The WHA Information Center this week added three new team members as it gears up to collect and disseminate hospital data starting with data from the fourth quarter of 2003. WHA Information Center Vice President Joe Kachelski said the transition is proceeding according to plan. The Information Center is scheduled to accept its first data submissions in January 2004.

The WHA Information Center employee team members to date include:

• Joe Kachelski, vice president, started his new position on September 29. He brings 17 years of health care payer experience to the Information Center, including his most recent position as deputy director of the Wisconsin Association of Health Plans. Previously, as director of government affairs at Physicians Plus Insurance Corporation, Kachelski was responsible for implementing and overseeing the company’s Medicaid contract operations among other duties. He is a 1984 graduate of the University of Wisconsin-Madison.

• Shannon Schumann, data analyst, began November 3. She comes to WHA Information Center after holding a series of health care and data related positions. A Wisconsin native, Schumann recently returned to the state after attending college and working in Maine. As MIS manager at Community Counseling Center in Portland, Maine, Schumann guaranteed the performance integrity and quality of data and databases, and supervised and monitored the quality of the data entry process. She holds a Bachelor of Arts degree in biology from the University of Southern Maine.

• Debbie Rickelman, RHIT, information center manager, assumed her new duties on November 10. Debbie most recently worked for the Wisconsin Medical Society as program manager for the Wisconsin Antibiotic Resistance Network (WARN). Rickelman is familiar with quality/utilization management and quality improvement methodologies. While at Dean Medical Center, Rickelman coordinated data collection and reporting for system performance assessments.

• Julie Callies, RHIA, information center director, began November 12. Callies was formerly medical records operations manager at Meriter Hospital in Madison. She holds a Bachelor of Science degree in health information administration from the University of Wisconsin – Milwaukee. She has taught introductory medical records at Madison Area Technical College, and worked at Waukesha Memorial Hospital in the medical records department.

Steve Brenton said the new staff members are taking great care to ensure a smooth transition from BHI to WHA. "Their knowledge of the processes and the detail involved in the collection and dissemination of hospital data will enable the Information Center to evolve into a high performance organization that will not only meet the needs of those who use the data, but will exceed the service that these users have seen in the past," Brenton said.

Return to top

Rep. DuWayne Johnsrud (R-Eastman) and Sen. Russ Decker (D-Schofield) are once again introducing legislation to reinstate Capital Expenditure Review (CER). Under the proposal, any new hospital construction over $1 million and any hospital renovation project above $1.5 million would have to be approved by DHFS.

The bill comes a little over a year after Sen. Decker’s proposal to ban all hospital construction and renovation projects statewide (except in Racine) was rejected by the legislature. That proposal triggered strong opposition from editorial boards and the public.

In a June 2002 poll, 83% of Wisconsinites rejected the notion of state control of hospital budgets and construction projects (poll can be viewed on WHA’s website: www.wha.org)

"The public simply does not want central planners in Madison making decisions about health care access, including hospital construction and renovation," said WHA’s Eric Borgerding. "In fact, we are glad to see opposition to these proposals growing from other industries, including employers and labor."

This week, WHA was joined by WMC, Associated General Contractors (AGC) of Wisconsin and Milwaukee, the Plumbers Local 75 and the Rural Wisconsin Health Cooperative in urging legislators not to co-sponsor the bill. The groups sent a joint memo to the legislature expressing their opposition to the bill (memo available on WHA’s website – also see AGC Milwaukee Executive Vice President Mike Fabishak’s guest column in this issue of Valued Voice).

"While hospital construction bans and CER programs may sound effective, we know that construction accounts for only about 5% of total Wisconsin hospital expenditures," said WHA’s George Quinn. "That amounts to about two cents of every health insurance premium dollar."

Return to top

Thanks to those of you who have completed and returned the WHA Hospital Personnel Survey. As a reminder to those of you who have not completed the survey, it was mailed November 6 to all WHA members, addressed to the Human Resources Department. You can:

• Complete and return the paper survey to Judy Warmuth at WHA in the envelope provided.
• Complete the survey online by going to www.wha.org (click on Workforce, and go to 2003 Personnel Survey). Then, save the document and email it back to jwarmuth@wha.org, print the form and fax it to Warmuth at 608-274-8554, or mail it in the envelope provided.

Please complete and return the survey by November 17, 2003. If you have questions, contact Judy Warmuth at 608-274-1820 or email jwarmuth@wha.org .

