August 26, 2011
Volume 55, Issue 33


"Apology Bill" Passes Assembly Committee

AB 147—the "Apology Bill"—was approved August 24 by the Assembly Health Committee on a 7-3 vote. The Senate version of the bill, SB 103, received committee approval earlier this year.

The bill, authored by Representatives Erik Severson (R-Star Prairie) and John Nygren (R-Marinette) in the Assembly and Senator Pam Galloway (R-Wausau) in the Senate would protect statements of apology by health care providers or administrators to patients and families from being used against them in a lawsuit.

Voting in favor of the bill were Committee Chair Representative Jeff Stone (R-Greendale), and Reps. Severson, Dean Kaufert (R-Neenah), Pat Strachota (R-West Bend), Kevin Petersen (R-Waupaca), Michelle Litjens (R-Oshkosh), Karl Van Roy (R-Green Bay). Voting against the bill were Representatives John Richards (D-Milwaukee), Mark Pocan (D-Madison) and Sandy Pasch (D-Whitefish Bay).

As previously reported in the June 3, 2011 Valued Voice (www.wha.org/pubArchive/valued_voice/vv6-3-11.htm), WHA testified in support of the bills. WHA’s testimony is available at: www.wha.org/governmentRelations/pdf/WHAtestimonyAB147.pdf. A video of WHA Senior Medical Advisor Chuck Shabino, MD testifying is here: www.wha.org/2011ApologyBillShabino6-1.wmv.

When a health care outcome is not what was planned or expected, a heartfelt statement of concern or apology can be very helpful for all involved. However, in Wisconsin, those statements can be used as evidence in a lawsuit, making health care providers and administrators less willing to communicate with patients and families at times when communication is crucial.

AB 147 and SB 103 will lead to better quality of care by encouraging the open and honest collaborative communication between health care providers and their patients that results in the best possible health care environment.

Like SB 103 in the Senate, AB 147 is now available for consideration by the full Assembly where action in both houses is expected this fall. The legislation can then be forwarded on to Governor Walker for his consideration.

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Wisconsin Office of Free Market Health Care Releases Health Reform Insurance Market Report

The Wisconsin Office of Free Market Health Care (OFMHC) released a report August 24 highlighting the impact of the Patient Protection and Affordable Care Act (PPACA) on Wisconsin residents, employers, and insurance markets. Governor Walker created the Office of Free Market Health Care earlier this year with the goal of ensuring that Wisconsin maintains a competitive and consumer-driven health insurance market based on free market principles. The Office is directed by the Department of Health Services (DHS) and the Office of Commissioner of Insurance (OCI).

The analysis was conducted by Gorman Actuarial, LLC and Dr. Jonathan Gruber, MIT economist. The report contains key findings that raise important concerns about how health care reform will impact Wisconsin. Wisconsin already has one of the most competitive insurance markets in the nation with 33 health insurers participating in the individual market, and 25 in the small group market.

Key findings of the study highlighted in a release from the Wisconsin OFMHC include:

  • Premiums will increases for both the individual market and the small group market.
  • Premium increases are largely the result of new rating practices required under PPACA, as well as the fact that individuals will be required to purchase new and richer benefit packages.
  • In the individual market, premiums are projected to increase an average of 41 percent for the majority (87 percent) of the market. Even though premiums for some individuals will be offset by tax subsidies, 59 percent of those in the individual market will see their premiums increase. In the small group market, 53 percent of employers will see a premium increase of 15 percent on average.
  • 100,000 people will be involuntarily dropped from their employer’s insurance.

Further analysis of the study shows that the number of uninsured is projected to decrease in Wisconsin, largely based on the PPACA required individual mandate. The individual mandate is the subject of much debate, with one U.S. Circuit Court having ruled the provision constitutional, while another recently finding the individual mandate to be unconstitutional. This conflict sets up the possibility for the U.S. Supreme Court to take up the issue in the near future.

Access the full report and a PowerPoint presentation from the Office of Free Market Health Care at: www.freemarkethealthcare.wi.gov/section.asp?linkid=1748&locid=173.

