September 28, 2012
Volume 56, Issue 39
Public Wants More Control, More Choice, Less Government in Health Care
Health care leaders are accustomed to hearing that "change is coming," but when that message comes from Scott Rasmussen, a highly-respected pollster best-known for sharing keen political insights, it carries a new sense of urgency. Sweeping change will hit every aspect of health care, according to Rasmussen, who presented at the WHA 2012 Summit held September 21 in Madison.
"It’s not just about what is happening in Wisconsin’s health care industry," according to Rasmussen, best-selling author and president of Rasmussen Reports. "The health care industry is going to change more than you can imagine. A decade from now it will be financed differently, patients will be interacting with you differently and your jobs will be different."
People recognize that lifestyle choices have a greater affect on their health than medical care, but people can’t agree on what the role of government should be in rewarding—or penalizing—unhealthy lifestyles. While people believe that insurance companies should offer a discount to subscribers that have a healthy lifestyle, they are at the same time, paying a smaller share of their disposable income toward health care than people did 50 years ago.
Rasmussen said 82 percent of the voters believe that if your company provides health insurance, you should be able to use that money to buy a policy that works for you. However, if they find a less expensive policy, they believe they should be able to ‘keep the change.’
"When people around the country hear about the ‘exploding cost of health care,’ they are not personally seeing it," Rasmussen said. "Government agencies are seeing it, insurance companies and employers are seeing it, but most people are not feeling it in their own pocket."
As people become more responsible for the cost of care, they will also demand more control over their choices. This will trigger transformational change in the industry. Rasmussen predicts that less care will occur in hospitals and clinics and more will be done at home, which will change the relationship between patient and care provider.
"If you figure out where public opinion is going, you will see what the end result is going to be in health care and the right policies and right choices are going to fall into place that will give individuals the maximum amount of control over their own health," Rasmussen said.
On the political scene, Rasmussen said the presidential race continues to be too close to call. While President Obama "got a good bounce" out of the Democratic convention, according to Rasmussen, the Republicans are more engaged. Rasmussen said Wisconsin is one of eight pivotal states for Obama and Romney in the upcoming election. Meanwhile, control of the senate could hang on the results in four toss-up states—Wisconsin, Virginia, Connecticut and Massachusetts.
Rasmussen noted that in a presidential election, the most important number to watch is the President’s job approval rating because that is a rough estimate of the percentage of votes the President will garner on Election Day. For three years, President Obama’s job approval rating has been, on average, 47 percent. And the biggest driver of the approval rating is no surprise, the economy. Only 16 percent of the public believes that today’s children will be better off than their parents. In the 1930’s, 37 percent thought the next generation would be better off.
"The public is ready to make thoughtful changes in programs, but it will take a leader to articulate that and when you go through change, it is a painful process," Rasmussen said. "There will be turmoil and anger as we go through these changes."
On Medicare, Rasmussen said only 40 percent of people under 40 think Medicare is a good deal for them. They like the concept, but they don’t like the way the system is working today. While the public largely opposes the health reform law, they recognize that change is needed, but they have no idea how to change the system.
"People are getting the sense that the health care debate is not about them—it is just about who sets the rules and how you get paid for it," according to Rasmussen. "They don’t want government or insurance companies to make choices for them. They are looking for a new, different process."
To help their communities cope with the rapid change that is ahead in health care, Rasmussen encouraged hospitals to remain patient-centered and "give a lot of thought to how you actually can help your patients improve their health."
Top of page (9/28/12)
The WHA Medicaid Reengineering Group (MRG) was reconvened and met at WHA September 25, led by Chair Nick Desien, CEO of Ministry Health. The group, which is comprised of member CEOs and CFOs, was created in 2011 to study various aspects of the Wisconsin Medicaid program. Under its ongoing charge, the MRG is taking on the complex issues around Medicaid expansion in Wisconsin. The group’s goal is to develop recommendations related to ACA implementation in Wisconsin, and in keeping with the WHA Medicaid principles of maintaining Medicaid as a safety net for Wisconsin’s vulnerable citizens.
"The Supreme Court decision has caused a number of unanswered questions, yet policy makers are going to be grappling with how to structure the Medicaid program in Wisconsin in the face of this uncertainty," said Desien. "We want to be proactive in our approach to understanding the policy questions and coming up with ideas and input."
In its previous work, the MRG developed over 47 recommendations for reforming the Medicaid program. At this meeting, members reviewed the WHA Medicaid Guiding Principles, and the MRG policy assumptions. These policy assumptions guided its work in the past and members agreed they are still relevant today. The policy principles are:
Joanne Alig, senior vice president for policy and research at WHA, walked the MRG through WHA’s current analysis of the Supreme Court’s ruling on Medicaid expansion. The ruling makes optional the health care reform law’s requirement to expand eligibility to anyone with income below 133 percent of the federal poverty level. In Wisconsin the key population group that would be affected by this provision is adults without dependent children (the "childless adults"). Alig said it ultimately boils down to policy questions about what income threshold should be used to determine eligibility for Medicaid for all population groups and whether subsidized coverage through an exchange or the Basic Health Plan provide better alternatives.
"We are carefully considering Wisconsin’s choices and their implications on providers, recipients, the state and the overall cost shift to employers," said WHA Executive Vice President Eric Borgerding. "We are fortunate in this state that our members are engaged and willing to commit their time to these issues."
The MRG is currently scheduled to meet three times through the end of November.
Top of page (9/28/12)
Totals to the 2012 Wisconsin hospitals state political action funds fundraising campaign surpassed $200,000 this week, raising $206,746 to date. More than $12,000 has been raised in the last two weeks from 31 more individuals, putting the total number of participants at 339, and 50 of them are members of the Platinum Club contributing $1,500 or more to the 2012 campaign.
The 2012 campaign continues its strong pace, $38,000 ahead of last year at this time and nearly $13,000 ahead of the 2010 record breaking year. The campaign is at 83 percent of the goal to raise $250,000 by year’s end, which if achieved, would be the highest total ever raised in a single campaign year, a long way from the $60,000 record raised back in 2001, just over ten years ago.
