July 8, 2011
Volume 55, Issue 26


WHA Urges Congressional Delegation to Oppose Medicare, Medicaid Cuts
Continues grassroots push in opposition to federal deficit proposals

On behalf of Wisconsin hospitals, WHA President Steve Brenton wrote Wisconsin’s Congressional Delegation this week in strong opposition to proposals being discussed during federal deficit talks that would cut hospital payments for Medicare and Medicaid.

"Wisconsin hospitals are already facing reduced reimbursement levels in both Medicare and Medicaid," Brenton began. "Continuing to add further reductions onto these programs, as is being discussed during deficit negotiations, would put access to care in jeopardy for the elderly and the neediest in our state."

In the Medicare program, hospitals are estimated to lose $100 million in FY 2012 alone under the proposed Inpatient Prospective Payment System’s "coding offset," a flawed policy WHA and the American Hospital Association are actively working to push back.

Additionally, Wisconsin hospitals are estimated to lose $2.6 billion over the next 10 years due to implementation of the Affordable Care Act. And on the Medicaid side, Wisconsin’s recently enacted state budget includes nearly $500 million in Medicaid spending reductions.

While across-the-board, arbitrary cuts to Medicare and Medicaid are extremely troubling, one specific proposal WHA continues to be concerned by is an effort to reduce or eliminate a state’s ability to utilize provider taxes. Wisconsin’s successful hospital assessment has been the only way the state has been able to stabilize its Medicaid program and minimize the impact of the recession on hospitals and patients. Wisconsin is one of 47 states who have provider assessments.

"We are very concerned by proposals being discussed that reduce or eliminate a state’s ability to use provider assessments like in Wisconsin," said Brenton. "Curtailing this option will result in lower funding and even more pressure to cut Medicaid, jeopardizing services to the most needy and forcing hospitals to pass on hundreds of millions in unpaid Medicaid costs to employers and their employees."

Grassroots Push Continues

WHA continues to turn up the grassroots HEAT in opposition to Medicare and Medicaid cuts, including engaging HEAT advocates, who have already sent hundreds of emails to members of Congress, as well as scheduling face-to-face meetings with between members of Congress and hospital CEOs.

WHA will also launch a series of radio ads highlighting the potential for devastating cuts and how those would impact hospital care across Wisconsin.

"There is no doubt that Congress and the President need to get the country’s fiscal house in order or that doing so will require some tough decisions," said WHA Executive Vice President Eric Borgerding. "But we need to educate the public that simply cutting hospital Medicare and Medicaid payments by billions of dollars will do nothing to reform these programs or address the issues that are driving their costs. Instead of embracing meaningful reforms, like we are trying to do with Medicaid here in Wisconsin, Congress and the President seem poised to take the easy route … further cut provider payments, call it ‘entitlement reform’ and continue shifting the actual costs onto everyone else through higher health insurance premiums."

For more information or if you need assistance in making sure your voice is heard on this important issue, please contact WHA’s Eric Borgerding or Jenny Boese at 608-274-1820.

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Guest Column: Opportunities for New Delivery Models Without Participation in the Medicare Shared Savings Program
By C. Frederick Geilfuss, Partner, Foley & Lardner LLP

Wisconsin hospitals have been preparing for Accountable Care Organizations (ACOs). They have understood that health care cost increases are unsustainable, and that a change in the delivery system is needed.

The proposed regulations for the Medicare Shared Savings Program (MSSP) utilizing ACOs issued by CMS in the spring were a disappointment to many. Many felt the requirements for participation were onerous; the infrastructure and upfront costs, as well as ongoing operational costs, were very significant; and the financial return was at best uncertain and likely to be low. Moreover, given the continued predominance of fee-for-service payments, a fair question was whether participating providers would modify how they practice medicine to achieve the benefits of coordination.

With the challenges facing the health care industry—reductions in reimbursement, unsustainable cost trends, significant capital needs, new competition, and weakening demand—providers must prepare for new delivery models.

There are several alternatives available for innovative hospitals hoping to address these significant issues. Among them are:

In sum, innovative hospitals have opportunities to explore new delivery models. Those willing to test these or other models will be better prepared for the move to payment models that will make providers more accountable for delivering quality outcomes more efficiently.

