Staying true to their commitment to continuously expand the amount of information available in CheckPoint, WHA’s quality and safety reporting program, hospitals are now reporting surgical infection prevention (SIP) measures. These measures are indicators of the progress that hospitals have made in implementing processes that reduce and prevent surgical infections. It is important to know that the data on SIP do not represent infection rates in hospitals, because at this time, there is not a national standard for this data.

More than 80 hospitals have indicated that they will report SIP data to CheckPoint. At this time, 32 hospitals were ready to report third quarter 2004 through first quarter 2005 data; more are expected to have data collected and submitted in time for the next CheckPoint update in March. The SIP measures are for hysterectomies and surgery of the hip, knee, and colon.

CheckPoint now includes data on 27 measures with 99 percent of the hospitals voluntarily participating in the program. In just under 20 months, CheckPoint has become a national model for private-initiative quality and error prevention reporting. Unique to CheckPoint is that it also reports hospitals’ scores on error prevention measures that align with the National Patient Safety goals.

In 2006 WHA plans to add medication reconciliation to its array of error prevention measures, as well as information related to patient experience of care. The Agency for Health Care Research and Quality (AHRQ) is nearing completion of a standard patient experience of care survey called H-CAHPS. The National Quality Alliance has indicated that, when available, this information will be added to the national hospital public reporting Web site, HospitalCompare (www.hospitalcompare.hhs.gov).

Dana Richardson, WHA vice president for quality, is pleased with the progress that CheckPoint has made, but sees an ever expanding role for the program as Wisconsin business and industry move their employees towards consumer-driven health care products.

"We know as the public assumes more responsibility for their health care purchases, the information that we provide through CheckPoint will become increasingly more relevant to them, and the corresponding use of the Web site will increase," Richardson said. "The fact that 99 percent of our hospitals are voluntarily reporting the information now shows just how seriously our members take their commitment to proactively provide this information so it is available when it is needed in their communities," she concluded.

It was at times nearly a breakneck pace in 2005 at the Association. Advocating for Wisconsin’s hospitals, with the support of hospital leaders, the Association successfully met challenges and created opportunities that will ensure that Wisconsin’s community hospitals can continue to do what they do best—serve their communities. WHA started the year with an aggressive Medicaid campaign, partnering with Wisconsin Manufacturers and Commerce, to get the word out on the "hidden tax," a term which soon fell into common usage among legislators and business leaders. By summer, the state began to see a medical access crisis take shape as the Supreme Court struck down statutory limits on non-economic damages.

In a year that saw unprecedented levels of member participation in activities ranging from grassroots advocacy to providing testimony at multiple hearings, keeping the length of the publication, "2005 Results" (enclosed in this week’s Packet) to eight pages was not easy.

"As I prepared to write the 2005 Results, I reviewed all the issues of The Valued Voice from 2005, along with reports and documents that were produced by staff throughout the year," said Mary Kay Grasmick, WHA vice president of communications. "I couldn’t help but be impressed by how much we’ve accomplished—staff and members working together. I think I can speak on behalf of my colleagues when I say it is an honor to be able to serve the leaders of Wisconsin hospitals. Every day, everywhere in Wisconsin, you’re making a difference."

This past weekend U.S. House and Senate conferees agreed to a deficit reduction budget package. The House passed the package early Monday morning (December 19) and the Senate followed suit on December 21.

The bill preserves full updates for Medicare inpatient and outpatient payment rates with the overall Medicaid cut on the agreed upon package coming in at $4.7 billion in the next five years. The $4.7 billion is lower than proposals earlier this year, which ranged from $30-50 billion.

The package moves in the right direction on several issues of concern to the Wisconsin Hospital Association and American Hospital Association. First, the package directs the Centers for Medicare & Medicaid Services (CMS) to place a moratorium on new limited service specialty hospitals for six months with an ability to extend the moratorium for another two months. During that time CMS will develop a report to Congress of the issue and provide administrative and legislative recommendations for Congress to consider.

Second, the package extends the second-year 60 percent phase-in threshold for inpatient rehabilitation facilities an additional year. As such, the second-year-phase-in of the 75 Percent Rule extends to 2007 when it will become 65 percent and then in 2008 it will rise to the full 75 percent.

Of particular note, the package includes several quality reporting requirements which have raised concerns due to the provisions’ many unknowns. These quality reporting requirements, set to take effect in 2007, include adding more measures and increasing the penalty to Market Basket minus 2.0 for hospitals that do not report all the required categories. They also include a new reporting requirement for hospital-acquired infections (HAI) in which hospitals whose patients contract HAIs will not receive the higher DRG payment.

