April 13, 2012
Volume 56, Issue 15


Legislative Leaders Panel Confirmed for Advocacy Day
Registrations at nearly 700 with over a week to go

A bipartisan legislative leadership panel will be one of the highlights of the Wisconsin Hospital Association’s Advocacy Day event April 24 in Madison at the Monona Terrace. The leadership panel will give attendees in-depth insight into the issues facing our state, including health care and the economy. This year’s confirmed panelists are:

State Representative Robin Vos (R-Burlington)

Rep. Robin Vos, Republican, represents the 63rd State Assembly District in southeast Wisconsin. Most notably, Vos is co-chair of the powerful Joint Committee on Finance, the Legislature’s budget-writing committee. Vos was first elected to the Assembly in 2004 and has been reelected since 2006. Prior to being elected, he served on the Racine County Board for 10 years.

Representative Peter Barca (D-Kenosha)

Rep. Peter Barca, Democrat, represents the 64th State Assembly District. Most notably, Barca is the Assembly Minority Leader, and serves on the Assembly Organization and Rules Committees. Barca was first elected to the State Assembly from 1984 to 1992 then served in the U.S. Congress from 1993-94. He has been reelected to the State Assembly since 2008.

Registrations for Advocacy Day are nearly at 700 again this year. Close to 400 of those attendees will also take the hospital message to the halls of the State Capitol in the afternoon.

If you have yet to register yourself or your hospital contingent, please do so today. A complete program and easy online registration for 2012 Advocacy Day on April 24 in Madison are available at http://events.SignUp4.com/AdvocacyDay12.

For Advocacy Day questions, contact Jenny Boese at 608-268-1816 or jboese@wha.org. For registration questions, contact Lisa Littel at llittel@wha.org or 608-274-1820.

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WHA Quality Staff Shares "Wisconsin-Style" Quality Improvement with HRET
Collaboration drives performance for Wisconsin hospitals

The Health Research Education and Trust (HRET), an affiliate of the American Hospital Association, recently brought quality leaders together from the 34 states that are working on the National Partnership for Patients initiative for a two-day conference in Chicago. The states participating in HRET’s hospital engagement network met to learn about resources and best practices. Stephanie Sobczak and Jill Hanson, WHA quality improvement managers, shared how Wisconsin hospitals have driven performance improvement "Wisconsin style" by readily participating in collaborative learning.

With a reputation as a state where hospital quality is among the best in the nation, Wisconsin hospitals frequently and voluntarily participate in collaborative programs to quicken the pace of their improvement. With 98 percent of WHA member hospitals participating in an engagement network—which is one of the highest participation rates in the county—the WHA Partners for Patients engagement network is a public-private partnership that will help improve the quality, safety and affordability of care for patients in Wisconsin.

WHA recognizes with budget restrictions it is not feasible for hospitals to free up staff to travel for meetings on a regular basis, so the WHA quality staff has shifted their collaborative focus to that of webinar-based learning as a means to teach and share knowledge.

"As we have learned from our ‘On the CUSP’: Stop Healthcare Associated Infections (HAI) and Transforming Care at the Bedside (TCAB) collaboratives, involving front-line staff to adapt evidence-based practices to their unique environment is key to speeding the process of change," according to Kelly Court, WHA chief quality officer. "We have gathered the best information available and re-packaged it into a monthly webinar series. As a result, WHA quality staff engages participating hospitals in the adoption of evidence-based practices using 30-day cycles of learning, testing and measuring."

In addition to guest speakers on conference calls, participating hospitals share their successes (including bumps in the road) with other initiative participants. Several hospitals participating in the TCAB collaborative have even arranged site visits with each other to further the staff-to-staff learning. WHA has helped facilitate those opportunities, but has then encouraged hospitals to make direct connections with one another.

"There are so many new practices that hospitals can adopt that it can be overwhelming to know how to begin implementing these," Court said. "Teams participating in WHA collaboratives have found that multi-disciplinary project teams that include front-line staff and leadership engagement are key to implementing practices efficiently."

Court added that the Partners for Patients work will allow WHA to help hospitals expand involvement, and with that, increase their capacity to tackle several improvements at once.

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CMS Announces 27 New ACOs in Medicare Shared Savings Program
Three Wisconsin health systems, one physician group participate in federal ACO models

The Centers for Medicare and Medicaid Services (CMS) announced April 10 that it had selected 27 new entities to participate in its Accountable Care Organization program, the Medicare Shared Savings program, including one organization in Milwaukee. 