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Political Action Spotlight: Political Action Fundraising Total Climbs to $105K

The Wisconsin hospitals state political action funds fundraising campaign has raised $105,794 to date from 173 individuals contributing an average $612. This puts the 2011 campaign at 42 percent of the goal.

Earlier this year, the Advocacy Committee decided to strive for a higher goal, as it has done in each of the last nine years, determining the 2011 goal should be to raise $250,000—more than $15,000 higher than the 2010 total raised. If the goal is reached, it will be the highest total ever raised.

Individual contributors are listed in The Valued Voice by name and affiliated organization on a regular basis. 2011 contributors to-date are listed below. Contributors are listed alphabetically by contribution category. The next publication of the contributor list will be in the July 22 edition of The Valued Voice. For more information, contact Jodi Bloch at 608-217-9508 or Jenny Boese at 608-274-1820.

Contributions ranging from $1 - 499

Alstad, Nancy             Fort HealthCare

Ashenhurst, Karla         Ministry Health Care

Ayers, Mandy         Wisconsin Hospital Association

Bablitch, Steve         Aurora Health Care

Bailet, Jeffrey         Aurora Health Care

Banaszynski, Gregory         Aurora Health Care

Beall, Linda             Hudson Hospital

Bloom, Deborah         Sacred Heart Hospital

Boudreau, Jenny         Wisconsin Hospital Association

Braunschweig, Jennifer         Gundersen Lutheran Medical Center

Brenny, Terrence         Stoughton Hospital Association

Byrne, Frank         St. Mary’s Hospital

Campbell-Kelz, Nancy         Aspirus Wausau Hospital

Casey, Candy         Columbia Center

Censky, Bill         Holy Family Memorial, Inc.

Clapp, Nicole         Grant Regional Health Center

Clark, Renee         Fort HealthCare

Connor, Michael         Aurora Health Care

Cooksey, Patricia         Hudson Hospital

Dahl, James         Fort HealthCare

Decker, Michael         Divine Savior Healthcare

DeRosa, Jody         St. Mary’s Janesville Hospital

Devermann, Robert         Aurora Medical Center in Oshkosh

Dolohanty, Naomi         Aurora Health Care

Donlon, Marcia         Holy Family Memorial, Inc.

Elliott, Roger         St. Joseph’s Hospital

Evans, Kim         Bellin Hospital

Facey, Alice         St. Clare Hospital and Health Services

Fielding, Laura         Holy Family Memorial, Inc.

From, Leland         Beloit Health System

Fuchs, Tom         St. Joseph’s Hospital

Furlong, Marian         Hudson Hospital

Giedd, Janice         St. Joseph’s Hospital

Govier, Mary         Holy Family Memorial, Inc.

Grohskopf, Kevin         St. Clare Hospital and Health Services

Groskreutz, Kevin         St. Joseph’s Hospital

Halida, Cheryl         St. Joseph’s Hospital

Hemes, Jim

Hieb, Laura         Bellin Hospital

Hockers, Sara         Holy Family Memorial, Inc.

Hoege, Beverly         Reedsburg Area Medical Center

Holub, Gregory         Ministry Door County Medical Center

Jelle, Laura         St. Clare Hospital and Health Services

Keene, Kaaron         Memorial Health Center - An Aspirus Partner

Klay, Lois         St. Joseph’s Hospital

Klein, Rick         Aurora Health Care

Kuehni-Flanagan, Tracy         St. Joseph’s Hospital

Laird, Michael         Froedtert Health St. Joseph’s Hospital

Lange, George         Westgate Medical Group, CSMCP

Margan, Rob         Wisconsin Hospital Association

Marquardt, Amy

Maurer, Mary         Holy Family Memorial, Inc.

