July 26, 2013
Volume 57, Issue 30
WHA Board Identifies Key Factors, Issues Shaping Health Care Environment
There is no question that Wisconsin’s health care delivery system is among the very best in the nation. But as the WHA Board ticked off the unique attributes that catapulted Wisconsin to the top rung of the quality and value ladder, they acknowledged that the footings are resting on ground that is rapidly shifting.
The WHA Board Planning Session July 18-19 focused heavily on identifying members’ priorities and aligning them with the Association’s strategic plan. In this volatile and uncertain political and economic climate, a strategic plan provides a way to navigate unchartered territory. Jim Bentley, who spent 18 years with the American Hospital Association directing strategic policy, led the Board discussion that will be used to draft WHA’s strategic plan. WHA Chair-Elect Ed Harding, president/CEO, Bay Area Medical Center, presided over the two-day session.
"Wisconsin’s health care environment is challenging, but you are certainly in a better starting place in the era of reform than many other states," Bentley said. In the most recent Commonwealth Fund ranking of states’ health systems, eight regions in Wisconsin placed in the top quartile for overall performance compared to all health systems in the country, outperforming their peers on multiple indicators.
"No matter what happens in the next decade, I hope your scores continue to be this high—or better," Bentley told Board members. "You have done an extraordinary job. You are consistently high performers. Wisconsin is unique, and all I can say is keep it up!"
While there are many factors that contribute to Wisconsin hospital and health systems’ high performance, Board members pointed to integration as one of the most significant.
"There is a strong, collaborative relationship among hospital providers and physician groups, which is not the norm in the rest of the country," Board member Mark Herzog, president/CEO, Holy Family Memorial Hospital, Manitowoc observed. Herzog, who has previous experience in Indiana, Ohio and Pennsylvania, said in those states, care was much more fragmented and uncoordinated than is the norm in Wisconsin because hospitals and physician clinics worked independently and were less likely to coordinate care across settings.
Wisconsin’s early adoption of transparency, public reporting and electronic medical records, along with investments in information technology are "leading edge" and have all contributed to the state’s high performance, according to Kathy Jacobson, president/CEO, Froedtert Health.
The Board identified and discussed several issues that will influence the Association’s revised strategic plan:
It’s anyone’s guess as to how well Wisconsin’s insurance exchange will function when open enrollment begins October 1.The implementation process has created a great deal of confusion. According to Bentley, large employers are unlikely to make major changes in how they provide coverage. But, for those transitioning from government programs like Medicaid to purchasing coverage on the exchange, the road will be rocky and present challenges for providers and patients alike.
WHA has unveiled an aggressive agenda to help implement the Governor’s plan to cut the uninsured rate in half. That work has included the creation of a WHA Enrollment Action Council (see
related story in this issue) and a series of webinars and communications aimed at helping members prepare for enrollment activities.
Increasingly, financial risk is being shifted to providers. Whether it is through the accountable care organizations, or in bundled payments and medical homes, in the future health systems will assume more responsibility for keeping people well and out of the hospital, even as the payment system itself continues to be rooted in a volume, not value, based model.
The implementation of ICD-10 will have a far reaching impact on health systems and hospitals as the level of specificity that can be achieved through coding, and the amount of data that will be generated will increase dramatically. Bentley said the use of ICD-10 will likely result in major modifications to the DRG system. For some hospitals, this will mean an increase in payments, for others, a decrease.
WHA President Steve Brenton noted that the Association has been successful in launching new initiatives that have influenced public policy. A recent example is the Governor including funding in the state budget to boost medical education, which aligns with recommendations in the WHA report, "100 New Physicians a Year: An Imperative for Wisconsin."
"Legislators and the media attributed the Governor’s proposals directly back to WHA’s report," Brenton said. "Our strategy and initiatives made that possible."
While physician workforce issues are critically important, Bentley said even during the recession, hospitals reported difficulties in recruiting other key professionals. As the population ages, hospitals will find it challenging to fill vacant positions in an increasingly competitive labor market.
For WHA it will mean expanding its workforce agenda beyond physicians and nurses to include technical positions, and promoting health care as an attractive career.
