October 14, 2005
Volume 49, Issue 38
Assembly Committee Requests Modification to Insurance Regulation
"Proposed rule would create hardship for patients and providers"
The Assembly Committee on Insurance and the Senate Committee on Agriculture and Insurance held a joint hearing this week on proposed amendments to the Wisconsin administrative rule INS 9, providing for regulation of preferred provider plans offered by some insurers. WHA advised the committee members that the rule included a provision that not only exceeded the Office of the Commissioner of Insurance’s statutory authority, but also was simply bad public policy.
Proposed INS 9.32(2) would require an insurer offering a preferred provider plan to include in its contracts with providers a provision requiring the provider to fully disclose to a patient who is in the insurer’s PPO, the name of each provider that may participate in the delivery of care and whether each provider is a participating or nonparticipating provider in the patient’s PPO.
WHA objected to this provision for a number of reasons, including that the provision suggests that providers are better positioned than the insurers themselves to advise insured members of the details of their policy; the rule would put into law what should be a negotiated contract term; and again, OCI does not have the statutory authority to regulate providers.
During the hearing, Representative Gregg Underheim, pointedly asked Insurance Commissioner Jorge Gomez, "Can you tell me where you have the statutory authority to regulate providers? If OCI has the authority to require providers to know about and inform patients of their insurance benefits, where does the authority stop?" Representative Curt Gielow said that, "The rule as proposed would create undue hardship for both patients and providers."
WHA’s memo observed, "If an insurer would like its participating providers to provide the insurer’s enrollees with certain information, that extra service should be part of the contract negotiations and not part of the rulemaking process." The Assembly Committee on Insurance agreed with WHA’s concerns and passed a motion requesting that the Commissioner of Insurance consider modifications to the rule, and if the Commissioner fails to notify the Committee by November 7, 2005, of his agreement to modify the rule, then the Committee objects to the rule.
A copy of WHA’s memo to the Committees is available on the WHA website.
New Study Confirms Urgent Need for Damage Caps
Projects Massive Increases in WI Liability Insurance Premiums Absent a Meaningful Cap
on Pain and Suffering Awards
WHA issued this news release statewide on October 12, 2005.
MADISON, WI (October 12, 2005) — A new study of Wisconsin’s medical liability climate substantiates what health care providers, a majority of the legislature and the public already know: Wisconsin’s cap on pain and suffering awards has been a key element of a balanced liability system that has helped shield Wisconsin from the litigation storm now wreaking havoc on health care systems across the country.
That is just one of several key findings included in a September, 2005 study conducted by Pinnacle Actuarial Resources, an independent firm headquartered in Bloomington, IL. Pinnacle, one of ten largest property/casualty actuarial consulting firms in the country, was retained by the Wisconsin Hospital Association (WHA) and the Wisconsin Medical Society (Society) to conduct the analysis.
According to the report, the loss of Wisconsin’s cap is expected to result in a 12-15 percent premium increase for medical liability insurance, and a doubling of premiums paid to the Injured Patients and Families Compensation Fund (IPFCF), and that’s just for starters. In the long-term, uncapped pain and suffering awards will likely cause liability premiums to increase rapidly and unpredictably. Such volatility has caused physicians to flee from many states with no caps or ineffective caps.
"Wisconsin’s balanced environment is now in jeopardy without a meaningful cap," said study author Robert Walling. "It appears that either a low cap such as California’s $250,000 cap or a medium cap of less than $550,000 are essential to maintaining the current availability, affordability, and stability of medical malpractice coverage in the state of Wisconsin."
One of the most enlightening components of the study is its analysis of the incremental impact caps have on medical liability premiums. According to the study, physicians in states with either high caps (greater than $550,000) or no caps at all have been hit with premium increases up to four times higher than those in Wisconsin.
According to the report, all caps on pain and suffering awards reduce payouts and, to varying degrees, stabilize liability insurance premiums. But the impact diminishes as the size of the cap increases. A cap of $250,000 eliminates approximately 25% of unlimited losses, a $550,000 cap eliminates about 15% and a $1 million cap eliminates about 7%. (It is important to note that there is no limit on the amount of economic damages that can be awarded in Wisconsin).
"Not all caps are created equal, and a flat cap that exceeds $1million, without any other considerations, is effectively no cap at all," said WHA President Steve Brenton. "It is important that the legislature and Governor Doyle not only reinstate a cap, but at a level that will keep physicians in Wisconsin and maintain access to obstetricians, neurosurgeons and other high risk specialists that are fleeing other states amidst a deluge of lawsuits."
The study proves very timely as the State Legislature begins an expedited process to restore caps on pain and suffering awards. A task force appointed by Assembly Speaker John Gard recently made several recommendations on how to reinstate a cap, including a formula that would account for life expectancy, but did not recommend a specific cap amount. Both WHA and the Society believe the study can help guide that decision for both the Legislature and Governor Doyle.
"In the end, this issue is about patients," said Society Executive Vice President/CEO Susan Turney, MD. "Access to care is a nonpartisan issue, so we all need to work together to restore the balance that made our medical liability system one of the best in the country."
Other key findings of the study include:
2. Have had more stable rate levels over the last several years.
3. Have insurance carriers competing for their business.
NOTE: The study is available on the Pinnacle Web site at: www.pinnacleactuaries.com/pages/publications/files/Pinnacle-WHAFinalReport.pdf. The executive summary is available at
www.wha.org.Top
Wisconsin Hospitals Political Action Funds Exceed 2005 Fundraising Goal
Earlier this week, contribution totals to the Wisconsin Hospitals PAC, Conduit and AHA PAC exceeded the $175,000 fundraising goal for 2005.
Individuals representing 90 hospitals raised over $175,473, setting an all-time record for contributions raised in a single year. Contributions this year increased by almost 16 percent over last year’s record of $152,000.