All individual contributors are listed in The Valued Voice by name and affiliated organization on a regular basis. Thank you to the 2012 contributors to date who are listed on pages 12-13. Contributors are listed alphabetically by contribution amount category. The next publication of the contributor list will be in the October 12 edition of The Valued Voice. For more information, contact Jodi Bloch at 608-217-9508 or Jenny Boese at 608-274-1820.
|Contributors ranging from $1 to $499|
|Appleby, Jane||Aurora Health Care|
|Arendt, Kathleen||Aspirus Wausau Hospital|
|Ashenhurst, Karla||Ministry Health Care|
|Bair, Barbara||St. Clare Hospital & Health Services|
|Beglinger, Joan||St. Mary's Hospital|
|Bell, Kristine||Aspirus Wausau Hospital|
|Bernklau, Robert||Aspirus Wausau Hospital|
|Biros, Marilyn||SSM Health Care-Wisconsin|
|Bliven, David||Aspirus Wausau Hospital|
|Bosio, David||Aspirus Wausau Hospital|
|Boson, Ann||Ministry Saint Joseph's Hospital|
|Bowers, Laura||SSM Health Care-Wisconsin|
|Brenholt, Craig||St. Joseph's Hospital|
|Brenton, Andrew||Wisconsin Hospital Association|
|Buettner, Susan||Aurora Health Care|
|Burgener, Jean||Aspirus Wausau Hospital|
|Buss, Diane||St. Mary's Hospital|
|Bychinski, Paul||Aspirus Wausau Hospital|
|Calhoun, William||Mercy Medical Center|
|Carlson, Peter||Aurora Psychiatric Hospital|
|Censky, Bill||Holy Family Memorial|
|Cieslak Duchek, Mary||Aurora Health Care|
|Clark, Julie||St. Joseph's Hospital|
|Clesceri, Maryann||Aurora Health Care|
|Coil, Joseph||St. Clare Hospital & Health Services|
|Cox, Tamarah||Aspirus Wausau Hospital|
|Culotta, Jennifer||St. Clare Hospital & Health Services|
|Cummings, Mike||Aurora Health Care|
|Dahl, James||Fort HealthCare|
|Dalebroux, Steve||St. Mary's Hospital|
|Danner, Forrest||Aspirus Wausau Hospital|
|Davis, Leslie||Aurora Health Care|
|DeRosa, Jody||St. Mary's Janesville Hospital|
|Dettman, Amy||Bellin Hospital|
|Dietrich, Dean||Aspirus Wausau Hospital|
|Dodd, Petra||Aspirus Wausau Hospital|
|Drengler, Kathryn||Aspirus Wausau Hospital|
|Dufek, Nancy||Memorial Medical Center - Ashland|
|Dux, Larry||Community Memorial Hospital|
|Elliott, Roger||St. Joseph's Hospital|
|Entenmann, Kim||St. Joseph's Hospital|
|Fabich, Robb||Aspirus, Inc.|
|Facey, Alice||St. Clare Hospital & Health Services|
|Fielding, Laura||Holy Family Memorial|
|Francaviglia, Stephen||Aurora Health Care|
|Freimund, Rooney||Bay Area Medical Center|
|Fuchs, Thomas||St. Joseph's Hospital|
|Gajeski, Lynn||St. Vincent Hospital|
|Garavet, Scott||Aspirus Wausau Hospital|
|Garibaldi, Isabelle||Wheaton Franciscan Healthcare - All Saints|
|Garvey, Gale||St. Mary's Hospital|
|Gates, John||Aurora Health Care|
|Giedd, Janice||St. Joseph's Hospital|
|Govier, Mary||Holy Family Memorial|
|Grady, Raymond||Aurora Health Care|
|Granger, Lorna||ProHealth Care, Inc.|
|Gresham, James||Wheaton Franciscan Healthcare|
|Groskreutz, Kevin||St. Joseph's Hospital|
|Grundstrom, David||Flambeau Hospital|
|Gulan, Maria||Aspirus Wausau Hospital|
|Halida, Cheryl||St. Joseph's Hospital|
|Hattem, Marita||Aspirus Wausau Hospital|
|Hedrington, Brian||Sacred Heart Hospital|
|Heinzen, James||Aurora Medical Center in Hartford|
|Hieb, Laura||Bellin Hospital|
|Hill, Nick||St. Joseph's Hospital|
|Hinker, Jennifer||Aspirus Wausau Hospital|
|Hinton, George||Aurora Sinai Medical Center|
|Hockers, Sara||Holy Family Memorial|
|Hoege, Beverly||Reedsburg Area Medical Center|
|Holub, Gregory||Ministry Door County Medical Center|
|Huber, Mark||Aurora Health Care|
|Hueller, Julie||Wheaton Franciscan Healthcare|
|Huemmer, Paul||St. Mary's Hospital|
|Irwin, Ron||Aurora Health Care|
|Jelle, Laura||St. Clare Hospital & Health Services|
|Jensema, Christine||HSHS-Eastern Wisconsin Division|
|Jensen, Russell||St. Mary's Hospital|
|Johnas, Nancy||Aspirus Wausau Hospital|
|Johnson, George||Reedsburg Area Medical Center|
|Jones, Mary||Meriter Hospital|
|Karow, Deborah||Ministry Health Care's Howard Young Medical Center|
|Keene, Kaaron||Memorial Health Center|
|Kelsey Foley, Kathy||Aspirus Wausau Hospital|
|Kempen, Jacob||Aspirus Wausau Hospital|
|Kepchar, Dennis||Ministry Health Care|
|King, Steve||St. Mary's Hospital|
|Kingston, Mary Beth||Aurora Health Care|
|Klay, Lois||St. Joseph's Hospital|
|Klein, Richard||Aurora Health Care|
|Klein, Tim||Holy Family Memorial|
|Kleinschmidt, Sherry||Aspirus Wausau Hospital|
|Koch, Doug||Aurora Health Care|
|Kocourek, Cathie||Aurora Medical Center in Two Rivers|
|Koss, Gail||Aspirus, Inc.|
|Krause, Carolyn||Meriter Hospital|
|Lachecki, Therese||Memorial Medical Center - Ashland|
|Lambrecht, Randy||Aurora Health Care|
|Lampman, Sandra||St. Mary's Hospital|
|Larson, William||St. Joseph's Hospital|
|Leonard, Mary Kay||St. Mary's Hospital|
|Lewandowski, Terri||Ministry Our Lady of Victory Hospital|
|Logemann, Tim||Aspirus Wausau Hospital|
|Lucas, Roger||Aspirus Wausau Hospital|
|Ludgin, Richard||Aurora Health Care|
|Lynch, Sue||Mayo Health System - Franciscan Healthcare|
|Marcouiller, Don||Memorial Medical Center - Ashland|
|Margan, Rob||Wisconsin Hospital Association|
|Mason, Paul||Wheaton Franciscan Healthcare - All Saints|
|Maurer, Mary||Holy Family Memorial|
|McMeans, Scott||Holy Family Memorial|
|Meicher, John||St. Mary's Hospital|
|Merrick, Marianne||St. Mary's Hospital|
|Mohr, Carol||Sacred Heart Hospital|
|Moon-Mogush, Cindy||Aurora Health Care|
|Moss, Kenneth||Meriter Hospital|
|Murphy, Thomas||Aurora Health Care|
|Neeno, Joan||St. Mary's Janesville Hospital|
|Nelson, Dean||St. Mary's Hospital|
|Nevers, Rick||Aspirus, Inc.|
|Nguyen, Juliet||Sacred Heart Hospital|
|Norbin Killoran, Carrie||Aurora Health Care|
|Norton, Marcella||Aspirus Wausau Hospital|
|O'Hara, Tiffanie||Wisconsin Hospital Association|
|Ojala, Theresa||St. Mary's Hospital|
|Olson, Bonnie||Sacred Heart Hospital|
|Olson, Christine||Aurora Medical Center in Kenosha|
|Olson, Keri||St. Clare Hospital & Health Services|
