May 6, 2016
Volume 60, Issue 18


Registration Open for 2016 Wisconsin Rural Health Conference, June 29-July 1
“The Changing Winds of Rural Health Care”


Register today and join your colleagues at the 2016 Wisconsin Rural Health Conference, scheduled June 29-July 1 at The Osthoff Resort in Elkhart Lake. This annual event is the forum for examining the issues that impact small and rural hospitals most, networking and collaborating with colleagues, and connecting with your team of senior staff and trustees.

Each year, WHA’s Council on Rural Health plans this conference, and this year they have crafted an interesting and diverse education agenda. Attendees of the annual Wisconsin Rural Health Conference will discuss public policy issues affecting rural health care, identify how the delivery of and access to rural health care are changing, and identify ways in which data and technology are improving health care for rural populations. The conference will again include the popular education track focused on governance and trustee issues.

Opening keynote speaker Ryan Donohue of National Research Corporation will examine how consumer decision making is affecting health care, what is important to the health care consumer, and ways hospitals and health systems can better connect with consumers. In addition, Toby Freier, president of New Ulm Medical Center in New Ulm, Minnesota, will discuss the challenges this rural hospital overcame to create a national model for the future of rural health care.

Make attendance at this year’s conference a priority by registering today. A brochure is included in this week’s packet, and online registration is available at https://events.SignUp4.net/16Rural.


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HCAHPS, Patient Satisfaction & Opioid Prescribing: Debunking the Myths
Wednesday, June 1, 2016, 12:00-1:00 pm 


Register today at: https://events.SignUp4.net/HCAHPS-0601

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Will You Be On the First Contributor Listing for 2016? 
Contribute to the Wisconsin Hospitals State PAC & Conduit before May 27
 

The 2016 Wisconsin Hospitals State PAC & Conduit campaign is revving up into full gear. To date we have raised almost $90,000 from over 90 contributors. Is your name among them? Help the 2016 Wisconsin Hospitals State PAC and Conduit campaign rocket past the $100,000 mark with your contribution. Make your contribution before May 27 to be included in the first contributor listing that will be published in the May 27 edition of WHA’s Valued Voice newsletter. 

The 2016 Wisconsin Hospitals State PAC and Conduit campaign goal is to raise $300,000, a 10 percent increase over last year. This is an aggressive but reachable goal when everyone pitches in. The Wisconsin Hospitals State PAC and Conduit support candidates of both parties who value hospitals and health systems. 

Elections matter and participation is important. Join the success story by contributing to the Wisconsin Hospitals State PAC and Conduit today. Contribute online at www.whconduit.com or contact Jenny Boese at 608-268-1816 or jboese@wha.org.

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WHA Summit Focused on Collaborative Community Partnerships

“Collaboration” was a recurring theme in the presentations at the WHA Community Benefit/Population Health Summit held May 5 in Madison. Working together with partners, Wisconsin hospitals and health systems share a common mission to improve the health status of people living in the communities they serve. 

Attorney General Brad Schimel, one of the state’s leading advocates for curbing opiate abuse and misuse, delivered the keynote address to the nearly 100 participants and described his participation in ProHealth Care’s community health needs assessment process. Schimel acknowledged WHA’s support of his efforts and the statewide campaign, “A Dose of Reality.” 

“I knew if we were going to find a way out of this situation, the health care community would have to be a major partner,” Schimel said. “I found a ready partner in WHA, the medical society and other health organizations, and we developed a trusting relationship. I can now brag that (these organizations) are all at the table with us.”

Schimel reported 62,618 lbs. of prescription drugs were collected April 30 during the state’s “take-back” day. That’s a 40 percent increase over the October 2015 total, which at the time was a record-breaking collection. 

In his welcoming remarks, WHA President/CEO Eric Borgerding said WHA is proud to partner with Attorney General Schimel and to very actively participate in the dialogue he has helped convene, the collaboration he and others have fostered, and the change he is helping lead.

“His passion for and commitment to this issue will, without question, prevent many tragedies and in the long run, improve the health and well-being of countless people and families all across Wisconsin,” said Borgerding.

WHA has also worked closely with Rep. John Nygren, lead author of the Heroin and Opioid Prevention and Education (HOPE) legislation. To date, WHA has held four education sessions for its hospital and health system members related to issues associated with opioid misuse (see www.wha.org/pubarchive/valued_voice/WHA-Newsletter-4-29-2016.htm#7); and has created a resource page at www.wha.org/opioid.aspx. The WHA webinar June 1 will focus on the influence patient satisfaction surveys may have on prescribing patterns (https://events.SignUp4.net/HCAHPS-0601).