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Wisconsin Office of Economic Advisors Predicts Future Nursing Shortage
OEA demos Nurse Supply Demand Prediction Model

While the current economy has put a temporary damper on the demand for new nurses in Wisconsin’s hospitals, future projections continue to show serious shortages are on the horizon. A newly-created nurse supply and demand model created within the Office of Economic Advisors (OEA) at the Department of Workforce Development (DWD) was demonstrated to the members of the WHA Workforce Council August 24 in Madison.

The model, presented by OEA staff members Victoria Udalova, economist, and Tom Walsh, research analyst, was designed to provide projections on the RN supply and demand for Wisconsin. A forecasting tool has long been needed to assist health care organizations and educational facilities determine what impact retirements, graduations and a wide range of variables will have on the supply of nurses in Wisconsin.

The model uses Wisconsin-specific data and provides a better way to predict both the supply of and demand for nurses. Udlova and Walsh said the model is easily adaptable to other occupations, as well.

The base supply model uses a constant ratio of RNs to the total population by gender to project the future supply of RNs. The scenario supply model allows users to change the ratios by changing the factors that influence supply, which includes the number of new graduates, the labor force participation rate, retirement patterns and net migration in and out of the nursing profession.

The success of OEA’s model is due in large part to the fact that the data inputs are coming from the 2010 RN Renewal License Survey. The use of that data allowed the OEA to expand and improve their forecasting model. WHA was a strong supporter of the RN renewal survey from its inception.

Health System Mandates Employee Influenza Vaccination

SSM Health Care recently made national news by mandating influenza vaccination for all employees. Linda Taplin Statz, regional vice president of human resources for SSM Health Care, explained the policy and answered questions raised by Council members. She said overall, the employee response to the policy has been favorable.

ICD-10 Requires Workforce Planning

The greatest challenge associated with the implementation of the new medical coding system, ICD-10, will be in having adequate staff resources. The new coding system could require as much as 80 hours of training for medical coders, a factor that must be considered in the planning process to meet the ICD-10 mandatory implementation date of October 1, 2013.

Debbie Rickelman, senior director of the WHA Information Center, said retirements and job changes will be a factor in the medical coding field. She recommends that health systems spend the time necessary to understand the challenges that medical coders will face and invest in their current coding staff. Hospitals should also consider bringing on temporary additional staff to help bridge the initial anticipated decrease in productivity. Computer-assisted coding could prove valuable and Rickelman encouraged hospitals to evaluate software packages that automatically generate a set of medical codes for review/validation based on the documentation provided by the practitioners.

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Study: Most Heart Attack Patients Receive Angioplasty in Recommended Time

Nearly all heart attack patients who require emergency artery-opening procedures are treated within the recommended 90 minutes from hospital arrival, according to a study in the August 30 issue of the journal Circulation. That’s up from 44 percent of those patients in 2005. Based on data from more than 300,000 patients undergoing emergency angioplasty from January 2005 through September 2010, the study found average time from hospital admission to angioplasty decreased from 96 to 64 minutes.

"This improvement, experienced across the country and across different types of hospitals, represents a remarkable elevation in practice that was achieved over a relatively short period of time and in the absence of financial incentive," the authors state.

(Source: AHA News Now, August 23, 2011)

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New ICD-10 Management Resource Available on WHA Web Site

A new WHA white paper aimed at raising awareness of the implications that ICD-10 will have on health care organizations was added to the WHA Web site at www.wha.org/icd-10.htm. The online paper features a WHA video interview with Tyson McDowell, CEO of Benchmark Resources. It is aimed at CEOs, CFOs, Board members and physicians and it explains the role that each will have in ensuring a successful transition from the ICD-9 coding system in use now to the new ICD-10, which will be implemented nationwide on October 1, 2013.

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President’s Column: Are YOU Prepared for ICD-10?

October 2013 is still two years out, an eternity for many but an important date for a new federal medical billing and coding mandate that will require a significant investment in resources by hospitals and clinics across the nation.

In addition to Meaningful Use (MU) requirements, relating to both EHR adoption as well as Health Information Exchange, the ICD-10 mandate requires compliance with new diagnostic and procedure billing codes that will challenge our physicians, HIM professionals and billing staff. According to recent WHA survey results, most members are well into their assessment and planning stages—and some are into the implementation phase. But the field’s response to ICD-10 implementation is uneven—consistent with what is being seen in the rest of the country.

