October 19, 2012
Volume 56, Issue 42
Physician Workforce, Protecting Medicare/Medicaid High 2013 Priorities for WHA
WHA Board views Association advocacy efforts as key
With Election Day just a couple of weeks away, WHA’s advocacy efforts have been in high gear in a number of key areas. WHA President Steve Brenton said WHA’s "Protect Hospitals Care: Oppose Payment Cuts," is just one example. It is a multi-pronged, comprehensive advocacy campaign aimed at educating and engaging hospital advocates. Contact with federal legislators is encouraged to ensure that they are aware of the impact these cuts could have on their community hospitals.
"There is a lot in play related to the Medicare and Medicaid programs," Brenton told the WHA Board at their October 18 meeting in Madison. "A number of our non-CAH, rural hospitals that have special payment provisions saw them vanish at the end of September. And that is just the start."
More reimbursement cuts are on the way, according to Brenton, in the form of:
Brenton said the advocacy goal is to "minimize the damage the cuts will immediately create in our hospitals given the enormity of what is coming next." WHA is working closely with the American Hospital Association. WHA hospital representatives have met with the Wisconsin Congressional Delegation in Washington several times. Those trips, as well as in-district meetings, have been well attended. Town hall meetings have been held with Congressmen Kind, Ribble and Petri, and more are planned in the near future.
"We are pushing the value that health care brings to our state, to help our Congressional delegation understand the consequences that cuts will have to our state’s economy," Brenton said. He noted that the cuts are a bit of "déjà vu," harkening back to the Balanced Budget Act of 1997, which put $112 billion in Medicare provider cuts into place between 1998 and 2002. The cuts were partially restored in 1999 and 2000, especially for rural hospitals.
"The fiscal environment that led to those over-reaching cuts then exists now," Brenton said. "Medicare cuts are happening to our providers, with no reduction in benefits. That is not sustainable. We will continue to be very involved in advocacy efforts to mitigate these cuts."
WHA Continues to Make Progress on Expanding Graduate Medical Education (GME)
WHA Senior Policy Advisor George Quinn outlined the six key areas that WHA Board members identified at the Board Planning Session held earlier in the summer as critical in addressing the shortage of GME opportunities in Wisconsin. Quinn shared the work plan, developed with input from the WHA Board and members along with key stakeholders, which will:
WHA Executive Vice President Eric Borgerding said WHA will develop a strategic, consensus-building approach to advocacy for GME and the physician workforce issues that align with the Board-approved work plan. It is one of a handful of key issues that WHA has discussed with more than 70 candidates during visits over the past couple of months. He also said WHA is working with Wisconsin Health News to host a lunch program that will focus on the physician shortage and other workforce issues.
WHA Medicaid Re-Engineering Group Reconvenes
WHA Medicaid Reengineering Group (MRG) Chair Nick Desien, president/CEO, Ministry Health Care, said the group was reconvened to address the effects in Wisconsin of the Supreme Court decision on the health care reform law which made expansion of Medicaid an option rather than a mandate for states. The group’s goal is to develop recommendations related to the Medicaid program in Wisconsin in keeping with the WHA Medicaid principles of maintaining the program as a safety net for Wisconsin’s vulnerable citizens.
WHA Senior Vice President Joanne Alig explained that in Wisconsin, the key population group that would be affected by the Supreme Court ruling on the Medicaid expansion is adults without dependent children (the "childless adults"). Kaiser estimates that there are 205,000 childless adults in Wisconsin with income below 133 percent FPL. Alig said it ultimately boils down to policy questions about what income threshold should be used to determine eligibility for Medicaid for all population groups and whether subsidized coverage through an exchange is a better alternative. In its analysis, the MRG will carefully consider potential impacts on recipients and on the uninsured, impacts on provider reimbursement and the cost-shift, and impacts on the state budget for Medicaid. (See related story in The Valued Voice, September 28, 2012:
High Quality, High Value Health Care As Economic Advantage Resonates in News Rooms
When WHA Executive Vice President Eric Borgerding updated the Board on WHA’s continuing effort to message the concept that Wisconsin’s high quality, high value health care is a competitive economic advantage in our state, he was quite sure he was on the right track. With three successful editorial board visits completed over the past few weeks, and two editorials that confirm the message rings true (see related story in this issue of Valued Voice), Borgerding said WHA is now preparing for a direct mail campaign aimed at reaching employers.