Advocacy is a top priority at WHA, and it will remain there. Board members recognized and applauded WHA’s strong presence and effectiveness at the State Capitol, which is bolstered by the local efforts of hospitals and health systems to educate their elected representatives. Executive Vice President Eric Borgerding outlined WHA’s 2013-2014 advocacy agenda that starts with addressing issues associated with implementing the exchange, but also includes updating the state’s hospital regulations (DHS-124), building support for WHA’s mental health legislative agenda, and worker’s compensation.
The complexity of the health care environment and multitude of issues facing hospitals and health systems at both the state and national level will require a solid, but nimble strategic plan moving forward, a goal that Brenton said can be accomplished.
"We are fortunate to have some of the finest health care leaders in the country right here in Wisconsin, in this room, actively engaged with WHA," Brenton said. "The WHA Board strategy planning session was an opportunity to build on one another’s knowledge to improve a strategic plan that will help us to anticipate and respond to the challenges that lay ahead."
Top of page (7/26/13)
The WHA Enrollment Action Council (EAC) held its first meeting July 23 led by Mark Taylor, president/CEO of Columbia St. Mary’s, Inc., and Therese Pandl, president/CEO of HSHS in Eastern Wisconsin. The EAC is charged with providing leadership for members around patient enrollment into new coverage options that will be available through the health insurance exchange, as well as through Medicaid. Members of EAC represent hospitals and health systems from all parts of the state.
The purpose of the EAC is to:
"We have a particular interest in this topic in southeastern Wisconsin given the number of Medicaid enrollees, uninsured, and newly-eligible Medicaid recipients that are in our market," according to Taylor. "We understand the importance and urgency of enrolling people in either Medicaid or the exchange."
WHA Senior Vice President Joanne Alig outlined WHA’s proposed enrollment plan that includes engaging members and policymakers, coordinating with stakeholder groups and communicating with members through The Valued Voice, webinars and a dedicated website that is now under development.
Alig shared the Centers for Medicare and Medicaid anticipated timeline for the exchange, emphasizing that enrollees must select a plan by December 15 in order for coverage to begin January 1. She noted that federal rules on assisters were just released July 12, and the state Insurance Commissioner’s Office is working on rules to implement regulations for assisters (see www.wha.org/Data/Sites/1/pubarchive/valued_voice/WHA-Newsletter-7-19-2013.htm#1). As hospitals are trying to make decisions about how to engage in enrollment activities, it will be important to understand the regulatory environment in which they need to operate.
Two health systems presented their exchange preparation plans to date, both of which include a tremendous amount of community outreach. Mike Richards, Gundersen Health, and Joan Mueller, Mayo Clinic Health Systems, said their systems are working together with other community organizations in the La Crosse area to "get as many people signed up for the exchange or Medicaid as possible." Richards noted that a key part of their plan is communications to the public, to patients and internally to hospital staff. Tracy Wymelenberg, Aurora Health Care, said that health system is equally focused on connecting patients with coverage and with helping them to maintain coverage options, as well. Wymelenberg noted important considerations for hospitals and health systems such as patient and caregiver communications, internal operations and processes, and working with external partners.
"WHA is fortunate to have so many engaged members who are willing to share information on this topic," said Alig. With less than 70 days until exchange implementation, hospitals are trying to gear up as quickly as possible, and sharing information in a collaborative way helps us all move forward."
The Council will meet again in late August.
Top of page (7/26/13)
A series of interviews with newly-elected legislators, by Mary Kay Grasmick, editor
As a first-time elected official, Mary Czaja said her goal is to create opportunities for young people now that she had when she graduated from college. And she believes that the state has the resources it needs to build a different future, but the assets must be deployed in new ways.
"I think Wisconsin has plenty of tax dollars, but I don’t think we use them as wisely as we should," she said.
Czaja, who owns and operates an independent insurance agency in Tomahawk, recognizes that "anyone can fall down in this day and age."
"I want to help people get back on their feet. But when you have three or four generations on public assistance, we need to teach or provide incentives to them to help themselves because we need to use the state’s resources to take care of people who absolutely are not able to take care of themselves," according to Czaja.
Government has a role to play in creating opportunity, but people must take personal responsibility.
"If you lose your Medicaid coverage, but you are eligible for insurance in the exchange, you have to take the initiative," she said. "There is no reason anyone needs to go without insurance anymore."