Karen Timberlake, director, UW Institute for Population Health, described the research the Institute has done to identify common priorities among Wisconsin hospitals’ community health needs assessments (CHNAs). Timberlake said 30 percent of the CHNAs identify one or more of the following health needs: nutrition/obesity, behavioral health/mental health, and health care access. She emphasized the importance of networking and sharing best practices among hospitals and public health departments. To facilitate that sharing, the Institute created a webpage that has links to all hospital and public health department CHNAs and implementation plans. Find it here: www.improvingwihealth.org

State Public Health Director Karen McKeown said her department is collaborating with stakeholders across the state to develop a focused set of health priorities that are “cross-cutting, help to eliminate disparities” and consider the impact that social determinants of health have on achieving the best possible results. McKeown and Timberlake both emphasized that more progress can be made statewide that will make a difference in health status if hospital, health system and public health priorities are aligned. 

Memorial Medical Center (MMC) in Ashland is a single hospital that serves two counties that cover a lot of geography, but not a lot of people. That poses challenges, but Kevin Stranberg, CPXE, MMC Director of Strategy & Patient Experience, and Cyndi Zach, MPH, BSN, RN, Public Health Supervisor/Health Officer, Ashland County Health & Human Services, told the group by setting a manageable evidence-based priority, and getting buy-in from stakeholders, they hope to make measurable progress on the goal of reducing alcohol-related health issues in their region. 

Paula Morgen, ThedaCare community health manager, and Appleton Health Department Director Kurt Eggebrecht have also found that working together “moves the needle.” Sometimes, Morgen said, hospitals see all health and social issues as being in their purview to address, but she added, “You can’t solve a problem you don’t own.” That requires building trusting partnerships in the community, and involving stakeholders in setting the priorities.

ThedaCare has found that by educating stakeholders and then immersing them in the community has helped them better understand the issues they are trying to address at the ground level. The day-long bus trip that starts the process is so popular, Morgen said they prioritize the invitations to those “who need to get it and who get it” to ensure the right people are at the table from the start of the process.

A review of the requirements of Schedule H and new information on “what counts” as community benefit was provided by Trina Hackensmith, vice president, Lyons Software. Lyons is the web-host for the annual WHA Community Benefit Survey. Jenna Hanson, WHA liaison to Lyons, reminded participants that the WHA survey is now open through May 31. WHA member hospitals can now access the survey tool and enter their 2015 year-end community benefits data. Contact Jenna Hanson at 608-274-1820 or jenna.hanson@wha.org if you have questions.

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President’s Column: Physician Payment Reform a WHA Top Priority

In every corner of Wisconsin, health care is characterized by the existence and growth of integrated care. From Reedsburg to Milwaukee, Madison to Ladysmith, local and regional health systems are aligning the elements of the “continuum of care,” building new care teams and retooling traditional structures in preparation for assuming more accountability/risk for delivering better outcomes and improving health. 

A primary component of these Wisconsin health systems, great and small, are physicians. In fact, it is estimated that over 70 percent of Wisconsin physicians are employed by or closely aligned with our hospitals and health systems. It’s no wonder that WHA’s member surveys consistently identify physician workforce and physician leader development and engagement as priorities for WHA. 

As the composition and function of our members evolves, so do their expectations of WHA, and thus, so does our structure, focus and purview, as illustrated by these examples:

The next and most significant to-date example of our widening bandwidth comes via MACRA. Enacted as part of 2015’s SGR fix, MACRA will combine and streamline several existing Medicare physician payment systems into two new value-focused systems. With its MIPS (Merit-Based Incentive Payment System) and APMs (Alternative Payment Models), this latest helping of regulatory alphabet soup will reshape long-standing Medicare physician payment policy, influence the same for the private sector, and will most certainly lead to similar streamlining and alignment of Medicare’s multi-layered hospital payment programs. 

Crafting and implementing MACRA will be a complex undertaking, with myriad moving parts and anticipated but unknown downstream impacts on WHA’s community and regional health system members. While physician-specific in its impact, Wisconsin health systems will bear much of the cost of MACRA implementation and ongoing compliance with new physician reporting requirements and performance incentives. They will also feel the reimbursement impacts. By 2026, payment bonuses under MACRA could be as high as 9.25 percent, penalties as high as 9 percent. 