"This is a whole new way to talk about high quality, high value health care and with important new audiences," according to Borgerding. "There is a new message here that resonates—high quality care, and our member’s commitment to pursuing excellence, is a Wisconsin competitive advantage, as important to our business infrastructure as roads and utilities."
Borgerding shared the first direct mail piece with Board members, which will be mailed to more than 3,000 corporate, education, and chamber of commerce leaders in Wisconsin. Employers will be encouraged to contact their local hospital or health system to learn how they can keep their employees healthy and to help control health care costs.
"We are ahead of other states in our efforts to raise quality, but we also make it clear that we are reaching higher and that we won’t settle for best—that achieving excellence is an ongoing goal," he said. "In Wisconsin, hospitals and health systems view employers as our partners in delivering effective, efficient care."
WHA Outlines 2013 Priority Issues
Borgerding identified the Association’s 2013 priority issues, "All of which align with and better enable the delivery of high quality, high value care for Wisconsin employers," Borgerding said. WHA’s 2013 legislative priorities include:
Wisconsin Hospitals Enthusiasm for WHA Partners for Patients Runs High
Kelly Court, WHA’s chief quality officer, finds it hard to be humble when she is at national meetings because hospitals here continue to lead the country in their quality improvement efforts. Court reported that Wisconsin hospitals working with WHA on the Partners for Patients initiative are fully participating in educational opportunities that are being offered, and Wisconsin has among the highest rates as a data submitter to the Hospital Engagement Network (HEN) coordination body, which is AHA’s Hospitals Research and Education Trust (HRET).
"We think what really drove our data submission rate up is the fact that we selected measures that our members are already working on and are collecting data for," Court said. "Our goal was always to complement the quality improvement work that is already occurring in our hospitals, not duplicate it."
The WHA Quality Center website (www.whaqualitycenter.org) has been recognized nationally as a "best practice" within the HRET HEN. Court described it as a "one-stop shop" for quality-related resources.
WHA Creates Task Force to Improve Health Care Worker Flu Immunization Rates
Court said WHA is working with the Wisconsin Medical Society to review best practices related to health care worker influenza immunizations. The goal is to increase the rate of influenza vaccination rates among health care personnel in Wisconsin in order to protect patients, personnel and the people in Wisconsin’s communities from the spread of influenza.
Court said the task force is creating a toolkit and developing resources that will be helpful to hospitals, nursing homes, and clinics as they plan their employee immunization programs in 2013. The task force plans to complete their work early in 2013.
WHA Board Approves Association 2013 Budget
WHA Board Chair Sandy Anderson and Brian Potter, WHA senior vice president, presented the 2013 WHA budget as forwarded for approval by the WHA Budget Committee. The budget includes funding for work on key advocacy objectives including health care reform, physician workforce and quality initiatives. After discussion, the Board approved the 2013 WHA budget as submitted.
