October 14, 2016
Volume 60, Issue 41


Wisconsin Lawmakers Release Rural Health Care Proposals
Includes WHA-backed initiatives


A group of rural Wisconsin lawmakers released a package of proposals October 11 that would provide financial support to expand the rural health care workforce, bolster WHA’s quality improvement efforts and incentivize the creation of community wellness initiatives in rural communities. The proposal, packaged as the second round of a legislative agenda called the Rural Wisconsin Initiative, was released by Reps. Romaine Quinn (R-Rice Lake), Ed Brooks (R-Reedsburg) and Travis Tranel (R-Cuba City). 

The Rural Wisconsin Initiative was created by these three lawmakers, with input from WHA’s members and policy staff, to sustain rural communities into the future. The Initiative focuses on four key areas critical to rural economic development, including health care, technology, workforce and education. The announcement on October 11 regarding the health care portion of this agenda was the first of these four areas to rollout for the next legislative session. To see a copy of the legislators’ slide deck outlining these priorities, go to www.wha.org/pdf/Rural-wisconsin-initiative-spotlight-on-health-care10-13-16.pdf.

“There is no doubt that rural areas of our state face unique challenges as they strive to deliver high-quality, accessible health care by attracting and keeping highly skilled health care professionals,” according to WHA President/CEO Eric Borgerding. “Health care is a key factor in economic development, but it is critically important for rural areas. This package of initiatives is a well-thought out and targeted approach to ensuring that hospitals and health systems in our more rural areas of the state receive the support they need to continue to deliver the high-quality care that has gained our state a national reputation.”

The agenda includes items addressing the following needs:  “Good health care policy is bipartisan, and we look forward to working with Democrats and Republicans in the next legislative session to move forward on these important initiatives,” Borgerding said. 

The legislation associated with these ideas will be introduced early in the next legislative session, which starts in January 2017.

For more information on the Rural Wisconsin Initiative, visit www.ruralwisconsininitiative.com.

See WHA’s press release at www.wha.org/WHAruralHealthInitiatives10-11-16.aspx.


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CNA Workforce Issues Remain Front and Center for WHA Members

WHA’s Council on Workforce Development met October 13 and its members covered a broad array of topics. The evolving role of pharmacy technicians was presented by Danielle Laurent and Sarah Sorum of the Pharmacy Society of Wisconsin (PSW). Council members were asked to consider the impact of licensing and/or credentialing on the pharmacy tech workforce. Currently, Wisconsin is one of five states that do not regulate pharmacy technicians. PSW shared they are in the initial stages of examining this issue in depth and are seeking stakeholder input. 

Another topic presented at the October 13 meeting was apprenticeship opportunities in health care. Cindy Anderson of the Wisconsin Department of Workforce Development (DWD) outlined the emphasis on the health care sector by the Bureau of Apprenticeship Standards (BAS). Currently BAS is focusing on the roles of medical assistants, community health workers, medical technicians and pharmacy technicians. The previous focus on licensed practical nurses has been eliminated due to the multiple licensing and credentialing barriers for entry into practice. 


Aurora Medical Center Oshkosh presented their response to the continued shortage and difficulty in recruiting certified nurse aides (CNAs). Aurora’s Priscilla Buteyn and Linda Mingus explained that in response to a significant CNA shortage over ten years ago, they began to consider how they could “grow their own” CNA workforce. Research and planning ultimately led to Aurora establishing their own community-based CNA training program. This State of Wisconsin-approved program has since trained more than 400 CNAs. Multiple challenges in establishing the program have been outweighed by the advantages of training their own CNAs. 

“We are able to expose these individuals to our culture early on and by making the investment in them, we feel they will make an investment in us,” stated Buteyn. 

Recent focus has been on recruiting potential “career CNAs”—those individuals who are not looking to become a CNA as a stepping stone to other health professions, such as a registered nurse (RN). Whereas the use of CNA training and expertise is an important piece of addressing the overall health care workforce pipeline in that those individuals who become RNs often stay employed at Aurora, Buteyn shared that in order to address turnover and churn, individuals who are seeking work long term as a CNA is crucial. Buteyn has begun incorporating interactions between their established career CNAs with incoming students and reports that the initial evaluation of this approach has been very positive. Buteyn encouraged other hospitals to consider this tactic. 