McKevett, Timothy         Beloit Health System

McNally, Maureen         Froedtert Health

Merline, Karen

Meyer, Jeffrey         Osceola Medical Center

Muellerleile, Steven         Westfields Hospital

Mulder, Doris         Beloit Health System

Niemer, Margaret         Children’s Hospital and Health System

O’Keefe, James         Mile Bluff Medical Center

Olson, Bonnie         Sacred Heart Hospital

Ose, Peggy         Riverview Hospital Association

Page, Alison         Balwin Area Medical Center

Palecek, Steve         St. Joseph’s Hospital

Penczykowski, James         St. Mary’s Hospital

Peters, Kenneth         Bellin Hospital

Petonic, Mary Frances         Meriter Hospital

Potts, Dennis         Aurora Health Care

Priest, Geoffrey         Meriter Hospital

Proehl, Sheila         Hudson Hospital

Radoszewski, Pat         Children’s Hospital and Health System

Rambo, Kari         Hudson Hospital

Reinke, Mary         Aurora Health Care

Rickelman, Debbie         WHA Information Center

Roller, Rachel         Aurora Health Care

Samitt, Craig         Dean Health System

Schaefer, Mark         Froedtert Health

Scieszinski, Robert         Ministry Door County Medical Center

Sheehan, Heather         Hayward Area Memorial Hospital and Water’s Edge

Stanford, Cynthia

Stoffel, Julie         St. Joseph’s Hospital

Sullivan, Gail         St. Joseph’s Hospital

Tapper, Joy         Milwaukee Health Care Partnership

Taylor, Steve         Beloit Health System

Tews, Carol         Memorial Medical Center - Neillsville

Van Meeteren, Bob         Reedsburg Area Medical Center

VanDeVoort, John         Sacred Heart Hospital

Walker, Troy         St. Clare Hospital and Health Services

Worrick, Gerald         Ministry Door County Medical Center

Yaron, Rachel         Ministry St. Clare’s Hospital

Zeller, Brad         Hayward Area Memorial Hospital and Water’s Edge

Contributions ranging from $500 - 999

Anderson, Sandy         St. Clare Hospital and Health Services

Bjork, Tanya

Bukowski, Cathy         Ministry Eagle River Memorial Hospital

Bultema, Janice

Canter, Richard         Wheaton Franciscan Healthcare

Carlson, Dan         Bay Area Medical Center

Clough, Sheila         Ministry Health Care’s Howard Young Medical Center

Court, Kelly         Wisconsin Hospital Association

Deich, Faye         Sacred Heart Hospital

Dietsche, James         Bellin Hospital

Eckels, Timothy         Hospital Sisters Health System

Frank, Jennifer         Wisconsin Hospital Association

Garcia, Dawn         St. Joseph’s Hospital

Grundstrom, David         Flambeau Hospital

Guirl, Nadine         ProHealth Care

Heifetz, Michael         SSM Health Care-Wisconsin

Huettl, Patricia         Holy Family Memorial, Inc.

Johnson, Patricia         Hayward Area Memorial Hospital and Water’s Edge

Kerwin, George         Bellin Hospital

Lewis, Gordon         Burnett Medical Center

Mantei, Mary Jo         Bay Area Medical Center

Mohorek, Ronald         Ministry Health Care

Nelson, James         Fort HealthCare

Nelson, Nanine         ProHealth Care

Oberholtzer, Curt         Bay Area Medical Center

Russell, John         Columbus Community Hospital

Schafer, Michael         Spooner Health System

Selberg, Heidi         HSHS-Eastern Wisconsin Division

Shabino, Charles         Wisconsin Hospital Association

Swanson, Kerry         St. Mary’s Janesville Hospital

VanCourt, Bernie         Bay Area Medical Center

Westrick, Paul         Columbia St. Mary’s, Inc. - Milwaukee

Zenk, Ann Ministry         Sacred Heart Saint Mary’s

Contributions ranging from $1,000 - 1,499

Alig, Joanne         Wisconsin Hospital Association

Boese, Jennifer         Wisconsin Hospital Association

Brenton, Mary E.