Nominating Committee Report
Nominating Committee Chair Nick Turkal, MD, president/CEO, Aurora Health Care, presented the slate of WHA Board nominees as follows:
WHA Chair Elect: Ed Harding, President/CEO, Bay Area Medical Center, Marinette
Nominees to serve three-year terms as at-large board members beginning January 1, 2013:
Nick Desien, President /CEO, Ministry Health Care, Milwaukee (2nd term)
Duane Erwin, CEO, Aspirus Wausau Hospital, Wausau (2nd term)
George Hinton, CAO, Aurora Sinai Medical Center, Milwaukee (2nd term)
Bill Sexton, CEO, Prairie du Chien Memorial Hospital, Prairie du Chien (2nd term)
Mark Herzog, President/CEO, Holy Family Memorial, Inc., Manitowoc (1st term)
Mary O’Brien, CAO, Aurora St. Luke’s Medical Center, Milwaukee, (1st term)
Mark Taylor, President/CEO, Columbia St. Mary’s, Inc., Milwaukee (1st term)
Nominee to fill an unexpired term as an at-large Board member beginning January 1, 2013:
Catherine Jacobson, President, Froedtert Health, Milwaukee
Nominee to Chair the WHA Audit and Investment Committee:
Greg Britton, Systems President/CEO, Beloit Health System
The Board approved all nominations as presented.
WHA Council Reports
Workforce Development – Chair Nicole Clapp, president/CEO, Grant Regional Health Center, Lancaster: WHA staff described several legislative initiatives that are expected to be brought up in the next legislative session. They included the Wisconsin Nurses Association proposals for APN licensure, a re-licensure survey for health professionals, and influenza immunization of health care employees. The Council also provided feedback on a new legislative study committee that has been created to enhance the opportunities for graduates and ensure that high school students have the necessary skills to meet job requirements in health care. Members said this work is important, and they provided examples where employer needs were not met by new high school grads. They encouraged WHA to participate in and follow the study committee’s work.
Medical & Professional Affairs – Kelly Court, WHA: The Council discussed the Jandre case and emphasized that addressing the issues raised by the Supreme Court decision is an Association priority. Karen McKeown, administrator of the Division of Public Health, met with the Council and identified existing and future intersections between the work of public health and hospitals. The Council suggested two projects that would be good candidates for this work: reducing early deliveries and promotion of patient self-management programs to help reduce readmission.
Public Policy – Eric Borgerding, WHA: Special guest Sen. Tim Cullen applauded Wisconsin hospitals’ efforts for being leaders in public reporting. He said he hopes that if Wisconsin develops a web-based insurance exchange, that it will provide links to the information available on both CheckPoint and PricePoint, along with more performance and outcome data. Borgerding updated the group on WHA’s effort to promote the quality and value of health care in Wisconsin as it relates to economic development. Laura Leitch, WHA senior vice president and general counsel, discussed the Association’s efforts to address the Jandre case. The Council also received a status report on the Wisconsin Hospitals PAC/Conduit.
Finance & Payment – Brian Potter, WHA: Special guest Donna Smith, a 3M project manager, presented an overview of how hospitals could model the financial impact of ICD-10 conversion. Debbie Rickelman, senior director, WHA Information Center, discussed how WHA and the Information Center are also investigating ways to assist member hospitals in analyzing this impact. WHA’s ICD-10 workgroup continues to develop resources aimed at helping to guide hospitals through the transition.
Joanne Alig presented WHA’s analysis of the Supreme Court PPACA decision. Potter updated the Council on several Medicaid issues, including the 2013 hospital assessment and the development of an enhanced ambulatory patient groupings (EAPG) outpatient payment methodology that takes effect January 1, 2013.
Rural Health – Chair Edward Harding, president/CEO, Bay Area Medical Center: Paul Merline, WHA vice president, government relations, provided an update on state legislative issues and the upcoming state elections. Jenny Boese, WHA vice president, external relations/member advocacy, described WHA’s Protect Hospital Care campaign that is aimed at fighting proposed Medicare/Medicaid reimbursement cuts.
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WHA’s Behavioral Health Task Force, chaired by George Kerwin, president/CEO, Bellin Health System, met October 19 and worked through an agenda addressing both long-term and short-term advocacy efforts and opportunities related to behavioral health policy.