The chosen entity is the Accountable Care Coalition of Southeast Wisconsin, LLC.  This ACO is formed in partnership between Independent Physician Network, Inc. (IPN) and Collaborative Health Systems (CHS).  CHS will partner with seven other organizations in other states as well, and will provide various administrative services, including care coordination, analytics and reporting, and technology.   IPN was established in 1984 and has grown to include more than 900 member physicians who serve more than 130,000 patients in southeastern Wisconsin.  The ACO is expected to serve nearly 10,000 beneficiaries.

CMS received a lot of negative feedback from the ACO rules it first proposed last year.  To address some of the criticism and concerns, the agency created two other ACO models in addition to the Medicare Shared Savings Program.  These are the Pioneer ACOs and the advanced payment model. 

Pioneer ACOs - Earlier this year, CMS announced the participants in the Pioneer ACOs There are two Pioneer ACOs in Wisconsin:  Allina Hospitals & Clinics, Minnesota and Western Wisconsin; and Bellin-ThedaCare Healthcare Partners, Northeast Wisconsin. The Pioneer ACO was an option for organizations with experience offering coordinated, patient-centered care, and operating in ACO-like arrangements.   In the first two performance years, the entity will receive a fee-for-service payment, but it will have higher levels of reward and risk than in the Shared Savings program.   In year three, Pioneer ACOs that have shown savings over the first two years are eligible for a “population-based” payment model – essentially a capitated payment.   This would replace some or all of the ACO’s fee-for-service payments with a prospective monthly payment.  Pioneers also had the opportunity to suggest alternative payment arrangements in their applications.

Advance Payment program – In its April 10 announcement for the Shared Savings Program, CMS also announced the organizations participating in the Advance Payment Model beginning April 1, 2012.  None are in Wisconsin.  The Advanced Payment Model is available for ACOs that include only hospitals that are critical access hospitals and/or Medicare low-volume rural hospitals and that have less than $80 million in total annual revenue.  These ACOs will receive advanced payments to help offset their up-front costs.  These payments would have to be paid back to the federal government from any savings generated by the program.   

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WHA HIT Task Force Concerned About Stage 2 Meaningful Use
Hospitals encouraged to complete EHR survey by April 20

WHA’s Health Information Technology (HIT) Task Force met April 5 and discussed the newly-released Stage 2 "meaningful use" proposed rules. Overall, the Task Force expressed concerns about the feasibility of meeting some of the new requirements within the timelines provided as well as whether proposed requirements would in fact promote greater efficiency and improved quality through better use of EHR technologies. The Task Force also provided input on a WHA EHR survey sent out to hospital and hospital system information service leaders April 13.

The Task Force expressed particular concerns about a number of new issues raised by the proposed rules, including:

Comments on the Stage 2 meaningful use and EHR certification rules are due May 7. WHA will be submitting comments and will create a model comment letter that hospitals may use to submit their own comments. The WHA Task Force will be convening again April 26 to review both the WHA comment letter and the model comment letter. The model comment letter will be available by April 30. Your comments can help encourage needed changes to the proposed rules before they are implemented as final rules sometime later this year.

Additional information about the Stage 2 meaningful use proposed rules, including a summary PowerPoint of the HIT Task Force’s April 5 meeting, can be found at www.wha.org/meaningful-use-stage-2.aspx. If you have any questions or comments on the proposed rules, please contact Matthew Stanford at mstanford@wha.org or 608-274-1820.

Stage 2 Meaningful Use EHR Survey

WHA is seeking member input to better craft its advocacy messaging on the Stage 2 meaningful use and EHR certification proposed rules. WHA needs input from its members on the impacts of the meaningful use rules. To help garner that critical input, WHA sent a survey to hospital and hospital system information service leaders on April 13 to gather experiences with preparing for or achieving Stage 1 meaningful use and impressions on key Stage 2 proposed requirements.

Encourage your hospital to complete the survey by the deadline—Friday, April 20. Aggregate results from the survey will be used in WHA’s advocacy efforts; individual responses will not be shared outside WHA. Direct questions Matthew Stanford at mstanford@wha.org or 608-274-1820.