The AHA summary is included in the Packet and can be found on the WHA Web site at www.wha.org/governmentRelations/pdf/deficitreductionact12-21-05.pdf.

On December 15, the WHA Board approved the report and recommendations of the WHA Task Force on Community Benefits, setting the stage for implementation of an initiative that will be a top 2006 priority.

The primary Task Force recommendation is that WHA should initiate a voluntary community benefit reporting system using a common set of definitions. The Task Force embraced CHA/VHA definitions already used by many Wisconsin hospitals and identified the Michigan Hospital Association’s reporting software as a vehicle that can facilitate statewide reporting.

WHA Board members agreed that results of ongoing community benefit reporting must be publicly reported via an ambitious, statewide communication plan that should focus on internal audiences (hospital governing boards, hospital staff, volunteers and physicians), as well as external audiences including the general public, news media and policymakers.

The belief that real life stories are more important than the release of financial data strongly motivated Task Force members and influenced their recommendations. Specific examples of hospital/community collaboration and personal testimonials will be a key feature of the strategic communications campaign.

The WHA Board action means that statewide community benefit results will be released in mid 2006. The Board’s commitment to community benefit reporting is also indicative of WHA’s ongoing commitment to an ambitious and expanding transparency agenda. The public reporting of community benefits, along with quality and safety measures and hospital prices, demonstrates the hospital field’s willingness to be publicly accountable for efforts to improve patient care and collaborate with our communities. The bottom line: measuring and reporting will ultimately improve all that we do.

Special Note: This is the last Valued Voice that will be published in 2005. In that vein, special kudos to WHA’s strong cadre of voluntary leaders who devote their time and talents to developing and supporting the Association’s advocacy agenda and program initiatives. Special appreciation to 2005 Chair Ned Wolf for so ably fulfilling his duties as Association Chair this year!

Merry Christmas! And best wishes for a joyous holiday season.

Steve Brenton
President

In early 2005, WHA began the Hospitals Education & Advocacy Team (HEAT), a program designed to educate and mobilize hospitals across the state on legislative issues. A look at the numbers provides a glimpse of the impact of the HEAT program in its first nine months:

• Over 3,000 individual legislative contacts on issues
• Recruitment of over 300 new HEAT grassroots members (and growing daily)
• At least 16 opinion editorials or letters to the editor in newspapers such as the Appleton Post Crescent, Milwaukee Journal Sentinel, Rhinelander Daily, Marshfield News Herald, Wisconsin State Journal, Green Bay Press Gazette, Capitol Times and the Milwaukee Business Journal
• Dozens of visits by legislators to the hospitals in their district
• "Email My Legislators" web page on wha.org resulted in close to 400 email messages alone to legislators
• Successful WHA Advocacy Day - 450 participants and 150 legislative visits telling the Legislature to "make Medicaid a priority!"

"Grassroots is fundamental to a successful government relations program," said Steve Brenton, WHA president. "Legislators need to hear from you personally in order to know how important an issue is to your hospital and your community."

It’s the soft stuff that matters.

While hard number statistics are always impressive, it’s really the stories behind those statistics that win the day in grassroots advocacy. National grassroots consultant Amy Showalter said this about measuring grassroots:

"Grassroots measurement is more than just numbers. What is the value of a credible, trusting relationship with a legislator? What is the organizational price of a strained relationship with a legislator? The soft stuff is the hard stuff."

That’s it exactly; the soft stuff is the hard stuff! Take these examples of WHA’s hard-working advocates and the long-term value of their efforts!

• St. Mary’s and St. Vincent Hospitals partnered with Prevea Clinics in Green Bay to author an opinion editorial in support of a medical liability cap right before the State Senate was scheduled to vote on the bill. Their efforts showed a united front to the Green Bay community that a liability cap must be restored in Wisconsin.
  
• St. Joseph’s Hospital in Chippewa Falls worked to "Make Medicaid a Priority" in the Legislature. They sent 800 letters to their four local legislators who then went on to become some of the strongest proponents on WHA’s Medicaid Downpayment Plan during the state budget bill.
  
• Saint Joseph’s Hospital in Marshfield held multiple legislative forums, the most recent of which included hosting seven area legislators. The forums provide an ongoing opportunity for Saint Joseph’s employees to discuss pertinent issues with their legislators and for legislators to meet hospital employees. Saint Joseph’s truly "gets it" regarding the importance of building relationships with elected officials.
  
• Hospitals from across the state descended on Madison in May for WHA’s Annual Advocacy Day. Over 450 attendees participated in the day-long grassroots educational training event. The highlight was when 150 of those attendees took their grassroots knowledge and turned up the HEAT in the Capitol during legislative visits. One attendee said this about the day’s event: "You made us feel we could really make a difference."