Britton, Gregory         Beloit Health System

Duncan, Robert         Children’s Hospital and Health System

Francis, Jeff         Ministry Health Care

Hahn, Brad         Aurora Health Care

Harding, Edward         Bay Area Medical Center

Hilt, Monica         Ministry Saint Mary’s Hospital

Kerschner, Joseph         Children’s Hospital and Health System

Kosanovich, John         UW Health Partners Watertown Regional Medical Center

Loftus, Philip         Aurora Health Care

Martin, Jeff         Ministry Saint Michael’s Hospital

Mettner, Michelle         Children’s Hospital and Health System

Mohorek, Ronald         Ministry Health Care

Morgan, Dwight         Aurora Health Care

Normington, Jeremy         Moundview Memorial Hospital and Clinics

Olson, David

Potter, Brian         Wisconsin Hospital Association

Robertstad, John         ProHealth Care - Oconomowoc Memorial

Sexton, William         Prairie du Chien Memorial Hospital

Stanford, Matthew         Wisconsin Hospital Association

Troy, Peggy         Children’s Hospital and Health System

Wallace, Michael         Fort HealthCare

Wolf, Edward         Lakeview Medical Center

Contributions ranging from $1,500 - 1,999

Bloch, Jodi         Wisconsin Hospital Association

Borgerding, Dana

Coffman, Joan         St. Joseph’s Hospital

Eichman, Cynthia         Ministry Our Lady of Victory Hospital

Grasmick, Mary Kay         Wisconsin Hospital Association

Herzog, Mark         Holy Family Memorial, Inc.

Kammer, Peter         Essie Consulting Group

O’Brien, Mary         Aurora St. Luke’s Medical Center

Olson, Edward         ProHealth Care

Starmann-Harrison, Mary

Turkal, Nick         Aurora Health Care

Warmuth, Judith         Wisconsin Hospital Association

Woodward, James         Meriter Hospital

Contributions ranging from $2,000 - 2,499

Fish, David         Hospital Sisters Health System

Kachelski, Joe         Wisconsin Statewide Health Information Network

Katen-Bahensky, Donna

Leitch, Laura         Wisconsin Hospital Association

Levin, Jeremy         Rural Wisconsin Health Cooperative

Merline, Paul         Wisconsin Hospital Association

Neufelder, Daniel         Affinity Health System

Pandl, Therese         HSHS-Eastern Wisconsin Division

Size, Tim         Rural Wisconsin Health Cooperative

Contributions ranging from $2,500 - 2,999

Borgerding, Eric         Wisconsin Hospital Association

Desien, Nicholas         Ministry Health Care

Contributions ranging from $3,000 - 3,999

Erwin, Duane         Aspirus Wausau Hospital

Contributions ranging from $4,000 - 4,999

Contributions $5,000 +

Tyre, Scott         Capitol Navigators, Inc

Brenton, Stephen         Wisconsin Hospital Association

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Governor’s Commission on Waste, Fraud and Abuse Releases Interim Report
Suggests possible savings of $177 million from increased oversight of public assistance programs

In January, Governor Scott Walker created the Commission on Waste, Fraud and Abuse to recommend efficiencies in government programs and reducing waste, fraud and abuse. The Commission released its interim report this week, identifying possible savings of $177 million from operational changes intended to eliminate improper payments made to recipients of public assistance programs, including the Medicaid, Child Care, W-2 and FoodShare programs.

The report highlights that relaxed enrollment standards and limited program integrity efforts over the past several years have led to individuals receiving benefits for which they may not have been eligible and other improper recipient payments. Specific to Medicaid, the report noted that no quality assurance activities were conducted related to the enrollment of childless adults in Medicaid and FoodShare from 2008 until December of 2010. Moreover, the report finds inconsistencies in the application of policies among workers, and a lack of coordination between programs. The report suggests that the enrollment process be redesigned and streamlined to enforce eligibility standards up front, rather than "chasing down" potentially ineligible individuals after they have been enrolled in these programs.

"In the past few years, the Medicaid program has increasingly focused program integrity efforts on providers and provider payments," said Eric Borgerding, WHA executive vice president. "Medicaid now pays Wisconsin hospitals less than 10 percent of their actual charges for outpatient procedures—that’s hardly an incentive for fraud and abuse. We believe this report should be used to focus efficiency and savings efforts on ensuring appropriate enrollment standards. This will help make sure that Medicaid remains a true safety net for our most vulnerable citizens who have no other options."

The recommendations contained in the Commission’s report are aligned with recent recommendations from the WHA Medicaid Reengineering Group, chaired by Nick Desien. Among several topics, the Group discussed possible changes in eligibility and enrollment that could help the state streamline the program and find savings in light of the Medicaid budget deficit. The Group specifically considered program integrity issues, such as additional verification of the information used in determining a person’s eligibility. The group also recommended streamlining and consolidating processes so that rules and policies are implemented consistently.