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President’s Column: WHA Member Acknowledgements….Past and Present

In his Foreword, former Wisconsin Governor and HHS Secretary Tommy Thompson writes, "The most important message in Potent Medicine is … there is no top-down-from Washington, one-size-fits-all cure for health care….everyone with skin in the game—doctors, hospitals insurers, Medicare and patients—needs to engage now in a wide range of experiments…on the best way to apply these principals…" Thompson notes the book’s focus on transparency and paying for value, observing that those principles are behind Wisconsin’s pioneer efforts to transform health care.

Bill was on the Search Committee that recruited me back to Wisconsin a decade ago and was a real go-to in providing the voluntary peer leadership that was so helpful in my return to the Badger State. Bill is an aficionado of health care policy—something of an admitted policy "wonk," and will undoubtedly stay engaged, helping me and others navigate the messy environment that’s still ahead of us. Finally, in addition to leading Froedtert Health’s growth and success as an academic medical center with a community health component, Bill has been a passionate leader of the important work of the Milwaukee Health Care Partnership in its efforts to improve access in the most difficult health care ecosystem in Wisconsin.

Steve Brenton,
President

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HHS Proposes One-year Delay of ICD-10 Compliance Date

The Department of Health and Human Services (HHS) pushed the ICD-10 compliance date back one year, from October 1, 2013 to October 1, 2014. Some provider groups expressed doubts that they could meet the October 1, 2013 compliance date. Some of the concerns were due to implementation issues they have experienced meeting HHS’ compliance deadline for the Version 5010 standards for electronic health care transactions. Compliance with Version 5010 is necessary prior to implementation of ICD-10. Other providers said that statutory initiatives such as meaningful use are stretching their resources, and surveys and polls indicated a lack of readiness for the ICD-10 transition.

A key message in an HHS fact sheet is that "all covered entities must transition to ICD-10 at the same time to ensure a smooth transition to the updated medical data code sets. Failure of any one industry segment to achieve compliance with ICD-10 would negatively impact all other industry segments and result in rejected claims and provider payment delays." HHS is encouraging providers and other covered entities to use the time to prepare and fully test their systems to ensure a smooth transition. See HHS fact sheet at www.cms.gov/apps/media/fact_sheets.asp.

The proposed rule, CMS-0040-P, may be viewed at www.ofr.gov/inspection.aspx. CMS is allowing a 30-day comment period.

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Next Steps for ICD-10 Preparation

Now that the Department of Health and Human Services (HHS) has proposed October 1, 2014 as the new deadline for ICD-10, hospitals will need to consider their next steps. How should organizations best make use of this additional time?

For more information, visit the ICD-10 website, www.WICD10.org.

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Partners of WHA Donates $2.3 Million, 1.46 Million Volunteer Hours in 2011

Partners of WHA, Inc., the non-profit, volunteer service organization affiliated with WHA, raised and donated over $2.3 million to hospitals throughout the state for needed equipment and other capital projects in 2011. This was accomplished through nearly 550 separate fundraising activities.

In addition, Partners of WHA members volunteered 1.46 million hours of service to Wisconsin hospitals in 2011, as reported by Mark Schaefer, current president of Partners of WHA. The financial value of a hospital volunteers’ time has been estimated nationally at $21.79 per hour (based on 2011 figures for national value of volunteer time). At that rate, the Partners of WHA volunteers donated a total value of $31.8 million of their time and services to Wisconsin hospitals and health systems during 2011. Partners of WHA also awarded over $450,000 through 444 scholarships to both traditional and non-traditional students seeking health care-related degrees in 2011.

Partners of WHA is comprised of nearly 12,000 volunteers and auxilians at 74 Wisconsin hospitals. Founded in 1951 as Wisconsin Hospital Association Auxiliaries, Partners emphasizes volunteer service and participation in grassroots advocacy, public policy and community health education, and health career programs for Wisconsin hospitals. Additionally, Partners promotes leadership development offering resources and educational seminars to local hospital volunteer and auxiliary groups, and shares information on successful community health education initiatives, advocacy and fundraising activities and trends on volunteerism through a variety of channels, including its annual fall convention and quarterly newsletter, Reaching Out.

More information about Partners is available at www.partnersofwha.org, or contact Jennifer Frank, WHA’s liaison to Partners, at 608-274-1820 or jfrank@wha.org.

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In Memoriam: Matthew Hubler 1932-2012
Former WHA chair and administrator, Sacred Heart Hospital, was mentor, friend to many

Matthew Hubler passed away on April 10, 2012, at Sacred Heart Hospital in Eau Claire, Wisconsin.