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

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Wisconsin Hospitals State PAC & Conduit: Contribute & Disburse
Countdown to elections begins


With the elections less than 30 days away, now is the time to make sure you’ve contributed to the 2016 Wisconsin Hospitals State PAC & Conduit campaign. Doing so will help ensure your contributions are disbursed to candidates of both parties before the November 8 election.

“Wisconsin Hospitals State PAC & Conduit members statewide are maximizing their impact on the November elections by supporting both Republicans and Democrats who support good health care policy in Wisconsin,” said Nora Statsick, WHA political affairs consultant. “Your contributions in this last month before the elections can help candidates who value hospitals and health systems.” 

To check on your current Wisconsin Hospitals Conduit account balance or to disburse your dollars to candidates, contact Nora Statsick at nstatsick@wha.org or 608-239-4535.

On the fundraising side, the 2016 Wisconsin Hospitals State PAC & Conduit has raised over $262,000 from 304 individuals, putting the effort at 87 percent of the aggressive $300,000 goal. Don’t delay. Make your contribution today so you can put those dollars to use during this important state election year.

“Why is the goal to raise $300,000 this year? So that together you can support as many pro-hospital candidates as possible,” said Jenny Boese, WHA vice president, federal affairs & advocacy. “Supporting candidates who value the role of your hospital and health system is essential. Better candidates lead to better legislators who craft better laws.” 

To contribute at any time, log onto www.whconduit.com or call Jenny Boese at 608-268-1816.

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WI Delegation to CMS: Change OPPS Proposed Section 603 Implementation 
WHA thanks Delegation for expressing concerns with proposal 


For the second time in six months, Wisconsin’s Congressional Delegation signed onto letters urging the Centers for Medicare & Medicaid Services (CMS) to provide necessary flexibility in the implementation of the Bipartisan Budget Act of 2015’s Section 603 provision impacting off-campus, provider-based hospital outpatient departments (HOPDs). 

“On May 24, you received a letter signed by the majority of both houses of Congress (235 Members of the House and 51 Senators) stressing the importance of implementing this section in a way that protects patients’ access to care and provides predictability for the hospital field…We are extremely disappointed that those concerns were not addressed as requested in the proposed rule, and we are writing to urge changes in the final rule to ensure our constituents maintain access to quality care,” said the letter signed by 45 Members of the U.S. Senate, including Senators Ron Johnson and Tammy Baldwin. 

In a similar letter sent by 261 Members of the U.S. House of Representatives—including Reps. Sean Duffy, Glenn Grothman, Ron Kind, Gwen Moore, Mark Pocan, Reid Ribble and Jim Sensenbrenner— legislators urged CMS to address key areas, such as HOPD relocations. 

“We are also concerned about the treatment of necessary and valid relocations of existing HOPDs,” the U.S. House letter read. “Existing HOPDs may need to relocate for various reasons, such as being located on an earthquake fault line or a revised flood plain, having a lease expire, becoming obsolete or damaged, or becomes too small because of population shifts and increased patient loads. The need to relocate or rebuild for these types of reasons should not trigger payment reductions under Section 603.”

The letters also highlighted concerns with CMS’s proposed policies, such as the failure to provide hospital payments in 2017 for services provided in new off-campus HOPDs or for new types of services grandfathered HOPDs may wish to provide going forward. In each scenario, CMS is proposing hospitals receive no payment in 2017 until it can develop a mechanism to do so. 

“The Wisconsin Hospital Association continues to have serious concerns with the approach outlined by CMS for implementing Section 603, and we believe there is significant overreach by the agency,” said WHA President/CEO Eric Borgerding. “WHA greatly appreciates the support of the Wisconsin Delegation—Sens. Johnson and Baldwin, and Reps. Duffy, Grothman, Kind, Moore, Pocan, Ribble and Sensenbrenner—and their ongoing efforts to ensure that CMS provide hospitals with fairness and flexibility under Section 603.” 

Read the U.S. Senate letter to CMS. Read the U.S. House letter to CMS.