Steve Brenton, WHA’s president said, "It’s absolutely fantastic that we have not only reached the goal, but set a fundraising record. Hospital leaders, staff and volunteers recognize that to have an impact, you’ve got to play to win – this means working to elect officials who understand the value of hospitals in their community and being active on legislation during the legislative session."
WHA’s Jodi Bloch explains why there has never been a better time to get in advocacy activity. "Preserving access to health care continues to be at stake this fall, and hospitals have much to lose," began Bloch. "From restoring non-economic damage caps in Wisconsin to adequately funding Medicaid, hospitals have to be vigilant in electing representatives who understand our priority issues, and then vigilant in making sure those representatives are educated on those priorities in the months to come."
This is where the Wisconsin Hospitals fundraising campaign and the WHA HEAT program come into play. Both programs make it easy for you to be involved in political and legislative advocacy. According to WHA’s Jenny Boese, "The overall goal is pretty simple: to build legislative relationships. The more politically and legislatively involved you are, the better able you will be to build relationships and positively impact the development of health care policy for your hospital and hospitals statewide."
For more information about Wisconsin Hospitals PAC, Conduit, AHA PAC or the HEAT program, contact either Jenny Boese or Jodi Bloch at 608-274-1820.
Contributions ranging from $1 - $249
Margan, Rob Wisconsin Hospital Association
Baalrud, Laura St. Joseph’s Hospital
Korff, Sally St. Nicholas Hospital
Kowalkowski, Carolyn St. Joseph’s Hospital
McKay, Jean Sacred Heart Hospital
Melby, Shirley Tri-County Memorial Hospital
Olszewski, Kathleen Saint Michael’s Hospital
Skulan-Balmer, Anna Sacred Heart Hospital
Tandberg, Christine Sacred Heart Hospital
Therou, Maureen St. Joseph’s Hospital
Axelsen, Kathern Sacred Heart Hospital
Anderson, Mark Sacred Heart Hospital
Carlson, Carol Sacred Heart Hospital
Evans, Carol Memorial Medical Center, Ashland
Gullicksrud, Lynn Sacred Heart Hospital
Hill, Nancy Saint Joseph’s Hospital
Hon, Ronald Sacred Heart Hospital
Hundt, Pamela Sacred Heart Hospital
Konopacky, Kathy Saint Michael’s Hospital
Lien, Kristine Sacred Heart Hospital
Mickelson, Ronald St. Clare Hospital and Health Servs.
Ose, Peggy Riverview Hospital Association
Pielhop, Judy Sacred Heart Hospital
Piper, Barbara Sacred Heart Hospital
Reinke, Kathy Shawano Medical Center
Smalley, Scott St. Joseph’s Hospital
Spanos, Chris Meriter Hospital
Sternweis, Margaret Saint Joseph’s Hospital
Wolf, Diane Saint Joseph’s Hospital
Wulff, Gary St. Joseph’s Hospital
Anderson, Sherry St. Marys Hospital Medical Center
Anich, Matthew Memorial Medical Center, Ashland
Arts-Strenke, Cynthia Lakeview Medical Center
Barry, Barbara Memorial Medical Center, Ashland
Betthauser, Sue Mile Bluff Medical Center
Bier, Michael Mercy Health System
Brunner, Pam Sacred Heart Hospital
Caven, Michael Memorial Medical Center, Ashland
Cohen, Joan Aspirus Wausau Hospital
Dittrich, Peggy Memorial Health Center
Drengler, Kathryn Aspirus Wausau Hospital
Dwyer, Amy Sacred Heart Hospital
Gamroth, Charlotte Tri-County Memorial Hospital
Giedd, Jan St. Joseph’s Hospital
Johnson, Howard Lakeview Medical Center
Laufenberg, Don St. Joseph’s Hospital
Lorenz, Bruce Aspirus Wausau Hospital
Maurer, Mary Holy Family Memorial Medical Center
Meicher, John St. Marys Hospital Medical Center
Meixelsperger, Jeffrey St. Marys Hospital Medical Center
Meyer, Markie Community Memorial Hospital
Nezworski, Joseph Sacred Heart Hospital
Nicolaus, David Flambeau Hospital
O’Brien, Susan St. Marys Hospital Medical Center
Olson, Keri St. Clare Hospital and Health Services
Ott, Virginia St. Joseph’s Hospital
Pengra, Mary Sacred Heart Hospital
Pittsley, Kim Aspirus Wausau Hospital
Polenz, Scott Sacred Heart Hospital
Posthuma, Diane Waupun Memorial Hospital
Richbourg, Mary Sacred Heart Hospital
Santini, Kathy Memorial Medical Center - Ashland
Schmelzle, Barbara Sacred Heart Hospital
Skifton, Russell Saint Michael’s Hospital
Smith, Ellen St. Marys Hospital Medical Center
Sullivan, Anne Memorial Medical Center - Ashland
Toycen, Mary St. Joseph’s Hospital
Voigt, Yolanda Aspirus Wausau Hospital
Vorwald, Virginia St. Marys Hospital Medical Center
Lenertz, Brad Memorial Health Center
Aminpour, Ali Sacred Heart Hospital
Clark, Dennis St. Joseph’s Hospital
Dalebroux, Steve St. Marys Hospital Medical Center
Krause, Elaine St. Marys Hospital Medical Center
Seldal, Kent Memorial Medical Center, Ashland
Barkovich, Catherine Sacred Heart Hospital
Gahagan, Marsha St. Marys Hospital Medical Center
Marcouiller, Don Memorial Medical Center, Ashland
Carlson, Kathleen Memorial Medical Center, Ashland
Monien, Yvonne Saint Michael’s Hospital
Schrage, Karen St. Joseph’s Hospital
Lucas, Ann Wisconsin Hospital Association
Aittama, Craig Saint Michael’s Hospital
Baetke, Jan Aurora Medical Center - Manitowoc
Baker, David Saint Michael’s Hospital
Beckler, Rick Sacred Heart Hospital
Beers, William St. Clare Hospital and Health Services
Benn, Cheryl Sacred Heart Hospital
Benusa, Kris Tri-County Memorial Hospital
Bessen, Paulette Saint Michael’s Hospital
Boudreau, Jenny WHA Financial Solutions, Inc.