Update on the Medicaid Medical Home for Individuals with a Mental Health Diagnosis Pilot Initiative
Rebecca McAtee from the Department of Health Services provided the Task Force with an update on the Department’s development of a Medical Home for Individuals with a Mental Health Diagnosis Pilot for Medicaid enrollees, including some of the early thinking on possible models. McAtee explained that the purpose of the pilots will be to find new ways to better coordinate the care for certain Medicaid enrollees with mental illness to ensure cost effectiveness while improving the overall quality of care. The Department is still in the planning phase for this pilot project but is encouraging hospitals and health systems that may be interested in providing input into the pilot planning or participating in the pilot to contact the Department. If your hospital is interested in contacting the Department to receive more information about the pilot, contact WHA’s Matthew Stanford at firstname.lastname@example.org or 608-274-1820.
HIPAA Harmonization/Mental Health Care Coordination Bill
Removing statutory barriers to the coordination of care for individuals with mental illness by enacting the HIPAA Harmonization/Mental Health Care Coordination Bill in the next legislative session has continued to be a goal that the Task Force, WHA, and others have been working toward this year. The Task Force discussed the ongoing efforts of WHA, hospitals, other stakeholders and individual Task Force members to build support for the bill throughout the state. If you or your hospital know of one or more individuals that work in your hospital or live in your community that would be interested in helping to support the efforts to pass this bill, please share that information with WHA’s Matthew Stanford at 608-274-1820 or email@example.com.
Review of Iowa’s Public Mental Health System Redesign
One of the recommendations of the Task Force’s White Paper in 2009 was to pursue the transition of Wisconsin’s public mental health system from a county-based system to a regional-based system. Like Wisconsin, Iowa has had a county-based mental health system, but over the course of two legislative sessions has made significant reforms that are transitioning Iowa’s mental health system into a regionally-based system in order to improve care for individuals, reduce variations in access to mental health care, and improve efficiency. WHA has been in discussion with the Iowa Hospital Association to learn more about Iowa’s experience, and the Task Force received a report on and discussed some of the key aspects of Iowa’s new regionalized system. Notable elements of Iowa’s new regionally-based system included a modernized set of core preventive, outpatient, and inpatient services that the regions would be required to make available and accessible, as well as increased oversight of the county government-based regions by the state to better ensure access to necessary services.
Alzheimer’s Study Committee
The Task Force also received an update on the Legislative Council Study Committee on Legal Interventions for Persons with Alzheimer’s Disease and Related Dementias. Dr. Ken Robbins, medical director for Stoughton Hospital Geropsychiatry, and Dr. Gina Koeppl, northern region director of Behavioral Health Services for Ministry Health Care both serve on this committee. This study committee is largely focusing on issues related to the provision of emergency services for individuals with Alzheimer’s disease created by the Helen EF case decided by the Wisconsin Supreme Court earlier this year. To address these issues, the Study Committee is in the process of drafting legislation that would make it easier for an individual to provide for admission to a hospital for psychiatric treatment through a power of attorney document, as well as legislation to create a more workable process to help individuals with Alzheimer’s Disease get necessary emergency care when they need it. More information about the Committee’s work can be found at: http://legis.wisconsin.gov/lc/committees/study/2012/ALZ/index.html.
WHA Behavioral Health Issues Survey
The Task Force also discussed early impressions from the results of a WHA survey of Wisconsin hospitals on various behavioral health issues. The results showed that a significant number of hospitals continue to experience chronic administrative difficulties related to Wisconsin’s emergency detention process. The results also showed an overall downward trend throughout Wisconsin in the perceived availability and accessibility of county-supported behavioral health services. However, the results did show that many hospitals and other community stakeholders are now regularly meeting to try to address behavioral health challenges in their communities. The survey also identified an interest in educational opportunities to learn about clinical best practices to address behavioral health related challenging behaviors.
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Legislation supported by the Wisconsin Hospital Association (WHA) and the American Hospital Association (AHA) has been introduced in Congress by U.S Reps. Sam Graves (R-MO) and Adam Schiff (D-CA) to address issues in Medicare audit programs. The legislation is called the Medicare Audit Improvement Act, HR 6575.
