Milwaukee’s health systems, community health centers, the Medical College of Wisconsin and state and local government health agencies have been working on three key priorities: 1) secure health care coverage for all 2) enhance the availability, accessibility and quality of primary and specialty care and 3) improve care coordination across the delivery system for low-income uninsured and medically underserved people in Milwaukee County.

Together with many other health and human service agencies, we have demonstrated that collaboration can strengthen the safety net, connect individuals to timely and appropriate services and increase access to primary care, dental care, behavioral health services and affordable medications.

That said, as a partnership and a community, we face significant challenges. Through 2013, almost half of Milwaukee County’s population was considered medically "vulnerable." With incomes under 200 percent of the federal poverty level, 31 percent of county residents were covered by Medicaid (55 percent of whom were children), and 13 percent were uninsured at any given point.

As the "Poor Health" series pointed out, those with limited incomes, inadequate housing, transportation, education and social supports are at a disadvantage in navigating complex insurance and medical systems and are likely to delay care until their needs are severe. We know that regular primary care at a medical home is ideal. But ultimately, the answer to eliminating health disparities in Milwaukee is not more hospital beds; it is about addressing the root causes of poverty, unemployment, homelessness, violence and illiteracy.

Partnership members have aligned funding to improve care delivery in low-income communities, successfully moved thousands of uninsured individuals into coverage, increased capacity at safety net clinics, increased access to affordable medications and connected many uninsured and underinsured emergency department patients with medical homes. These activities and investments are in addition to individual health systems’ community contributions, charity care and Medicaid shortfalls for under-reimbursed services, which combined, totaled $542.5 million last year.

Moreover, partnership members have been involved individually and collectively in numerous other health and social initiatives including education (Milwaukee Succeeds), neighborhood revitalization (Walnut Way), engagement with the faith community (Chronic Disease Management Clinics) and efforts addressing violence, infant mortality and food insecurity.

Clearly there is more to be done. The magnitude and complexity of Milwaukee’s health needs require more focus, more attention and more leadership from all stakeholders. Government leaders, community-based organizations, insurance providers, employers and the philanthropic community need to work together to address systemic issues such as poverty, health care workforce shortages and insurance payment reform.

It requires a focused community health improvement plan that includes access to care and has a broader public health and prevention strategy. Through the Milwaukee Health Care Partnership, we are working together to improve health care coverage, access and care coordination for Milwaukee’s most vulnerable. As a community, we now have to work much further upstream from hospital and medical care and address the underlying socioeconomic determinants of health. Our collective commitment can end the cycle of poverty and poor health.

Cathy Jacobson is CEO of Froedtert Health and chair of the Milwaukee Health Care Partnership. Joy Tapper is executive director of the partnership, whose members include Aurora Health Care, Children’s Hospital and Health System, Columbia St. Mary’s, Froedtert Health, Wheaton Franciscan Healthcare, the Medical College of Wisconsin, Outreach Community Health Centers, Milwaukee Health Services, Inc., Sixteenth Street Community Health Centers, Progressive Community Health Centers, Wisconsin Department of Health Services, Milwaukee County Department of Health and Human Services and the City of Milwaukee Health Department.

Milwaukee Journal Sentinel by JOURNAL/SENTINEL, INC. Reproduced with permission of JOURNAL/SENTINEL, INC. in the format Post on the Internet via Copyright Clearance Center.

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HHS Grants Bolster Health Care and Public Health Disaster Preparedness

Wisconsin has received $3.6 million in funding for the hospital emergency preparedness program and $11.5 million for public health emergency preparedness from the Department of Health and Human Services (HHS) to continue improving emergency preparedness of state and local public health and health care systems.

The grant funds are distributed through two federal preparedness programs—the Hospital Preparedness Program (HPP) and the Public Health Emergency Preparedness (PHEP) programs. These programs represent critical sources of funding and support for the nation’s health care and public health systems. The programs provide resources needed to ensure that local communities can respond effectively to infectious disease outbreaks, natural disasters, or chemical, biological, or radiological nuclear events.

The fiscal year 2014 funding HHS awards include a total of $228.5 million for HPP and $611.75 million for PHEP.

Administered by the Office of Assistant Secretary for Preparedness and Response, HPP funding supports building sustainable community health care coalitions that collaborate on emergency planning and response. PHEP funding is used to advance public health preparedness and response capabilities at the state and local level.

This marks the third year that HPP and PHEP funds are being awarded jointly, encouraging further cooperation between the nation’s health care and public health systems, and reducing the administrative burden on grantees. With aligned HPP and PHEP cooperative agreement programs, communities can conduct more effective joint planning, exercising and program operations. These activities are vital for communities to prepare for, respond to, and recover from emergencies, and help communities manage health care and public health on a daily basis.

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Learn to Tell Your Story at Hospital Foundation Workshop
Complimentary workshop offered August 7

On August 7, WHA, the Wisconsin Office of Rural Health (WORH) and the Rural Wisconsin Health Cooperative (RWHC) are teaming up to offer a no-cost, one-day workshop exclusively for hospital foundation staff and boards. "Prescription for Success: A Workshop for Hospital Foundations," will take place at the Stoney Creek Hotel & Conference Center in Rothschild.

Nationally-recognized health care philanthropy consultant Betsy Chapin Taylor will facilitate a day full of interactive sessions that will assist staff and board members in conveying the human impact of their foundation’s work with powerful and emotional mission storytelling. In addition, attendees will learn to identify the various levers that can enhance a foundation’s performance; as well as strategies to identify and engage key allies.

Again, due to the partnership and support of the WHA, WORH and RWHC, this workshop is available at no cost to hospital and hospital foundation staff; however, pre-registration is required. The day’s agenda and online registration are available at http://events.SignUp4.net/Foundation14.

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