Boyce, Sherry Saint Michael’s Hospital
Bradford, Deborah Froedtert Memorial Lutheran Hospital
Burmeister, Kerry Columbia St. Mary’s-Milwaukee
Buss, Diane St. Marys Hospital Medical Center
Christensen, Leslie St. Marys Hospital Medical Center
Clark, Julie Ann St. Joseph’s Hospital
Clough, Sheila Howard Young Medical Center
Coats, Robert Meriter Hospital
Cote, Sean WHA Financial Solutions, Inc.
DeMars, Nancy Sacred Heart Hospital
Elmer, Paula Monroe Clinic, The
Fedie, Robin St. Joseph’s Hospital
Folstad, John Sacred Heart Hospital
Gantner, Sue Aspirus Wausau Hospital
Garcia, Dorothy Agnesian HealthCare
Gaskell, Rose Froedtert Memorial Lutheran Hospital
Goffinet, Jo St. Marys Hospital Medical Center
Gutsch, Mike Memorial Health Center
Haeberle, Judith ProHealth Care
Hartman, Katherine St. Joseph’s Hospital
Hassemer, Robert Sacred Heart Hospital
Heider, Lisa Community Memorial Hospital
Hemes, Lisa St. Elizabeth Hospital
Hook, James St. Marys Hospital Medical Center
Huemmer, Paul St. Marys Hospital Medical Center
Jahnke, John Waukesha Memorial Hospital
Jensema, Christine St. Nicholas Hospital
Johnson, Kimberly Sacred Heart Hospital
Jones, Mary Meriter Hospital
King, Steve Saint Michael’s Hospital
LaBarge, Margie Saint Michael’s Hospital
LuCore, Michael Sacred Heart Hospital
LuCore, Patricia Sacred Heart Hospital
Maersch, Nancy Meriter Hospital
Marnell, John Hudson Hospital
Marten, Donna Sacred Heart Hospital
Mason, Robert Sacred Heart Hospital
Mathews, Larry St. Vincent Hospital
May, Carol Mercy Health System
McKenzie, Paula St. Marys Hospital Medical Center
Niekamp, Robert Saint Michael’s Hospital
Padilla, Gilbert Sacred Heart Hospital
Pahl, Joan Meriter Hospital
Peot, Tracy Bellin Memorial Hospital
Peskie, Walt Flambeau Hospital
Pfeifer, Patricia Saint Michael’s Hospital
Possin, Charles Meriter Hospital
Ries, John St. Marys Hospital Medical Center
Rothenbuehler, Gary St. Marys Hospital Medical Center
Schultz, Rebecca Sacred Heart Hospital
Schwoegler, Mary St. Marys Hospital Medical Center
Shave, Sandra Saint Michael’s Hospital
Shipman, Elisa Children’s Hospital of Wisconsin
Shoup, Judy St. Michael Hospital
Shulfer, Susan Saint Michael’s Hospital
Sparks, Steven St. Marys Hospital Medical Center
Sprengeler, John Sacred Heart Hospital
Stanton, Gary Memorial Health Center
Stubbs, Pat Mile Bluff Medical Center
Studer, Vince Shawano Medical Center
Swanson, Bert St. Joseph’s Hospital
VanDeVoort, John Sacred Heart Hospital
Watts, Susan St. Vincent Hospital
Marino, Richard Sauk Praire Memorial Hospital
Craft, Carolyn St. Joseph’s Hospital
Adams, Daniel Memorial Medical Center - Ashland
Bundner, Mark Meriter Hospital
Chandler, Susan Meriter Hospital
Deich, Faye Sacred Heart Hospital
Eckman, Theresa S t. Marys Hospital Medical Center
Elsen, Mary Pat St. Clare Hospital and Health Services
Facey, Alice St. Clare Hospital and Health Services
Groth, Kathy Meriter Retirement Services
Jacobsen, Joan Meriter Hospital
Jelle, Laura St. Clare Hospital and Health Services
Marggi, Michele St. Marys Hospital Medical Center
Roethle, Linda Bellin Psychiatric Center
Schaetzl, Ron St. Clare Hospital and Health Services
Skiles, Anna Meriter Hospital
Walker, Troy St. Clare Hospital and Health Services
Weden, Mary Children’s Hospital of Wisconsin
Werner, Kathleen Meriter Hospital
Whiteaker, Les Memorial Medical Center - Ashland
Achenbach, Connie Prairie du Chien Memorial Hospital
Albers, Kirstin Meriter Hospital
Anderson, Frances Meriter Retirement Services
Anderson, Susan Beloit Memorial Hospital
Baer, James Shawano Medical Center
Beck, James All Saints Healthcare
Beglinger, Joan St. Marys Hospital Medical Center
Bellin, Carolyn Froedtert Memorial Lutheran Hospital
Benson, Karen L St. Marys Hospital Medical Center
Bernklau, Robert Memorial Health Center
Boland, Susan All Saints Healthcare
Braun, James Flambeau Hospital
Brenny, Terrence Stoughton Hospital Association
Carr Lee, Mary Meriter Hospital
Coller, James St. Mary’s Hospital Medical Center
Dassenko, Dennis Univ. of Wisconsin Hospital/Clinics
DesJarlais, Robert Aurora Medical Center - Manitowoc
Dickey, John Luther Hospital
Dittmar, Clarence Community Memorial Hospital
Driggers, Steve Holy Family Memorial Medical Center
Dwyer, Maxine St. Marys Hospital Medical Center
Fenske, William Agnesian HealthCare
Flanagan, Tracy Sacred Heart Hospital
Forbush, Marilyn St. Clare Hospital and Health Services
Fry, Robert Bellin Memorial Hospital
Gifford, Bridget WHA Financial Solutions, Inc.