"For several years, Wisconsin hospitals and health systems have been dealing with various administrative and process problems stemming from Medicare audit programs like the Recovery Audit Contractors (RAC)," said Jenny Boese, WHA vice president, external relations & member advocacy. "This legislation is an important step forward in making sure several significant problems are corrected. WHA encourages Wisconsin’s U.S. House members to cosponsor this bill."
Among other measures, the bill would:
Access the legislation online at www.gpo.gov/fdsys/pkg/BILLS-112hr6575ih/pdf/BILLS-112hr6575ih.pdf. For questions, contact Jenny Boese at 608-268-1816 or firstname.lastname@example.org.
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Preparing for ICD-10 implementation continues to be a challenging task for hospital steering committees. The Rural Wisconsin Health Cooperative (RWHC) is offering a webinar series in a package with options that meet the needs of various stakeholders within a provider organization. Not only will coders require ICD-10 education, but many ICD-10 internal customers will need to know how the ICD-10 transition will affect them and understand their role within that change.
Hospital internal stakeholders all possess unique skill sets and will each be responsible for different tasks throughout the different phases of ICD-10 implementation. RWHC coding expert and AHIMA ICD-10-CM/PCS Approved Trainer Sheila Goethel has developed and structured five different 45-90 minute webinars to address various training needs. Sessions will have target audiences and will offer detailed information regarding various ICD-10 functions—including a broad overview of the entire ICD-10 transition, a review of the ICD-10-CM and PCS guidelines, provide ICD-10 introduction for physicians, address anatomy and physiology components for both CM and PCS, and review documentation expectations. Each were developed and structured to provide distinctive information—individualized for different members of your ICD-10 Steering Committee and offer strategies to better prepare your entire organization for the ICD-10 system.
The ICD-10 on-demand sessions are archived to allow you and your team the ability to view them whenever and as often as you prefer. They can be viewed independently, or as a group. These sessions are designed to provide diverse training opportunities for various members of your ICD-10 Steering Committee and supply the tools you need for a successful ICD-10 transition. If your organization has not started the transition, this is a way to jumpstart the education process or to check-in to make sure you are on track.
For more information or to register, go to: www.rwhc.com/Services/EducationalServices/ICD10SessionsonDemand.aspx.
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The quality of health care in Wisconsin was reaffirmed this summer when the federal Agency for Healthcare Research and Quality issued a report that showed the state as No. 2 in overall health care quality (behind Minnesota).
The quality of health care in Northeastern Wisconsin was reaffirmed later this summer when the Medical College of Wisconsin announced it would locate a satellite campus in the Green Bay area.
We agree with those affirmations, and we think local officials should use them to our advantage when trying to attract businesses to the region.
The Green Bay area can boast about its four hospitals and the clinics they run, the nursing programs at Northeast Wisconsin Technical College and Bellin College and the Professional Program in Nursing at UW-Green Bay; a veterans clinic in Green Bay slated for completion is spring 2013, which will save many veterans from through Northeastern Wisconsin of having to travel to Milwaukee; and now a Medical College of Wisconsin campus.
Health care is a "blossoming sector of our economy," according to Fred Monique, vice president of economic development for Advance, the economic development division of the Green Bay Area Chamber of Commerce.
In fact, when selling the area to prospective businesses, health care is one of the three noneconomic factors he talks about. The other two are public safety and schools.
Health care professionals, though, believe it’s as important as tax credits, TIFs or other economic inducements. Dr. Ashok Rai, CEO of Prevea Health Services, said locating clinics in workplaces can show a return on investment that’s better than a tax credit. "Businesses are spending less and getting more for their health care dollar," he said during a recent meeting with the Green Bay Press-Gazette editorial board. Prevea has on-site health and wellness clinics at more than 20 businesses and wellness programs at almost 200 businesses.