Economic development is important to northern Wisconsin. It would create good-paying, family-sustaining jobs, and Czaja feels that by helping some of the northern-oriented industries move forward, such as forestry, for example, the jobs would follow, along with good benefits, and "schools would do better, hospitals would do better, and industry would do better."
To accomplish that, Czaja said, "We need more certainty. Wisconsin is moving in a good direction, but more certainty would be good."
Access to care, especially mental health services, is an ongoing struggle for those living in areas of northern Wisconsin. There is a growing awareness of the need for mental health services, but she recognized that effective treatment of both mental and physical ailments hinges on the patient’s care team having all the information that they need to treat the whole person.
"We need to start treating mental health just as we would any other health condition," according to Czaja.
Harmonizing Wisconsin state laws with federal HIPAA laws could help achieve greater care coordination among care teams, and that is a priority for WHA this session.
Top of page (7/26/13)
The Wisconsin hospitals state political action fundraising campaign has raised $115,000 to date from 150 individuals. This puts the 2013 campaign at 44 percent of the goal to raise $260,000 by year’s end. If the goal is reached it will be the highest total ever raised.
So far individuals are contributing an average $767 and the median contribution is $500. While the average contribution is up as is the median contribution, the pace of the campaign is behind as the number of individuals participating is behind last year by 47 contributors. While the overall number of individuals participating may be less at this particular point in the campaign, the number of individuals joining the 2013 Platinum Club continues to rise as 45 members have contributed more than $1,500 each to the 2013 campaign, ahead of last year by 12 members.
All individual contributors are listed in The Valued Voice by name and affiliated organization on a regular basis. Thank you to the 2013 contributors to date who are listed below. Contributors are listed alphabetically by contribution category. The next publication of the contributor list will be in the August 9 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|
|Ashenhurst, Karla||Ministry Health Care|
|Bair, Barbara||St. Clare Hospital & Health Services|
|Bayer, Tom||St. Vincent Hospital|
|Bergmann, Ann||Spooner Health System|
|Boson, Ann||Ministry Saint Joseph's Hospital|
|Brenny, Terrence||Stoughton Hospital Association|
|Brenton, Andrew||Wisconsin Hospital Association|
|Calhoun, William||Mercy Medical Center|
|Capelli, A.J.||Aurora Health Care|
|Cardinal, Lori||St. Agnes Hospital|
|Casey, Candy||Columbia Center|
|Censky, Bill||Holy Family Memorial|
|Connors, Lawrence||St. Mary's Hospital Medical Center|
|Cormier, Laura||Bellin Hospital|
|Culotta, Jennifer||St. Clare Hospital & Health Services|
|Dahl, James||Fort HealthCare|
|Dalebroux, Steve||St. Mary's Hospital|
|Ferrigno, Sandra||St. Mary's Hospital|
|Fielding, Laura||Holy Family Memorial|
|Furlong, Marian||Hudson Hospital & Clinics|
|Gille, Larry||St. Vincent Hospital|
|Granger, Lorna||Aurora Health Care|
|Hafeman, Paula||St. Vincent Hospital|
|Halida, Cheryl||St. Joseph's Hospital|
|Hardy, Shawntera||Hudson Hospital & Clinics|
|Hieb, Laura||Bellin Hospital|
|Hockers, Sara||Holy Family Memorial|
|Hofer, John||Bay Area Medical Center|
|Jelle, Laura||St. Clare Hospital & Health Services|
|Jensema, Christine||St. Vincent Hospital|
|Jensen, Russell||St. Mary's Hospital|
|Johnson, Charles||St. Mary's Hospital|
|Josue, Sherry||St. Mary's Hospital|