Here’s a link (www.wha.org/ICD-10healthleadersarticleJuly11.pdf) to a worthwhile HealthLeaders Media Intelligence Report article discussing the results of a recent survey that is an important read for senior leaders. Highlights of the article:

It comes as no surprise that health care organizations are facing a daunting array of IT related compliance issues that are competing for already scarce resources. The specter of Medicare payment cuts due to MU non-compliance is disconcerting. But so should be the strong possibility of cash flow shortfalls due to ICD-10 implementation problems.

ICD-10 implementation issues are high on WHA’s radar screen and will continue to be so as we near the very certain date of 10-1-13. WHA staff efforts are being capably led by WHA Information Center Senior Director Debbie Rickelman. With Debbie’s guidance, WHA is offering a free webinar on September 29 for physicians that will build awareness of the critical role they play in the successful implementation of this new coding system. For information/registration information, go to: http://events.SignUp4.com/EngagingICD10.

WHA is a founding member of the Wisconsin ICD-10 Partnership, which has developed a Web site, www.WICD10.org, that is a virtual library of resources for physicians, coders and hospital leaders. WHA also just released a new white paper that features an embedded video link to an interview with Tyson McDowell, an expert on the implications that ICD-10 will have on the revenue cycle. The white paper, www.wha.org/icd-10.htm, will be emailed to WHA members this week.

Steve Brenton
President

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U.S. Rep. Duffy Visits St. Mary’s of Superior

Congressman Sean Duffy visited St. Mary’s Hospital of Superior on August 18.

"We were grateful for the opportunity to discuss the many challenges of health care with Congressman Duffy," said Mary Shaw, COO/Administrator, St. Mary’s Hospital. "We appreciated his genuine interest in understanding the complexities of delivering high quality health care services."

To date the Congressman has visited or met with the leaders of more than a dozen hospitals in his district.

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WHA Information Center Releases 2010 Guide to Wisconsin Hospitals
7,500 patients are hospitalized every day in Wisconsin

The 2010 Guide to Wisconsin Hospitals, which presents selected descriptive financial, utilization and staffing data about individual Wisconsin hospitals, is now available on the WHA Information Center Web site, www.WHAInfoCenter.com. The Guide is based on data submitted to the WHA information Center on the Fiscal Year (FY) 2009 and 2010 Hospital Fiscal Survey and the FY 2009 and 2010 Annual Survey of Hospitals.

Here are some facts gleaned from the narrative portion of the Guide:

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Wisconsin Chapter of ACHE and WHA Partner to Offer Category I Session

WHA and the Wisconsin Chapter of ACHE have teamed up, once again, to offer a 3 credit Category I seminar as part of the WHA Annual Convention in September.

The session, titled "Are Medical Groups in Your Portfolio? Critical Factors to Manage Your Investment," will be presented by MGMA consultant and ACHE faculty Nick Fabrizio. This session will occur as one of two concurrent session choices during the Thursday, September 15 afternoon education sessions at the WHA Annual Convention. There are a variety of registration options to meet your budget, your schedule and your need for both Category I and II credit.

In addition to the Thursday afternoon seminar, on Friday, September 16, the Wisconsin Chapter of ACHE invites you to attend the annual chapter breakfast meeting, highlighted by keynote speaker Chris Van Gorder, ACHE’s immediate past chair and president/CEO of Scripps Health in San Diego. Finally, a 1.5 credit Category I panel discussion will be held on September 16, entitled "Bending the Executive Curve: Implementing Successful Organizational Change in Hospitals and Health Care Organizations" at the conclusion of the WHA Annual Convention.

Online registration for the Annual Convention, including the ACHE sessions, is available at http://events.SignUp4.com/Annual2011.

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Wisconsin Hospitals Community Benefits: Acute, Chronic and Communicable Disease Prevention and Control

Hospitals are well aware of the critical role they have in protecting public health. Whether it is working with public health agencies to develop protocols and responses to pandemic flu outbreaks, teaching children proper hand-washing techniques or educating people about how to live with chronic conditions, Wisconsin hospitals partner with key stakeholders to improve the health status of their communities.