Bellin Health was celebrated in a recent New York Times editorial for helping businesses cut health costs. One of the examples told how Fincantieri Marine Group saved $2 million on health care after Bellin set up a clinic at its shipyard in Marinette where it is building littoral combat ships for the U.S. Navy.
As Bellin’s website says, "The best way to lower employee health costs is to improve the health of employees."
This quality of health care, such as St. Vincent Hospital’s Regional Cancer Center or Aurora BayCare Sports Medicine, should be the focus of employer recruitment.
"We know two border states if they moved their manufacturing here they’d get better health care and save money," Rai said.
The logic is pretty simple: Employees who have easier access to health care are healthier, and healthy workers miss work less often and help reduce an employer’s health care costs. It’s a win-win-win.
Health care is never perfect, but the quality here is superior to that of many other places. If you don’t believe that, take the word of someone who worked in the South for 20 years. "I really believe the care is better (in Wisconsin), the whole Midwest is better," said Dan Meyer, chief administrative officer for Aurora BayCare Medical Center.
The Green Bay area has become a medical hub, Meyer said, and "economically, that’s very good for the community."
The cooperation of the four hospitals—Aurora BayCare Medical Center, Bellin Hospital, St. Mary’s Hospital Medical Center and St. Vincent Hospital—might not have been imaginable 10 years ago when Aurora arrived on the scene.
Today, however, that’s not the case. There’s more collaboration and less duplication, said Therese Pandl, president and CEO of Eastern Wisconsin Division Hospital Sisters Health System, which overseas St. Vincent and St. Mary’s.
It’s that collaboration that was one of the selling points in the Medical College of Wisconsin’s decision to locate a campus here.
Recruiting companies and people to Northeastern Wisconsin is a competitive business. So when discussing all the attributes of the region, from the Green Bay Packers to public safety to excellent schools, atop the list should be the quality of health care.
The Green Bay Press-Gazette recently held an editorial board meeting with leaders in the health care community. Those in attendance were:
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WHA Staff Visits Member Hospitals, Sees Quality Initiatives Making a Difference
As WHA’s quality team continues to visit hospitals throughout the state, they are finding that the Partners for Patients initiative is a catalyst for bringing new concepts and strategies to leaders and front line staff alike.
"At this point in the collaborative we are starting to see hospitals are turning the corner on their initiatives and implementing many great new interventions that are making a significant impact on patient safety and the quality of care," according to Tom Kaster, WHA quality improvement advisor.
Kaster said the hospitals are pleased with the support the WHA improvement advisors have provided, along with the well-organized and timely resources and tools that are available on the WHA Quality Center website at www.whaqualitycenter.org.
"The hospitals have already utilized several of the presentations and tools that are on the website to help them bring the Partners for Patients concepts and strategies to leaders and front line staff throughout their organizations," he added.
Kaster’s reports follow:
Memorial Health Center, Medford
At Memorial Health Center in Medford, Kaster had a great opportunity to present an overview of Partners for Patients to a group of department leaders. He found they were a "very engaged" group and that it was obvious that building and cultivating a culture of safety was a high priority in their organization. Evidence of their patient-centered focus is their accomplishment of having received a Pathway to Excellence designation, as well as the Doyle Award for using Milliman Care Guidelines.
Their quality team has focused on their CAUTI, patient falls and Just Culture initiatives. Since the Memorial Health Center quality team’s responsibility includes the hospital as well as the adjoining nursing home and clinic, they have been able to spread the knowledge and interventions from WHA Partners for Patients and improve patient safety across their system.
Ministry Good Samaritan Health Center, Merrill
Merrill has been doing great work on their readmissions initiative, according to Kaster. They have tested and built a strong patient education program and are continuing to refine their post discharge phone call process. They have appreciated the fact that WHA has been recording each initiative webinar because it gives them the flexibility to get caught up if they are unable to attend the live session. The group in Merrill also expressed their appreciation for how the WHA improvement advisors have kept them on track and on target to achieve the goals they set.