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CMS Announces Rural Health Council Solutions Summit
WHA pleased to see ongoing rural health focus


Over the past several years the Wisconsin Hospital Association (WHA) has worked with rural hospitals and other stakeholders to engage the Centers for Medicare & Medicaid Services (CMS) further into understanding the unique role of providing care to patients in rural communities. Several of WHA’s efforts include working with the Rural Wisconsin Health Cooperative to host CMS Deputy Administrator Sean Cavanaugh in Wisconsin where he visited two rural Wisconsin hospitals. WHA was also invited earlier this year to a small, invite-only meeting with CMS Acting Administrator Andy Slavitt in Chicago to discuss Medicare’s new physician payment system, MACRA. At that meeting, WHA provided insight to CMS on the need for MACRA to reflect care in rural settings. 

In CMS’s ongoing rural-focused efforts, earlier this year it established an intra-agency Rural Health Council made up of experts from across the agency. The key strategic areas of focus for the Council are on ways to improve access to care for all Americans in rural settings, ways to support the unique economics of providing health care in rural America, and making sure the health care innovation agenda appropriately fits rural health care markets. 

Most recently CMS announced that this Rural Health Council will host its first “Solutions Summit” October 19 at CMS headquarters in Baltimore, Maryland. During the Summit, CMS will bring in stakeholders from all sectors of the health care industry to engage in in-depth discussions about ways to improve access to care in rural America and support local innovation in care delivery. 

“WHA appreciates the ongoing dialogue by CMS with rural providers in Wisconsin and nationally, including through the upcoming Solutions Summit,” said WHA President/CEO Eric Borgerding. “We continue to ask the agency to ensure the policies it crafts will reflect the realities of providing care in rural settings.” 

To learn more or register for the Rural Health Council Solutions Summit, log onto: 
https://register.mitre.org/CMS_Rural_Health_Solutions_Summit/index.html

Review the Summit agenda.

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Anthony Mirasola Joins WHA Information Center

Anthony Mirasola recently joined the WHA Information Center (WHAIC) as an outreach and analytics specialist. Mirasola’s primary responsibility will be working with the 20 rural hospitals that have elected to participate in the Small Hospital Improvement Program (SHIP) administered by the Wisconsin Office of Rural Health. Mirasola will help to define and refine dashboards and other reports in WHAIC’s new Kaavio analytics and visualization tool to help rural hospital decision makers and data analysts. Mirasola will also assist the WHAIC team with analysis and reporting initiatives.

Mirasola holds a Bachelor’s of Science degree with majors in both economics and public administration from the University of Wisconsin-La Crosse. Prior to coming to WHAIC, Mirasola completed an internship with Gundersen Health System’s Global Partners’ initiative where he analyzed data and statistics to help support and promote the program.

“We are very happy to have Tony join our team in the Information Center,” said WHAIC Vice President Jean Doeringsfeld. “His skills are of great value as we work to expand the use of Information Center data and enhance our data visualization and reporting capabilities.”

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National Attorneys General Meeting Focuses on Opioid Abuse
WHA VP for Workforce and Clinical Practice Steven Rush participates as panel member


The 2016 Midwestern region meeting of the National Association of Attorneys General (NAAG) was held October 6 and 7 in Milwaukee and focused on the role of the attorneys general in fighting opiate abuse. Wisconsin Attorney General (AG) Brad Schimel welcomed the crowd and shared how Wisconsin has become a successful “model” of collaboration in battling the epidemic. Schimel spoke of how other AGs throughout the country have referenced Wisconsin’s success. 

Doug Peterson, Nebraska Attorney General, moderated the plenary session, “Collaboration with Professional Associations and Organizations” and included in his opening remarks, “I think Wisconsin is probably three to four years ahead of us in Nebraska on this issue. The open and cooperative dialog I hear about between the various stakeholders and associations in Wisconsin is certainly a large part of that progress.” 

Four different professional associations took part in the session, and included Joseph Best of the Wisconsin Dental Association, Mark Grapentine of the Wisconsin Medical Society, Danielle Laurent of the Pharmacy Society of Wisconsin and Steven Rush of the Wisconsin Hospital Association. All panelists shared with the audience the coalition building and collaboration they have engaged in to collectively address the opioid crisis. 