|Karuschak, Michael||Amery Regional Medical Center|
|King, Steve||St. Mary's Hospital|
|Klay, Lois||St. Joseph's Hospital|
|Klein, Tim||Holy Family Memorial|
|Lange, George||Westgate Medical Group, CSMCP|
|Larson, William||St. Joseph's Hospital|
|Lepien, Troy||St. Mary's Hospital|
|Martin, Nancy||Ministry Saint Michael's Hospital|
|Maurer, Mary||Holy Family Memorial|
|Natzke, Kristin||Marshfield Clinic|
|Nguyen, Juliet||Sacred Heart Hospital|
|O'Hara, Tiffanie||Wisconsin Hospital Association|
|Oland, Charisse||Rusk County Memorial Hospital and Nursing Home|
|Olson, Bonnie||Sacred Heart Hospital|
|Ose, Peggy||Riverview Hospital Association|
|Ott, Virginia||St. Joseph's Hospital|
|Palecek, Steve||St. Joseph's Hospital|
|Pavelec-Marti, Cheryl||Ministry Saint Michael's Hospital|
|Penczykowski, James||St. Mary's Hospital|
|Reinke, Mary||Meriter Hospital|
|Rocheleau, John||Bellin Hospital|
|Roundy, Ann||Columbus Community Hospital|
|Schaetzl, Ron||St. Clare Hospital & Health Services|
|Schubring, Randy||Mayo Health System - Eau Claire|
|Simaras, James||Wheaton Franciscan Healthcare|
|Statz, Darrell||Rural Wisconsin Health Cooperative|
|Stelzer, Jason||St. Clare Hospital & Health Services|
|Teigen, Seth||St. Mary's Hospital|
|Thornton, Eric||St. Mary's Janesville Hospital|
|Walker, Troy||St. Clare Hospital & Health Services|
|Westrick, Paul||Columbia St. Mary's Columbia Hospital|
|Whitinger, Margaret||Agnesian HealthCare|
|Woleske, Chris||Bellin Psychiatric Center|
|Wolf, Edward||Lakeview Medical Center|
|Wymelenberg, Tracy||Aurora Health Care|
|Wysocki, Scott||St. Clare Hospital & Health Services|
|Yaron, Rachel||Ministry Saint Clare's Hospital|
|Contributors ranging from $500 to $999|
|Bablitch, Steve||Aurora Health Care|
|Carlson, Dan||Bay Area Medical Center|
|Dietsche, James||Bellin Hospital|
|Dolohanty, Naomi||Aurora Health Care|
|Dube, Troy||Chippewa Valley Hospital|
|Freimund, Rooney||Bay Area Medical Center|
|Gullingsrud, Tim||Hayward Area Memorial Hospital and Nursing Home|
|Hinner, William||Ministry Saint Clare's Hospital|
|Hyland, Carol||Agnesian HealthCare|
|Jacobson, Terry||St. Mary's Hospital of Superior|
|Joyner, Ken||Bay Area Medical Center|
|Krueger, Mary||Ministry Saint Clare's Hospital|
|Larson, Margaret||Mercy Medical Center|
|Lewis, Gordon||Burnett Medical Center|
|Mantei, Mary Jo||Bay Area Medical Center|
|May, Carol||Sauk Prairie Memorial Hospital|
|Mulder, Doris||Beloit Health System|
|Nelson, James||Fort HealthCare, Inc.|
|Richards, Theresa||Ministry Saint Joseph's Hospital|
|Rickelman, Debbie||WHA Information Center|
|Rocole, Therese||Wheaton Franciscan Healthcare|
|Russell, John||Columbus Community Hospital|
|Schafer, Michael||Spooner Health System|
|Selberg, Heidi||HSHS-Eastern Wisconsin Division|
|Shabino, Charles||Wisconsin Hospital Association|
|Stuart, Philip||Tomah Memorial Hospital|
|Swanson, Kerry||St. Mary's Janesville Hospital|
|VanCourt, Bernie||Bay Area Medical Center|
|Worrick, Gerald||Ministry Door County Medical Center|
|Contributors ranging from $1,000 to $1,499|
|Britton, Gregory||Beloit Health System|
|Dexter, Donn||Mayo Health System - Eau Claire|
|Heifetz, Michael||SSM Health Care-Wisconsin|
|Huettl, Patricia||Holy Family Memorial|
|Hymans, Daniel||Memorial Medical Center - Ashland|
|Kerwin, George||Bellin Hospital|
|Levin, Jeremy||Rural Wisconsin Health Cooperative|
|Martin, Jeff||Ministry Saint Michael's Hospital|
|McKevett, Timothy||Beloit Health System|
|Natzke, Ryan||Marshfield Clinic|
|Roller, Rachel||Aurora Health Care|
|Turkal, Nick||Aurora Health Care|
|Contributors ranging from $1,500 to $1,999|
|Alig, Joanne||Wisconsin Hospital Association|
|Anderson, Sandy||St. Clare Hospital & Health Services|
|Bloch, Jodi||Wisconsin Hospital Association|