Ministry Sacred Heart Hospital, Tomahawk, and Ministry St. Mary’s Hospital, Rhinelander
This quality team supports both Sacred Heart in Tomahawk and St. Mary’s in Rhinelander. They have developed a very strong multidisciplinary team to work on reducing readmissions. In addition, in their effort to eliminate venous thromboembolism events (VTE), they have implemented a new staff-supported assessment form. In regards to the OB adverse events initiative, prior to Partners for Patients, they had already made significant improvements by reducing elective deliveries prior to 39 weeks and are now working to further hard-code the practice throughout their facilities.
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WHA has posted new EHR Meaningful Use Stage 2 resources on WHA’s website under the Health Information Technology tab. To directly access those resources, go to: www.wha.org/meaningful-use-stage-2.aspx. Among the new resources is a link to the American Hospital Association’s (AHA) in-depth Regulatory Advisory on Stage 2 Meaningful Use, as well as a detailed summary prepared by Cadence Analytics for the Hospital Association of New York State (HANYS). AHA is also holding AHA member conference call on the Effects of Stage 2 Meaningful Use on Hospitals and Physicians on October 24 from 2 - 3:30 pm Central Time. Register at:www.aha.org/advocacy-issues/hit/mu/12octstage2calls.shtml.
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Member News: Postler-Slattery Accepts Position in Michigan
Diane Postler-Slattery, president/chief operating officer of Aspirus Wausau Hospital, has accepted the position of president/CEO of MidMichigan Health in Midland, Michigan.
Postler-Slattery has been active in the Wisconsin Hospital Association, serving on the Council on Public Policy since 2006 and as chair from 2009-2012. She has been a member of the WHA Executive Committee since 2009, and participated on the Wisconsin Hospitals Issue Advocacy Council, Inc. from 2009-2012.
"Diane has been an outstanding advocate for Wisconsin’s hospitals," said WHA Executive Vice President Eric Borgerding. "We still remember the day she appeared at our press conference in Madison, a nurse leader then, to help defeat the ill-conceived hospital construction ban. Since then, and as chair of the WHA Public Policy Committee, she has been the definition of an advocate and volunteer leader. The WHA team says ‘thank you,’ and wishes her the best of luck in Michigan."
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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.
At the heart of it all
The world froze right before her eyes when a 63 year-old woman found out that she had congestive heart failure and would require extensive therapies and hospital visits.
She was wheeled by medical staff into the emergency department at Aurora Medical Center of Manitowoc County by doctors and nurses standing right next to her bedside, and with all variety and color of cords and tubes attached to her body. She remained calm and collected, bracing for a huge emotional and psychological impact, while the doctors were trying to feed oxygen into her lungs for blood flow into the heart.
Upon recovery, she was met by financial counselor Barb Schneider to discuss payment options for her medical bill. The patient and her husband received Social Supplemental Income (SSI) for disability on a monthly basis, but had no health insurance.
Barb explained, "The patient was not quite 65 years old and therefore, short by less than one year, ineligible to receive Medicare. Her only option was to apply for the Aurora Helping Hand financial assistance program because, with her diagnosis, she was required to visit the hospital three times a week to have a Dobutamine infusion."
After a few weeks, Barb called the patient with the welcomed news that she had been accepted for the Aurora Helping Hand program and a 100 percent discount to cover all medical costs. Barb noted, "I am just glad that we were able to assist the patient and that she is able to maintain her quality of life as best she can. The Dobutamine infusions are expensive and, with the help of Aurora’s Helping Hand program, she is able to worry less and focus on her normal routine."
Later, the patient came back to the hospital, this time holding a bag of candy and handing it out to every Aurora caregiver she could find. Barb remarked, "She is definitely one of the sweetest women you would ever want to meet. She is extremely appreciative of our help."
The Aurora Helping Hand program covered over $200,000 of the patient’s medical bills.