“There are states across this country where folks in our roles (panel members) don’t collaborate on much of anything, including issues as vitally important as this,” stated Grapentine. “But in Wisconsin, people on this panel and many in this room meet frequently and discuss how we can address issues collaboratively.” 

The final comments from the panel came from Rush in response to a question posed by former Wisconsin AG J.B. Van Hollen. When asked why Wisconsin has been successful on this front where other states have not, Rush replied, “I think I can speak for many in this room, and certainly for WHA when I say we decided very early on this was going to be a concerted effort free of finger pointing and free of blame. We, and I mean we as a culture, got to this place together. We all had a role in creating the culture, and we all have a responsibility in addressing the epidemic.”

For more information contact Rush at 608-274-1820 or srush@wha.org.

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November 16 WHA Conference Focuses on Role of Future Health Care Leaders

If Wisconsin is to maintain its national reputation as a “leader state,” today’s leaders must work to attract, retain and mentor the next generation of health care leaders who are working in our systems. To help you achieve this in your organization, WHA is offering a one-day learning event November 16 in Madison designed to focus on the role the next generation of health care leaders will play in effectively addressing current health care trends.

This event, “Today’s Challenges, Tomorrow’s Opportunities: A Future Leader’s Guide to Wisconsin Health Care” will feature Ryan Donohue and Kris Baird, both nationally-respected experts in health care consumerism and the patient experience and outstanding presenters. In addition, WHA President/CEO Eric Borgerding will examine the current state of health care in Wisconsin and the possible impact of the new presidential administration on health care. Seth Teigen, FACHE, regional VP of ancillary services for SSM Health-Wisconsin and president of ACHE Wisconsin Chapter, will discuss how advocacy can be an important tool in an emerging leader’s toolbox.

Have you identified several emerging leaders in your organization and encouraged them to register for this important event? There is still time. Pass along this online registration link to your rising stars today, and encourage them to attend on November 16:

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Registration Deadline Fast Approaching for Wisconsin GME Summit

The registration deadline for the November WCMEW/WCRGME GME Summit is October 28. Don’t miss the opportunity to attend this one-day event that will focus on the challenges and opportunities in expanding graduate medical education (GME) programs in Wisconsin. 

“Wisconsin GME Summit: Celebrating Successes & Exploring Opportunities” will be held November 15 at the Best Western Premier Park Hotel, on the Capitol Square in Madison. To register, visit: https://events.SignUp4.net/16WCMEW-GME-1115. The event is sponsored by the Wisconsin Council on Medical Education and Workforce (WCMEW) and the Wisconsin Collaborative for Rural GME (WCRGME).

The Summit will begin with a “State of the State” on Wisconsin’s GME efforts, followed by two panel discussions on Wisconsin’s state-funded GME grant programs, one including grantees that have started new programs and another with those that have expanded existing programs. Using a small group discussion format, the afternoon will focus on the topics of garnering broad community support for a GME program, effectively using technology to deliver GME training and support, and developing GME partnerships for efficiency. 

For more information, including the day’s agenda and online registration, visit: https://events.SignUp4.net/16WCMEW-GME-1115. Registration questions can be directed to Kayla Chatterton at kchatterton@wha.org or 608-274-1820.

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WCMEW and AHEC November 10-11 Conference – Reminder

The Wisconsin Council on Medical Education & Workforce (WCMEW) and the Wisconsin Area Health Education Center (AHEC) System invite you to register for Interprofessional Collaborations: Advancing Wisconsin’s Healthcare and Education, an interprofessional conference.

This Thursday-Friday conference is designed to bring together educational institutions and health care facilities together from across Wisconsin. The event is being presented through a partnership of AHEC and WCMEW. The conference will take place November 10 and 11, 2016 at the Marriott West in Madison.

Register for the conference and access more information including the agenda, event details and learning objectives at https://ahec.wisc.edu/IP2016.htm.