The Governor’s Commission reviewed other state government issues as well, including use of overtime, use of state staff versus contracted staff for specific functions, and shared services. The Commission recommends use of Lean strategies throughout state government. Future topics for the Commission include state procurement, oversight of information technology projects, and local grants. The Commission’s final report is due by January 1, 2012.

The Commission’s entire report can be found at: http://walker.wi.gov/docview.asp?docid=21877&locid=177

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Guest Column: The Peak is Never Passed
By Eric Borgerding, WHA Executive Vice President

As Steve noted in his column last week, the first six months of 2011 have been busy and productive for WHA. Looking back (briefly), patient safety legislation that took three tries and six years to enact (The Quality Improvement Act) and the first hospital base Medicaid payment increase in well over a decade are surely the highlights within a bucket of accomplishments coming out of the 2011-12 legislative session thus far.

The Legislature is adjourned until September, a "summer recess" of sorts. But those who work the legislative process professionally, particularly association lobbyists, know there really is no such thing as down time in Madison, and laurels are short lived. Yes, it’s been a good session so far, but easing into neutral has never been a strand in WHA’s DNA. So, here are just a few of the matters currently defining WHA’s post-state budget agenda:

WHA is positioned to be one of those key stakeholders, as evidenced by the just-completed work of our member-driven Medicaid Reengineering Group (MRG). After six meetings spanning April through June and dozens of hours of staff work, next week we will finalize and deliver to the Department of Health Services the work product—a report containing 47 specific recommendations on how (and how not) to reform Medicaid. While the final report culminates the MRG’s massive effort, it really is just the beginning—our seat (we hope) at the table of a Medicaid reform effort that will play out at both the state and federal level for the next 24 months.

This is a very serious threat that WHA and our members are mobilizing to address on all fronts, pulling out every grassroots tool at our disposal to make our voice heard and concerns understood by our Congressional delegation (see related article above  for more information about this effort).

Wasn’t health care supposed to become less complex? This week alone WHA submitted comments relating to a proposed rule mandating hospitals administer flu vaccinations on demand to any and all who walk through our doors (or risk losing Medicare certification), and another rule defining state methods for ensuring access (via provider payment policies) to covered Medicaid services.

Health care is not becoming less complex, and here’s a peek at the rules and regulations that are on tap, and on which WHA will be chiming in:

There is a plateful of issues to be dealt with here, many of which emanate from increasingly obsolete, disconnected-from-reality statutes (specifically Ch. 51) that place Wisconsin hospitals in conflicting, or ambiguous at best, situations. It is a complex and daunting problem wrapped up in the tangle of state and county finances. Solutions will not be wholesale and will necessarily involve multiple levels of stakeholders, but that process of constructing those solutions must begin very soon during this legislative session.

There are literally more than a dozen other issues not covered here, both inside and outside Madison and the State Capitol, in which WHA is playing an active, if not lead, role. The Valued Voice remains WHA’s primary communication vehicle, but always feel free to contact one of the WHA staff for more of the latest developments.

Health care issues and advocacy are not cyclical. They are constant, in a state of motion that is here to stay. As noted above, while we are pleased with our progress so far, there are MASSIVE challenges ahead, and now is certainly not the time to pause, rewind or replay… nor, with the continuing help and support of our members, do we intend to.

From first to last,
The peak is never passed ...
One moment’s high and glory rolls on by,
Like a streak of lightning
That flashes and fades in the summer sky

- Neil Peart, Marathon

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CMS Releases Medicare Outpatient Payment Rule for 2012
Rule includes new policy proposals for the 2014 Inpatient VBP Program and proposed changes to the quality reporting requirements of the EHR Incentive Program

The Centers for Medicare and Medicaid Services (CMS) has released the calendar year (CY) 2012 proposed payment rule for the Medicare Outpatient Prospective Payment System (OPPS). The proposed rule updates outpatient payment rates and policies and implements provisions of the Affordable Care Act (ACA) of 2010.