|Ose, Peggy||Riverview Hospital Association|
|Peck, Lori||Memorial Health Center|
|Peiffer, Susan||Sacred Heart Hospital|
|Pempek, Kalynn||Aspirus Wausau Hospital|
|Penczykowski, James||St. Mary's Hospital|
|Pennebecker, Allen||Ministry Saint Michael's Hospital|
|Pirsig-Anderson, Jane||Aurora Health Care|
|Platt-Gibson, Melanie||St. Clare Hospital & Health Services|
|Prunty, Brian||Aspirus Wausau Hospital|
|Quinn, George||Wisconsin Hospital Association|
|Reinke, Mary||Meriter Hospital|
|Reynolds, Kristen||Aurora Health Care|
|Richbourg, Mary||Sacred Heart Hospital|
|Rocheleau, John||Bellin Hospital|
|Roethle, Linda||Bellin Hospital|
|Roundy, Ann||Columbus Community Hospital|
|Rozenfeld, Jonathan||St. Mary's Hospital|
|Rubenzer, Deanne||St. Joseph's Hospital|
|Rudolph, Wade||Sacred Heart Hospital|
|Rueber, Joel||Aspirus, Inc.|
|Samuelson, Bonnie||Aspirus Wausau Hospital|
|Sanicola, Suzanne||Columbia St. Mary's Columbia Hospital|
|Saunaitis, Tamara||Meriter Hospital|
|Schaetzl, Ron||St. Clare Hospital & Health Services|
|Schraufnagel, Patricia||Memorial Medical Center - Ashland|
|Schwartz, Mary||St. Clare Hospital & Health Services|
|Scinto, Jeanne||Aspirus Wausau Hospital|
|Sczygelski, Sidney||Aspirus Wausau Hospital|
|Sheehan, Heather||Hayward Area Memorial Hospital and Nursing Home|
|Sio, Tim||Wheaton Franciscan Healthcare - All Saints|
|Slomczewski, Constance||Wheaton Franciscan Healthcare - All Saints|
|Stapelfeldt, Kimberly||Aurora Medical Center in Hartford|
|Statz, Darrell||Rural Wisconsin Health Cooperative|
|Steevens, Alan||St. Clare Hospital & Health Services|
|Stelzer, Jason||St. Clare Hospital & Health Services|
|Stewart, Jeff||Children's Hospital and Health System|
|Strasser, Kathy||Aspirus, Inc.|
|Sullivan, Anne||Memorial Medical Center - Ashland|
|Tapper, Joy||Milwaukee Health Care Partnership|
|Teigen, Seth||St. Mary's Hospital|
|Thornton, Eric||St. Mary's Janesville Hospital|
|Thurmer, DeAnn||Waupun Memorial Hospital|
|Tobin, Susan||Aspirus Wausau Hospital|
|Turner, Sally||Aurora Health Care|
|Tuttle, Kathryn||Memorial Medical Center - Ashland|
|Voelker, Thomas||Aspirus Wausau Hospital|
|Walker, Troy||St. Clare Hospital & Health Services|
|Wanless, Kathy||Aspirus Wausau Hospital|
|Watts, Susan||St. Vincent Hospital|
|Wojciechowski, Gary||Aspirus Wausau Hospital|
|Woleske, Chris||Bellin Psychiatric Center|
|Worrick, Gerald||Ministry Door County Medical Center|
|Wymelenberg, Tracy||Aurora Health Care|
|Wysocki, Scott||St. Clare Hospital & Health Services|
|Zaverl, Kimberly||Froedtert Health|
|Zeller, Brad||Hayward Area Memorial Hospital and Nursing Home|
|Contributors ranging from $500 to $999|
|Arca, Marjorie||Children's Hospital and Health System|
|Bard, Jeffrey||Aurora Health Care|
|Bonin, Christopher||Aurora Health Care|
|Brooks, Alenia||Aurora Health Care|
|Brophy, Michael||Aurora Health Care|
|Bukowski, Cathy||Ministry Eagle River Memorial Hospital|
|Carlson, Dan||Bay Area Medical Center|
|Chess, Eva||Aurora Health Care|
|Chumbley, Bud||Aspirus, Inc.|
|Clough, Sheila||Ministry Eagle River Memorial Hospital|
|Dietsche, James||Bellin Hospital|
|Eckels, Timothy||Hospital Sisters Health System|
|Ewing, Thomas||Aurora Health Care|
|Fields, Mary||Aurora Health Care|
|Garcia-Thomas, Cristy||Aurora Health Care|
|Guffey, Kerra||Meriter Hospital|
|Hart, Shelly||Aurora Health Care|
|Heifetz, Michael||SSM Health Care-Wisconsin|
|Huettl, Patricia||Holy Family Memorial|
|Hyland, Carol||Agnesian HealthCare|
|Jacobson, Terry||St. Mary's Hospital of Superior|
|Joyner, Ken||Bay Area Medical Center|
|Just, Lisa||Aurora Medical Center in Hartford|
|Kellar, Richard||Aurora West Allis Medical Center|
|Kerwin, George||Bellin Hospital|
|Klimisch, Ronald||Aspirus Wausau Hospital|
|Larson, Margaret||Mercy Medical Center|
|Lentz, Darrell||Aspirus, Inc.|
|Lewis, Gordon||Burnett Medical Center|
|Mantei, Mary Jo||Bay Area Medical Center|
|May, Carol||Sauk Prairie Memorial Hospital|
|McDonald, Brian||Aurora Health Care|
|McKennie, Randall||Aurora St. Luke's Medical Center|
|McNally, Maureen||Froedtert Health|
|Miller, Jim||Children's Hospital and Health System|
|Nelson, Dave||SSM Health Care-Wisconsin|
|Nelson, James||Fort HealthCare|
|Potts, Dennis||Aurora Health Care|
|Richards, Theresa||Ministry Saint Joseph's Hospital|
|Rickelman, Debbie||WHA Information Center|
|Roberts, Paula||Children's Hospital and Health System|
|Samitt, Craig||Dean Health|
|Schafer, Michael||Spooner Health System|
|Selberg, Heidi||HSHS-Eastern Wisconsin Division|
|Shabino, Charles||Wisconsin Hospital Association|
|Skowlund, Kathleen||Aurora Health Care-South Region|
|Stuart, Philip||Tomah Memorial Hospital|
|Swanson, Kerry||St. Mary's Janesville Hospital|
|Talley, Barbara||St. Clare Hospital & Health Services|
|Taplin Statz, Linda||SSM Health Care-Wisconsin|
|Trenschel, Robert||Aurora Health Care|
|VanCourt, Bernie||Bay Area Medical Center|
|Wilk, Leonard||Aurora Medical Center in Grafton|
|Zenk, Ann||Ministry Saint Mary's Hospital|
|Zorbini, John||Aurora Health Care|
|Contributors ranging from $1,000 to $1,499|
|Anderson, Sandy||St. Clare Hospital & Health Services|
|Bablitch, Steve||Aurora Health Care|
|Bailet, Jeffrey||Aurora Health Care|
|Banaszynski, Gregory||Aurora Health Care|
|Bedwell, Elizabeth||Children's Hospital of Wisconsin|
|Britton, Gregory||Beloit Health System|
|Buck, Catherine||Froedtert Health|
|Byrne, Frank||St. Mary's Hospital|
|Canter, Richard||Wheaton Franciscan Healthcare|
|Court, Kelly||Wisconsin Hospital Association|
|Deich, Faye||Sacred Heart Hospital|
|Falvey, Patrick||Aurora Health Care|
|Fischer, Edwin||Fort HealthCare|
|Francis, Jeff||Ministry Health Care|
|Frank, Jennifer||Wisconsin Hospital Association|
|Garcia, Dawn||St. Joseph's Hospital|
|Gunn, Veronica||Children's Hospital and Health System|
|Gutzeit, Michael||Children's Hospital and Health System|
|Herzog, Mark||Holy Family Memorial|