Aurora Medical Center of Manitowoc County, Two Rivers
Josie’s Story: A Huge Blessing
In 2008, Josie’s insurance expired between completing schooling and getting a job. Josie has an autoimmune disease, and she couldn’t find a company who would insure her due to her preexisting condition.
There is no cure for her disease, so Josie just lives with the frustrations that it brings. She gets sick frequently and incurs many medical bills because of it. Something as simple as a minor cold can lead to pneumonia, so she must seek medical attention frequently. That and the cost of her medications add up.
Over the last few years, Mayo Clinic Health System in Menomonie has written off some of Josie’s bills incurred for urgent and emergent services.
"This is a huge blessing," Josie says. "I’m only able to work part-time, and the cost of rent alone is big. There is no way I’d be able to go to the doctor and get the medical care I need without assistance from the clinic."
Thankfully, Josie was able to get insurance in early 2011. "Before that, I don’t know what I would have done without the help."
Mayo Clinic Health System - Red Cedar, Menomonie
Community Care helps uninsured student
A 26-year-old gentleman suffered a traumatic brain injury while riding on an inner tube that was being pulled by an ATV. During the ride he was spun around and smashed his head on a fence post. The patient was an uninsured student, who lived with parents and worked part time—14 hours per week. His very limited income left him without insurance and no funds to cover his care. Property insurance for the site of the accident only covered a very small portion of his extended medical bills due to the severity of his injury and length of care. He and his parents were very grateful for the gift of Community Care (charity care) that allowed his medical bills to be covered.
St. Vincent Hospital, Green Bay
Patient gets back to work thanks to financial assistance
Thirty-one year old Steven L. had worked as a union carpenter since the age of 19. But with the economic downturn, he suddenly found himself out of a job and without health insurance.
Steven moved home to live with his parents and enrolled in college to pursue a degree in construction management. Shortly thereafter, he discovered a large mass near his groin. He went to the emergency department at Wheaton Franciscan – Elmbrook Memorial in Brookfield where he was diagnosed with an inguinal hernia. An additional physical exam revealed Steven also had an umbilical hernia located near his belly button.
Suddenly, Steven was faced with the difficult decision of having surgery immediately or waiting until he could find a job with benefits. He knew it would be hard to continue to work in construction with two hernias. He elected to undergo surgery and worked with a Wheaton Franciscan Healthcare financial counselor to apply for Community Care.
His application was approved, and days later he underwent the hour-long outpatient procedure. "I was really impressed by the care at Elmbrook Memorial," Steven said. "From the nurses and doctors to the financial counselor, everyone was very helpful."
Steven has since found a job and is working again in construction, made possible thanks to the care he received at Wheaton Franciscan – Elmbrook Memorial.
Wheaton Franciscan Healthcare - Elmbrook Memorial, Brookfield
Hitting bottom, and the long journey back to wellness
Substance abuse, hypertension and arteriovenous malformation of the brainstem brought a 37-year-old single male to Aurora St. Luke’s Medical Center on numerous occasions: ten emergency room visits and six inpatient admissions from November 2010 to present, to be exact, as well as Cyberknife treatment and continuing outpatient care. It was difficult for him to speak due to the impairments from prolonged substance abuse; further, he was agitated and uncooperative with the financial counselors, social workers and medical staff.
The patient was unable to maintain steady employment due to substance abuse and related health issues. But with his family’s intervention, the patient yielded and the Aurora Helping Hand financial assistance program was introduced to him. With his family’s assistance, the patient was able to successfully submit a completed Aurora Helping Hand application, and he was approved for 100 percent coverage. The Aurora Helping Hand program has enabled this patient to receive consistent, medically necessary treatment, which has resulted in improved health and his sobriety. Current hospital bills covered by the Aurora Helping Hand program, so far, exceed $193,500, and the patient has also been approved for extended Helping Hand program coverage as he continues to receive outpatient care at Aurora.
Aurora St. Luke’s Medical Center, Milwaukee
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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