In addition to updating outpatient payments for CY 2012, the rule includes new policy proposals related to the second-year implementation of the ACA’s Medicare inpatient value-based purchasing (VBP) program. Complete program polices for the first program year (federal fiscal year (FFY) 2013), and several program policies for the second program year (FFY 2014) have already been adopted by CMS.

CMS’ proposed rate updates, along with adjustments for budget neutrality, result in an outpatient conversion factor of $69.420 for CY 2012 compared to $68.876 for CY 2011, a 0.8 percent increase.

The proposed CY 2012 conversion factor would be updated as follows:

Plus 2.8 percent: CMS is proposing to update the conversion factor by a market basket of 2.8 percent.

Minus 1.2 percentage points: Offsetting the market basket is an ACA-mandated productivity reduction of 1.2 percentage points.

Minus 0.1 percentage points: Offsetting the market basket is an ACA-mandated pre-determined reduction of 0.1 percentage points.

Minus 0.73 percent: CMS is proposing to reduce the outpatient conversion factor by 0.73 percent to ensure the budget neutrality of the payment system based on the proposed implementation of a payment adjustment that would increase outpatient payments to cancer hospitals.

CMS is also using the OPPS proposed rule to propose changes to the quality reporting requirements of the Electronic Health Record (EHR) Incentive Program authorized by the American Recovery and Reinvestment Act (ARRA) of 2009 and implemented by CMS last year.

A CMS Fact Sheet on the proposals is available on the CMS Web site at: www.cms.hhs.gov/apps/media/fact_sheets.asp. The CMS display copy of the proposed rule can be found on the CMS Web site at: www.ofr.gov/OFRUpload/OFRData/2011-16949_PI.pdf.

Comments on the all aspects of the proposed rule, including the VBP and EHR program proposals, are due to CMS by Wednesday, August 31.

WHA is working on a comprehensive summary and analysis of the proposal that will be available later this month.

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Grassroots Spotlight: Congressman Duffy Visits Aspirus Wausau Hospital
Medicare/Medicaid cuts among top concerns

On July 1, first-term Wisconsin Congressman Sean Duffy (R-Ashland) took time from his busy in-district schedule to meet with some of his local Aspirus hospital leaders, including WHA Board member and Aspirus President & CEO Duane Erwin and WHA Public Policy Council Chair and Wausau Hospital President & COO Diane Postler-Slattery.

At a lunch meeting and hospital tour, Duffy heard directly from Aspirus leaders about how they are pursuing innovative ways to reduce costs, including new approaches to post-hospital care which are delivering quantifiable savings. Aspirus and WHA staff also discussed the cuts to hospital Medicare and Medicaid payments Congress is now considering as part of the deficit reduction/debt ceiling negotiations taking place back in Washington.

Duffy was mindful of the impact cuts to provider payments will have on access to quality care, and is concerned about the massive Medicare cuts already enacted as a part of PPACA. (EDITOR’S NOTE: Shortly after his visit to Aspirus, Congressman Duffy agreed to sign on to a bipartisan letter to CMS being circulated in Congress objecting to elements of the latest round of hospital Medicare cuts, including the so-called "coding offset" included in the pending Inpatient Prospective Payment System Rule. If this coding offset goes through, Aspirus is estimated to lose $1.3 million (see June 10 issue of The Valued Voice).

Given the rural nature of his district, Duffy has a strong interest in improving access to care, including ensuring there are enough physicians to meet demand and that the technological infrastructure, including fiber optic broadband, is in place to support telemedicine applications.

WHA is working with members across the state to quickly host in-district meetings with their members of Congress to discuss the impact of a potential new round of massive cuts to Medicare and now Medicaid (see related article at www.wha.org/pubArchive/valued_voice/vv6-24-11.htm#7).

Aspirus’ visit with Rep. Duffy is yet another example of hospitals making sure their voices are heard by members of Congress on these and other important issues. If your hospital has hosted a legislator recently or would like to do so, please contact WHA’s Jenny Boese at 608-268-1816 or jboese@wha.org.