Born in St. Paul, Minnesota on August 13, 1932, Mr. Hubler was a graduate of the College of St. Thomas in St. Paul where he earned a Bachelor of Arts degree in sociology, and St. Louis University in St. Louis, Missouri, where he earned a master’s degree in hospital administration. Mr. Hubler had a long and distinguished career in the health care field. Following military service, he worked as assistant administrator at St. Mary’s Hospital in Duluth, Minnesota; assistant administrator and then administrator of Divine Redeemer Memorial Hospital in St. Paul, Minnesota; and administrator of St. Joseph’s Hospital in Chicago, Illinois. Mr. Hubler came to Wisconsin as associate administrator at Sacred Heart Hospital in Eau Claire in January 1974 before being appointed administrator in July of that year. He served as Sacred Heart’s administrator until his retirement February 1, 1998.

During his tenure at Sacred Heart Hospital, Mr. Hubler expertly guided the hospital and community through a time of growth and improvement. This included the development of The Healing Place, Sacred Heart Hospital’s free grief and bereavement center, and St. Francis Apartments, an independent living facility for senior citizens. The Friends of Sacred Heart Hospital, the fundraising arm of the hospital, was established during Mr. Hubler’s tenure, and he was very active in establishing the Healing Place Endowment and the Second Century Endowment. Mr. Hubler was active on numerous state and local health care committees and also served a term as chairman of the Wisconsin Hospital Association, and several terms as a member of the WHA Board of Trustees. He was a member of the Wisconsin Hospital Rate Review Appeals Board and the Catholic Health Association’s Committee on Finance. Mr. Hubler also served as the chair of the Wisconsin Hospital Association’s Prepayment and Finance Committee, and the Catholic Health Association’s Research and Information Committee. He served as president of the Western Wisconsin Emergency Medical Services System Board.

"Matt was a visionary leader. He helped shape the health care landscape in Wisconsin, and his leadership and direction were felt long after he retired," said WHA President Steve Brenton. "Our heartfelt sympathy goes out Carol, his family, and to all those who had the privilege of knowing Matt. He will be deeply missed."

Mr. Hubler and his wife, Carol, were married for 55 years, and have four children and seven grandchildren.

The funeral service is at 1 p.m., April 14 at St. Patrick’s Church, 316 Fulton Street, Eau Claire, Wis. A visitation will be held one hour prior to the service.

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Wisconsin Hospitals Community Benefits: Physical Activity

Physical activity is a preventive factor for many adverse health conditions, such as heart disease, stroke, high cholesterol, depression, and bone and joint disease. In communities across Wisconsin, hospitals are dedicating resources and doing what they can to encourage people of all ages to stay active.

Move to improve

People making a New Year’s resolution to get healthy in 2011 had some support in making this resolution a reality thanks to Medford Therapy & Fitness’ Move to Improve program. Open to anyone interested, the 12-week program began in early 2011 and focused on helping participants adopt a healthy lifestyle and maintain it.

Twelve teams of 5-6 people each participated in the program. Team coaches and Medford therapy & fitness staff volunteered many hours to motivating and instructing participants. Over the three months, participants lost an average of 12.85 pounds. A summer maintenance program that included weekly group exercise classes and weekly weigh-ins was also offered to participants. All of the summer participants continued to lose weight.

"My big reason for signing up for the program was that I needed to lose a few extra pounds and I couldn’t do it on my own," says Gayle Perrin of Medford. "I figured a coach would push me enough to get me to do it, and my coach Jen [Warmanen] did."

Perrin’s teammate DeAnna Miller of Athens joined the program as a way of putting herself first while also doing something good for her entire family.

"During my 10 years as a stay-at-home mom, I did not devote time to myself," she says. "Finally, all my kids are in school and I had time to focus on me and put myself back on the list. My main goal was to really know how to work out and how to eat better so I could bring these lessons home and model them for my family."

Both women say in addition to the motivating workouts alongside their coach, lessons in healthy eating were a highlight of the program.

"They took us to the grocery store and showed us what foods to buy and what ones to avoid," Perrin recalls.

"We also went through how to read food labels and attended a cooking class," Miller adds. "That was very enlightening. There are so many vegetables and plants that I didn’t know and had no clue how to cook or incorporate into my eating. I learned a lot."