Frankly, given the high levels of physician integration in Wisconsin, coupled with care migration to outpatient settings, reimbursement for aligned physicians will soon stand side- by-side with hospital reimbursement on the WHA priority list. 

“Don’t think of these as fully calibrated models, rather change opportunities for how you deliver health care,” I heard CMS Acting Director Andy Slavitt say at AHA’s annual meeting this week. “We need meaningful engagement on this proposal,” he said. 

We agree. While details are now being determined, the implications are loud and clear, and affecting MACRA and its components is a top WHA priority today and going forward. 

Given the breadth of MACRA’s impact, all elements of WHA’s team, including our internal and external research, policy, quality, legal and government relations staff will also be “aligned” to engage in shaping this seminal payment policy. This also means tapping the expertise of our physician leaders, including our Physician Leaders Council and new Board members. And Wisconsin is fortunate to have Jeffrey Bailet, MD, executive vice president, Aurora Health Care, and co-president, Aurora Health Care Medical Group, chairing the MACRA-created Physician-Focused Payment Model Technical Advisory Committee (PTAC). This committee is tasked with making recommendations to HHS about implementing new value-based physician payment models. WHA was glad to endorse Dr. Bailet for this role, and we look forward to working closely with him going forward.

We will also craft future WHA quality improvement activity and programming with our eyes toward MACRA, helping our members stay steps ahead of and be better prepared for coming MIPS quality measures.

And finally, WHA’s subsidiary Physician Compass, created in March 2015 as a joint venture with the Wisconsin Collaborative for Health Care Quality, will position itself to be a quality improvement resource and reporting vehicle for physicians, both employed and independent, in the coming MACRA world.

Again, many moving parts and unknowns coming at us, so watch for more information in the near future. In the meantime, know that WHA is “on it.” 

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WHA, Hospital Leaders in DC and on Capitol Hill
Section 603, GME and Bay State Boondoggle on the agenda


Wisconsin hospital leaders and the Wisconsin Hospital Association traveled to Washington, DC this week to discuss important issues with Wisconsin’s Congressional Delegation. Hospital CEOs participating in this fly-in included: Mike Wallace of Fort HealthCare, Mary Starmann-Harrison and Therese Pandl of Hospital Sisters Health System, Jerry Worrick of Ministry Health Care, and Dr. Sue Turney of Marshfield Clinic. 

“The Wisconsin Hospital Association appreciates the time and effort of our hospital and health system leaders who traveled to Washington, DC with us this week,” said WHA President/CEO Eric Borgerding. “We believe there is tremendous value in meeting regularly with our elected leaders during these trips so legislators understand the issues impacting Wisconsin providers on the ground.” 

During the May 3 meetings on Capitol Hill, attendees asked for legislators to sign onto several “dear colleague” letters related to implementation of the Bipartisan Budget Act of 2015’s Section 603 on provider-based hospital outpatient departments. Attendees also discussed the impacts of Section 603 on projects under development at the time of the BBA’s enactment, and the need for a targeted, legislative fix.

Attendees thanked Wisconsin legislators for their overwhelming bipartisan support for The Advancing Medical Resident Training in Community Hospitals Act, HR 4732/S 2671, authored by U.S. Rep. Reid Ribble and U.S. Rep. Ron Kind. Hospital leaders asked that this legislation be moved quickly this year to ensure physician residencies are available to meet capacity needs in the Green Bay area. 

Finally, participants reminded legislative offices that Wisconsin continues to lose millions of dollars due to the “Bay State Boondoggle” which was enacted several years ago. The “boondoogle” was a manipulation of the Medicare wage index by Massachusetts, which allowed that state’s hospitals to gain hundreds of millions of dollars in increased Medicare reimbursement at the expense of the vast majority of hospitals across the country, including Wisconsin. WHA continues to advocate for a correction to this manipulation.

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Petasnick Receives AHA Distinguished Service Award

The American Hospital Association (AHA) presented its highest honor, the Distinguished Service Award, to William Petasnick, president and CEO, emeritus, Froedtert Health in Milwaukee. This award recognizes significant lifetime contributions and service to health care institutions and associations. Petasnick received the award at a ceremony May 2 at the AHA Annual Membership Meeting in Washington, D.C.

Petasnick served as chair of the AHA Board of Trustees in 2008 and was instrumental in developing AHA’s positions on delivery system organization and integration through his chairmanship of several AHA task forces. He currently chairs AHA’s Health Forum. Petasnick was WHA Chair in 2000 and received WHA’s Distinguished Service Award in 2005. 