Gilles-Khouri, Lucy St. Marys Hospital Medical Center
Helin, Shelby St. Joseph’s Hospital
Herbert, William Meriter Hospital
Hoege, Beverly Reedsburg Area Medical Center
Jablonske, William St. Joseph’s Hospital
Kramper, Edward Wisconsin Hospital Association
Lemke, Debra Children’s Hospital of Wisconsin
Lensen, Kathie St. Nicholas Hospital
Macken, Thomas Aspirus Wausau Hospital
Martin, Julie Meriter Hospital
McAvoy, Michael All Saints Healthcare
McCloskey, Lynne Saint Michael’s Hospital
Meyer, Jeffery Osceola Medical Center
Meyer, Loren All Saints Healthcare
Mohr, Carol Sacred Heart Hospital
Mosack, Kathleen Sacred Heart Hospital
Mueller, Bonita St. Marys Hospital Medical Center
Mugan, James Agnesian HealthCare
Nicklaus, Ronald Aspirus Wausau Hospital
Nohelty, Peter Sacred Heart Hospital
Overholt, Peter Children’s Hospital of Wisconsin
Pangborn, Janet St. Michael Hospital
Pechan, Marlene St. Marys Hospital Medical Center
Peiffer, Susan Sacred Heart Hospital
Piehl, Steven Children’s Hospital of Wisconsin
Pieters, Donald St. Nicholas Hospital
Pinekenstein, Barbara Meriter Hospital
Pollard, Dennis Community Memorial Hospital
Post, A Charles Children’s Hospital of Wisconsin
Prince, Nancy Aspirus Wausau Hospital
Rickelman, Debbie WHA Information Center
Riegler, John Aurora Health Care
Rocole, Theresa All Saints Healthcare
Rothfuss, James Meriter Hospital
Rounds, Thomas St. Marys Hospital Medical Center
Ruehl, Teena Wisconsin Hospital Association
Sanders, Paul Community Memorial Hospital
Schmidt, Kari Aurora Health Care
Schultz, Rhea Meriter Hospital
Schulz, Janet Oconomowoc Memorial Hospital
Sio, Tim Meriter Hospital
Stenson, Jill Agnesian HealthCare
Sutton, Mary St. Marys Hospital Medical Center
Thompson, Mark Aurora Health Care
Thundercloud, Debbie Bellin Memorial Hospital
Utech, Laura Children’s Hospital of Wisconsin
Van Winkle, Gregory Community Memorial Hospital
Zorbini, John Community Memorial Hospital
Ballentine, Anne Covenant Healthcare System, Inc.
Callies, Julie WHA Information Center
Keene, Kaaron R. Memorial Health Center
Thorsness, Tom Sacred Heart Hospital
Boylan, Michelle Aspirus Wausau Hospital
Burgener, Jean Aspirus Wausau Hospital
Burgett, Lyle Aspirus Wausau Hospital
Casanova, James Aspirus Wausau Hospital
Clark, Mary Ann Cumberland Memorial Hospital
Danner, Forrest Aspirus Wausau Hospital
Dietrich, Dean Aspirus Wausau Hospital
Dietsche, James Bellin Memorial Hospital
Ellis, Nancy Aspirus Wausau Hospital
Erickson, Robert Aspirus Wausau Hospital
Gengler, Tim Aspirus Wausau Hospital
Hessert, Peter Aspirus Wausau Hospital
Kiel-Rosser, Karen Agnesian HealthCare
Klauck, James Froedtert Memorial Lutheran Hospital
Maloney, Barbara Froedtert Memorial Lutheran Hospital
McBrearty, Mary Jo St. Nicholas Hospital
Meysembourg, Len Spooner Health System
Nevers, Rick Aspirus Wausau Hospital
Petersen, Mary Beth Children’s Hospital of Wisconsin
Raaum, Karl Froedtert Memorial Lutheran Hospital
Roberts, Mary Aspirus Wausau Hospital
Rubenzer, Deanne St. Joseph’s Hospital
Scherff, Pam Froedtert Memorial Lutheran Hospital
Schroeder-Jaeger, Keri Froedtert Memorial Lutheran Hospital
Schumacher, Elizabeth Meriter Hospital
Sczygelski, Sidney Aspirus Wausau Hospital
Svetlik, Joe Reedsburg Area Medical Center
Swiderski, Julie Covenant Healthcare System, Inc.
Yunk, Dennis Agnesian HealthCare
Burger, Kristy Moundview Memorial Hospital and Clinics
Connell, Marilyn Froedtert Memorial Lutheran Hospital
Franson, Patricia Meriter Hospital
Hemes, Jim St. Elizabeth Hospital
Hinner, William Saint Michael’s Hospital
Hofer, John Bay Area Medical Center
Leonard, Mary Kay St. Marys Hospital Medical Center
Lockhart, MD, Jack Gundersen Lutheran Medical Center
Mulder, Doris Beloit Memorial Hospital
Onsager, Sandra St. Marys Hospital Medical Center
Peterson, Douglas Chippewa Valley Hospital/Oakview Care Ctr.
Schill, Jane Saint Michael’s Hospital
Schriner, Janet Covenant Healthcare System, Inc.