|Boese, Jennifer||Wisconsin Hospital Association|
|Byrne, Frank||St. Mary's Hospital|
|Clapp, Nicole||Grant Regional Health Center|
|Coffman, Joan||St. Joseph's Hospital|
|Court, Kelly||Wisconsin Hospital Association|
|Eichman, Cynthia||Ministry Our Lady of Victory Hospital|
|Francis, Jeff||Ministry Health Care|
|Frank, Jennifer||Wisconsin Hospital Association|
|Grasmick, Mary Kay||Wisconsin Hospital Association|
|Harding, Edward||Bay Area Medical Center|
|Lepore, Michael||Wheaton Franciscan Healthcare|
|Meyer, Daniel||Aurora BayCare Medical Center in Green Bay|
|Millermaier, Edward||Bellin Hospital|
|Potter, Brian||Wisconsin Hospital Association|
|Sanders, Michael||Monroe Clinic|
|Sexton, William||Prairie du Chien Memorial Hospital|
|Size, Tim||Rural Wisconsin Health Cooperative|
|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.|
|Desien, Nick||Ministry Health Care|
|Duncan, Robert||Children's Hospital of Wisconsin|
|Gage, Weldon||Children's Hospital of Wisconsin|
|Herzog, Mark||Holy Family Memorial|
|Jacobson, Catherine||Froedtert Health|
|Kachelski, Joe||Wisconsin Statewide Health Information Network|
|Kammer, Peter||The Kammer Group|
|Kief, Brian||Ministry Saint Joseph's Hospital|
|Leitch, Laura||Wisconsin Hospital Association|
|Little, Steve||Agnesian HealthCare|
|Mettner, Michelle||Children's Hospital of Wisconsin|
|Neufelder, Daniel||Affinity Health System|
|Normington, Jeremy||Moundview Memorial Hospital & Clinics|
|O'Brien, Kyle||Wisconsin Hospital Association|
|Oliverio, John||Wheaton Franciscan Healthcare|
|Pandl, Therese||HSHS-Eastern Wisconsin Division|
|Starmann-Harrison, Mary||Hospital Sisters Health System|
|Woodward, James||Meriter Hospital|
|Contributors ranging from $3,000 to $4,999|
|Borgerding, Eric||Wisconsin Hospital Association|
|Contributors $5,000 and above|
|Brenton, Stephen||Wisconsin Hospital Association|
|Tyre, Scott||Capitol Navigators, Inc|
Top of page (7/26/13)
Wisconsin Medicaid Director Brett Davis spoke to the Speaker’s Mental Health Task Force on Tuesday, July 23 about the Department’s goals for advancing integrated behavioral health and physical health services in Medicaid and the importance of removing Wisconsin barriers to the seamless flow of information between treating providers to those goals.
WHA also formally submitted to the Speaker’s Task Force on July23 a set of seven statutory proposals to reform elements of Wisconsin’s mental health laws that build upon WHA’s March testimony to the Task Force. Those seven proposed bills were developed over the summer with the input of WHA’s Mental Health Task Force.
"Overall improved health care value for Medical assistance members" through better quality and reduced costs is the goal of the Department’s integrated care delivery efforts, Davis explained. Allowing for continuity of care for individuals across multiple providers, collaborating across a "team" of multidisciplinary professionals to develop and deliver an individualized care plan, and aligning financial incentives and sharing of information across providers are all elements of the Department’s definition of integrated care.
"Sharing of information across providers is very significant," Davis said in his comments on key drivers of integrated care. "The goal overall is to have a seamless flow of information back and forth and protecting people’s privacy to the greatest extent possible."
"How can we get that flow of information seamlessly happening?" asked Davis. "Because at this point, [Wisconsin law] is a barrier to overall service and health outcomes." He noted that health care providers have "red flagged" statutory barriers to information sharing as a significant obstacle to integrated care, and he also noted this issue has surfaced in previous Task Force meetings.