“Bill brought a keen understanding of the health care field and deep policy expertise to his tenure on the AHA board,” said AHA President and CEO Rick Pollack. “His strong record of collaboration and commitment to improving health care exemplified effective hospital leadership.” 

As president and CEO of Froedtert Health, Petasnick created an extensive health care network that balanced the needs of many types of communities, patients and hospitals, including community hospitals, academic medical centers and public hospitals. He was a founder of the Milwaukee Health Care Partnership, a collaborative, multi-stakeholder approach to improving coverage and access for Milwaukee-area’s vulnerable patients and communities. 

Prior to becoming the CEO and president of Froedtert Hospital, Petasnick served in other professional roles as administrator of the University of Iowa Hospitals and Clinic in Iowa City, Iowa; director of operations, University of North Carolina Hospitals and Clinics in Chapel Hill, N.C.; associate director, University of Wisconsin Hospitals & Clinics in Madison, Wisc.; special assistant to the director, University of Michigan Hospitals in Ann Arbor, Mich.; and commissioned officer, United States Public Health Service in Washington. 

He is the recipient of an honorary doctorate degree in medicine from the Medical College of Wisconsin. He earned a bachelor’s of arts from the University of Wisconsin-Madison and a master’s in health care administration from the University of Minnesota-Twin Cities.

A clip from AHA, which includes a link to a video is available at http://news.aha.org/article/160504-william-petasnick-receives-distinguished-service-award.

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Celebrate National Hospital Week May 8-14: “Health Care from the Heart”

The Wisconsin Hospital Association joins hospitals from across the country in celebrating National Hospital Week May 8-14. This year’s theme is “Health Care from the Heart,” recognizing the more than 100,000 people who care for patients, families and communities every day in Wisconsin’s hospitals and health systems. 

“This week we stop to acknowledge the people who comprise our dedicated, remarkable workforce for providing the high-quality, high-value care that has become a standard in Wisconsin,” said WHA President/CEO Eric Borgerding. “Their commitment to their profession and to the higher calling of caring for others when they need it most is an invaluable asset in communities across our state.” 

The American Hospital Association has created a video from real photos contributed by AHA members and personal membership groups. The video offers hospitals and others a special way to say “thank you” during National Hospital Week.

WHA will be active on its social media channels throughout Hospital Week. Watch for posts on Facebook and Twitter.

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Wisconsin Medical Society Offers CME Webinar Series to Address Opioid Problem

Addressing opioid misuse and abuse is the focus of a new webinar series developed by the Wisconsin Medical Society. Approved for AMA PRA Category 1 Credit™, the webinars are designed to address the challenges faced by physicians and other prescribers and to improve opioid prescribing practices without compromising the quality of patient care. Click here for more information.

Webinars will be presented by Wisconsin physicians who specialize in addiction and pain management. The webinars will be offered live on the dates listed below and archived for on-demand viewing. Click on the links to register or for more information.

Drug Testing in Clinical Practice: The Science and Art of Drug Monitoring
May 18, 2016; 7–8 a.m. CST

Critical Conversations: Using Advance Care Planning to Provide Person-Centered Care
May 25, 2016; noon–12:30 p.m. CST

Risk Management Tools in Opioid Prescribing: Pain Agreements and the Wisconsin Prescription Drug Monitoring Program (PDMP)
June 8, 2016; 7–8 a.m. CST

The Opioid Epidemic and the Clinical Prescriber: Responses to Opioid Over-Prescribing
June 22, 2016; 7:30–8:30 a.m. CST

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Fast Facts from the WHA Information Center: Bicycle Injury Awareness

May is National Bike Month. It’s the perfect time to get out and ride with your family and friends. But, be careful! According to the WHA Information Center, in 2015 there were 2,350 ER visits in Wisconsin hospitals due to a bicycle-related injury. 41.6 percent of the total visits occurred in children ages 5-14, 17.2 percent in young adults ages 15-24, and 21.0 percent in adults ages 45 and older. Men accounted for 68.3 percent of those visits. 

For more information on bicycle safety, visit www.cdc.gov/HomeandRecreationalSafety/Bicycle.

Data provided by the WHAIC (www.whainfocenter.com). The WHA Information Center is dedicated to collecting, analyzing and disseminating complete, accurate and timely data and reports about charges, utilization, quality and efficiency provided by Wisconsin hospitals, ambulatory surgery centers and other health care providers.

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