Strombom, Peter Meriter Hospital
Contributions ranging from $250 - $499
Nockerts, Steven Richland Hospital
Brazys, Mary Wisconsin Hospital Association
Oberholtzer, Curt Bay Area Medical Center
Ambrosius, Mark Aurora St. Luke’s Medical Center
Arnett, E. Stuart Aurora Health Care-South Region
Baker, Chris St. Marys Hospital Medical Center
Bezucha, Gary Boscobel Area Health Care
Biros, Marilyn SSM Health Care-Wisconsin
Blanchard, Michael Saint Joseph’s Hospital
Blask, Daniel ProHealth Care
Buerstatte, Gary Waukesha Memorial Hospital
Bukowski, Cathy Our Lady of Victory Hospital
Comello, Chris Meriter Hospital
Dallman, Michael University of Wisconsin Hospital and Clinics
Huettl, Patty Sacred Heart Hospital
DeVetter, Roberta Saint Joseph’s Hospital
Dreher, Charles Columbia St. Mary’s-Milwaukee Campus
Ellis, Sandra Children’s Hospital of Wisconsin
Erickson, William Sacred Heart-St. Mary’s Hospitals
Fischer, Kay Children’s Hospital of Wisconsin
Fish, Linda Aspirus Wausau Hospital
Greene, Roxanne Our Lady of Victory Hospital
Gresham, James Covenant Healthcare System, Inc.
Grimstad, Vicki Aurora Health Care
Hamilton, Mark Univ. of Wisconsin Hospital/Clinics
Jordan, Barb Monroe Clinic, The
Hammer, Michael Good Samaritan Health Ctr., Merrill
Penczykowski, James St. Marys Hospital Medical Center
Hanson-Melzer, Rita St. Joseph’s Regional Medical Center
Mattes, Dan Covenant Healthcare System, Inc.
Harding, Edward Columbus Community Hospital
Heifetz, Michael SSM Health Care-Wisconsin
Hendricks, Richard St. Marys Hospital Medical Center
Hilgart, Mark Aurora Health Care
Hill, Cheryl Columbia St. Mary’s Ozaukee
Hilt, Monica Sacred Heart-St. Mary’s Hospitals
Norton, Andrew Froedtert Memorial Lutheran Hospital
Hinton, George Aurora Sinai Medical Center
Hoff, Linda Meriter Hospital
Hoffman, Nancy Wisconsin Hospital Association
Hyland, Carol Agnesian HealthCare
Jablonski, James Children’s Hospital of Wisconsin
Jaeger, Lee Aurora Health Care
Jensen, Russell St. Marys Hospital Medical Center
Miller, Barbara St. Marys Hospital Medical Center
Johnson, Curtis Tri-County Memorial Hospital
Kalepp, Mandy Wisconsin Hospital Association
Wrabl, Carol Saint Joseph’s Hospital
Bayer, Tom St. Vincent Hospital
Kostroski, Sharon Saint Joseph’s Hospital
Krauklis, Gene Aurora Health Care-South Region
Kuiper, Laurie Aurora Health Care
Lange, George West Gate Medical Group
McCutcheon, Norma Wisconsin Heart Hospital, The
Miloszewicz, Angela Wisconsin Hospital Association
Mlynarek, Robert Oconomowoc Memorial Hospital
Neidenbach, Joseph St. Vincent Hospital
Neikirk, Jon Froedtert Memorial Lutheran Hospital
Siebecker, William Aspirus Wausau Hospital
Nelson, Nanine ProHealth Care
Nick, Mary Meriter Hospital
Nunn, Jake Aurora St. Luke’s Medical Center
Olkowski, Leland Aspirus Wausau Hospital
Paul, Mary Columbia St. Mary’s-Milwaukee
Peterson, Kimberly Bellin Memorial Hospital
Potter, Brian Wisconsin Hospital Association
Rouzer, Cindy Spooner Health System
Sanicola, Suzanne Columbia St. Mary’s-Columbia
Spieckerman, Jill Sacred Heart-St. Mary’s Hospitals
Steevens, Alan St. Clare Hospital and Health Services
Tait, Karen Howard Young Medical Center
Weisman, Steven Children’s Hospital of Wisconsin
Werner, Cinda Children’s Hospital of Wisconsin
White, Michelle WHA Financial Solutions, Inc.
Brandel, Patrick Holy Family Memorial Medical Center
Carlson, Dan Bay Area Medical Center
Christianson, Roger St. Marys Hospital Medical Center
Decker, Michael Divine Savior Healthcare
Friese, Carolyn St. Vincent Hospital
Grundstrom, David Flambeau Hospital
Hisgen, William Meriter Hospital
Hymans, Daniel Memorial Medical Center - Ashland
Kellar, Richard West Allis Memorial Hospital
Kuzel, Russel Aurora Health Care
Mantei, Mary Jo Bay Area Medical Center
McGee, Fred Meriter Hospital
Meyer, Miles Meriter Hospital
Myers, Raymond St. Joseph’s Hospital
Neet, Bradley Saint Michael’s Hospital
Priest, MD, Geoffrey Meriter Hospital
Riddle, Roberta Wisconsin Hospital Association
Ronstrom, Stephen Sacred Heart Hospital
Roraff, Greg Memorial Health Center
Simuncak, Sandra Froedtert Memorial Lutheran Hospital
Skaden, John Saint Joseph’s Hospital
Van Court, Bernie Bay Area Medical Center
Bestor, William Community Memorial Hospital
Needham, Jean Holy Family Hospital
Pandl, Therese Columbia St. Mary’s-Milwaukee
Barnett, Jane University Health Care, Inc.
Bultema, Janice Univ. of Wisconsin Hospital/Clinics
Byrne, Frank St. Marys Hospital Medical Center
Schumann, Shannon WHA Information Center
Contributions ranging from $500 - $999
Kryda, Michael Ministry Health Care
Anderson, Sandy St. Clare Hospital and Health Services
Buck, Catherine Froedtert Memorial Lutheran Hospital
Morgan, Dwight Aurora Health Care
Wick, Timothy Burnett Medical Center
Reardon, John Memorial Medical Center - Ashland
Christensen, Cinthia Children’s Hospital of Wisconsin
Duncan, Larry Children’s Hospital of Wisconsin
Dykehouse, Rodney Froedtert Memorial Lutheran Hospital
Entwistle, David Univ. of Wisconsin Hospital/Clinics
Flowers, Patty Children’s Hospital of Wisconsin
Kinsella, Connie Univ. of Wisconsin Hospital/Clinics
Forman, Elizabeth Froedtert Memorial Lutheran Hospital
Frank, Jennifer WHA Financial Solutions, Inc.