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WHA Education: Upcoming Webinars Focus on Hot Topics for Quality & Risk Management

Over the next several weeks, WHA is offering a variety of webinars focused on reducing readmissions, accommodating religious/cultural diversity, risk management and health literacy. This is a great opportunity to educate your whole team for one low cost and without the need to travel. Upcoming webinars include:

Reducing Readmissions and Improving Transitions
July 12, 2011, 9:00–10:30 am

This webinar focuses on the Care Transitions Intervention™, developed by Dr. Eric Coleman. Dr. Coleman is also co-author of the seminal article published in the New England Journal of Medicine, "Re-hospitalization among patients in the Medicare fee-for-service program." During this session, Dr. Coleman will discuss the impetus for health care leaders to implement the Care Transitions Intervention™, including health policy, clinical and business drivers. In addition, Christina Pavetto Bond of Crouse Hospital, an independent community teaching hospital and one of the first to implement the Care Transitions Intervention™, will share their real world experience in enabling patient self-management through the Care Transitions intervention. Its success in reducing readmissions and emergency room visits for patients enrolled in this intervention will also be discussed. Online registration is available at: http://events.SignUp4.com/July2011

Accommodating Religious and Cultural Diversity
July 13, 2011, 10:00–11:30 am

This webinar will help hospitals understand the types of religious issues that may appear in the workplace, the responsibilities of supervisors to respond to complaints of religious discrimination and requests for accommodations, and "best practices" for religious accommodation policies and procedures. Online registration is available at: http://events.SignUp4.com/July2011

Hot Topics in Risk Management
August 4, 2011, 12:00–1:30 pm

This fast-paced webinar will focus on the hot topics in risk management that impact patient safety today. Some of the discussion items will include 10 things to know about The Joint Commission (TJC) 2011 patient-centered communication standard; fatigue and patient safety issues, CMS and TJC requirements for verbal orders; 20 tips to ensure CMS restraint and seclusion compliance; top five hot TJC compliance standards; and more. Additional information and online registration is available at: http://events.SignUp4.com/August11

The Value of a Comprehensive Patient Education Program
August 18, 2011, 10:00–11:30 am

This webinar will focus on health literacy, strategies for overcoming the challenges that low health literacy presents, tips for developing health literate patient education materials, best practices for integrating patient education into the workflow, and real-life examples and case studies of how a comprehensive patient education program can have a positive impact on things like readmission reduction and patient satisfaction. Online registration is available at: http://events.SignUp4.com/August11

For registration questions on any of the WHA webinars, contact Lisa Littel at llittel@wha.org or at 608-274-1820.

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Mercy Hospital Demonstrates Early Success on TCAB Site Visit

WHA’s Judy Warmuth, vice president, workforce, has been conducting site visits at the 18 medical-surgical nursing units participating in the Transforming Care at the Bedside project (TCAB). The major purpose of a site visit is to ensure that each team has successfully launched TCAB on their unit. Warmuth reports this week on her visit to Mercy Hospital in Janesville.

The TCAB Team at Mercy Hospital in Janesville had many projects to report on during their site visit. Rather than report out themselves on all activities, the team asked staff from the dietary, housekeeping and central supply departments to provide a summary on collaborative patient care improvement projects.

According to Mike Sheehy, director, food and nutrition services, "I was impressed when I was invited to come to the unit to discuss an issue with the TCAB team. Talking face-to-face about something that could improve care for our patients resulted in a great conversation and a new way to help visitors and family members. Each department changed their process and everyone gained."

On June 30th, the team held a kickoff event, which allowed all Mercy employees to learn about the TCAB project and the many initiatives already undertaken by the team.

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Wisconsin Hospitals Community Benefits: AODA and Disease Prevention and Control

Alcohol and Other Drug Abuse

Alcohol and substance abuse has a devastating toll on individuals, families, and society. Armed with expertise and determination, Wisconsin hospitals are fighting the war on drugs and alcohol in their communities with counseling and services aimed at prevention and treatment.

Making a difference

Written by Rick Peterson, C.A.R.E. Director, Prairie du Chien Memorial Hospital, Prairie du Chien

Established in 1989, the Crawford Abuse Resistance Effort (C.A.R.E.) of Prairie du Chien Memorial Hospital collaborates with the community to provide primary substance abuse prevention and youth development programs within Crawford County, Wisconsin. C.A.R.E.’s mission is to reduce and/or prevent the use of alcohol, tobacco and other drugs among Crawford County youth and adults using comprehensive prevention and health promotion strategies.