Removing outdated statutory barriers to the seamless flow of information between treating providers has been a priority for WHA and a key message to the Speaker’s Task Force from WHA and other health care providers, including psychiatrists, since the Task Force was created in February.
WHA’s set of seven proposed bills offered to the Speaker’s Task Force includes the "HIPAA Harmonization for Mental Health Care Coordination Bill," which would remove barriers in Wisconsin law to the coordination of care for persons with a mental health diagnosis that do not exist for persons that do not have a mental health diagnosis and that do not exist in the federal HIPAA privacy and security law. Not only is enacting the HIPAA Harmonization Bill critical for better coordinated mental and physical care, but it also should result in savings to public and private payers. A study released in January by Johns Hopkins suggests such a change would reduce psychiatric readmissions alone by 35-40 percent.
The bill proposals formally submitted by WHA on July 23 build off of WHA’s testimony to the Speaker’s Task Force in March. In addition to HIPAA harmonization, the bill proposals include reforms to emergency detention processes, funding efforts to improve mental health access using savings generated from HIPAA harmonization, clearer alignment between emergency detention related responsibilities and authorities of health care providers, creating a trauma system-like structure to differentiate different types of emergency detention facilities in order to better ensure Wisconsin has an appropriate range of emergency detention services available, and enabling rulemaking to create data-driven reports on county performance on providing core mental health services to facilitate more informed future discussions as to how to best ensure that the mental health system is meeting Wisconsin’s needs.
WHA’s previous testimony to the Task Force as well as WHA’s bill proposals can be found here: www.wha.org/mentalHealth.aspx.
Tuesday’s meeting was the fifth meeting of the Speaker’s Mental Health Task Force and concluded the invited testimony phase of the Task Force. In the coming weeks, the Task Force plans to develop a report and offer recommended legislation for consideration by the full Legislature.
Top of page (7/26/13)
In addition to the six major health care systems (Aurora, Wheaton Franciscan, Froedtert, Columbia St. Mary’s, ProHealth and Children’s), GE Healthcare and The Medical College of Wisconsin made the list. Other corporations rounding out the top dozen were Roundy’s Inc, Kohl’s, Quad/Graphics, and Northwestern Mutual.
Employment numbers reported for some organizations included workforce located outside of the Milwaukee area.
Webinars will be held August 27 and 28 as well as four dates in September. Look for specific information in next week’s Valued Voice.
Feedback on the project to date has been significant and will likely generate many changes to the reporting initiative. But additional engagement is important.
Top of page (7/26/13)
On September 17, a mere 14 days from the October 1 launch date to begin enrolling Wisconsin residents in the health insurance exchange, WHA is offering another member forum to provide the most up-to-the-minute information on the exchange implementation.
During this member forum, WHA’s Senior VP for Policy and Research Joanne Alig will provide the latest information available about the implementation of the exchange in Wisconsin. In addition, Lisa Olson, interim director of Enrollment for Health Wisconsin and director of policy and program for the Wisconsin Primary Health Care Association, will provide an update on the progress of the statewide strategy for exchange enrollment activities.
Offered via webinar, this Member Forum will take place Tuesday, September 17 from 12 - 1:30 pm. If you cannot participate on the scheduled date, you can register to receive an audio recording from the presentation. There is no cost to participate in this Member Forum webinar, but pre-registration is required and attendance is limited to WHA hospital and corporate members.
Register today at http://events.SignUp4.com/13HCExch14Days.
Top of page (7/26/13)
Sauk Prairie Memorial Hospital & Clinics (SPMHC) has been working to reduce readmissions for the last three years. As a result of numerous process improvement efforts and initiatives, the hospital has reduced their all-cause readmission rate to six percent, down from 11 percent—an improvement of 45 percent. Some of the process improvement initiatives include: 48 hour call-backs, personal interviews with all patients who have been re-admitted and physician chart audits of all readmissions for quality improvement.
SPMHC also recently initiated a pilot that places a certified social work case manager in one of the clinics who works closely with providers and staff to manage complex patients. Through collaboration with physicians and clinicians in the clinics, numerous patients with complex issues have received assistance with the coordination of their care, which has resulted in improved quality of care and patient/provider satisfaction.
"One great example of improved care is the case of a newly-diagnosed diabetic patient who had concerns about the cost of his diabetic supplies," according to Dawn Procter, SPMHC case manager.