Getto, Carl Univ. of Wisconsin Hospital and Clinics
Goodenow, John Covenant Healthcare System, Inc.
Range, Richard Baldwin Area Medical Center
Grady, Glen Memorial Medical Center - Neillsville
Groepper, Ron St. Joseph’s Regional Medical Center
Gutzeit, Michael Children’s Hospital of Wisconsin
Heisler, John SSM Health Care-Wisconsin
Johnson, Charles St. Marys Hospital Medical Center
Johnsrud, Kimry Elmbrook Memorial Hospital
Jones, Michael Children’s Hospital of Wisconsin
Kerwin, George Bellin Memorial Hospital
Ketterhagen, James Covenant Healthcare System, Inc.
Potter, Terri Meriter Hospital
Korom, Nancy Children’s Hospital of Wisconsin
Kosanovich, John Watertown Memorial Hospital
Martin, Jeff Saint Michael’s Hospital
Richardson, Dana Wisconsin Hospital Association
Modjeska, Alicia St. Michael Hospital
Niemer, Margaret Children’s Hospital of Wisconsin
O’Connell, Blaine Froedtert Memorial Lutheran Hospital
Postler-Slattery, Diane Aspirus Wausau Hospital
Reynolds, Sheila Children’s Hospital of Wisconsin
Richards, Theresa Saint Joseph’s Hospital
Robertstad, John Oconomowoc Memorial Hospital
Runge, Charles Froedtert Memorial Lutheran Hospital
Schafer, Michael Spooner Health System
Schmidt, Craig Partners Health System, Inc
Schmidt, Michael Saint Joseph’s Hospital
Schroeder, Patricia Covenant Healthcare System, Inc.
Standridge, Debra St. Francis Hospital
Steiner, Garith Vernon Memorial Healthcare
Teigen, Bobbe Aurora Medical Center - Manitowoc
Thompson, Scott Aurora Health Care
Verploegh, Alan Aspirus Wausau Hospital
Brasseaux, Mary St. Nicholas Hospital
Devermann, Robert Aurora Medical Center of Oshkosh
Buser, Kenneth All Saints Healthcare
Sanders, Michael Monroe Clinic, The
Eichman, Cynthia Our Lady of Victory Hospital
Falvey, Patrick Aurora Health Care
Grasmick, Mary Kay Wisconsin Hospital Association
Karuschak, Michael Amery Regional Medical Center
Kief, Brian Howard Young Medical Center
McCausland, Maureen University of Wisconsin Hospital and Clinics
Meyer, Daniel Aurora Sheboygan Memorial Medical Center
Mohorek, Ronald Ministry Health Care
Contributions ranging from $1000 - $1999
Dunigan, Thomas Children’s Hospital of Wisconsin
Ela, Susan Aurora Health Care
Anderson, Loren Aurora Health Care-South Region
Banks, P. Gregory Aurora Health Care - Kettle Moraine Region
Birkenstock, Timothy Children’s Hospital of Wisconsin
Koehler, Thomas Aurora BayCare Medical Center
Milakovich, Paul Aurora Health Care
Bolz, Terry University of Wisconsin Hospital and Clinics
Bonk, Daniel Aurora Sheboygan Memorial Medical Center
Brideau, Leo Columbia St. Mary’s-Columbia Campus
Britton, Gregory Beloit Memorial Hospital
Bruce, Bill St. Joseph’s Community Health Services
Buettner, Susan Aurora Health Care
Cutler, Dave WHA Financial Solutions, Inc.
Dell Uomo, Paul Covenant Healthcare System, Inc.
Desien, Nicholas Ministry Health Care
Fale, Robert Agnesian HealthCare
Starmann-Harrison, Mary SSM Health Care-Wisconsin
Fish, David St. Joseph’s Hospital
Gazzana, Thomas Children’s Hospital of Wisconsin
Huxley, Eliot Aurora Health Care
Johnson, George Reedsburg Area Medical Center
Kachelski, Joe WHA Information Center
Kaufman, Nancy Aurora Health Care
Munson, Kenneth Children’s Hospital of Wisconsin
Olson, David Bay Area Medical Center
Olson, Edward Waukesha Memorial Hospital
Petasnick, William Froedtert Memorial Lutheran Hospital
Rudolph, Colin Children’s Hospital of Wisconsin
Shabino, Charles Aspirus Wausau Hospital
Boese, Jenny Wisconsin Hospital Association
Smith, Linda Aurora BayCare Medical Center
Steinman, John Aurora Health Care
Tapper, Joy Covenant Healthcare System, Inc.
Titus, Rexford ProHealth Care
Turkal, Nick Aurora Health Care
Mahoney, Lorelle Aurora Health Care
Westrick, Paul Columbia St. Mary’s-Milwaukee Campus
Wolf, Edward Lakeview Medical Center
Bazan, Bill Wisconsin Hospital Association
Nannis, Paul Aurora Health Care
Borgerding, Dana Wisconsin Hospital Association
Stanford, Matthew Wisconsin Hospital Association
Braddock, Jonathan WHA Financial Solutions, Inc.
Leitch, Laura Wisconsin Hospital Association
Warmuth, Judith Wisconsin Hospital Association
Eiler, Gary University of Wisconsin Hospital/Clinics
Vice, Jon Children’s Hospital of Wisconsin
Bloch, Jodi Wisconsin Hospital Association
Contributions $2000 and above
Sollenberger, Donna University of Wisconsin Hospital/Clinics
Brenton, Mary E. Wisconsin Hospital Association
Borgerding, Eric Wisconsin Hospital Association
Brenton, Stephen Wisconsin Hospital Association
Quinn, George Wisconsin Hospital Association
Size, Tim Rural Wisconsin Health Cooperative
Howe, Edwin Aurora Health Care
President’s Column: Medical Malpractice/Tort ReformSteve Brenton
President
Reedsburg Medical Center President George Johnson didn’t pull any punches when he was interviewed by NBC Channel 15-Madison reporter Zach Schultz, as Schultz toured the new $9.6 million Reedsburg Senior Lifestyle Center.