|Hilt, Monica||Ministry Saint Mary's Hospital|
|Hymans, Daniel||Memorial Medical Center - Ashland|
|Johnson, Charles||St. Mary's Hospital|
|Kosanovich, John||Watertown Regional Medical Center|
|Lappin, Michael||Aurora Health Care|
|Loftus, Philip||Aurora Health Care|
|Mattes, Dan||Wheaton Franciscan Healthcare|
|Mohorek, Ronald||Ministry Health Care|
|Niemer, Margaret||Children's Hospital and Health System|
|Peterson, Douglas||Chippewa Valley Hospital|
|Radoszewski, Pat||Children's Hospital and Health System|
|Reynolds, Sheila||Children's Hospital and Health System|
|Ricci, Anthony||Aurora Memorial Hospital of Burlington|
|Robertstad, John||ProHealth Care - Oconomowoc Memorial Hospital|
|Roller, Rachel||Aurora Health Care|
|Russell, John||Columbus Community Hospital|
|Sanders, Robert||Children's Hospital and Health System|
|Tempelis, Eric||Gundersen Lutheran Health System|
|Uhing, Michael||Children's Hospital of Wisconsin|
|Westrick, Paul||Columbia St. Mary's Columbia Hospital|
|Wolf, Edward||Lakeview Medical Center|
|Contributors ranging from $1,500 to $1,999|
|Alig, Joanne||Wisconsin Hospital Association|
|Barney, Steven||SSM Health Care-Wisconsin|
|Bloch, Jodi||Wisconsin Hospital Association|
|Boese, Jennifer||Wisconsin Hospital Association|
|Clapp, Nicole||Grant Regional Health Center|
|Coffman, Joan||St. Joseph's Hospital|
|Eichman, Cynthia||Ministry Our Lady of Victory Hospital|
|Geboy, Scott||Hall, Render, Killian, Heath & Lyman|
|Gorelick, Marc||Children's Hospital and Health System|
|Grasmick, Mary Kay||Wisconsin Hospital Association|
|Hahn, Brad||Aurora Health Care|
|Harding, Edward||Bay Area Medical Center|
|Levin, Jeremy||Rural Wisconsin Health Cooperative|
|Maciver, Carolyn||Aurora Health Care|
|Meyer, Daniel||Aurora BayCare Medical Center in Green Bay|
|Natzke, Ryan||Marshfield Clinic|
|O'Brien, Mary||Aurora St. Luke's Medical Center|
|Postler-Slattery, Diane||Aspirus Wausau Hospital|
|Potter, Brian||Wisconsin Hospital Association|
|Stanford, Matthew||Wisconsin Hospital Association|
|Wallace, Michael||Fort HealthCare|
|Warmuth, Judith||Wisconsin Hospital Association|
|Contributors ranging from $2,000 to $2,999|
|Brenton, Mary E.|
|Duncan, Robert||Children's Hospital and Health System|
|Erwin, Duane||Aspirus, Inc.|
|Jacobson, Catherine||Froedtert Health|
|Kachelski, Joe||Wisconsin Statewide Health Information Network|
|Kief, Brian||Ministry Saint Joseph's Hospital|
|Leitch, Laura||Wisconsin Hospital Association|
|Little, Steven||Agnesian HealthCare|
|Manas, Julie||Sacred Heart Hospital|
|Merline, Paul||Wisconsin Hospital Association|
|Mettner, Michelle||Children's Hospital and Health System|
|Neufelder, Daniel||Affinity Health System|
|Normington, Jeremy||Moundview Memorial Hospital & Clinics|
|Oliverio, John||Wheaton Franciscan Healthcare|
|Pandl, Therese||HSHS-Eastern Wisconsin Division|
|Sanders, Michael||Monroe Clinic|
|Sexton, William||Prairie du Chien Memorial Hospital|
|Starmann-Harrison, Mary||Hospital Sisters Health System|
|Taylor, Mark||Columbia St. Mary's, Inc.|
|Woodward, James||Meriter Hospital|
|Contributors ranging from $3,000 to $4,999|
|Borgerding, Eric||Wisconsin Hospital Association|
|Fish, David||Hospital Sisters Health System|
|Turkal, Nick||Aurora Health Care|
|Contributors $5,000 and above|
|Brenton, Stephen||Wisconsin Hospital Association|
|Size, Tim||Rural Wisconsin Health Cooperative|
|Tyre, Scott||Capitol Navigators, Inc|
Twenty-one Hospitals Attend WHA-Led TCAB Learning Session
Top of page (9/28/12)
Nearly 150 nurses and clinicians gathered in Wisconsin Dells to launch the second Transforming Care at the Bedside (TCAB) initiative. Led by the Wisconsin Hospital Association, 23 hospital units representing 21 hospitals participated in a two-day TCAB education session designed to give caregivers the tools, and the inspiration, to improve care at the bedside by engaging all employees in patient-centered process improvement. WHA’s Stephanie Sobczak, quality manager, and Judy Warmuth, vice president of workforce, facilitated with assistance from Betsy Lee, director, Indiana Patient Safety Center, Indiana Hospital Association. The keynote presentation and leadership luncheon was provided by Lynn Cote, nurse manager from Southern Maine Medical Center, which just completed a three-year TCAB collaborative with Aligning Forces for Quality.
TCAB is an innovative quality improvement model that calls for nurses to lead unit and hospital-wide team efforts to improve the quality and safety of patient care.
"The beauty of TCAB is that quality becomes practical in the hands of bedside nurses who are given the tools to conduct small tests of change, then adapt, adopt, or abandon those tests until an innovation becomes a new way of doing things," according to Judy Warmuth, WHA vice president, workforce.
The 23 TCAB units are also charged with spreading their improvement strategies to the entire hospital.
The participants in the two-day TCAB event learned how to motivate and engage frontline staff to rethink how they do their work. The teams were asked to come up with a new idea that would lead to better patient care, and then they were given an opportunity to share that improvement with the larger audience by performing a short skit. There were more teams volunteering to share than there was time left in the day. That eagerness to collaborate is a hallmark of Wisconsin’s quality efforts.
"We can be very proud of the fact that once our hospitals find a way to improve the quality and safety of the care, they are more than willing to share—and even to teach—it to others," according to Sobczak. This best practice sharing was facilitated by presentations from WHA member hospitals who participated in the initial TCAB cohort. Front line nurses from Boscobel, Beloit Memorial, Reedsburg, and Froedtert Community Memorial hospitals shared their experiences and lessons learned in several aspects of the TCAB work.
