December 5, 2003
Volume 47, Issue 48
All Saints Healthcare Hosts CMS National Open Door Forum Dec. 2
Ken Buser, president and CEO of All Saints Healthcare, said they welcomed the opportunity to host CMS. Randy Hillman, regional director of reimbursement services for Covenant and All Saints, coordinated the very successful CMS visit in Racine. According to Hillman, it provided an opportunity for both health care systems to discuss issues that specifically related to issues in their facilities, but, "in reality, the issues that we discussed with CMS relate to the much broader hospital community in Wisconsin."
Tom Grissom, CMS director of the Center for Medicare Management, opened the forum by reviewing key aspects of the new Medicare legislation related to hospitals. Grissom said there is a lot for hospitals to like about the new Medicare legislation. For the first time, hospitals will see a full market basket update if they participate in the CMS/AHA public reporting effort. (see story in this issue for detail)
In describing the new legislation, Grissom said a lot of effort went into making Medicare look more like a private sector insurance plan, which should also strengthen its financial footing.
"Those least able to pay…and those with the highest drug costs…stand to benefit the most," said Grissom. "It incorporates those values that are most important to Americans."
Grissom noted that it was the 31st such session hosted by CMS.
Joining Grissom at the Forum in Racine from CMS were: Barbara Paul, MD, Center for Beneficiary Choices; Susan Nedza, MD, Region V Medical Director; Jackie Garner, Region V Administrator; Tom Barker, counsel to the administrator; and Tom Reilly, assistant to the director. Also attending was John Oliverio, president and CEO of Wheaton Franciscan Services, Inc., the parent corporation for both All Saints and Covenant in Milwaukee, and Paul Dell Uomo, President and CEO, Covenant Healthcare.
CMS’ Grissom Calls WHA CheckPoint
SM Program "National Model"WHA had an opportunity to present the CheckPointSM program to the leaders of the Centers for Medicare and Medicaid Services (CMS) during their stop in Racine. Dana Richardson, WHA’s vice president, quality initiatives, told CMS that 106 Wisconsin hospitals had signed up to participate in CheckPointSM long before they knew that CMS was considering financial incentives for participation in quality reporting efforts.
Tom Grissom, CMS’ director of the Center for Medicare Management, remarked after hearing WHA’s presentation, "It seems to me somebody has done a lot of missionary work on this and knew what it took in terms of process. I hope this is a model that can be exported."
CMS staff was very interested in the processes that WHA employed in signing hospitals up for the program, and how WHA is working with MetaStar to synchronize CheckPointSM with the AHA/CMS effort. CMS staff was also very interested in barriers to participation.
Grissom was impressed with what he heard about CheckPointSM and the fact that 106 hospitals have signed up to date, which covers about 96% of the inpatient admissions in Wisconsin.
Following Richardson’s presentation on CheckPointSM, Richard Lofgren, MD, Medical College of Wisconsin, representing the Wisconsin Health Care Collaborative, and Amanda Borgsdorf from the Madison Patient Safety Collaborative, provided an overview of their work in the area of patient safety.
Select Committee Reviews Health Care Workforce Development Efforts
The Select Committee, convened by Department of Workforce Development Secretary Roberta Gassman at the request of Governor Jim Doyle, met for the third time on December 1. Four subgroups that were formed reported that they have reviewed the workforce recommendations developed by a task force in 2002, assessed the current environment and noted the progress made to date. The subgroups generated a list of action steps that could be quickly implemented to help alleviate shortages. Longer term solutions are also being considered, but the short-term goal is to do what is needed now to alleviate shortages in key health care positions.
The subgroups reported general agreement on the following:
Gassman asked the subgroup chairs to meet again in December to assemble an action plan.
Enrollment in Baccalaureate Nursing Programs Up Nearly 16 Percent
According to preliminary results released this week by the American Association of Colleges of Nursing, enrollments in entry-level baccalaureate programs in nursing showed a 15.9% increase over the previous year, continuing a three-year upward trend. Johnson & Johnson reports that interest in nursing as a profession has been renewed with 55% of teens age 16-18 reporting that they have seriously considered a career in nursing.
The national news mirrors the experience in Wisconsin. Schools of Nursing statewide have seen a growing interest in nursing as a career. All of the technical college districts and UW schools, along with 11 private schools of nursing, reported increased enrollment in their nursing programs in fall 2003.
It is important to celebrate this success and note that a field that had declining interest and enrollment in the 1990s has reversed the trend. Many people are to be congratulated. Raising awareness of the need and the quality and quantity of great jobs in nursing has been everyone’s goal.
It is clear, however, that while these small changes in enrollment are important, they still are not great enough to meet the needs of Wisconsin residents in the future.
"The magnitude of the problem, the age of the current workforce and the growing need for health care workers is much greater than the current small improvements can address," according to Judy Warmuth, WHA vice president, workforce development. "This growth is still not sufficient to address the current registered nurse (RN) shortage which is expected to intensify over the next ten years."
For more information, visit www.aacn.nche.edu/. The Johnson & Johnson report "Healing the Crisis in Nursing" is available at www.discovernursing.com.
MYTH: The $400 million payment improvements for Wisconsin hospitals included in the Medicare reform legislation is a "windfall" that will reduce the current $1 billion annual Medicare and Medicaid shortfall.
FACT: While new Medicare payment improvements are meaningful and significant, they will likely have no impact on the $1 billion annual Medicaid/Medicare shortfall that is such a huge driver of private sector health care costs. Here’s why:
FACT: What the $400 million in payment improvements will likely do, at least for awhile, is slow the rate of growth in the $1 billion Medicare and Medicaid shortfall …and that’s not insignificant given recent trends. Some of this good news, however, must be couched in the reality that Wisconsin’s Medicaid budget remains in difficult straits.
FACT: Even with these reality checks, we are appreciative of congressional and Bush Administration support for these important payment "fixes."
200 Register for Data Training Sessions
More than 200 people have registered for one of the three training sessions being offered this month by WHA Information Center, LLC. The sessions are intended to orient data submitters from hospitals and ambulatory surgery centers to the new data submission process that becomes effective in January.
WHA Information Center will begin accepting fourth-quarter 2003 data on January 2. Facilities will submit the data via a new Web-based submission tool, which will replace the bulletin board system previously used by the Bureau of Health Information.
The December 16 session in Madison has reached its registration limit, but the meetings in Brookfield (December 17; Embassy Suites) and Wisconsin Rapids (December 18; Hotel Mead) still have space available. Each training session begins at 10 a.m. and ends at 3 p.m. There is no charge to attend, and lunch will be provided.
Registration is open through Friday, December 12. Contact Debbie Rickelman at 608-274-1820 or email WHAInfoCtr@wha.org.