Return to top

On October 16, the Internal Revenue Service announced the limit changes that were due to the Economic Growth and Tax Relief Reconciliation Act of 2001 ("EGTRRA") as well as the application of cost of living adjustments.

Read the entire article in Solutions Spotlight, included in this week’s packet or contact Dave Cutler at WHA Financial Solutions at 800-362-7121 or dcutler@wha.org  for more information.

Return to top

We recently met with officials of the Wisconsin Hospital Association (WHA) to discuss issues of mutual interest. We discussed the high cost of health care and the components involved in those rising costs.

As an association we are concerned about these costs to our member employers and their employees. We know the state budget crunch has had a dampening effect on the growth of our industry and wondered the status of hospital building projects. Listening to Steve Brenton, president of the Wisconsin Hospital Association and his associates, we learned a few things we would like to pass on to you.

We are obliged to strike down some myths about construction and hospitals. When our family, friends, neighbors and business associates see a crane at a hospital we have to convince them this means something good for our communities. We know from past experience that new construction or major remodeling projects at Wisconsin hospitals sites can actually mean more efficient delivery of health care, lower energy costs and possible lower cost to society in the form of quicker and better outcomes and less time off from work.

Recent figures we reviewed with the WHA indicated that hospital care represents about 32% of health care dollar expenditures in Wisconsin – a decrease of 12% in recent years; whereas prescription drugs are now 11% of dollars spent in Wisconsin – and a 55% increase in cost in recent years. Health care costs have increased nationally by less than 6% annually over the past eight years, while hospital costs increased by an average of 4.2% annually.

We also learned how Wisconsin health insurance premiums are spent:

• 32% Hospital Care
• 12% Insurance Company Administrative Expenses
• 30% Physician and Other Professionals
• 17% All Other
• 9% Prescription Drugs

Only 6% of the dollars hospitals receive goes to construction or remodeling cost – or about a half a cent of every claims dollar.

As an industry we must get our message out to leaders and legislators that hospital construction costs are a very small part of the hospital dollar pie. These projects employ hundreds of workers who spend their payroll dollars in our communities, pay taxes to our state and federal government and buy health care in various forms throughout the year.

Our focus should be directed to helping reduce the costs of health care by putting pressure on our elected officials to change the way they see our health care system.

• Wisconsin hospitals rank 45th of all states in Medicare reimbursement.
• Wisconsin’s Medicaid program ranks 45th nationwide in adequacy of hospital reimbursement.

These two factors alone dramatically force hospitals to shift costs to private payers.

Workforce shortages are another factor forcing higher costs in Wisconsin. Hospitals have to pay higher salaries to attract and retain staff.

The third component in these higher costs is advances in patient care. The new technologies demanded by a well-educated consuming public mean higher survival rates and safer, more convenient hospital services.

So the next time you hear a friend, neighbor or business associate mumble about the crane at your area hospital, you will be better armed to say, "The crane is a good thing for this community." It may even be the impetus you need to contact your state and federal elected officials to seek adequate reimbursement for government health care programs.

Return to top

If the nursing shortage seems to have resolved itself, consider it a temporary, not permanent state. A few factors have temporarily eased the nursing shortage in some areas, but according to Peter Buerhaus, RM, Ph.D., the current situation does not mean that the serious issue of inadequate supply of nurses is resolved. Buerhaus, a nationally known nurse researcher presented the results of a current study at a meeting of Wisconsin nurses November 12 in Milwaukee. He explained that a surge of nurses entering the workforce filled serious vacancies in many places and eased the chronic shortages many hospitals were experiencing. That is the GOOD news.

The bad news is that roughly two-thirds of the nurses that joined the workforce were age 50 or older, while foreign-born nurses accounted for most of the rest. Contributing to the employment jump was a nearly 5% increase in wages and a downturn in the economy, which caused some RNs to rejoin the workforce or increase their hours, according to Buerhaus. Hospitals also have implemented successful recruitment and retention programs, made improvements in the work environment and offered other incentives that enticed nurses back to the workplace, his data showed. He cautioned that while older nurses have taken up much of the slack as the number of young women entering nursing has declined, this large cohort of nurses will begin to retire around 2010.

Buerhaus believes that unless there is a rapid increase in foreign-born RNs or in younger cohorts’ interest in nursing as a career, future shortages will be much more severe. How severe? Buerhaus says that hospitals will close for lack of nursing staff if dramatic action is not taken. He says action at the national and state levels are needed and that everyone must work to increase nursing school enrollments, nurse retention and faculty preparation.

The study has been published in the November/December issue of Health Affairs.