Memorial Health Center, Medford


"Healthy Kids" program sponsored by RAMC

Reedsburg Area Medical Center (RAMC) is excited to sponsor a program to help fight childhood obesity called Healthy Kids. This comprehensive program is designed to educate children and their families about nutrition, food choices, exercise and activities to promote a healthy lifestyle. The three-week courses are offered in two sessions, one for kids entering grades 1-3 and the other for grades 4-6.

Healthy Kids is open to all area children who will be entering grades 1-6 in the next school year and is held at a local elementary school. Each year the program is held in July for three weeks, on Monday, Wednesday and Fridays from 8-10 a.m. for grades 1-3 and from 12:30-2:30 p.m. for grades 4-6. There is a parents/family night held beforehand for registration.

Each day the kids have the opportunity to do fun activities and exercise in a group setting. Healthy snacks are provided each day and all kids receive a Healthy Kids t-shirt.

The three-week program is $20, including a t-shirt and snacks. Scholarships are available to those who are not able to afford the fee. RAMC promotes this program through fliers in all the schools and by handing out information in their Butterfest parade, in early June.

Reedsburg Area Medical Center, Reedsburg


Fit Kids… Fit Families

Aurora Medical Center in Washington County (AMCWC) received a grant in 2004 from the University of Wisconsin School of Medicine and Public Health to create a Fit Kids…Fit Families program. The program was a success and is recognized as an evidence-based program by the University of Wisconsin School of Medicine and Public Health. With its continued success, the class remains operating in Washington County.

Fit Kids... Fit Families is a multidisciplinary program focused on the prevention and treatment of childhood weight concerns. The program is run in partnership with the Kettle Moraine YMCA. The goals are to:

Improve children’s eating habits

Increase children’s activity levels

Create life-long healthy behaviors

The Fit Kids… Fit Families class meets one night weekly for 10 consecutive weeks. Twelve children between the ages 6 and 17 attend each session. An adult family member is encouraged to attend each class with their child. A team consisting of a dietitian and nurse from AMCWC and a Kettle Moraine YMCA exercise specialist guides families on what to eat, how to eat and how to increase daily physical activity.

Fit Kids… Fit Families Coordinator Heidi Anderson at AMCWC is the class instructor. Heidi has been a part of Fit Kids…Fit Families since its inception, and it is very important to her. "I am so glad to see healthy lifestyle changes from the participants," Heidi stated. "This program is about introducing new foods that add nutritional value to their diets. For example, I introduced sushi to one of the groups. I was pleased that everyone at least tried the sushi. Although a few did not like it, they were able to decide whether or not they liked it by trying it first, rather than just making assumptions. That’s the type of empowerment I try to instill in everyone – making informed choices about the foods they eat," Heidi added.

Aurora Medical Center - Washington County, Two Rivers


Wellness is the winner in Sauk Prairie

Last fall Sauk Prairie Memorial Hospital & Clinics’ Wellspring center and the Sauk Prairie community participated in the Winning With Wellness challenge which brought out the best in both area businesses and citizens. Spearheaded by the Sauk Prairie Recreation Department, participants in the program chose from one of two tracks: 1) losing weight in the fashion of NBC’s "The Biggest Loser," or 2) kids and adults getting in shape and trying out local fitness opportunities.

Numerous area businesses offered free fitness opportunities for participants to take an active role in their health and wellness. Wellspring donated instructors to lead Zumba and water aerobics classes, and also offered free nights and weekends in their wellness center.

"We believe that our role is to promote health and we want to help people maintain health," said Jeena Breunigof Wellspring. "We also want to get the word out that prevention is key."

The event brought in 235 participants — 110 for The Biggest Loser and 125 for the fitness opportunities. Of the 40 Biggest Loser participants who did the final weigh-in, there was an over 400 pound weight loss.

While the numbers were impressive, the excitement generated in the community left a lasting impression.

Jed Eichhorn, director of the Sauk Prairie Recreation Department, saw firsthand the changes made week to week and was thrilled that people were staying active after the program ended. He was particularly excited that this program showed people that age doesn’t matter.

"The second place participant in the weight loss challenge was in his late 50s and, at the end, felt that he had finally dedicated time to himself instead of always just putting himself last."

Sauk Prairie Memorial Hospital & Clinics, Prairie du Sac


Submit community benefit stories to Mary Kay Grasmick, editor, at mgrasmick@wha.org.

Read more about hospitals connecting with their communities at www.WiServePoint.org.

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