One of C.A.R.E.’s most recent successes was joining forces with the Prairie du Chien Police Department and the Crawford County Sheriff’s Department to prevent adult-hosted drinking parties in Crawford County using the "Parents Who Host, Lose the Most: Don’t be a party to teenage drinking" campaign. Prior to this campaign, C.A.R.E. collaborated with the Prairie du Chien police chief and city administrator to pass Social Host and K2/Spice Synthetic Marijuana Ordinances for the City of Prairie du Chien. C.A.R.E. also works closely with law enforcement to conduct alcohol and tobacco compliance checks and party/saturation patrols to keep alcohol, tobacco and other drugs out of the hands of minors.

C.A.R.E. staff is instrumental in the operation of a county-wide PALS (People Actively Linked with Students) Mentor Program matching high school youth with at-risk elementary students during the school year. A week-long PALS 4 Good summer camp targets at-risk students in second through fifth grade as an extension of the mentor program.

Our annual Youth Leadership Training Conference has provided training on decision-making, healthy risks and communication skills to over 2,000 high school youth since 1989. Currently, over 70 Crawford County youth are actively involved in youth leadership committees in their respective schools. Many of these students have spoken to state legislators and representatives on the benefits of raising the state alcohol excise tax while others are involved in the FACT (Fighting Against Corporate Tobacco) movement and were actively engaged in changing state laws pertaining to tobacco tax and smoke free air by speaking to state legislators and other key stakeholders.

Additionally, we are instrumental in the planning and development of a Crawford County Teen Court program which will begin this fall. For more information on C.A.R.E. and their programs, call 608-357-2083.

Prairie du Chien Memorial Hospital, Prairie du Chien

Acute, Chronic and Communicable Disease Prevention and Control

Hospitals are well aware of the critical role they have in protecting public health. Whether it is working with public health agencies to develop protocols and responses to pandemic flu outbreaks, teaching children proper hand-washing techniques or educating people about how to live with chronic conditions, Wisconsin hospitals partner with key stakeholders to improve the health status of their communities.

Living Well With Chronic Conditions

It was a natural fit for Aurora Parish Nurses to team up with the Kenosha County Aging & Disability Resource Center to co-sponsor and present a six-week self-management program called "Living Well With Chronic Conditions," launched April 21 at St. Mary’s Catholic Church in Kenosha.

In their health ministry nursing practices, Aurora parish nurses witness the daily struggles of those living with chronic conditions. They see how it impacts one’s physical, psychological, emotional and spiritual well-being. They’ve seen how conditions such as arthritis, heart problems, asthma, stroke, pain, cancer, osteoporosis, diabetes, obesity, high blood pressure and emphysema can cause the loss of physical conditioning over the course of years.

The self-management program was designed to help individuals suffering the debilitating effects of their conditions by teaching them new strategies to build confidence, motivation and skills needed to manage their health more effectively, as well as the challenges they face.

Under the direction of health professionals, participants in the Living Well with Chronic Conditions workshop learned skills to improve their quality of life, such as:

• Developing a suitable exercise program

• Symptom management

• Nutrition management

• Breathing exercises and stress management

• Medication management

• Communicating with family, friends and health care professionals

• Dealing with emotions such as anger and depression

• Problem solving and goal setting

Aurora Health Care, Milwaukee

Hand washing lessons

Proper hand washing can be an easy way to help people avoid getting themselves or others sick. Yet, some people don’t take the time to wash their hands the right way or don’t know how.

To help spread the word about how to not spread infection and disease, Memorial Health Center staff shared the how-tos of hand washing with more than 400 children and adults at the annual Taylor County Fair. For many, participation in the interactive hand washing activity came with a shock – the things they thought they were doing right weren’t quite correct or needed improvement.

Prostate cancer education for men

Prostate cancer is one of the most common types of cancer in American men. To give men an opportunity to learn more about this disease, Memorial Health Center on-staff urologist Dr. Roy Brandell held a free roundtable presentation and discussion. During this event, men learned the facts about prostate cancer, the risks and benefits of screening for it, and the latest treatment options for the disease that affects more than 186,000 men each year. Those attending also had an opportunity to ask questions and share their experiences.

Memorial Health Center – An Aspirus Partner, Medford

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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