Don’t miss the photos taken during the TCAB launch, including a group photo of every hospital team there, at: www.wha.org/pubarchive/special_reports/2012tcab9-2012.pdf.
Top of page (9/28/12)
The headlines last week focused on the boos Paul Ryan received when he addressed the AARP, the self-styled seniors’ lobby. But as so often occurs, the mainstream media conveniently ignored the real story, which was that the Republican vice presidential nominee was modestly rewarded for telling some hard truths by actually receiving some applause.
The Wisconsin Congressman deserves credit merely for showing up at an organization that portrays itself as nonpartisan but whose leadership is hardly that. Just last week, WSJ opinion writer Kimberley Strassel reported (http://online.wsj.com/article/SB10000872396390444165804578008413907642282.html#articleTabs%3Darticle) on a long email trail showing how AARP officials aided the White House in passing the ACA. And at the AARP convention, CEO Barry Rand used his opening remarks to defend the ACA, including the taking of $716 billion from Medicare (providers), an action that does nothing to improve the long-term finances of the program.
Ryan showed up with his message that Medicare is on a path to bankruptcy if it isn’t reformed. His statements didn’t go over well with some in the crowd who tipped their political bent by booing and heckling.
Largely unreported, however, was the applause Ryan received. That came in response to his criticism of the ACA’s Independent Payment Advisory Board, the 15 "unaccountable bureaucrats" empowered to make cuts to Medicare providers that Ryan said will "jeopardize access to care." As a reminder, the payment board is largely shielded from Congressional review precisely so it can ration care with little oversight. Even some ACA supporters admit discomfort with the scheme.
The Wisconsin Congressman was also cheered for his promise that his Medicare premium-support reform would "force insurance companies to compete against each other to better serve seniors, with more help for the poor and the sick...."
As critically noted in the Wall Street Journal a few days ago, "The press corps like to whine that politicians duck the ‘hard choices,’ but when a politician doesn’t duck, they quickly call it politically foolish. That’s what they’re now doing on Medicare, repeating the spin that seniors oppose reform even as the polls show Republicans doing better on the issue than is usually the case."
Medicare spending can’t continue on its current course, and one difference in this campaign is that Congressman Ryan is willing to say just that. As observed in this space previously, there are only two choices for transforming Medicare—moving toward a defined contribution approach—or—propping up a broken down FFS status quo with an "independent" board empowered to further whack providers.
Top of page (9/28/12)
On Friday, September 21, WHA staff attended a forum held by Senators Jon Erpenbach and Jon Richards in the State Capitol on the implementation of the Affordable Care Act in Wisconsin. The featured speaker was Kenneth Munson, Region V director of the U.S. Department of Health and Human Services (HHS). Munson previously held positions in Wisconsin, including deputy secretary for the Department of Health Services under Governor Doyle.
The two main topics covered at the forum were the health insurance exchanges and Medicaid expansion. On the exchanges, Munson laid out the timeline for a state to choose to operate its own exchange. Long-term, exchanges must be operational beginning October 2013 when enrollment into health plans in the exchanges is expected to begin. In the near-term, states must submit a "blueprint" to HHS by November 16 describing the steps taken thus far to develop an exchange and future steps toward implementation. If the state has not submitted the blueprint by the November 16 deadline, federal government officials will assume the state is not implementing an exchange and will take steps to implement a federally-run exchange instead. Munson said that 12 Governors have sent letters to HHS declaring their intention to operate a state exchange.
Given the number of states—including Wisconsin—that are waiting for the November elections before deciding on exchange implementation, some questioned whether the federal government is considering extending the timelines for exchange implementation. Munson said that HHS currently has no plans to relax the current deadlines, the requirement that exchanges be implemented for 2014 is in the law, and HHS could not, through rule, modify the deadlines.
Although Governor Walker halted work on the exchange in Wisconsin pending the November elections, the Administration had made some progress on implementation prior to that decision, and had spent federal grant funds of approximately $2 million on exchange planning. In response to a question, Munson said that there has been no determination that those funds would have to be returned.
Munson also discussed the Essential Health Benefits (EHB) package, which is the minimum set of benefits that must be offered in the individual and small group markets beginning in 2014. HHS is asking that states select an EHB by the end of September, although there is no official deadline for states to decide. Munson said that about 30 states have been working on determining the EHB. States can choose their EHB from one of ten existing plans in the market. If the state does not elect an EHB from one of the ten, the default selection will be largest (by enrollment) small group market plan in the state.
On Medicaid, Munson said that there is no deadline for a state to decide whether or not to expand. In Wisconsin, the "expansion population" generally refers to adults without dependent children ("childless adults"). Although states are eligible for a higher match for this population, the match rate in Wisconsin is still uncertain, and he indicated there has been no determination yet for Wisconsin. Moreover, some have indicated an interest in possibly expanding Medicaid for smaller groups of individuals with a lower income level than is provided for in the health care reform law. Munson indicated there was no answer yet from HHS on whether states can expand coverage for individuals with income up to the poverty line and still be eligible for a higher match. WHA reconvened its Medicaid Reengineering Group September 25 (see article on page 1) to discuss these issues as part of its overall deliberations on Medicaid expansion.
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The Wisconsin Hospital Association submitted comments September 24 to the Internal Revenue Service in response to proposed regulations issued by the U.S. Department of Treasury and the IRS to implement, in part, the additional obligations for tax-exempt hospitals as a result of the Patient Protection and Affordable Care Act of 2010. The obligations include that each hospital maintain a financial assistance policy and an emergency medical care policy, limit amounts charged to individuals determined to be eligible under the a facility’s financial assistance policy, and refrain from taking extraordinary collections actions until the facility has made reasonable efforts to determine an individual’s eligibility under the financial assistance policy.
In its letter, WHA emphasized that the Wisconsin hospital community fully supports the goals of the new statutory requirements. WHA, however, expressed concern about the proposed rule’s lack of flexibility and its oftentimes administratively inefficient standards that would apply regardless of the circumstances. While the Treasury’s stated objective was to balance the patient protection goals of the statute with the efficient administration and operation of hospitals, WHA wrote that the proposed rules do not achieve the balance. WHA is concerned that the proposed regulations consist of extremely detailed and prescriptive requirements that do not provide hospitals with the flexibility to use the most efficient and effective means to meet the new requirements in their communities.
WHA asked the agencies to work with the hospital community to address the identified issues as they work to finalize the rules. A copy of the WHA comment letter is available at: www.wha.org/data/sites/1/legal/IRS501_9-24-12.pdf.
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"Senator Moulton, having a background in health care, fully understands the challenges we face, particularly Medicaid reimbursement issues," said hospital President/CEO Brian Kief. "He also appreciates that Ministry Saint Joseph’s Hospital is serving a critical need for the patients and families we serve."
As this is the first time representing the medical campus, Moulton had an extensive visit with the hospital team, including the following agenda:
A meeting with the combined managers team of more than 40 people;
A roundtable discussion with nursing leaders and other key hospital executives;
A tour of Saint Joseph’s Children’s Hospital;
A tour of nuclear medicine;
A tour of the region’s only 24-7 acute care hyperbaric oxygen chamber; and
A tour of Independence Square (rehabilitation).