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WHA Webinar Series Highlights Critical Issues for CAHs, November 3

On November 3, WHA’s Legal & Regulatory Webinar Series will feature “Critical Updates for Critical Access Hospitals.” This webinar will provide an overview of and update on important legal and compliance issues facing rural providers in the Critical Access Hospital (CAH), Rural Health Clinic (RHC) and related provider settings. Topics covered will include CAH Medicare regulatory and payment developments and strategies, provider-based hot topics, RHC requirements, Stark law developments, rural affiliation models, and virtual joint ventures. The session will be presented by David Snow of Hall, Render, Killian, Heath & Lyman, P.C., a WHA gold-level corporate member.

Online registration for this session, as well as all other sessions scheduled as part of the Legal & Regulatory webinar series, can be found at https://events.SignUp4.net/16LegalSeries.

Other upcoming sessions include: 

There is not a registration fee for webinars in this series, but pre-registration is required. The series is intended for WHA hospital and corporate members as a member benefit, and includes a range of topics, each presented by a representative of a WHA corporate member law firm. 

In addition, if you missed any of the previous webinars from this series, the slide decks and audio recordings are available on-demand in the WHA members-only portal at http://members.wha.org. If you do not have an account in the WHA members-only portal, go to http://members.wha.org and click on “Register” to create an account. If you have questions about how to register, contact Tammy Hribar at thribar@wha.org or 608-274-1820.

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WHA “Members Only” Portal Offers Custom Reports, Analysis

There is an abundance of data in the field of health care, but unless it is organized into useable reports it is not useful for decision making in your organization. WHA has developed a number of hospital-specific customized reports in the areas of finance and quality that members will find extremely useful. These reports are located on WHA’s website in the Members Only portal at http://members.wha.org.

If you do not have a member account in the WHA members-only portal, go to members.wha.org and click on “Register” to create an account. If you have questions about how to register, contact Tammy Hribar at thribar@wha.org or 608-274-1820.

The WHA members only section can be accessed at any time by clicking on the Data navigation tab at WHA.org, then click the “members only” icon.

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MetaStar Health Care Quality Symposium Features WHA Staff and Members

Register now for the MetaStar Health Care Quality Symposium scheduled November 1, 2016 at the Glacier Canyon Conference Center at the Wilderness in Wisconsin Dells. This year’s event focuses on “Mindful Care, Improved Health for All” and will feature Wisconsin-based speakers sharing their experiences and efforts to improve health through cultural and community-based efforts. 

WHA Quality Improvement Manager Jill Hanson will present at one of the breakout sessions. The first keynote will feature Alison Page, CEO of Western Wisconsin Health and Kim Miller, CEO of Beaver Dam Community Hospital, who will discuss their efforts and implementation of Blue Zones inspired changes. The Symposium will also feature research from the Center for Healthy Minds and demonstrate compassion training, from which all roles of the community and health system can benefit. The day concludes with a patient story tied directly to the Blue Zones inspired changes made by one of the health systems featured earlier in the day. 

To register or for more information, go to www.metastar.com/symposium.

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Partners of WHA Honors Ned Wolf with “Best of the Best Administrative Award”

Partners of WHA, Inc. presented its 2016 Best of the Best Administrative Award to Ned Wolf, FACHE, chief administrative officer of Lakeview Medical Center/Marshfield Clinic Health System in Rice Lake, Wisconsin, at an October 5 luncheon as part of its annual convention in Appleton. Each year, this award recognizes an on-site hospital executive who demonstrates a cooperative, supportive, enthusiastic, and well-defined relationship with his or her volunteer organization. 

Wolf’s nomination by the Volunteer Partners of Lakeview Medical Center shared many examples of his support, including his regular attendance at Volunteer Partner meetings and volunteer-sponsored events, as well as his promotion and recognition of the Volunteer Partners with staff and local media. The Volunteer Partners described Wolf as “consistently approachable and open-minded to requests or suggestions,” and always supporting them with the resources they need, including covering state Partners of WHA membership dues, attendance at the state Partners convention and WHA’s annual Advocacy Day in Madison.

In closing their nomination, the members of the Volunteer Partners of Lakeview Medical Center stated, ”Without our Administrator’s confidence in the volunteers and their talents, we would not have been able to ‘think outside the box’ and create new volunteer programs.”

For more information on the Partners of WHA Best of the Best Administrative Award, visit www.partnersofwha.org.