Return to top

Federal Communications Commissioner Michael J. Copps met with representatives of Beaver Dam Community Hospital on November 7 to gain a better understanding of the hospital’s use of the Universal Service Rural Health Care Program. The program, administered by the FCC, is designed to help rural health care providers obtain access to modern telecommunication and information services for medical and health purposes.

Beaver Dam President John Landdeck, CFO Scott Abrams, and Health Information Director Carol Ciancio told the Commissioner that they use the program to provide telecommunication capabilities for their shared lab services program. They also suggested improvements for the application process. Copps thanked the group for their input, and indicated that he would use the information to help streamline and improve the Rural Service Program.

On November 13, in a statement delivered following a meeting of the FCC, Copps said he now understands that the Rural Health Care Program has not lived up to its potential. He announced that the FCC has now enacted rule changes that will expand the interpretation of eligible health care providers, provide flat support for Internet access and review the standard for urban area rate comparison.

Copps said the application process is in need of a major overhaul. "The application calls on health care professionals to master the complexities of such things as total billed mils and the intricacies of all sorts of convoluted tariff rates," he wrote. "These rural hospitals have limited staff, urgent priorities and…months of work translate in a couple of thousand collars of one-month support. They question if the paper chase is at all worth it. From what I saw (at Beaver Dam and in Alaska), I don’t blame them."

Copps said the rule changes will improve the Rural Health Care Program in a manner that is more consistent with its statutory mandate.

Return to top

On November 12, 2003, Ann Lucas presented a scholarship to Stephanie Harvey, a Northcentral Technical College sonography student as part of the NTC Scholarship Award day. Stephanie completed her AD in Radiography and returned to NTC for a sonography degree. Stephanie, a Rhinelander resident, works at Good Samaritan Health Center, Merrill, and is completing her clinicals in sonography in Iron Mountain, Michigan. In addition to work and school, Stephanie is a member of the Radiology Club and is involved with starting a sonography club at NTC.

"This is a great honor to receive. I really feel all my hard work and dedication has been validated by being selected over many others . . . I have never received a scholarship before, and I want you to know it really makes a person feel special," Harvey noted in a thank you letter to the WHA Foundation.

The WHA Foundation launched a new scholarship program this fall, providing $64,000 for scholarships for students in the final semester of a degree program in a health care. Waukesha County Technical College has awarded a scholarship to Lori Duesing, a nursing student graduating in December 2004.

Return to top

The American Hospital Association and U.S. News & World Report have partnered to produce a comprehensive, consumer-oriented online directory of hospitals in the United States. The Directory of America’s Hospitals, which launched online November 7, is free and does not ask visitors to register or provide any personal information.

The directory (www.usnews.com/hospitals) contains key information, from types of treatment and specialized services to phone numbers and Web addresses, for 6,013 accredited facilities in all 50 states, Washington, D.C., Puerto Rico, and territories.

Data for the Directory of America’s Hospitals came from AHA. U.S. News developed the online directory. The database is searchable by state, region, or distance from any ZIP Code. Users looking for a particular hospital can search by name or use an alphabetical list. Searches can also be targeted to certain types of hospitals, or to those offering specific combinations of services.

A Best Hospitals Ranking page (where applicable) will also link visitors to a hospital’s ranking from U.S. News’ most recent "America’s Best Hospitals" report.

Return to top

Franciscan Skemp Healthcare, part of Mayo Health System, named Robert E. Nesse, M.D., president and CEO, effective January 1, 2004. Nesse will succeed Glenn Forbes, M.D., who announced his intention in January to return to Rochester, Minnesota in the role of academic neuroradiologist for Mayo Clinic.

Nesse, a family physician, is a nationally recognized leader who is currently serving as the vice chair for the Mayo Clinic Board of Governors, where he directs strategic planning for Mayo Clinic Rochester, a position he has held since 1999. In addition, he has held a variety of other leadership positions within Mayo Clinic Rochester, including chair of the Administrative Committee of the Board of Governors, chair of the Managed Care Operational Committee and chair of the Disease Management Coordinating Committee. He is also a member of the Mayo Health System Board of Directors.

Nesse will transition out of his current role at Mayo Clinic and his patient practice at Kasson Clinic, Department of Family Medicine in Kasson, Minnesota and into his full-time responsibilities at Franciscan Skemp by January 1, 2004. "Franciscan Skemp will benefit greatly from Rob’s extraordinary skills and experience," says Forbes. "I feel confident that the transition will go smoothly and that the vision set forth by our sponsors will be carried on."