The Senator was impressed by the scope of services offered on the medical campus.
During his visit, Sen. Moulton was also able to learn more about the hospital and its commitment to the community. The group also discussed important legislative issues facing hospitals, such as Medicaid and concerns with the LogistiCare program.
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The Wisconsin Hospital Association will staff and lead a group of Wisconsin hospital representatives November 29 for the upcoming American Hospital Association (AHA) Washington, DC Capitol Hill fly-in.
"We have an excellent group assembled already who will travel to DC to make the case known that reimbursement cuts are of significant concern to Wisconsin’s high value, integrated hospitals and health care systems," said WHA Executive Vice President Eric Borgerding. "I would encourage other leaders to consider the trip as a continuation of our ongoing efforts to protect hospital care."
Details on the AHA trips can be found at: www.wha.org/education/advday12flyer.pdf.
If you are interested in participating in the November 29 Washington, DC fly-in, please contact WHA’s Jenny Boese at email@example.com or 608-268-1816.
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During the listening session attendees discussed issues including Wisconsin’s high value health care and efforts at reforming health care’s payment model, to which Cong. Petri said, "We in Wisconsin are on the cutting edge of health care in a lot of areas. We are trying to manage the transformation of health care." He went on to describe the great efforts by Wisconsin hospitals, saying, "This institution and a lot of others are on the forefront of working to manage cost and quality."
In looking to the future, participants raised the issue of the physician shortages and referenced the WHA report on the subject along with the hospital field’s ongoing work in the area. The group discussed the flawed Medicare physician reimbursement formula (SGR), impending cuts under the sequester process and the burden of the Recovery Auditor Contractor program. With respect to the latter, one attendee indicated their hospital had recently copied 20,000 pages of records to comply with the RAC auditor request. Cong. Petri expressed his willingness to help.
The WHA Hospital Listening Sessions along with the WHA Telephone Town Halls have been a mainstay over the past year as a means for WHA to educate and motivate hospitals on important issues. 2012 events held to date include:
Additional events are in progress so watch The Valued Voice for details in the coming weeks and months. Contact WHA’s Jenny Boese with questions at firstname.lastname@example.org or 608-268-1816.
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Ken Buser, president of Wheaton Franciscan Healthcare’s south market, received the Wisconsin Hospital Association’s 2012 Distinguished Service Award for his service to the hospital, community and to the Association. WHA President Steve Brenton presented the award to Buser at a ceremony during the WHA Summit held September 21 in Madison.
Buser has been a valuable resource to and active in the Wisconsin Hospital Association. He served on the Board from 2001-2009 and was Chair of the Board in 2008 in addition to his participation on or leadership of numerous committees since 2004.
"Ken’s passion for serving others has been an inspiration to everyone who has had the pleasure to know him and to work with him," according to Brenton. "His leadership, vision and guidance have helped not only his own health care system to prepare for the future, but he has also shared his considerable talents unselfishly with the entire health care industry. I am personally honored to know Ken both as a friend and as a health care leader."
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Speaking at the WHA 2012 Summit, Colonel Leah Moore told the nearly 200 attendees that less than one percent of the U.S. population joins the military forces, but their education, commitment to community, and leadership set them apart. Moore spoke passionately about the benefits to hospitals that hiring guards, reservists and former soldiers has on the workforce.
"Soldiers are hard working, good humored, goal oriented, and community driven," Moore said. "Many have joined to serve a purpose greater than just themselves." Col. Moore summarized a few of the professional licenses that are extremely valuable in the health care workforce, which include:
Advanced Individual Training (AIT) – For those in the medical arena, this phase of training can last anywhere from 6 to 52 weeks. Several of these programs, upon successful completion earn a Soldier a nationally-recognized certificate and/or licensure in the following areas.
In his introduction of Col. Moore and Tim Flatley, executive director the Employer-Sponsored Guard and Reserve Program (ESGR), WHA President Steve Brenton noted that a majority of WHA’s members have signed the ESGR support statement.
On a related subject, the ESGR will host an employer seminar November 8 at North Central Technical College in Wausau. For more information, go to www.wha.org/pdf/VeteransBusinessSymposium11-8-12.pdf.
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Paula Hafeman, RN, MSN, FACHE received the Wisconsin Organization of Nurse Executives (WONE) 2012 Nurse Leader of the Year Award at WHA’s Leadership Summit September 21. Hafeman is chief nursing officer of St. Vincent Hospital and St. Mary’s Medical Center in Green Bay.
Hafeman has been a member of WONE for 12 years, serving on the Board of Directors for the past eight. She was the WONE president in 2010-2011. She currently chairs the Nurse Leadership Academy and developed the WONE Nurse Leader Succession Planning Toolkit.
Hafeman is a highly-respected chief nursing officer who has made nursing leadership, mentoring and succession planning a focus throughout her career. She is currently a mentor to several aspiring nursing leaders, assisted with her organization’s own nursing leadership development program, and has always had a succession plan in place for someone to follow in her footsteps. Under her guidance, three hospitals with differing cultures were brought together to form one successful Professional Nursing Practice Council, with the mission of standardizing nursing practice across the hospitals.
In support of her nomination, Therese Pandl, president, HSHS Eastern Wisconsin Division, said, "Paula is an exceptional nursing leader dedicated to advancing safe, quality, patient-centered care through the professional practice of nursing. She is a strong and passionate leader of nurses and health care."
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Two Wisconsin hospital trustees were honored recently by the Wisconsin Hospital Association. Memorial Medical Center (Ashland) Board member Donald Marcouiller and Memorial Medical Center (Neillsville) Board member Bob Barth are the recipients of the Wisconsin Hospital Association 2012 Trustee awards. The annual award goes to health care trustees that have made an exemplary commitment to the community.
Don Marcouiller first joined the board of Memorial Medical Center, Ashland, in 1981. In 1992, he assumed his first leadership position within the Board as treasurer and later on served as Board chair. This current term will be his last.
Marcouiller helped initiate the planning for Memorial Medical Center, Ashland, to transition to a critical access hospital. Finally, as the former campus administrator for Wisconsin Indianhead Technical College, he worked tirelessly to see that programs were available locally to ensure properly-trained health care professionals in northwest Wisconsin.
Bob Barth was asked to join the Memorial Medical Center, Neillsville Board in 1981, by then-president Walter ("Buster") Brown, and became Board president in the early 90s. He then left the board when his term finished. He was later asked by then CEO Glen Grady to fill a vacant position on the Board. After serving several years, Barth then reassumed the role of Board president, tallying his total tenure of service to the board at 30 years.
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Daniel Neufelder, FACHE, received the 2012 ACHE Regent’s Senior-Level Healthcare Executive Award, and Seth Teigen, MHA, RT(R), received the 2012 ACHE Regent’s Early Career Healthcare Executive Award. The awards were presented at WHA’s Leadership Summit September 21 in Madison.