Procter said the physician referred the patient to the social work case manager for further follow up. Working with the patient one on one, the case manager was able to assist him with his insurance coverage to get his supplies covered, and in the process discovered that he misunderstood how his insulin was administered. The patient was confused and thought that the actual needle held the insulin. Consequently, he thought he had run out of insulin early and could not afford more, so he was going to just stop taking it. The case manager was able to explain the misperception and assure him that he had enough medication for the rest of the month. The patient admitted that he would have just stopped taking it without the assistance of his case manager and may have likely ended up in the hospital.
"SPMHC is very dedicated to coordination of care and improvements that lead to better quality, safer care, both in the hospital and in our clinics," Procter said. "All of these efforts make up a complex matrix that addresses not only the medical concerns, but also the psychological and social issues that patients face as well."
The SPMHC quality team found that a "big picture" approach is key to delivering patient-centered care and, without it, efforts to improve quality are futile.
"We are doing some really great work, and we’re getting phenomenal results!" Procter said.
SPMHC is one of 91 hospitals working on readmissions with the Wisconsin Hospital Association Partners for Patients quality improvement initiative.
"Wisconsin hospitals are tackling the care transitions challenges head-on," according to Stephanie Sobczak, WHA quality improvement manager. "There are so many great examples like Sauk Prairie’s approach to care coordination. The lesson here is it pays to embrace the complexity and address many drivers at once to get great results."
Top of page (7/26/13)
Mark your calendar and plan to attend an important statewide event—a day-long conference focused on graduate medical education (GME) in Wisconsin. "Taking the Next Step: A Statewide Conference on Graduate Medical Education," is sponsored by the Wisconsin Council on Medical Education and Workforce (WCMEW) and will take place October 24 in Neenah. Hospital and health system leaders interested in participating in GME will want to participate. Attendees will receive practical information ranging from how GME fits into an organization’s strategic plan to what elements are needed for success.
Robert Golden, MD, dean of the University of Wisconsin School of Medicine and Public Health, and John Raymond, MD, president and chief executive officer of the Medical College of Wisconsin, will lead off with a discussion of GME in our state and the role that academic medical centers and teaching hospitals have in this important education activity.
The conference will be held Thursday, October 24, at the Best Western Bridgewood Resort Hotel & Conference Center in Neenah. More information and online registration will be available mid-August at www.wha.org/education-and-events.aspx. For questions, contact Chuck Shabino, MD, WHA senior medical advisor, at email@example.com or George Quinn, WHA senior policy advisor, at firstname.lastname@example.org.
Top of page (7/26/13)
A brochure and registration information can be found online athttp://events.SignUp4.com/13LeadershipSummit0919
Top of page (7/26/13)
WHA Joins Healthier Hospitals Initiative as a Supporting Organization
WHA has joined the Healthier Hospitals Initiative (HHI) as a supporting organization. In doing so, the Association joins a diverse group of organizations with an interest in the health care sector who recognize the important role they can play in health care environmental sustainability.
HHI is a no-cost, national campaign designed to lead change in the health care sector. HHI is bringing about this change by using the collective sustainability experience, purchasing power and industry representation of hospitals across the country to speed the greening of health care.
Founded by nonprofit organizations Health Care Without Harm, The Center for Health Design, and Practice Greenhealth, along with 13 initial health system sponsors that included Gundersen Health System, HHI has grown to more than 600 hospitals and health care systems nationwide.
"HHI’s objective is to embed sustainability into the culture and daily operations of health care, for the improved health of patients, staff, and the community; reduced environmental impact by the sector; and demonstrated fiscal savings that decrease national health care costs through better public health," said Gary Cohen, founder of HHI, and executive director of Health Care Without Harm.
"As an HHI supporting organization, we are committed to helping deliver better care, fostering better health and increasing the value of health care in our state," said WHA President Steve Brenton. "We are excited about our role to educate and encourage our hospitals to take advantage of the tools available in HHI."
To learn more about the campaign, visit Healthier Hospitals Initiative at www.healthierhospitals.org.
Top of page (7/26/13)
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.
A fighting chance at recovery in sight
In 2008 he lost his job. In due time he lost his home. As his opportunities and options diminished, he moved in with his father, who provided him with $300 a month in income. All the while a lesion on his face grew worse and finally became frightening. That’s when he sought help.