"Reedsburg Senior Lifestyle Center will lose approximately $600,000 the first year," Johnson told Schultz.
The problem, Johnson explained, is state reimbursements don’t cover expenses. Johnson says they lose $17 a day per patient and that number will increase to $40 a day in the new facility. The problem was made worse when Governor Doyle vetoed an increase in the last budget, instead directing the money to public education. It was the subject of a controversial veto override attempt in the Legislature that came up just two votes short, a fact that Schultz included in his news report.
The residents at the new Senior Lifestyle Center will come from the Snyder Nursing Home, where 30 of the 50 are on medical assistance, meaning the state reimburses the home for their care.
"Basically we’re projecting a substantial loss in this venture," says Johnson.
The Medical Center budget will continue to absorb the increasing deficits, but why build this $9.6 million facility in the first place, Schultz asked?
Jan Gerlach is on the Board of Directors, and her father Maury is a resident. "The rewards to the community are greater. That’s the way I view it as a board member. We need to keep these people in our community."
"A lot of discussion was held in this board room as to where are our priorities, what is our mission, what is our commitment to the community?" asks Johnson.
Brenda Reisdorph is the clinical director for the nursing home. She says the difference between Reedsburg and some of the homes that have closed is the partnership with the Medical Center. "I think partnerships are very important for the future in caring for our older people."
The Senior Lifestyle Center opens on October 26. (Story credit, NBC 15, Madison.)
WHA Financial Solutions: Good Benefits Communicators - A Way of LifeAs health care costs continue to be a larger part of payroll budgets, it becomes more important that good benefit communications become standard practice. Health benefit communications that happen on a regular basis help educate employees about ever rising health care costs and can help ease fears about health plan changes that are likely to happen.
In the October issue of Solutions Spotlight, included in this week’s packet, the seven qualities of a good benefits communicator are outlined. Also in the newsletter, understanding and creating a just culture for patient safety and the entrance of Roth 401(k)/403(b) plans into the retirement plan scene.
Thank You Letter Prompts Rep. Musser’s Visit to Tomah HospitalEver wonder if your grassroots letters to legislators matter? Tomah Memorial Hospital provides a great example that they do.
Officials at Tomah Memorial Hospital (TMH) had a chance to talk one-on-one with Rep. Terry Musser (R-Black River Falls) during a visit to TMH on Wednesday, October 12. The visit was the direct result of a thank you note sent by CEO Phil Stuart to Rep. Musser.
As a member of the Hospitals Education & Advocacy Team (HEAT), CEO Phil Stuart was aware of the legislature’s attempts to override Governor Doyle’s veto of increased funding for nursing homes and hospitals. Musser supported the override. While the override ultimately failed, Stuart sent Rep. Musser a thank you note. At the end of the note he extended an invitation to Rep. Musser to visit TMH. Rep. Musser accepted.
During the hospital visit, Rep. Musser and Stuart discussed a number of legislative issues dealing with health care, including the recent Wisconsin Supreme Court decision striking down caps on non-economic damages in medical malpractice cases.
Rep. Musser also had a chance to see firsthand the plans for an 800 sq. ft. addition that will house a new Magnetic Resonance Imaging unit. The project will also add a radiology suite, additional exam rooms and upgrade the rest of the recently expanded Specialty Clinic. In addition to the remodeling, the hospital will spend over $1 million to purchase new equipment.
When so few people are actively engaged in the legislative process, one letter can make a difference!
Does your hospital have a great grassroots example to share? Let HEAT know so we can showcase you in the Grassroots Spotlight. Contact Jenny Boese at 608-268-1816 or
jboese@wha.org.Top
AHLA Releases A Guide to Legal Issues in Life-Limiting Conditions
The American Health Lawyers Association recently released A Guide to Legal Issues in Life-Limiting Conditions. AHLA describes the Guide as "a rich resource for practicing attorneys and their clients, containing pertinent facts and real-world guidance savvy that will make it an advocacy tool for patients and their families. It provides key information about patient’s rights, health agencies and programs, including assisted living, long-term care, home health, palliative and hospice care, Medicare, and health insurance. It lists critical questions to ask in navigating the dizzying maze of details that surround the care of an aged grandparent, frail parent, or a seriously ill or injured loved one or close friend. The information can help ensure that an individual or the affected person they love receives the best care possible."
AHLA is encouraging wide distribution of the Guide, which is available at the following link:
www.healthlawyers.org/Content/NavigationMenu/Public_Interest_and_Affairs/Public_Information_Series/llc_guide.pdf.Top
WHA Education: November 16 Seminar Offered on 2006 Mastering Chargemaster
The educational seminar "Mastering Chargemaster-2006 is Almost Here!" is scheduled for Wednesday, November 16 for chargemaster/APC coordinators, coding staff, office managers, CFOs, and others who are responsible for charge generation processes. This program will concentrate on keeping you "in the know" for CPT and HCPCS coding revisions and new codes impacting the charge document.
The seminar will be held on November 16, 2005, from 9 am to 4 pm at the Plaza Hotel & Suites, Wausau. A brochure and a registration form are included in this week’s packet and on the web site at www.wha.org. On-line registration is available. The American Health Information Management Association (AHIMA) has approved this seminar for five (5) continuing education hours.