Neufelder is the current senior vice president of hospital operations for Ministry Health Care and president of Affinity Health System. In this capacity, he leads the 15 Ministry hospitals and is responsible for Affinity Health System, a regional integrated delivery system of three hospitals, the 300-provider Affinity Medical Group, and the 133,000-member Network Health Plan. He joined Ministry and Affinity in 2006 as president/CEO of Affinity. He assumed his current leadership position earlier this year.
Prior to joining Affinity, Neufelder served for 12 years as the executive vice president and COO of Memorial Hospital of South Bend, Indiana. He has been active in professional organizations and has served in leadership capacities with ACHE and the Healthcare Financial Management Association (HFMA). He currently serves as the chair-elect of the Wisconsin Hospital Association Board of Directors and is part of the United Way Fox Cities Board of Directors. Neufelder is the recipient of the 1997 Young Healthcare Executive of the Year Award for Northern Indiana, is an ACHE Fellow and a Certified Public Accountant. He received his Bachelor’s degree from the University of Southern Indiana and his Master’s degree in business administration from the University of Indianapolis.
Seth Teigen has 11 years of health care experience and is currently the administrative director of medical imaging for St. Mary’s Hospital and Dean Health System in Madison, Wisconsin. He has held previous director positions overseeing a variety of ambulatory areas, including orthopedics, neurosciences, pain programming, GI services, physical medicine and rehab, and medical imaging. He was also a radiologic technologist for two Wisconsin hospitals.
Teigen serves on the Board of Directors for the Wisconsin Chapter of ACHE and is current chair of the communications committee. In addition, he is involved with the Madison Area Technical College Radiology Advisory Board, WHA’s HEAT program, ACHE Wisconsin Chapter’s Young Professional Network, United Way of Dane County, and the St. Mary’s Hospital Foundation.
Teigen holds a degree in radiologic technology from the University of Wisconsin Hospital, a bachelor of science degree in health arts, and a master of science degree in health care administration from the University of St. Francis in Joliet, Illinois. He will become a Fellow of ACHE in November 2012.
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The WHA physician workforce report identified the creation of more opportunity for in-state graduate medical education as a top priority in ensuring that Wisconsin has enough physicians. An article published by the Wisconsin State Journal on September 22, written by health care journalist David Wahlberg, focused on several hospitals that have received funding from the Wisconsin Rural Physicians Residency Assistance Program, based at the UW Department of Family Medicine. WHA supported the creation of the Wisconsin Rural Physician Residency Assistance Program, which provides grants for the expansion or creation of new rural resident rotations and training tracks.
The story is reprinted by permission.
Training programs aim to ease shortage of rural doctors
Six medical facilities in rural Wisconsin are looking at starting or expanding training programs for medical school graduates, which could ease a rural doctor shortage expected to grow in coming years.
"Physicians who spend a significant portion of their training time in rural areas are much more likely to practice rural," said Wilda Nilsestuen, coordinator of the Wisconsin Rural Physicians Residency Assistance Program, based at the UW Department of Family Medicine.
The program recently awarded its first grants to doctor training projects in Baraboo, Berlin, Chilton, Dodgeville, Lancaster and Monroe.
The effort is funded by a tax imposed on—and supported by—rural hospitals two years ago. The tax brings in federal money to help the hospitals and place more health care providers in rural areas.
About $750,000 is available each year to set up or pay for rural residencies, the years of specialized training generally required after medical school.
With the state facing an estimated shortage of 2,200 doctors by 2030, most in primary care and many in rural settings, authorities say more rural training is needed.
"We need to continue to develop the pipeline," said Nicole Clapp, chief executive officer of Grant Regional Medical Center in Lancaster.
Grant Regional is using a $35,000 grant to study becoming a rotation site for a residency. New doctors would get several weeks of exposure to primary care, emergency care, obstetrics, surgery and other services in Lancaster, Clapp said.
Similar grants were awarded to Calumet Medical Center in Chilton, Community Health Network in Berlin and Upland Hills Health Center in Dodgeville.
UW’s Baraboo Rural Training Track, the only rural-based family medicine residency program in Wisconsin, got $35,000 to redesign its women’s health curriculum. It is based at St. Clare Hospital in Baraboo.
Monroe Clinic received $150,000 to develop a fellowship in emergency medicine, and the Rural Wisconsin Health Cooperative got $150,000 to organize many of the activities.
Future grants could support further efforts at those facilities or new projects at other places, Nilsestuen said. "We’re hoping some of these sites are going to develop into rural training tracks," she said.
Meanwhile, the Medical College of Wisconsin in Milwaukee said in June it plans to set up campuses in Green Bay and central Wisconsin, with the first students to be admitted in 2015.
A plan to open the Wisconsin College of Osteopathic Medicine was hindered in February when the main backer, Wausau-based Aspirus health system, said it wasn’t viable.
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Several recent articles in the media have raised the question of whether an unintended consequence of electronic health record (EHR) implementations is an increase in both facility and professional charges across the United States. On Monday, September 24, the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) sent a letter to five major hospital groups warning them not to use electronic health records to "game the system" and boost their revenues. The letter from HHS/DOJ came a few days after an article in the New York Times analyzing Medicare data that essentially inferred hospitals and physicians were using electronic health records to increase federal reimbursement by overstating the severity of the patients and the services they were providing.
The Association of Academic Health Centers sent a letter the following day to HHS and DOJ supporting concerns from the American Hospital Association (AHA) that the industry doesn’t have adequate guidelines on billing for the evaluation and management (E&M) codes—a set of codes developed and licensed for physician billing by the American Medical Association—the Current Procedural Terminology (CPT) codes. The codes were originally developed for use by physicians in 1992. Since 2000, CMS has required hospitals to file claims using these codes. The lack of hospital-specific codes, or guidelines for how hospitals should use physician codes, has left the system open to broad interpretation by hospitals.
During the 12 years that CMS has allowed hospitals to set their own billing policies for E&M codes, several organizations have proposed national guidelines. In 2002, the AHA and the American Health Information Management Association formed an expert panel to develop guidelines for hospital emergency room billing at the request of CMS. In 2003, the groups submitted detailed recommendations for a billing system for hospital ER services. The agency stated the AHA proposal was the "most appropriate and well-developed guidelines" available, yet the guidelines have not been implemented. Instead, CMS requires hospitals to develop their own guidelines using codes that were designed to bill physician services.
The AHA continues to push for guidelines. "We keep asking them to issue national guidelines," said Nelly Leon-Chisen, the association’s director of coding and classification. "We do it every year, and they don’t do anything about it."
The problem is magnified by the federal government’s campaign to convert the medical industry to electronic health records. In the rush to get the program off the ground, federal officials did not implement controls on billing software vendors to address the issue of medical fraud in simple terms referred to as "upcoding." The subjective nature of the coding process has left the medical industry and payers in continual conflict. Many physicians and billing experts claim that most practitioners charge too little when using paper.
Robert Tennant, a Washington lobbyist with the Medical Group Management Association, which represents large medical practices, said the software simply helps doctors pick the correct code. "With a paper-based system there’s a little bit of concern from providers that they don’t have sufficient documentation to support a particular coding level," he said. Electronic systems, however, can quickly retrieve a patient’s documented history. "I don’t use the term ‘upcode.’ I use ‘correct code.’ I see it more as physicians being reimbursed more appropriately for the work that they are doing," he said.