And you can make a difference in the development of public policy. Each of the grassroots stories above and the thousands of your contacts to legislators helps to drive the message home that Wisconsin hospitals are engaged.

"I encourage our employees to take an active role in their government," said Joe Neidenbach, CEO of St. Vincent’s Hospital in Green Bay. "HEAT is the perfect tool to help us understand the issues being debated in Madison and then to know how to effectively impact them."

2006 will be a HEAT grassroots testing ground. Will your hospital engage?

"While the growth of grassroots in 2005 is something to be proud of," said WHA President Steve Brenton, "there is still a long way to go in order to fully realize the power and influence of HEAT advocates in the Capitol."

The successful government relations programs are those that integrate grassroots into the culture of their organizations. While Wisconsin hospitals made good strides in 2005 in doing so, WHA is looking to 2006 as a testing ground of hospitals’ commitment to grassroots.

"Some hospitals have yet to fully grasp the importance and necessity of grassroots for the ultimate success of our issues," said WHA Senior Vice President Eric Borgerding. "Anyone who does not see how grassroots fits into the overall government relations picture is missing a very crucial ingredient to our legislative success."

The three fundamentals of a government relations program are: direct lobbyists, political advocacy funds and grassroots advocacy. Direct lobbyists represent an industry or a group’s position to elected officials on a day-to-day basis. Political advocacy funds support elected officials who understand and support an industry/group’s particular issues. Grassroots advocacy combines all of this together by tying an industry/group and its issues personally and directly back to the legislator through constituents.

With issues like the medical liability cap on the horizon, tying issues directly back to legislators and communities will be paramount in 2006.

Growing grassroots in 2006

Hospitals must lead the way in growing grassroots advocacy in 2006. It will be a pivotal year for the HEAT program and WHA will need all hospitals to engage in grassroots in the following ways:

• Designate a HEAT point person at your hospital.
• Discuss HEAT grassroots advocacy with management, staff, trustees and volunteers on a regular basis.
• Increase HEAT membership at your hospital.
• Respond to HEAT alerts and requests for action.
• Integrate grassroots into the culture of your hospital.

For assistance with any of the above, contact Jenny Boese at 608-268-1816 or jboese@wha.org. To join HEAT, log onto www.wha.org/speakUp/heatsignup.aspx.

The WHA Foundation would like to thank every organization and individual who made a contribution to the annual fundraising campaign in 2005.

Champion Donors – gifts of $5,000 or more

All Saints Healthcare System, Racine
Aspirus – Wausau Hospital, Wausau
UW Hospital & Clinics, Madison
WHA Financial Solutions, Inc., Madison

Contributions from Organizations

Amery Regional Medical Center, Amery
Bay Area Medical Center, Marinette
Bellin Health, Green Bay
Black River Hospital, Black River Falls
Flambeau Hospital, Park Falls
Holy Family Hospital, New Richmond
Lakeview Medical Center, Rice Lake
Memorial Health Center, Medford
Memorial Medical Center, Ashland
Mercy Health System, Janesville
Sacred Heart-Saint Mary’s Hospitals, Rhinelander/Tomahawk
Saint Joseph’s Hospital, Marshfield
SSM Health Care of Wisconsin, Madison
St. Vincent Hospital, Green Bay

Contributions from Individuals

Included in today’s Friday Packet is a WHA General Memo (6-05) on DHFS’ recent Medicaid Update concerning Medicaid referral lab issues. The memo contains the following:

• Background and summary of DHFS’ Medicaid Update on the issue;
• Certification requirements for becoming a Medicaid referral lab;
• The problems that the change in policy present to hospitals, and
• Recommendations on what hospitals should do now.

If you have any questions, contact George Quinn at gquinn@wha.org or Laura Leitch at lleitch@wha.org or 608-274-1820.

Through the cooperation of the Oconomowoc Area School District, adolescents in residential programs at Rogers Memorial Hospital can continue their high school education during treatment via NovaNET®, an online coursework system. The NovaNET® digital learning system offers lessons in English, mathematics, science, social studies and other electives that are aligned with state and national standards. Multimedia features such as photos, animated maps, timelines, movie clips and interactive exercises reinforce key learning concepts and motivate students as they progress through the lesson.

"With so many of our patients coming from across the nation and staying for 45 to 90 days, a key aspect of their committing to treatment is their ability to not fall behind in their school work," states Sarah Sheridan, director of residential services at Rogers Memorial Hospital. "The opportunity to obtain school credits through the Oconomowoc High School while they are in treatment here helps them stay current with their school work while focusing on the issues that brought them here."

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