For more information on the program content, contact Jennifer Frank at 608-274-1820 or jfrank@wha.org. For registration questions, contact Sherry Rabuck at 608-274-1820 or
srabuck@wha.org.If you register for both seminars: "Mastering Chargemaster-2006 is Almost Here!" on November 16 and "New Year, New Challenges, New APCs, and New Headaches" on November 17, you will receive a
$75 discount on your total registration fee. If interested in attending both seminars, contact Sherry Rabuck for more information at 608-274-1820 or srabuck@wha.org.
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WHA Education: November 17 Seminar Offered on New APCs
The education seminar "New Year, New Challenges, New APCs, and New Headaches" is scheduled for Thursday, November 17. This is a seminar that goes beyond the basics. The OPPS Final Rule for 2006 will be reviewed in-depth, along with review of the latest CMS program memorandums. Chargemaster/APC coordinators, coding staff, office managers, CFOs, and others who are responsible for charge generation processes are encouraged to attend.
The seminar will be held on November 17, 2005, from 9 am to 4 pm at the Plaza Hotel & Suites, Wausau. A brochure and a registration form are included in this week’s packet and on the web site at www.wha.org. Online registration is available. The American Health Information Management Association (AHIMA) has approved this seminar for five (5) continuing education hours.
For more information on the program content, contact Jennifer Frank at 608-274-1820 or email at jfrank@wha.org. For registration questions, contact Sherry Rabuck at 608-274-1820 or email at srabuck@wha.org.
Special Discount
If you register for both seminars: "Mastering Chargemaster-2006 is Almost Here!" on November 16 and "New Year, New Challenges, New APCs, and New Headaches" on November 17, you will receive a
$75 discount on your total registration fee. If interested in attending both seminars, contact Sherry Rabuck for more information at 608-274-1820 or
srabuck@wha.org.Top
HHS Accelerates Use of E-prescribing and Electronic Health Records
New regulations that support adoption of e-prescribing and electronic health records were announced by HHS Secretary Mike Leavitt. These proposals will speed adoption of health information technologies by hospitals, physicians, and other health care providers to improve quality and safety for Medicare beneficiaries and all Americans. Taken together, they represent a major step forward in meeting President Bush’s goal of widespread adoption of electronic health records.
Electronic prescribing enables a physician to transmit a prescription electronically to a patient’s pharmacy of choice. It decreases prescription errors caused by hard-to-read handwriting and automates the process of checking for drug interactions and allergies. Not only is this easier than paper prescriptions, but it also can improve patient safety and increase efficiency.
Click here to view:
www.hhs.gov/news/press/2005pres/20051005.htmlTop
WFHS Hosts "The Transparent Market: What Does it Mean in Health Care?"
Health care provider, insurer and data giant will provide perspectives
It’s on the front burner: Transparency. But what does it mean in health care? That is the subject that will be explored at a seminar sponsored by the Wisconsin Forum for Healthcare Strategy (WFHS) on November 16 from 9 am to 2 pm at the Country Springs Inn in Waukesha.
Humana’s CFO Gary Hovila will describe how their subscribers are making use of online tools that equip them with important health care plan analysis and decision-making information. Hovila will also share how Humana’s providers are responding to the need to put more information in the hands of consumers.
Greg Herrle, principal at Milliman, stands on both sides of the road; sometimes hailed by health care providers, other times, well, not so much. But all the time Milliman is providing the media and health care providers with analyses of health care data that sometimes make the front page and often land on the CEO’s desk. He’ll give participants an idea of how he sees providers navigating the changing marketplace.
Ford Titus, CEO at ProHealth Care, Inc. in Waukesha, knows that consumerism and transparency are more than buzzwords. In the health care system he leads, it is a way of life. Ford preaches the "value proposition" in health care and is prepared to explain what he thinks the changing market will bring to consumers and providers.
PricePoint rolled out this year, providing marketers and consumers with a new source of information on hospital charges and discounts. But, PricePoint isn’t the only new product to hit the runway this year. WHA Information Center Vice President Joe Kachelski will provide a look at the Information Center’s products and services.
The registration fee is $125 for WFHS members, $150 for non-members. To register, see the flyer in this week’s packet, or go to www.wfhs.org, and click on events. For information, contact WFHS member Mary Kay Grasmick at 608-274-1820 or
mgrasmick@wha.org.Top
Wage Index Improvement Project Continues
WHA is pleased to announce that we will be working once again with RC Healthcare on our wage index improvement project. We have been partnering with RC Healthcare for the past several years and have achieved excellent results on improving Wisconsin wage indices. This has a major impact on Medicare reimbursement for PPS hospitals.
The wage index project is maturing and will undergo a couple of changes for this year. We will only be offering one education session and it will be held in Madison on November 1. RC Healthcare is spending much more time doing hospital visits and making individual phone calls to facilities working on wage index reporting issues. Therefore, the education session is now more directed towards those who have not participated in the education sessions before, or would like a refresher on the S-3 worksheet and how it impacts the wage index.
The Wage Index Seminar is scheduled for Tuesday, November 1 from 10 am until 12 pm at the WHA headquarters in Madison. If you or someone else is interested in participating in person or by calling in, email Brian Potter at bpotter@wha.org. He will follow-up with respondents with directions to the WHA office or call-in instructions as applicable.
Member News: Affinity Health System Recognized for Clinician-Patient CommunicationAffinity Health System received the 2005 Institute for Healthcare Communication Program Partner Award from the Institute for Healthcare Communication (formerly the Bayer Institute) for its outstanding commitment to improving clinician-patient communication. Affinity is being honored for its service excellence initiative, C.A.R.E., which stands for connect, appreciate, respond and empower. Affinity has been using the program to educate its medical personnel since 2002. It was introduced to employees throughout the organization in May.
C.A.R.E. creates a system-wide culture for customer service excellence, and ensures that all patients will be treated consistently at all Affinity locations. "The experience our customers have has to be consistent anywhere people encounter our staff," says Scott Nygaard, MD, chief medical officer for Affinity Health System.