The HHS Agency for Healthcare Research and Quality, an advocate for electronic health records, supported that view when it wrote in September 2009 that [in a paper environment] physicians may choose billing codes that are too low. The agency suggested that converting to digital systems would enable physicians to bill higher fees, "translating into enhanced revenue."
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Fear of a bill should never prevent a patient from seeking care at a Wisconsin hospital. Wisconsin hospital charity care programs provided $232 million to more than 700 patients each day last year. The stories that follow illustrate the deep commitment and continuing concern that hospitals have to their patients to ensure they receive the care they need regardless of their ability to pay.
Struggling with severe diabetes and foot problems, Kate was able to maintain only a low-paying part-time job. One day, her leg pain became so unbearable that she went to the Huiras Family Community Health Center at Columbia St. Mary’s Ozaukee. Quick to realize what care Kate needed, the staff made an appointment with the financial counselor to apply for Community Care so she could receive specialty care and support for procedures. Given Kate’s part-time job status and recent inability to work, she met the financial standard.
A specialist diagnosed Kate with a Baker’s cyst. Most people do not develop severe complications from Baker’s cysts; when the cysts rupture, however, the leg becomes swollen and extremely painful. Unfortunately, Kate’s cyst had burst and she was barely able to walk.
Kate tried to continue working but had to reduce her hours drastically, as the discomfort from the cyst was unbearable. With Community Care funding, she was able to receive physical therapy to relieve the pain. After several sessions, the pain was better controlled, yet she was still unable to work. The funding supported Kate’s consultation with an orthopedic surgeon, who assessed her for surgical intervention.
Kate will continue to benefit from Community Care, as she is scheduled for surgery to repair the damaged area. With her continued commitment to healing, the skills of the surgeon and the financial support of Community Care, she expects to be able to return to work and independence.
Columbia St. Mary’s Hospital Ozaukee, Mequon
Step by step with a Helping Hand
A patient was transported to the emergency department and was admitted into Aurora Medical Center in Summit due to severe abdominal pain. The patient required emergency surgery to repair a hole in his bowel. The surgery was a success, but the patient was uninsured and had no way to pay for the operation. When Clarice Zess, Financial Counselor at Aurora Medical Center in Summit, learned of the patient’s situation, she immediately came to his aide.
"I met with him during his inpatient stay," said Clarice. She assessed his financial situation and began the application process for the BadgerCare Plus Core Plan." BadgerCare Plus Core Plan is insurance coverage under the Badger Care Medicaid program.
"Knowing that the current hospital stay would not be covered, we also completed the Aurora Helping Hand financial assistance application." Aurora’s Helping Hand program offers some level of discount for persons who are uninsured. The amount of discount received depends upon the patient’s adjusted income as compared with the U.S. Department of Health and Human Services Poverty Guidelines.
Clarice met with the patient numerous times to assist him step by step, which resulted in coverage under the BadgerCare Plus Core Plan. When the Aurora Helping Hand application was processed, the patient was given a 100 percent discount on his surgery and inpatient hospital stay. He also received complete support for three follow-up visits.
Clarice said, "He cried when I told him his care here had been covered. He was so relieved and could hardly believe it. This is just one example of several patients that I’ve helped. I am so proud to be able to offer such caring and supportive help through Aurora’s Helping Hand financial assistance program."
Aurora Medical Center in Summit
Back on pace
Sandy David stopped into the Froedtert & Medical College of Wisconsin Plank Road Clinic in 2002 for what she thought might be a case of pneumonia. A quick assessment and redirection to the emergency department revealed a much more serious diagnosis—congestive heart failure. Sandy had surgery within 24 hours, including the insertion of a pace maker, and for the next several years, she received routine care with excellent outcomes from her Medical College physicians. "I’ve chosen to get my care at Froedtert and the Medical College for a long time," says Sandy. "I wouldn’t go anywhere else!"
When the economy faltered though, Sandy lost her job as well as her health care coverage. And although she was able to find other full-time employment, it did not provide health benefits. Like so many others in the down economy, Sandy could not afford to purchase insurance on her own and hoped she could stay healthy until a job with health benefits came her way. She let routine medical check-ups lapse and only made essential visits to her cardiology team.
By October of 2010, Sandy wasn’t feeling up to par. She had little energy and suspected something was wrong. Her pacemaker reading that month verified that her aging pacemaker battery was not functioning properly, and had a very short time left. Sandy knew she would need another life-saving surgery, but initially declined due to the lack of medical insurance. With limited time left on her pacemaker and no insurance, her care providers feared time might tick away before she could afford the surgery for a new pacemaker.
Sandy’s care team immediately went to work on her behalf. They contacted the device manufacturer to see if a free or discounted pacemaker might be available, and they connected Sandy with a financial counselor at Froedtert Hospital to navigate the anticipated costs for another surgery. Froedtert’s patient financial services team determined that she qualified for a 69% discount for her care.
"I was relieved to learn that I was eligible for charity care," says Sandy. "There are not enough words to express my gratitude and appreciation!"
Sandy had her surgery in November 2010, and she is back on pace now, returning to work shortly after her surgery and able to cover the balance of her surgery costs. "I wouldn’t be here today if it weren’t for the overall care I received from Froedtert and the Medical College of Wisconsin. Everyone involved in my care made me feel important and that I was worth it."
Froedtert Hospital, Milwaukee
Caring Hearts program helps man diagnosed with cancer
"I’m sorry Joe, but we’ve got a problem."
Those words shattered Joe Nagan’s world on December 18, 2009. Over the telephone Nagan heard the diagnosis: cancer.
"At that moment, it’s worse than you can possibly imagine," said Nagan, 57, of Kaukauna.
He spent hours walking afterward, thinking about his family and business situations. On top of all that, he did not have health insurance. In fact, he was in the process of looking into health insurance, which led him to get a physical.
Nagan’s fears melted once he met Dr. Jeffrey Klingbeil of Fox Valley Surgical.
"The minute I met that guy, the minute he walked in the door, shook my hand, I felt a million times better," he said.
Nagan was also impressed to learn Klingbeil had already enlisted Dr. Nathan Munson and Dr. William Guenther.
"It was just amazing they were able to put all that information together in such a short period of time," he said.
Nagan worried about the expenses that would follow.
Enter ThedaCare’s Caring Hearts Financial Assistance Program, which covered $67,000 worth of medical bills.
Words cannot describe the surprise and relief he felt.
"It does show that the folks in the Fox Valley are concerned about folks who could use a little bit of help," he said. "We often talk about the Fox Valley and what a great place it is to live. People say that is lip service."
But he found that being on the receiving end of such care "levels the playing field."
"I don’t know how I could ever, ever thank the Caring Hearts organization for what they have done for me so that I can continue to do what I do," said Nagan.
Submit community benefit stories to Mary Kay Grasmick, editor, at email@example.com.
Read more about hospitals connecting with their communities at www.WiServePoint.org.
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