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Partners of WHA Recognize, Celebrate Volunteer Excellence at Annual Convention

Partners of WHA, Inc. celebrated hospital volunteerism and recognized volunteer excellence at its recent annual state convention. Partners hosted over 300 volunteer members from hospitals across Wisconsin on October 4-6 in Appleton. The statewide hospital volunteer organization raised and donated nearly $2.3 million dollars and volunteered 1.38 million hours of service to Wisconsin hospitals in 2015.

An annual highlight of the convention is the hospital CEO panel discussion. This year’s panelists included hospital leaders Bill Sexton of Crossing Rivers Health in Prairie du Chien; Therese Pandl of HSHS Eastern Wisconsin Division; Steve Little of Agnesian HealthCare in Fond du Lac; and Jeremy Normington-Slay of Ascension-Mercy Medical Center in Oshkosh. The panel was moderated by WHA President/CEO Eric Borgerding, and discussion included the topics of population health efforts, use of telemedicine, impact of the heroin and opioid epidemic on their communities and health systems; workforce issues, and the importance of volunteers in the health care setting.

Partners of WHA also awarded their annual Wisconsin Award for Volunteer Excellence (WAVE Award) to four volunteer member organizations, honoring outstanding programs in the categories of community service, fundraising, in-service hospital volunteer programs, and community outreach/collaboration. WAVE Award recipients included St. Croix Regional Medical Center Volunteer Partners in St. Croix Falls for their Little Free Library; SSM Health St. Mary’s Auxiliary in Madison for their No One Dies Alone program; Volunteers in Partnership with Community Memorial Hospital in Menomonee Falls for their Weekly Cookie Sale program; and Partners of HSHS St. Joseph’s Hospital in Chippewa Falls for their Community Garden program. 

Partners of WHA is comprised of over 10,000 volunteers and auxilians at 71 Wisconsin hospitals. Founded in 1951 as Wisconsin Hospital Association Auxiliaries, Partners of WHA, Inc. emphasizes volunteer service and participation in grassroots advocacy, public policy and community health education, and health career programs for Wisconsin hospitals. Additionally, Partners promotes leadership development offering re-sources and educational seminars to local hospital volunteer and auxiliary groups, and shares information on successful community health education initiatives, advocacy and fundraising activities and trends on volunteerism through a variety of channels, including its quarterly newsletter, Reaching Out. More information can be found at www.partnersofwha.org.

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Member News: ThedaCare President/CEO Gruner Announces Retirement

Dean Gruner, MD, president and CEO of ThedaCare since April 2008, announced his plans to retire. Gruner began in health care 40 years ago.

Gruner has served in multiple leadership positions with ThedaCare or its affiliates since it was founded as Novus Health Group in 1987. He previously served as chief medical officer of both ThedaCare and the former Touchpoint™ Health Plan, which was sold to United Healthcare in 2004. He was one of the founding physicians of Touchpoint, and was a practicing family physician with Family Doctors, S.C., which affiliated with ThedaCare in 1994. In 2000, Gruner was named chief medical officer for ThedaCare. In 2003 he became senior vice president for ThedaCare Physicians, an ambulatory care practice at the time consisting of 150 providers and 20 clinics. In 2008, he became president and CEO of ThedaCare.

Under his direction, ThedaCare became the largest health care provider in Northeast Wisconsin, and the largest locally based employer, with 7,000 employees, seven hospitals, 34 clinics and other health care services covering nine counties.

“Dr. Gruner has been committed to improving the health care of the communities we serve and the Board appreciates his dedication and devotion to our mission,” said John Davis, chairman of ThedaCare Board of Trustees. 

A national executive search firm has been hired to look for internal and external candidates, and a Board search committee has been formed, Davis said. The Board will hire the new leader and the process is anticipated to take six-nine months, with a transition to the new president and CEO to happen in summer 2017. 

Gruner received his undergraduate degree in chemistry and psychology from St. Olaf College in Minnesota, and his medical degree from the University of Minnesota Medical School. He completed his residency in family practice at St. Michael Hospital in Milwaukee. He earned a master’s degree in medical management from the Tulane University School of Public Health and Tropical Medicine in New Orleans, Louisiana in 2001.

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