Educating the public about cardiovascular health

Bellin Health is all heart when it comes to educating the public about cardiovascular health. That’s because representatives from the health system have been inviting children and adults alike to tour its giant human heart exhibit.

Earlier this year, Bellin purchased a 21-foot by 17-foot inflatable human heart display. The Green Bay-based health system has been offering guided tours through the giant heart in hopes of better educating the public about heart health.

The Bellin Health AmeriHeart offers a guided walk-through exhibit of the heart, exposing visitors to the basic structure of the heart—arteries, valves and other anatomical features—and ways to prevent heart disease. Visitors also learn about common abnormalities such as heart attack and valve defects.

"This exhibit is an interactive way to reach out to the community on heart health education," said Debbie Leoni, community outreach coordinator at Bellin. "Children and adults benefit tremendously from walking through this exhibit—complete with the heartbeat sound effect—and seeing the heart’s chambers, valves, arteries and veins. And it’s a lot of fun, too."

The heart exhibit has been offered at schools and public functions across Northeast Wisconsin and Michigan’s Upper Peninsula including the Superbowl of Safety at Lambeau Field, the Bellin Run, community concerts, and area health fairs. The heart also will be a part of a number of upcoming events including the American Heart Association’s Heart Walk and the inaugural Iron Mountain Heart Smart Yooper Trot.

"It’s a unique way to draw attention to heart health," Leoni said. "After all, it’s pretty hard to miss a giant, red heart when you’re at a public function like a local community concert or a neighborhood picnic in the park. It’s a curiosity that we use to our advantage to create an opportunity for heart health education."

According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for men and women. In 2010, heart disease was estimated to have cost the United States $316.4 billion including the cost of health care services, medications and lost productivity.

Bellin Health, Green Bay


Women gather for an evening of inspiration, education on how to prevent heart disease

When she’s doctoring a patient, Kristin Severson, DO, Hudson Physicians, often casts her eyes to the patient’s caregiver – the wife, mother or daughter sitting nearby gathering information about her loved one. The internist worries that the caregiver isn’t taking care of herself.

"We live in an affluent, educated, active community," Severson says. "But sometimes the women put themselves at the bottom. They are taking care of their parents or running to and from family activities. Then it dawns on them, ‘I haven’t taken care of myself.’"

Determined to inspire these busy women to take practical steps now to prevent future – often irreversible – heart disease, Severson and two physicians from Hudson Hospital & Clinics’ Specialty Clinic made presentations last February at a free community seminar called "Close to My Heart – for Women."

The event, hosted by the hospital, drew enough women to fill a conference room and a waiting list for a second seminar.

"Women have a sense that we are protected from heart disease completely, so we don’t really start thinking about it until perhaps at menopause," cardiologist Kiran Pandey says. "But this is not just a disease of men. It affects women equally and sometimes the results are much worse."

Practical suggestions infused with hopefulness

Attendee Becky Christiansen came away from the evening with a renewed sense of commitment: "I fool myself sometimes that I’m getting enough exercise. I do a lot. But, at the seminar, it hit me over the head. I need to do more things that get my heart rate going at an aerobic level."

She appreciated how the physicians focused on education and prevention, with an overriding message of hopefulness.

That was an important aspect to physician Rynn Burke, an internist and trained chef who shared cooking tips and recipes while educating the audience.

She emphasized that women need to be aggressive about heart health when they are young. But, at any age, even modest health improvements can make a big difference. For example, she suggested simple steps, such as adding two short walks a day, eating more vegetables and reducing salt.

Community collaboration

The seminar was a collaboration of Hudson Hospital & Clinics, Hudson Physicians, and Hudson Hospital Foundation. Participants were treated to delicious, heart-healthy food. They also received canvas grocery bags full of healthy ingredients, courtesy of County Market in Hudson.

"We had customers comment after the seminar that it was just a wonderful event," says County Market’s store director Dana Glade. "We received very, very positive feedback."

Hudson Hospital & Clinics


Submit community benefit stories to Mary Kay Grasmick, editor, at mgrasmick@wha.org.

Read more about hospitals connecting with their communities at www.WiServePoint.org.

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