This 53-year-old male was diagnosed by a primary care physician with an advancing stage of basal cell carcinoma—a skin cancer lesion that disfigured and obstructed the upper and lower lids of his left eye. The condition required surgical removal of the lesion and reconstructive skin grafting to save the eye. He was referred to an ophthalmologist at Aurora Medical Center in Summit for further evaluation.
Clarice, the financial counselor, evaluated this gentleman’s financial situation and introduced him to Aurora’s Helping Hand Patient Financial Assistance Program. He completed the application process and was approved for a 100 percent discount to receive the surgery and other treatment he needed for a recovery that would give him to have a fighting chance at getting back into the mainstream.
Aurora Medical Center in Summit
Providing the best possible care is our mission—to everyone
For many uninsured or underinsured people in today’s economy, the household budget simply isn’t big enough to cover out-of-pocket costs for doctor visits or hospital stays. Many postpone needed care because of their ability to pay or fall into debt when care can’t be avoided any longer.
When medical problems arise, UW Hospitals and Clinics wants patients to focus on what matters most— their health. The Community Care Program is able to relieve financial worries from already stressful medical situations. During Fiscal Year 2011, UW Hospitals and Clinics provided $20.9 million in charity care (at cost) to more than 7,670 patients.
Continue reading, and you will see letters of appreciation from UW Hospital and Clinics patients who received financial assistance from our Community Care program.
"Thank you for your kindness in approving me for Community Care adjustments on my recent gallbladder removal and follow-up visits. It’s an overwhelming blessing. I had 10 gallbladder attacks before seeking any help due to the fear of not having insurance and not ever wanting to incur debt I couldn’t handle. Thank you so much for forgiving me this debt and for all of your incredibly kind people who work for UW Hospitals and Clinics."
"Community Care will always be a treasure in my heart. This gift has relieved me of much stress."
"Thank you to UW Hospitals and Clinics and Community Care staff for submitting and paying off my debt. I was so surprised, I just cried. I have never received charity and it has given me hope."
"Thank you so much for helping me with Community Care. Your hospital and staff are the ’Best’ by far."
"Words alone cannot begin to express my appreciation for the generousness of your adjustment of my recent account. This is an immeasurable assistance in my recovery, both physically and emotionally, and financially."
"Thank you from the bottom of my heart…a heart now restored to healthy function due to the masterful efforts of your remarkable institution. And thank you for one of the most powerful and positive experiences of my entire life."
Every day of the year, UW Hospitals and Clinics faculty, nurses, and staff are united, dedicated and inspired to make lives healthier, longer and more fulfilling. When patients walk through UW Hospitals and Clinics’ doors, they are confident we will provide them the best possible care. We do not take this responsibility lightly—it is our mission.
UW Hospitals and Clinics, Madison
All Saints Heart Failure Clinic helps keep patients out of the hospital
Michael Kinzinger was short of breath when he first visited the Wheaton Franciscan Healthcare – All Saints Emergency Department. He was quickly admitted to the hospital and began receiving treatment for heart failure. A few months later, he again returned to the All Saints Emergency Department – this time for a kidney stone and an aortic aneurysm.
Based on his medical history, Michael was referred to All Saints’ Heart Failure Clinic, which is led by Dr. Kaye-Eileen Willard. The clinic is helping to manage what has become a fast-growing and very costly chronic disease. As more patients survive heart attacks, they have a high risk of developing complications as a result of weakened heart muscles. The clinic’s goal, according to Dr. Willard, is to keep people like Michael healthy and out of the hospital.
The Heart Failure Clinic has been a godsend for Michael. Uninsured, the clinic connected him with a financial counselor who helped him secure financial assistance through Wheaton’s Community Care program. Karen Murillo, a Nurse Practitioner in the Heart Failure Clinic, sees Michael on a regular basis and coordinates his care for the management of his pacemaker, coronary artery disease, and other pulmonary issues.
"Everyone who I encounter at the Heart Failure Clinic is helpful," Michael said. "They take care of everything related to my heart health. Having access to this clinic is keeping me out of the emergency department."
Wheaton Franciscan Healthcare - All Saints
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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